1. Shaping Health Services Uckfield Civic Centre 29 May 2013 1

2. Welcome Dr. Elizabeth Gill Chair, HWLH CCG

3. What is a CCG? Newly formed (1 April 2013) Responsible for 60 – 70% of Health Care GP Led, supported by a small management team …and why is it different? a member organisation, with GPs forming the majority of the Governing body GPs are closest to patients, and with them know their needs (and how best to meet them) better than anyone Our focus is the population, not any particular hospital 3

4. High Weald Lewes Havens CCG March 2012High Weald Lewes Havens CCG formed and chair elected July 2012Chief officer recruited CCG became a sub-committee of NHS Sussex PCT September 2012Governing Body met for the first time Merged strategic and operating plan published. October 2012Governance structure and constitution adopted Desktop review of CCG December 2012Governing body and management staff recruitment complete NHS Commissioning Board formal visit to the CCG March 2013Authorised as a CCG with conditions/legal directions April 2013Become a statutory NHS organisation “a young organisation, but developing fast …showing resilience, energy and focus”

5. High Weald Lewes Havens CCG 22 Practices 2 localities Primarily rural 164,000 patients (93000 High Weald, 71000 Lewes Havens) No acute provider within our boundaries 4 Community hospitals

6. Our Governing Body Dr Sarah Richards Dr Elizabeth Gill (Chair) Dr Peter Birtles (Prog. Lead Unplanned Care) Dr Vince Elliot (Prog.lead Planned Care) Dr Howard Wright (LH locality lead) Dr David Roche (HW locality lead) Frank Powell (PM lead) Karen Ford (PM lead) GP and locality representatives Lay & Clinician members Alan Keys (PPI) Peter Douglas (governance) Denise Matthams (Nurse) Michael Rymer (2ndry care clinician) Michael Schofield (CFO) Frank Sims (chief officer) Ashley Scarff (Head of Commiss & Strategy) Wendy Carberry (Head of Delivery) Sharon Gardner- Blatch (Head of Quality) Executive members Senior Managers

7. Our vision is to commission excellent and efficient healthcare for the residents of High Weald Lewes Havens We will do this by… Meeting the commitments laid down in the NHS constitution and mandate Ensuring what we commission reflects the needs of patients Improving the health and outcomes of the population Improving the quality and safety of services provided Ensuring patient voices are heard and responded to What drives and motivates us

8. The Health Needs of High Weald Lewes Havens Frank Sims, Chief Officer

9. A relatively healthy population, but with specific needs High numbers of Frail elderly Pockets of inequality Above average smoking, young people using alcohol & drugs Low flu vaccination rates for 65+ Above expected Circulatory and respiratory diseases Higher Cancer rates in under 65s Higher rates of depression and dementia High numbers of road injuries and deaths Lower % of deaths at own residence Source: http://www.eastsussexjsna.org.uk/http://www.eastsussexjsna.org.uk/

10. Where the Money Goes Commissioning£m Acute Services 85 Community services 21 Continuing Healthcare 12 Mental Health 18 Specialist Commissioning10 Other Commissioning 8 Subtotal 154 Primary Care (enhanced Services and Prescribing, NOT commissioning GPs) 28 Corporate Expenditure5 Reserves 9 Net operating costs for the year 196

11. 11 1.Smoking, and young people using alcohol and drugs Our health need (JSNA) Means of measurement Our joint priorities (with HWBB) Our Strategic Objectives 2.Low flu vaccination for 65+ 3.Frail elderly 4.Pockets of inequality 5.Circulatory & respiratory diseases 6.Cancer in under 65s 7.Depression and dementia 8.Road injuries and deaths 9.Lower % of deaths at own residence 1.Enabling people to manage and maintain their health and wellbeing 2.Providing high quality and choice of end of life care 3.Supporting those with special educational needs/disabilities 4.The best possible start for babies and young children 5.Long term conditions 6.Admission avoidance including prevention of falls, accidents and injuries ENGAGEMENT Patients feel ownership of health system Our Partnerships deliver integrated services QUALITY Commissioned services that deliver exceptional quality to patients FINANCIAL SUSTAINABILITY Transparent commissioning of Value for Money services COMMUNITY Commissioned services so that patients receive Treatment and Care (T&C) at or as close to home as possible ENGAGEMENT Range of engagement events Transparent planning /finances COMMUNITY Double amount of care commissioned in the community, costing no more than £34m 60% of patients die in preferred place of choice QUALITY Reduction of variation in health outcomes on those with disabilities Reduction of variation in number of overweight 5 year olds FINANCIAL SUSTAINABILITY Financial balance Delivery of surplus National obligations LEADING Leaders of the Local Health Economy LEADING 360 survey with stakeholders see CCG as the leader In 5 yrs 95% of patients prefer CCG Integration and partnership in the Local Health Economy Understanding the need informs our priorities & objectives

12. The challenge We are unlikely to see any significant increases in funding in the coming years But there are year on year increases in pressure across the NHS Therefore the CCG need to be able to balance the books while ensuring that high quality, patient focussed care is delivered to all who need it. 12

13. Suggested ways to meet this challenge 13 Area for prioritisation Present (13/14) positionDesired position for 15/16 Services in the community c.£17m is spent on Community Services All services are delivered by a single provider (via one Acute trust) There is double the level of services provided in the community, costing no more than £34m ‘Green triangle’ of HWLH Community Hospitals is formed with clear ‘brand’ End of Life Care 35% of patients die in their preferred place of choice [or usual residence] 60% of patients die in their preferred place of choice [or usual residence] Mental Health‘Low spend’ category and for outcomes patients report ‘Low level’ of satisfaction with MH services Satisfaction outcomes driven to upper quartile (nationally) for Mental Health Services, ideally remaining within ‘Low spend’ category. Reducing Health Inequalities The variation in life expectancy across the patch is c.10years Reduced variation in; number of overweight 5 year olds, smoking cessation and level of treatment for chronic diseases offered. Delivered through Quality Premiums Primary CarePrimary Care services are at capacity, with demand for GP contact increasing Increased service accessibility, delivered by appropriate professionals, within primary care practices (but not necessarily primary care)

14. So in three years time… Patients will…Acute Providers will…Other partners* will see… feel fully involved in decision making processes. be aware of the commissioning opportunities and options, and will acknowledge the associated implications and limitations. will understand how and where to access their care. have increased confidence in the (primary and secondary) care that they receive and feel safe. be confident that they can access a complete care and support package, pre- and post- events leading to treatment. be enabled to manage their own health and to lead a healthier lifestyle. see reduced activity. work more in partnership together. deliver high quality services with reduced variation. be financially stable. be reliable, efficient, quality-driven and efficient Be part of a ‘whole system’ of treatment and care increased integration and partnership working, including combined budgets from social care. a breakdown of barriers. a focus on patient needs, with funding attached to need rather than political imperatives a system wide approach to health care Well established working relationships between all groups. 14 * e.g. Local Authorities, private and voluntary providers, and providers of Mental Health, community and Out of Hours services

15. The long term vision We believe that the answer to the challenges now and in the future lies in community based care that is deliver in or as near to peoples homes as possible This means focussing on the needs of the population, rather than the functioning of acute hospitals How this vision is shaped and delivered is largely down to what patients tell us. 15

16. Our priorities This is where we are now Are we prioritising the right health needs? How can we reduce health inequalities? How can we involve you in our decision making? Where do we need to be in five years time?