1. Lewisham Clinical Commissioning Group Update July 2012

2. Contents Clinical Commissioning Groups Lewisham CCG Achieving the CCG Vision Background CCG Vision & draft Health & Wellbeing Aims Health & Wellbeing Priority Areas CCG Strategic Direction CCG plans & priorities 2012-13 Vision & Plans Governing Body Engagement with Practices Partnership Working Structures & Ways of Working Authorisation process Evidence Requirements Stakeholder Survey Authorisation

3. An introduction to Clinical Commissioning Groups Clinically-led membership organisations New statutory bodies (each CCG with own constitution, co-designed by member practices) Key tasks include improving outcomes and holding significant commissioning budgets CCGs vary in size according to management budget and scale of support purchased from CSS/working with partners Accountable for commissioning – but need to buy in ‘back-office’ and some ‘middle-office’ support 3

4. Introduction to Lewisham CCG Members are all 44 of Lewisham’s GP practices A Pathfinder CCG since April 2011 61% delegated commissioning responsibility since August 2011, 100% from April 2012 7 GP executives were elected in May 2011, chair Dr Helen Tattersfield Wave 2 CCG for authorisation: application and evidence to be submitted 3 September, site visit from NHS CB in October, outcome advised by end November 2012 4

5. Achieving the CCG Vision Lewisham People Best Care Respect for patients & carers Local care, strong communit y Value & develop staff Better Health Best Value The CCG leadership agreed its vision and values in June 2011 MMR Immunisation Rates MMR at 2 from 80.5% to 89.2% MMR at 5 from 67.4% to 72% COPD Pathway: in place Maternity: Action Plan Community Nursing: Standards Review QIPP 2011-12 93% achieved GP referral rates saving £300k at GSST & KCH Prescribing costs savings £1.04mn PPE involvement in COPD pathway development System-wide event to develop unplanned care strategy

6. CCG Vision & Draft Health & Wellbeing Strategy Aims Lewisham People Best Care Respect for patients & carers Local care, strong communit y Value & develop staff Better Health Best Value Improve Health Provide a wide range of support and opportunities to help adults and children keep fit and healthy and reduce preventable ill health. Improve Care Ensure that services and support are available to all those who need them so that they can regain their best health and wellbeing and maintain their independence for as long as possible. Reduce Cost Improve access and delivery, streamline pathways and ensure services provide good quality and value for money. The CCG vision and values fit with the aims of the draft health and wellbeing strategy.

7. Health & Wellbeing Board Priority Areas Increase the uptake of immunisation Prevent the uptake of smoking among children and young people and reduce the numbers of people smoking Reduce the harm caused by alcohol misuse Promote healthy weight Improve mental health and wellbeing Improve sexual health Delay and reduce the need for long term care and support Reduce the number of emergency admissions for people with chronic long term conditions Increase the number of people who survive colorectal, breast and lung cancer for 1 and 5 years Discussed and agreed at Health & Wellbeing Board December 2011

8. 1.Increase the uptake of immunisation 2.Prevent the uptake of smoking among children and young people and reduce the numbers of people smoking 3.Reduce the harm caused by alcohol misuse 4.Promote healthy weight 5.Improve mental health and wellbeing 6.Improve sexual health 7.Delay and reduce the need for long term care and support 8.Reduce the number of emergency admissions for people with chronic long term conditions 9.Increase the number of people who survive colorectal, breast and lung cancer for 1 and 5 years 1. Health Provide a wide range of support and opportunities to help adults and children keep fit and healthy and reduce preventable ill health. 2. Care Ensure that services and support are available to all those who need them so that they can regain their best health and wellbeing and maintain their independence for as long as possible. 3. Cost / Value Improve access and delivery, streamline pathways and ensure services provide good quality and value for money. Aims Priority Areas 3a. Managed Care (LTC & Elderly) 4. Cancer 2. Mental Health 1. Healthy Living The nine priorities group into four main themes which will be supported by success measures for: Better health Better care Better value 3b. Unplanned Care (LTC & Elderly) CCG Strategic Direction 8

9. CCG Plans & Priorities 2012-13 Health and Wellbeing Board Priorities QIPP Priorities SmokingObesityAlcoholA&EOutpatientsPrescribingPrimary Care Variation Mental Health COPD  Diabetes  Heart Failure  Alcohol  CCG focus on 4 long term conditions that will have a significant impact on the health outcomes of the Lewisham population:  COPD  Diabetes  Heart Failure  Alcohol misuse Mapped against health and wellbeing and QIPP priorities

10. CCG Governing Body Chair (Clinical)6 representatives of practices2 lay membersNurse memberSecondary care consultantAccountable OfficerChief Finance officerPublic HealthLocal AuthorityHealthwatchLMC Voting Members Advisory (Non-Voting) Members Each CCG must have a governing body that has overall responsibility for ensuring the organisation delivers its objectives and duties, and will also oversee a range of other structures and sub- committees.

11. Engaging with Our Member Practices Member Practices Neighbourhood 1Neighbourhood 2Neighbourhood 3Neighbourhood 4 Membership Forum (meets monthly) Information sharing and advisory Executive Committee (meets monthly) Decision-making and delegated authority Governing Body (meets monthly) Overall accountability and assurance

12. Working in Partnership Partnerships Lewisham Health & Wellbeing Board Joint Commissioning C&YP Joint Commissioning Adult Client Groups Public Health Lambeth & Southwark CCGs Clinical Strategy Performance & Quality South London CCGs Commissioning Support Services

13. Authorisation Process Only the NHSCB can legally make a decision on authorisation, although it must have regard to the assessment and views of SHAs and other parties. The formal assessment will be based on the evidence gained from: 360° survey Desk-top Reviews Case Studies Site Visits 3 possible outcomes for each applicant CCG: Authorised Authorised with conditions Established but not authorised. All CCGs will have a development plan agreed with the NHSCB which reflects the outcome.

14. Authorisation Evidence The CCG must submit core documents as part of its application, including: Proposed CCG constitution and any other documents detailing governance arrangements CCG organisational structure Relevant minutes of multi-professional meetings, governing body and other committees Organisational development plan 360° stakeholder survey report and CCG comments Draft joint strategic needs assessment (JSNA) Draft joint health and wellbeing strategy Relevant health and wellbeing board minutes and reports 2012-13 integrated plan and draft commissioning intentions for 2013-14 List of 2012-13 contracts agreed and signed off, via PCT clusters List of joint commissioning draft agreements or plans, including pooled budgets and Section 75 agreements Equality and diversity strategy Communications and engagement strategy.

15. 360° Stakeholder Survey Purpose: To assess the relationships that the CCG has with its partners and stakeholders. Recipients: Members of the shadow Health and Wellbeing Board, local authority, LINKs, member practices and providers. The survey period: From 16 th July to 10 th August. Criteria: Communicating a clear vision Involving other clinical colleagues Engaging with the shadow Health & Wellbeing Board Credible plans to deliver improvements in quality, financial balance, and QIPP and reduce inequalities Strong arrangements for joint commissioning and safeguarding

16. What We’re Asking For 1.The Board to note the strategic direction of the CCG, in particular to endorse that it is aligned with the needs identified in the JSNA and with the development of the draft health and wellbeing strategic aims and priorities 2.The Board to note the CCG’s commitment to local partnership working, as members of the Board and through existing joint commissioning arrangements for adult client groups and for children and young people 3. For those members of the Board who have been nominated to receive the stakeholder survey to reflect on the work of the CCG and to complete the survey accordingly.