1. CCG update November 2013 1

2. High Weald Lewes Havens A relatively healthy population, but with specific needs Differential life expectancy between localities High numbers of Frail elderly Pockets of inequality Poor recording by GPs of smoking status Above average 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/ A relatively healthy population, but with specific needs Differential life expectancy between localities High numbers of Frail elderly Pockets of inequality Poor recording by GPs of smoking status Above average 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/ 2 A small CCG over a primarily rural area 164000 Population (93000 High Weald, 71000 Lewes Havens) 22 Member Practices 125 GPs No acute provider within the CCG boundaries 1 community provider (integrated with acute) 3 Community hospitals A small CCG over a primarily rural area 164000 Population (93000 High Weald, 71000 Lewes Havens) 22 Member Practices 125 GPs No acute provider within the CCG boundaries 1 community provider (integrated with acute) 3 Community hospitals Introduction The Financial position Delivery – the Green Triangle The CCG Environment Commissioning Architecture Appendices High Weald Lewes Havens

3. Summary of 2014/15 Commissioning Intentions Community Services Review Better Care Better Value New Commissioning Models – MSK Contract Levers The CCG is not responsible for primary care contracting, but the plans for the future, including the Green Triangle, are interlinked with these services. The CCG has begun to develop a primary care strategy and working with the Area Team, will include a set of commissioning intentions for primary care and how they relate to the planned changes in community services. 3

4. The Green Triangle – a manifesto for Community Services “a fractured, confusing system made up of unclear and unwieldy referral pathways, and significant inequalities of provision across the CCG” “a firm commitment to radical change” Which means… A redesign of community services based on patient flows Integration of Health and Social Care to deliver better services for patients Development of a Primary Care Strategy that supports 7 day access to expert clinical advice; and GPs as gatekeepers to the whole treatment and care system. A review of mental Health Services currently delivered in the community 4

5. Commissioning a new MSK Service Musculoskeletal conditions (MSK) include disorders of muscles, joints, tendons, ligaments, and nerves. Current Treatments include physiotherapy, rheumatology, pain management, podiatry, and psychology 10,000 referrals pa in HWLH and EHS 5

6. Why commission a new MSK Service? 6 Variations in referrals, diagnoses, and treatment offered Lack of coordination Distance travelled by some patients for treatment Lack of alternatives to surgery offered

7. What will be better for patients? An integrated MSK service means better clinical outcomes as follows Promotes patient self-care More treatment in community based settings Quicker access to specialist advice, diagnostics, treatment, and rehabilitation One stop assessment and on-going care Better coordinated follow up care Shared Decision Making Single point of access on discharge Better coordination of rehabilitation 7

8. The timeline ActionDate/Status Clinicians design service specification based on patient feedbackDone Evaluation criteria to assess providers agreedDone Provider eventDone Invite bids for new serviceDone Competitive dialogue beginsFebruary 2014 Contract awardedMay 2014 Service goes livec. October 2014 8

9. For more information Hugo.Luck@nhs.net http://www.highwealdleweshavensccg.nhs.uk/ 9