1. Can PCTs Make a Difference? Chris Humphris, Chief Executive, Cambridge City PCT Yes they can!!

2. Bit about me Started in the NHS near this very spot Acute hospital Health Authorities Community Trusts Health Action zone Nursing / Residential Care Company Community Trust Primary Care Group Primary Care Trust

3. You may know Cambridge as

4. But it is a city of contrasts

5. Cambridge City PCT Started in April 2002 Well resourced PCG 143,000 population (108,000 live in the City) Budget of £108 million 18 GP Practices Community Hospital, Hospice, and range of community services Big teaching hospital (Addenbrookes) in the city

6. What does a PCT actually do? a) Provide Community Services Manage Brookfields Hospital, Arthur Rank Hospice, Community Nursing, Intermediate Care and other community services (some on behalf of South and East/Fenland PCTs)

7. b) Commission Services Commission services from Addenbrookes NHS Trust and other organisations

8. c) Develop primary care Serving a population of 143,000, registered with 18 General Practices We also support the development of Pharmacy, Dentist and Optician services

9. d) Work in partnership with Local Authorities Work closely with Social Services to integrate health and social care (e.g. Occupational Therapy and Discharge Planning) Work closely with the City Council and others to improve the health of the population (e.g. accident prevention, addressing inequalities, reducing smoking, Sure Start)

10. Who is the PCT? The Board The Professional Executive Committee The Senior Management Team Headquarters Staff Employees of the PCT GPs and their staff Dentists, Pharmacists, Opticians All of the above!

11. Ask not what the PCT can do for you Ask what you can do for the PCT Can we make a difference? Yes we can!!!

12. Making Connections The strength of the PCT lies in our ability to make connections

13. Some Cambridge Examples - Delayed Discharges Friday 8am meeting!

14. Tackling Delayed Discharges Building nursing and residential care capacity Building domicilary care capacity New Integrated Discharge Planning Team New process (estimated date of discharge) Marlowe House Continued focus on numbers Using the fines money up front Community support for vulnerable older people Investing in Rapid Response

15. Homeless Service Special PMS for the Homeless City Council funding premises Joint Strategy

16. Trumpington Branch Surgery 3 months notice from previous practice Assistance from local entrepreneur Persuaded a City practice to take it on Temporary accommodation with a view to the future

17. Operation Ortolan Preventing crack cocaine from taking a hold in Cambridge Had to move quickly to deal with the threat Criminals targeting vulnerable people in North Cambridge

18. Sure Start Unexpectedly selected PCT led the process Creating an inclusive Board Identifying local need

19. Health and Social Care Integration OT - Tackling waiting lists Equipment Aids and adaptations Social Services Manager in PCT Senior Management Team

20. Mapped pathways across whole system:- - Falls - Stroke - CHD - COPD Maps populated with activity data 4 maps generic medical pathway The 4 pathways were redesigned Some changes within existing resources Proposals developed for additional funding Care Pathways

21. So what about the Local Delivery Plan? ……and all those targets!!!!! ……..and all those pressures!!!!!!

22. Dealing with the Pressures We are in this for the long term Trying to avoid short-term expedient measures if at all possible if they get in the way of the long-term plan Make connections

23. Some of our challenges To reduce the demand for secondary care services by doing more, and doing it differently, in Primary Care Integrating health and social care for older people in a way that improves services and offers better value for money Working with the public to reduce drug expenditure Developing mental health services outside Cambridge

24. Can PCTs Make a Difference? Yes we can!!!