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NHS Newham CCG Annual General Meeting Tuesday 25 September 2018
2
Hello and welcomeDr Muhammad Naqvi
33
East London Health & Care Partnership and North East London Commissioning AllianceJane Milligan, Accountable Officer
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4
East London Health and Care Partnership
ELHCP brings together 12 local NHS organisations (commissioners and providers) and
eight local councils to improve health and care services and outcomes; highlights
include:
• Digital Technology
• Workforce
• Estates
• Cancer early diagnostic centre
• Patient Involvement
5
Collaboration across NEL – what this means for Newham CCG
• NEL Collaboration
• Joint Commissioning Committee
• Outpatients
• NHS111: Rollout of new integrated urgent assessment service (NHS111)
• Commissioning strategy
• London Ambulance Service
• Winter planning
66
2017/18 Financial Overview and 2018/19 ProgressLei Wei, Interim Chief Finance Officer
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We achieved good value for money for our patients in 2017/18, and successfully delivered all the key
financial duties and business requirements under the NHS Act 2006.
2017/18 Financial Overview
Key Financial Duties and Business Requirement
Target£'000
Performance
£'000Target
achived
Expenditure not to exceed income
499,263 497,553 Yes
Capital resource use does not exceed the amount specified in Directions
11 11 Yes
Revenue resource use does not exceed the amount specified in Directions
494,854 493,144 Yes
Revenue administration resource use does not exceed the amount specified in Directions
7,561 7,532 Yes
The CCG secured an unqualified opinion from our independent auditors in 2017/18 that the
financial statements. - Represented a true and fair view of state of the CCG’s affairs and.
- Have been properly prepared in accordance with accounting policies.
51%
8%
10%
9%
21%
2%
Acute Services
Community Services
Mental HealthServices
Other Non-acuteServices
Primary Care Services
Running CostAllowance
8
• Assured by NHS England, the CCG’s 2017/18 activity and finance plans aligned with our main
providers and key stakeholders, and we will continue to deliver all finance and business
requirements
2018/19 Progress
Financial Year 2018/19 £'000
Total Planned Commissioning Spending 497,056
Total Running Cost Allowance Expected 7,619
• Key areas of investment includes a Newham-based integrated health and care system, primary
care services, and collaborative initiatives to deliver financial efficiencies
• Despite the significant financial challenges Newham CCG are facing, we are currently on track in
delivering the financial plan for 2018/19.
9
AIRS Ministry Congolese Youth Choir
1010
Quality Improvement ProjectImproving discharge from hospital to community services
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11
50% reduction in grade 2 pressure
ulcers
I felt reassured when the team
manager called me
10% reduction in follow-up DNAs
MSK Physio Service
Before this it didn’t feel
meaningful
Feedback system at
Phlebotomy
‘Are you listening?’
Falls
prevention -
EPCT
in Community Health Services
Supporting
informal carers
12
Stimulus
Newham
CCG Quality Team
Local Authority:
Information and
investigations
Barts Health Trust :
Complaints, Serious
Incidents, PALS, staff
feedback
East London Foundation
Trust: Complaints,
Serious Incidents, staff
feedback
CCG: performance,
serious incidents,
complaints, patient
feedback
Care Homes: Incidents
and staff feedback
13
Purpose
To improve the safety of and patient/staff satisfaction with
the discharge process from Newham University Hospital into
East London Foundation Trust Community Services.
QI Team• Newham CCG Quality Team
• NUH Improvement Manager
• NUH Discharge Team Manager
• NUH Ward Managers
• NUH Therapies Managers
• ELFT Associate Director for Quality and Compliance
• ELFT Deputy Director Community Services
• ELFT QI Coach, Practice Educator and Nurse Adviser EPCT
• ELFT EPCT Manager
• ELFT Therapists
• ELFT EPCT Community Staff Nurse
• ELFT Telehealth
• Service user
Scope and Aim:Who, Measures,
Data, Where and How
Change IdeasProcess
Mapping
Review data, patient and
staff feedback
15
Themes arising and actions being undertaken
Understanding of community services• Improve referral form
• Resource folder for NUH staff outlining key contacts and referral criteria for services
• Emergency admission cards for EPCT patients
• Co-designed patient information leaflet – what to expect on discharge and how to escalate
concerns
Improved patient self-care• Self administration of medication encouraged on wards
• Patient activity on wards
• Use of interpreters prior to discharge
Equipment and medication on discharge• Use of medication packs
• Equipment ordering processes – who can order what and when
• Policy outlining responsibilities
16
Outcomes so far...
• Improved communication – improving patient journey between
providers
• Joint working – incident sharing arrangement and discharge policy to
improve safety and shared learning
• Impact further reaching
1717
Quality in Primary Care Dr Naqvi, Chair Newham Clinical Commissioning Group
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Quality in Primary Care
• Primary care services provide the first point of care, day or night, for the
vast majority of people who come into contact with the NHS.
• GP surgeries are a core element of primary care, but are not the only
element - it is also about coordinating access for people to a wide
range of services in the local community to help meet their health and
wellbeing needs.
• Engaging primary care practices in quality improvement (QI) activities is
essential to improving the health of the population and enhancing
patient experiences and outcomes.
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Quality can be described in the following context
• Patient experience
• Safety
• Clinical effectiveness
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Where we are now
• GP access is one the biggest concern for the people of
Newham.
• Newham is ranked below other north east London CCGs in
the CQC CCG ratings for Primary Care.
• Newham has 41 practices (80%) that are rated good,
however there is still a small pocket of practice that need
improvement.
21
Why is this
• Lowest number of full time GPs in the London
• Most deprived wards in the country
• Diverse and mobile population
• Population growth
• Chronic disease
22
So how can we achieve the quality outcome Newham deserves
• Extra funding given to east London
• Estates will deliver new fit for purpose buildings
• Commissioning projects
• Two GP Hubs planned offering GP and Nurse appointment evenings and
weekends
• Integrated care partnerships
• Developing the existing and up-and-coming primary care workforce
• Five year retention initiative
• Practice manager development
23
QI in practice
• Newham GP, Dr Nazmul Hussain, developed a passion for Quality
Improvement (QI) through his involvement with UCLPartners’ and Newham
CCG’s partnership programme.
• He and his team at Wordsworth Health Centre have used QI to improve
their patient appointment system, upskilling reception staff and
signposting to alternative community services.
• The team credit their health centre’s turnaround to their adoption of QI
methodology.
• This project is one of many taking place in GP surgeries around Newham
as a result of the GP development arm of the Newham Partnership
Programme.
2424
Quality Improvement at The Wordsworth Health Centre
Dr Nazmul Hussain
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The Wordsworth Health Centre
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Quality Improvement video
https://www.youtube.com/watch?v=IngpodLN67U
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Fun Day Event
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Fun Day Event
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Nu
mb
er o
f D
ocu
me
nts s
en
t t
o G
P’s
A COMPARISON OF THE NUMBER OF PAPER
DOCUMENTS SENT TO GP’s BEFORE and AFTER QI
Without QI
With QI
Peaks represent Monday’s
where most post comes in
Gap narrowed as
staff become more
confident
Gap widens as new
member of staff gets
trained up
Large difference to start off with
whilst staff familiarise with
process
31
Newham Primary Care Oscars 2018 winners
Practice responding to service user requests award
Recognising contribution of service users award
Practice with most Quality Improvement award
Practice Staff Leadership award
32
CMC Uptake in Newham
703
719
741
774
845 850 854 856866
885 890896
909915 920 922
933
951
968974
996
10151023
1041
10551061
10691075
700
750
800
850
900
950
1000
1050
1100
02/03/2018 02/04/2018 02/05/2018 02/06/2018 02/07/2018 02/08/2018 02/09/2018
CMC
CMC
3333
Priorities, Challenges and HighlightsSelina Douglas, Managing Director, Newham Clinical Commissioning Group
34
Achievements
• CCG rated as Good
• Outstanding for diabetes
• Green star for PPE
• No Recourse to Public Funding - tuberculosis in the homeless project
• Community Prescription joint with LBN
• 90% paperless referral ahead of 1 October deadline
• Discharge to community
• Latent tuberculosis infection (LTBI) screening and treatment programme
35
Challenge and focus for 2018/19
• Quality in Primary Care
• Newham Well-being Partnership
• Early Cancer diagnosis
• Making Every Referral Count
36
Highlights
• NHS70 birthday cards and letters from the Newham Show
• Newham’s community prescription programme 150Club
• East London Community Kidney Service
• NHS 70 Women Leader Award
3737
Q & A session
38
Closing remarksDr Muhammad Naqvi
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THANK YOU