Shaping Health Services

Uckfield Civic Centre29 May 2013

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Welcome

Dr. Elizabeth GillChair, HWLH CCG

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

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High Weald Lewes Havens CCG

March 2012 High Weald Lewes Havens CCG formed and chair elected

July 2012 Chief officer recruitedCCG became a sub-committee of NHS Sussex PCT

September 2012 Governing Body met for the first timeMerged strategic and operating plan published.

October 2012 Governance structure and constitution adoptedDesktop review of CCG

December 2012 Governing body and management staff recruitment completeNHS Commissioning Board formal visit to the CCG

March 2013 Authorised as a CCG with conditions/legal directions

April 2013 Become a statutory NHS organisation

“a young organisation, but developing fast …showing resilience, energy and focus”

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

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

Our vision is to commission excellent and efficient healthcare for the residents of High Weald Lewes HavensWe 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

The Health Needs of High Weald Lewes Havens

Frank Sims, Chief Officer

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 residenceSource: http://www.eastsussexjsna.org.uk/

Where the Money Goes

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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

ENGAGEMENTPatients feel ownership of health systemOur Partnerships deliver integrated services

QUALITYCommissioned services that deliver exceptional quality to patients

FINANCIAL SUSTAINABILITYTransparent commissioning of Value for Money services

COMMUNITYCommissioned 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

LEADINGLeaders 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

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.

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Suggested ways to meet this challenge

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Area for prioritisation

Present (13/14) position Desired 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 Care Primary 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)

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.

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* e.g. Local Authorities, private and voluntary providers, and providers of Mental Health, community and Out of Hours services

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.

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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?