Strengthening the patient voice West Bromwich Albion 5 July 2012 1
May 19, 2015
Strengthening the patient voice
West Bromwich Albion
5 July 2012
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Feedback Summary – morning session
• Where will the money go – control/governance• Engagement – are we practising what we discussed• GP burnout• Access – appointments, phone access, telephone costs,
choice, receptionists doing triage, online• Public health/local authority helping health agenda – schools
and recreation centres going – obesity agenda• Access to mental health – making decisions on my behalf• Links between secondary (hospital) and primary care• Joined up approach for social care and discharge back into
the community• Changing role of GP – home visits, out of hours
New NHS
LicensingLicensing
Department of Health
Department of Health
CQCCQCNHS Commissioning Board
NHS Commissioning Board
Local HealthWatchLocal HealthWatch
ParliamentParliament
MonitorMonitor
Patients & PublicPatients & Public
ProvidersProviders
PartnershipPartnershipLocal AuthoritiesLocal Authorities
SWB CCGSWB CCG ContractsContracts
Birmingham HealthWatchBirmingham HealthWatch
Sandwell HealthWatchSandwell HealthWatch
Accountability
Funding
Key:
Right Care Right Here partnership
BSMHT, BCP, BCHC, SWBH
Other providers BCH, BWH, ROH, DGH, RW, SWB, WM, and I/C.
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Birmingham
Complex range of providers for healthcare:
HospitalsHeart of England (3 hospitals), University Hospitals Birmingham, Sandwell West Birmingham, Birmingham Children’s Hospital, Royal Orthopaedic, Birmingham Women’s Hospital and Birmingham Dental Hospital, Dudley Group of Hospitals
SpecialistBirmingham and Solihull Mental Health Trust, Black Country Partnership Trust
Community Birmingham Community Healthcare
Acute & UrgentWest Midlands Ambulance Service; Range of urgent care, walk-in and other providers – Assura, Care UK etc
Third Sector – a wide range of provision e.g. over 40+ alcohol/drug dependency services
A wide range of services available to commission from
Sandwell
Our health priorities
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Our health needs
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Our health needs
7Health without boundaries - November 2011
Our vision and values
Mission Healthcare without boundaries
VisionWorking together, to improve health and care in our communities.
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Big and small…Clinical Commissioning Group Local Commissioning GroupRobustness at scale Local ownership
Resilience Ideas into action quickly
Strong voice in the health economy and contracts
Relevance
Ability to deliver through major partnerships
Patient representation and involvement
Overview of system Ability to respond to feedback, deliver improvements and efficiencies at practice level
“As a membership organisation we would like to build ways of working that are not bureaucratic with the right safeguards for all.”
Achieving the right balance - Localism
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Our Board Structure
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GP Directors
Lay Directors
One GP Directors to be Chair
Chair(GP Director)
Chair and Vice Chair of HealthWorks
Chair and Vice Chair of Sandwell Health Alliance
Chair and Vice Chair of Pioneers 4 Health
Chair and Vice Chair of Black Country
Chair and Vice Chair of ICOF
Vice Chair(Lay Director)
Notes•Directors are voting members•Other Board members are non voting members•The Chair will be one of the GP Directors from the LCGs, not an additional post•Vice Chair will be one of the two Lay Directors, not an additional post
GP Directors
Lay Director(Vice Chair)
Lay Director(Chair of Audit)
GP Directors
Executive Directors
Managing Director(Accountable Officer)
Finance Director(Chief Finance Officer)
GP Directors
Clinical Directors
Secondary Care Specialist
Nurse GP Directors
Other Board Members(Non Voting)
Independent Committee Members x2
Senior Officers x3
Public Health Member
Commissioning is:“Proactive strategic role in planning, designing and
implementing the range of services required – rather than just purchasing.
A commissioner decides which services or interventions should be provided, who provides them and how they should be paid for and may work closely with the provider in implementing the changes”
Commissioning what it is and why
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Finance & Performance Sub-
Committee
Quality & Safety Sub-Committee
Strategic Commissioning &
Redesign Sub-Committee
Audit Sub-Committee
Remuneration Sub-Committee
Partnerships
Our governance
Remit: To have on-going responsibility for the affordability of the local healthcare system, and to receive monthly monitoring reports. This group will highlight concerns to the Board.
Remit: To regularly review providers to ensure that services are safe, and that outcomes are monitored.
Remit: To consider service provision and ensure that services are commissioned for shorter pathways, better value for money and that provision is appropriate and adequate.
Remit: To help with discharging financial functions. Statutory and legal obligations, working with accountable officer.
Remit: To determine pay and remuneration for employees (likely to meet on an ad hoc basis)
Remit: To work with and lead partnerships, putting resources where challenges lay. Working and delivering on two evolving agendas with LAs, Health & Well-being Boards, HealthWatch and RCRH.
Main SWBCCG
Board
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OD Sub Group
Remit: To determine and implement the OD strategy for the CCG
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Continuously improving quality of care
Build feedback and improvement into
what we commission on your behalf
Monitor the quality and safety of care from the information you provide back to us
in a number of ways at our Quality and Safety Committee:
Healthcare Commissioning and Quality Plans
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Creating a patient revolution
• Co-production of services between patients and healthcare professionals• Community participation between public and the service• Improving customer experience of patients and carers
We will be looking at:• The enquiries we receive and issues raised• Reports that the organisations providing care produce to see what is happening• Surveys that patients and public complete with feedback• Complaints and PALS enquiries• Carers’ support
………………to improve patient experience
Our quality priorities
Our priority How we monitor this
Safety Population health is improving
Effectiveness Treatments are effective
Patient experience Population is satisfied with their treatments
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Clinical Commissioning Group (CCG)
NHS Commissioning Board
Public Health (local authority)
Community healthMaternity
Primary care– pharmaceutical, dental & NHS sight tests
Healthy Child Programme for school-age children
Elective hospital careRehabilitation
Highly specialised inc psychiatric Sexual health (exc. contraceptive)
Urgent and emergency care inc A&E
For those in prison and other custodial settings
Public mental health services
Older people’s healthcare Some services for armed forces Local programmes to promote physical activity
Children, mental health, learning disabilitiesContinuing healthcareInfertility & fertility
Public health services aged 0-5 inc health visiting & FNP, immunisation & screening
Drug and alcohol misuse, tobacco control including stop smoking and prevention
Wheelchair Home oxygenTreatment of infectious diseases
NHS Health ChecksInitiatives to prevent accidental injuryInitiatives to reduce seasonal mortality
Our integrated plan
Will be used to:
► Set our priorities, guiding our decisions on planning, investment and disinvestment
► Help partner organisations to see areas of focus, helping us align things strategically
► Provide a means of holding us to account
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Our strategic priorities
► Instigate – intervening early to prevent problems before they occur
► Integrate – putting the patient at the centre of their care► Innovate – changing the way we do things to deliver more
with less► Improve – focusing on the quality and safety of services in
all parts of the system ► Influence – playing a full role in local partnerships,
affecting the determinants of health
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Our plans are to:
► Increase the capacity and capability of primary care, using it as a foundation for system change
► Focus on the frail elderly, supporting independence and dignity in old age
► Accelerate the Right Care Right Here programme - providing care in the community and treating hospitals as specialist providers
► Treat mental ill health and promote wellbeing, viewing good mental health as a precondition to better physical health
► Work in partnership to improve maternity and early years, giving every child the best start in life
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Changes
Services we buy
Patients, carers and Public
CCG Staff & Member practices
Frail elderly – independence & dignity
Primary Care Capability
Partnership for maternity and early
years
Accelerate Right Care Right Here
No health without mental health
Integrated Plan
Performance & delivery
Clinicians and Partners
Contracts with emergency & urgent care e.g. Ambulance,
NHS 111
Contracts with community care
providers e.g. District nurses, therapies
Specialist support services
often Third sector
e.g. Drug, Alcohol Better Health
Contracts with hospitals &
services
Joint arrangements
with local authorities for
complex & continued care
Our Model for Delivery DeliveryPriorities
Engage:
Quality, , Innovation, Productivity and
Prevention
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Our plans 2012/13
Develop Primary care capability
Meet needs of Frail elderly - independence and dignity
Accelerate Right Care Right Here – care closer to home
No health without mental health – treat mental ill health and promote wellbeing
Work in partnership to improve maternity and early years – every child best start in life
How we work with other CCGs, CSS
► System leadership - The Compact – an agreed way of collective leadership for the NHS system
► For contracts - Agreed clinical leads and teams for commissioning for contracts with appropriate CCG representation
► Commissioning support – there are some areas where it makes sense to buy support into the CCG so it can be shared for efficiencies such as HR, ICT, information processing
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Thank you► Have learned a great deal already and much to
build on► Remain committed to what its all about….patients
and quality of care► Committed to working with the third sector,
patients, their carer’s and communities to develop together the best healthcare
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Questions ?
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Develop Primary care capability
1. Reach vulnerable people – make contact with primary care2. Working with CCG members and NHSCB to identify and
support to address inappropriate variation of primary care3. Proactive identification and management of long term
conditions - diabetes a priority - review lists, care plans, reviews
4. Development of services to support patients5. Improve consistency of referral through systems & peer
review6. Patient repatriation – look at discharges in hospital7. Making Every Contact Count – promote healthy lifestyles –
work in partnership with voluntary and community sector8. Improving screening and vaccinations e.g. Screening
programmes e.g. Bowel cancer and vaccinations e.g. Seasonal flu to help prevent avoidable illness
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Meet needs of Frail elderly - independence & dignity
1. Specific focus on dementia – implementing national dementia strategy, NICE guidance and identifying/scaling up local practice
2. Integrated working with social care & better case management3. Working in partnership with social care for comprehensive
package of ‘reablement ‘services to promote and maintain independence
4. Providing support to carers to ensure that their health and well being is not forgotten
5. Improving clinical input into nursing and residential care homes improving care and helping them with increasingly complex needs
6. Developing consistent intermediate care services and pathways7. When hospital needed, clear arrangements for care to be
transferred back to community safely
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Accelerate Right Care Right Here – care closer to home
Established track record of delivery improving and bringing services closer with over 30 care pathway reviews undertaken which £3.9m could be delivered locally for lower cost in community settings and reducing £600k of activity
1.Continue as active partners in Right Care Right Here2.Review Care Pathway Reviews to see what more can be brought into community prioritising diabetes and other long term conditions3.Remodel services as they are moved4.Work with partners to educate patients and public as locations and pathways change5.Support the trust to deliver final stage of programme in getting a new hospital facility
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No health without mental health – treat mental ill health and promote wellbeing
1. Working with local authority and voluntary sector - develop specific programmes to ensure promoted well being in all service areas
2. Develop and improve current mental health provision in primary care
3. Including the IAPT programme4. Making Every Contact Count on mental health – encouraging our
partners to do the same5. Review the Rapid Assessment Interface and Discharge (RAID)
approach with view to making it standard6. Adopt an assets-based approach to people with mental health
problems and learning disabilities – promoting independence wherever possible
7. Review current major investments such as pooled budgets in Birmingham between health and social care ensuring focussed and achieving desired outcomes
1. Improving access to maternity services esp vulnerable groups
2. Targeting lifestyle support at pregnant women, supporting mental health and healthier lifestyles
3. Increasing quality of health visiting – allied to Family Nurse Partnerships and post natal support services inc depression
4. Increasing uptake of childhood vaccines and screening programmes
5. Linking with local authority efforts to increase supply and uptake of evidence based parenting programmes and other interventions
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Work in partnership to improve maternity and early years – every child best start in life
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