Annual General Meeting 25 September 2018 Mike Maguire Chief - - PowerPoint PPT Presentation

Annual General Meeting

25 September 2018

Mike Maguire Chief Officer NHS West Lancashire CCG

NHS 5 Year Forward View

Published in October 2014. It has a series of system expectations:

• New systems of working both locally and nationally
• Exploit the information and IT revolution
• Accelerate Health Innovation Drive efficiencies and productivity

New NHS plan

• A new NHS plan is beginning to be developed
• With an extra £20.5bn for the NHS nationally over the

next years

• We want YOU to have YOUR say on how you feel this

funding should be spent

• Please visit the Healthier and Lancashire market stall

to complete the survey, or visit this link: http://bit.ly/NHShaveyoursay

Whole System Working

• First year of full co-commissioning of primary care alongside NHSE
• Integrating community services with primary care
• Developing closer working with VCFSE
• Finding a sustainable solution for Southport and Ormskirk NHS Hospital Trust with Southport

and Formby CCG along with ourselves

• Financial stability of the whole system

The challenges facing our health and social care system – Quality of care

Readmissions

• Mental health

unplanned readmissions are worse than national average A & E

• Poor performance

locally against 4 hour wait targets

• More awareness

work required on

• ther services

available to residents Access & wait times

• Access to a GP is a

growing challenge

• Number of

programmes have been introduced to address this such as Extended Access, extended hours at Walk-in centres, POD and promotion

• f self-care and use
• f pharmacy

The challenges facing our health and social care system – health and wellbeing

Cancer

• Main cause of

premature deaths

• Routinely missing

target of patients seen within 62 days Mental health

• A shortage of 80

mental health beds across Lancashire and South Cumbria

• In Lancashire and

South Cumbria there is double the average mental health referrals into services Frail and elderly

• Our population is

getting older

• Elderly residents

are living with multiple complex long-term health conditions Smoking

• Higher rates of

death due to smoke related illnesses, such as COPD

• Continued, greater

work around health risks of smoking required

• Primary Care at Scale
• Extended Access
• Working in Neighbourhoods

Primary Care

A new era in technology

• Orcha
• Artificial Intelligence
• Hospital of the Future
• Better Points

Viran Medical Centre

• Public engagement exercise open until Friday 28

September

• Public and market engagement taken place since

June 2017

• CCG commissioned H2A, an independent public and

patient engagement consultancy to manage consultation process

• Patient sub-group has been created to work with

H2A and the CCG

• Hilda and Helen from H2A are available today to

take comments as part of engagement exercise

• Final decision to be made after 8 October 2018

Looking ahead – 2018/19

• We will continue to work alongside our partners within the Healthier Lancashire and South

Cumbria Framework and with the Cheshire and Merseyside Health and Care Partnership to address the challenges

• We will continue to focus on a delivery of care outside of an acute setting and within the

community that we started four years ago

• We will continue to work with partners such as the VCFSE, Well Skelmersdale and West Lancs

Borough Council, to help redress the health inequalities that our residents face in West Lancashire and focus more on health and wellbeing

• We will focus more on supporting our care homes
• We will aim to maintain our ‘good’ CQC rating and strive towards ‘outstanding’
• We want residents to share their views on the long-term financial plan for the NHS. Please see

Lucy at the Healthier Lancashire and South Cumbria market stall for surveys or visit: http://bit.ly/NHShaveyoursay

Annual General Meeting (AGM)

• Our annual report and accounts for 2017/18 are available online
• r upon request
• The minutes of our last AGM are available to all attendees today

West Lancashire:

• 112,000 population
• 18 GP practices
• Three neighbourhoods: Ormskirk & Aughton, Skelmersdale and

Burscough and the Northern Parishes

• £168m funding allocation
• £1,500 per person

How we spend your money

Financial duties

• Delivered our statutory duty to break-even on our revenue allocation
• Managed within our cash limit
• Operated within running cost allocation
• Achieved our ‘Better Payment Practice Code’
• Clean audit report from External audit, including value for money
• pinion

Claire Heneghan Chief Nurse, NHS West Lancashire CCG

Transforming health and social care in West Lancashire

West Lancashire a picture of where we are at the moment

• Our population is ageing
• People are living longer with more complex illnesses and

long-term conditions

• The cost of drugs and new medical technology is rising
• There are growing problems around mental health and

wellbeing

• Limited resources means we have to use our money

wisely, ensuring the greatest benefit for our community as a whole

• We need to ensure that the limited resources are invested

fairly and equitably. We need to find the balance between health and social care

So what did we do?

• The focus used to be on acute care within a hospital setting
• Primary care and community services saw little investment
• So we listened to our local population
• These conversations lead to the development of the Building for the Future

vision

• Everything that we now do is centred around our neighbourhoods and our

communities

So where do we need to focus?

• We need to bring services out of hospital, with patients treated at

home or in the community

• We need to embrace technology
• We need to focus on recruitment within primary care
• We need to ensure that we offer value for money with ever

increased financial pressures

• We need to build safe, resilient, sustainable services

This is what we are doing to address these challenges

Dawn Threlfall Medicines Optimisation Project Support Manager NHS West Lancashire CCG

Prescribing Ordering Direct Service (POD)

Medicines waste programme

• Successful waste reduction programme ‘Being A Hoarder Is Out of Order’
• Aimed at tackling issues of wasted medication thought to cost NHS £300m nationally and

£600,000 per year in West Lancashire.

• CCG saved more than expected of which, the medicines waste campaign played a key role

and proceed right to do campaign

“Don’t Be a Waster”

To celebrate anniversary of our medicines waste campaign we have relaunched our campaign with a fresh new look.

So what lessons did we learn?

• Pharmacies ordering medication did contribute to wasted medicines
• We still had pockets of vulnerable patients that pharmacies were ordering

for that caused us concern

• We set out to get our own systems in order but did not achieve this
• Needed to trial new initiatives which is where our Prescribing Pod concept

came from

Prescription Ordering Direct Service (POD)

• This service is a new way in which patients

can order prescriptions.

• Started as proof of concept in Excel Primary

Care.

• Expanded across Skelmersdale Early 2018.
• New POD opening in Burscough on the 1

October 2018

• Between the two POD’s will cover all

practices apart from Beacon Primary Care, Viran, Parbold & Hall Green.

OUR VISION

We will partner with our local stakeholders, providing a designated point of contact to support them with all medicines related issues. Working together, we will improve:

SHARED ACCOUNTABILITY We will support the implementation of a strong, effective neighbourhood, providing a demonstrable model to highlighting the benefits of cluster working. COST UTILISATION We will reduce the cost of medicines through appropriate medicines use, the reduction of medicine errors and the reduction of medicines waste. TEAM CAPACITY We will reduce the time required to process prescriptions, increasing the capacity of the practice workforce to manage their workload more effectively.

WHAT DID WE DO TO ACHIEVE A PRESCRIBING CENTRE OF EXCELLENCE?

• 1. Set a clear vision
• 2. Planned to succeed – strong project management focus
• 3. Set measures that will provide benefits for patients, the workforce and the
• rganisations
• 4. Pooled back office resources
• 5. Provided dedicated time and space
• 6. Professionals present to train and coach the workforce, embed change and

realise savings

• 7. Opened phone line
• 8. Streamlined the workflow on emisweb

POSITIVE PATIENT OUTCOMES

• Improved access to clinicians
• Safer, more convenient prescribing
• One place to discuss medicines issues
• Care Navigation
• Patient education both patients and Clinicians
• Reduction in errors
• Improved medication review and management of long term conditions
• Identify red flags

Examples of positive patient outcomes

POSITIVE STAFF/ORGANISATIONAL OUTCOMES

• Reduced workload for clinicians
• Centre of excellence for all medication related queries
• Freed capacity for all staff – upskilling opportunities for all
• More accurate patient records – improving the interface with

secondary care (hospitals) and vice versa

• Improved access to Pharmacy and improved relationships
• Financial balance through QIPP savings and reduced waste

Thank you!

Times are changing

Dr Peter Gregory GP Executive Lead Director – West Lancs GP Federation (OWLS CIC Ltd)

Extended Access in West Lancashire

Extended Access

Extended Access

Extended Access

Extended Access

Extended Access

Extended Access

Extended Access

Extended Access

Extended Access

Sandra Bonner Respiratory Nurse Virgin Care

Respiratory Service

Teams within specialist nursing currently:- Cardiac, Diabetes, Respiratory, Tissue Viability, Continence The teams collectively provide:- Resource for specialist advice Advanced practice Education, management plans Support pathway redesign Guidance across the MDT in best evidence based practice/cost effective prescribing

We provide a wide variety of clinics including newly diagnosed disease, Oxygen assessment, Optimisation

• f treatment along with home visits for housebound and support with end of life care.

We also provide Specialist education programs for newly diagnosed patients with Diabetes and also with established Type 2 Diabetes. Type 1 education is provided on an individual basis.

We were delighted to be awarded a bid from Pfizer to deliver pulmonary rehabilitation, within the Skelmersdale area, which has given us the opportunity to explore how we can deliver this service in the future as we have had very positive feedback from the first group to complete.

Throughout all contacts with the teams a common thread is education for the patients, carers ( including care homes ) and the multi- disciplinary team.

5 3

Teams within specialist nursing currently:- Cardiac – who provide cardiac clinics along with home visits for patients with heart failure, which includes titration of medication including Metolazone which is only prescribed outside of consultant clinics by the team. As Diabetes Respiratory

Get in touch

NHS West Lancashire Clinical Commissioning Group Tel: 01695 588 000 Email: wlccg.myview@nhs.net @westlancsCCG @NHSWestLancsCCG www.westlancashireccg.nhs.uk To receive regular health advice and news, please speak to Marco and ask about joining our My View group

Questions and Answers