care services Welcome Housekeeping Fire exits and facilities - - PowerPoint PPT Presentation

SLIDE 1

Developing plans for your local health and care services

SLIDE 2

Welcome

Housekeeping

• Fire exits and facilities
• Please silence your mobile phones during the

session

• Meeting will last around two hours

SLIDE 3

Agenda

• Buckinghamshire CCGs’

federation and what it means for you

• The role of your localities
• Developing our local NHS

Plans

• How this fits into the wider

context of Sustainability and Transformation Plans

• Q&A

Buckinghamshire, Oxfordshire and Berkshire West

Sustainability & Transformation Plan

Bucks CCGs

Developing our local NHS plans

Your locality

7 Localities across Buckinghamshire

SLIDE 4

Governing Body in Common

One Clinical Executive

Grouped into Seven Localities across Buckinghamshire GP Member Practices Aylesbury Vale and Chiltern Clinical Commissioning Groups have federated, we now have one Executive and one Governing Body meeting in common We commission general hospital care, community healthcare services, mental health, learning disability services, NHS 111 and ambulance services Clinical decision making by local GPs remains at the heart of our

• rganisation.

Buckinghamshire CCGs Federation

SLIDE 5

Robust local knowledge Sharing best practice and patients’ experiences Local influence

• ver local

services

Your CCG Localities

SLIDE 6

Plans are based on feedback from public, patients and stakeholders:

Healthy Bucks Leaders Group, HASC, HWB, County Council etc Public engagement events, focus groups, online, CCG meetings, GP surveys

Buckinghamshire plans for local health and care services

Primary Care Strategy 300+ survey responses, 275 people at workshops Continuous process via multi-agency development group Consulting now

• n refreshed

priorities 8 public /staff engagement events, 183 attendees Discussions with local Boards/partners Joint Strategic Needs Assessment Input from Thames Valley Clinical Senate and Academic Health Science Network

SLIDE 7

Developing our local NHS Plan

• Our challenges and our strategy
• What we have done
• What we need to do next
• How you can help

SLIDE 8

An ageing population A growing population

New demands cost the NHS at least an

extra £10bn a year

Evolving healthcare needs, such as the increase in obesity and

diabetes

Our local Challenges

SLIDE 9

Our Strategy: We need to put care in the best place

If we do nothing to meet these challenges, our costs will exceed our funding by about £107million over the next four years across the Buckinghamshire health system.

Living, Ageing and Staying Well

Prevention & Early Intervention Fast Response & Reablement Low dependency levels High dependency levels

Living, Ageing and Staying Well Current balance of spend Future balance of spend Care in hospital and care homes

Care in hospital and care homes Fast Response & Reablement

Prevention & Early Intervention

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For example…

Shifting the focus of care Managing urgent and emergency care Integrating health and social care Redesigning GP-led care Developing new models of care

SLIDE 11

Examples in your locality

Chiltern CCG Southern

Relationship building Developing better relations with Heatherwood & Wexham Park and Frimley Health Foundation Trust to help reduce patient waiting times, outpatient appointments and ensure more effective sharing of appropriate information. Care & Nursing Homes - Training Working with local Care and Nursing homes, including more efficient sharing of information and facilitation of training and knowledge sharing. Care & Nursing Homes – Pharmacist Support Development and implementation of a Care Home Pharmacist role to support care homes to review and monitor their medicines usage in order to reduce wastage and ensure that medication remains appropriate for the residents current condition. Patient Education Education and signposting to ensure that patients receive the right care in the right place at the right time.

SLIDE 12

Examples in your locality

AV CCG North Locality

Over 75s The over 75s teams based in North locality practices continue to work with multi agency partners to support the care at home of vulnerable older patients in line with the Frail Older Person

• Strategy. While aiming to prevent unplanned hospital admissions as much as possible, when

these are necessary the teams work to ensure that these are managed in the best possible way for the patient Lifestyle and Prevention We will continue to work with Public Health to influence the design of services that affect our population and continue to promote self-referral to the Live Well Stay Well programme.

SLIDE 13

Examples in your locality

Chiltern CCG: Amersham and Chesham

Dementia Friendly Surgeries

• Improving diagnosis rates for dementia: aiming for 67% of predicted prevalence
• Identifying a Dementia Lead for each surgery
• 80% of each practice to attend dementia awareness training
• An action plan for each practice to become dementia friendly

Carers Clinics

• Delivered in all 9 locality practices, with a dedicated resource providing 1:1 clinics for all

carers identified in each practice

• In the year that the service has been running, we’ve seen 374 carers (114 of whom are new /

previously unidentified carers)

• This service will continue into 17/18

SLIDE 14

Examples in your locality

AV CCG: South

Over 75s

• Working with partners to care for vulnerable older patients in their own homes, in line with

the Frail Older Person Strategy

• Aim to prevent unplanned hospital admissions wherever possible; but when hospital is

necessary, the teams work to manage this in the best possible way for the patient Airedale

• Technology so care homes can contact a doctor 24/7 via video link to a hospital in Airedale,

Yorkshire

• Less need for residents to be taken from care homes to doctors’ appointments and fewer

A&E admissions (45% lower in other areas) South Central Ambulance Service

• The locality is funding a specialist paramedic to provide care for patients at home, following

triage by a GP, over the winter months

SLIDE 15

Examples in your locality

Chiltern CCG: Wooburn Green

Improving care for frail older people, with more support for people in their own homes

• Paramedics visiting older housebound patients
• Helps to avoid hospital admissions for these patients and ensure that they get quick access to

the care and services they need

• Feedback to practices on the types of services that these patients need = improved

information for planning future services Managing “clinical pathways”

• All GP practices engaged in reviewing referral rates to key services
• Comparisons between the various surgeries mean we can share and adopt best practice in

terms of clinical pathways and referrals

• Focus on using community services where possible, to ensure “right care first time” for the

patient

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Examples in your locality

AV CCG: Central

Urgent Care The Central Locality has worked in partnership with DLS (Digital Life Services) to introduce a GP access call centre hub which will manage the level of phone calls into practices; effectively improving patient access to “on the day” GP triage. This provides for the more effective use of the available resources whilst reducing inappropriate use of Out of Hours and A&E attendance. Over 75s The over 75s teams based in central locality practices continue to work with multi agency partners to support the care at home of vulnerable older patients in line with the Frail Older Person Strategy. While aiming to prevent unplanned hospital admissions as much as possible, when these are necessary the teams work to ensure that these managed in the best possible way for the patient

SLIDE 17

Examples in your locality

AV CCG: Central

Lifestyle and Prevention We will continue to work with Public Health to influence the design of services that affect our population and continue to promote self-referral to the Livewell/Staywell programme. Population Growth A predicted and steady growth of housing development has been earmarked for Aylesbury Vale by 2033. The increase in population will put a huge burden on local primary care services and the CCGs continue to work closely with the Local Authorities, Planners and Locality Members. The 3 largest developments affecting Central Aylesbury are Berryfields, Kingsbrook and Hampden

• Fields. The CCGs’ policy is to support existing practices to meet the needs for primary care

services arising through these developments, as well as supporting all member practices in estates transformation

SLIDE 18

Examples in your locality

Chiltern CCG: Wycombe

Black and Minority Ethnic Communities Dementia project - ‘My Life, My Memories’ Pilot launched in Wycombe in September 2016. The project aims to increase the awareness of dementia in BME communities and of the support services available. Continued focus on improving dementia identification rates to adhere to national target rate of 67% Utilisation of Live Well Stay Well A community based service using a combination of psychological therapies and digital technologies to: – improve health and social outcomes for patients with Long Term Conditions (LTCs) – reduce the number of people at risk of developing LTCs Locality Integrated Team project Continued focus on the Locality Integrated Team project piloted in Wycombe to support our most vulnerable and high risk adult patients.

SLIDE 19

What you told us earlier

• We need more information so we know what local

services are available when we need help

• We need more information so we can help ourselves

when that is possible

• We want more care available to us in the community

that we live in (less travel to hospital/access to community hubs)

• We want more access to GP services
• We want more joined up care – the health and care

systems need to act as one

• We want consistent relationships with our healthcare

professionals

SLIDE 20

Community Hubs and Locality Services

Each Locality: Integrated primary care and community based services Hospital based care Community Hubs:

• Co-ordinated care planning
• Rapid access to diagnostics
• Specialist support for

complex conditions

• Links to hospital

consultants and procedures

• Access to social & voluntary

services, information and prevention support

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Community Hubs: co-ordinating services & support

Community hubs will vary in services tailored to their local population needs; some services will be in a building, others may be virtual (e.g. video outpatients, information). This is where all services can be co-

• rdinated across the locality to

ensure a timely response to requests for additional support or advice Hubs will enable more efficient access to hospital based specialist advice, through local appointments

• r video conferencing.

Integrated primary care and community based services

Hospital based care

Community Hub: co-ordinating services

SLIDE 22

Developing plans for health and care services

• What are your views of these plans?
• Would community hubs work for you?
• What else do you want to see in our plans?

SLIDE 23

NHS planning across a wider population

What are Sustainability and Transformation Plans and what do they mean for Buckinghamshire and us locally?

SLIDE 24

STPs

Sustainability and Transformation Plans (STPs):

• Are ‘umbrella’ plans for change: provide an
• pportunity to work at scale across a larger

population where it makes sense to do so;

• Are the mechanism for sharing innovation and

delivering the Five Year Forward View;

• Plans address how we will collectively improve

health, care and finance for the wider population;

• Organisations retain their own accountability

while also working to a shared, agreed STP plan

SLIDE 25

• 1.8m population
• £2.5bn place-based

funding

• 7 CCGs
• 6 NHS Hospitals
• 14 local authorities
• Several other arm’s

length bodies (e.g. Thames Valley Clinical Senate)

Buckinghamshire, Oxfordshire and Berkshire West makes up our STP “footprint”

SLIDE 26

The majority of our Sustainability and Transformation work will be delivered locally:

About 70%

• f Buckinghamshire’s STP

is the local health and care plans that we’ve already been talking to you about About 30%

• f Buckinghamshire’s STP is

work across the larger Bucks, Oxfordshire and Berkshire West footprint

SLIDE 27

Our STP Workstreams

Shift the focus of care from treatment to prevention

1

Access to the highest quality Primary, Community and Urgent care Collaboration of the three acute trusts to deliver equality and efficiency Maximise value and patient

• utcomes from

specialised commissioning Mental Health development to improve the overall value of care provided Establish a flexible and collaborative approach to workforce Digital interoperability to improve information flow and efficiency

2 3 4 5 6 7

SLIDE 28

28

Our STP Workstreams

Consolidation of backroom services to ensure high quality and

• ptimise cost

effectiveness

Initiatives

Create robust out

• f hospital

services

• perating from

community hubs and coordinated by GPs to maintain independence of

• lder and frail

patients in their

• wn homes

Identify

• pportunities for

modifying pathways, standardising thresholds and increasing prevention to reduce spend and increase value

Challenges

Our footprint is made up of multiple health economies with different population characteristics & healthcare needs. Overall good health status masks variation and

• inequalities. Child and adult obesity
• increasing. The older population is

growing faster than the national average

The cost of delivering current health and care services is not sustainable in the long term

The high local cost of living and an aging workforce are leading to increasing difficulty in sustaining

• services. This is inhibiting

development of robust integrated out

• f hospital care, contributing to

variable performance and rising hospital admissions

Variation in access to care leads to quality and

• utcomes which don’t

meet patient expectations

• A dynamic social movement

which activates individuals to increase personal activity

• Everyone working together

so the population across BOBW have happier and healthier lives

• Reduced health inequalities
• Reduced demand for services
• Improved patient

and workforce experience

• Reduced turnover
• Reduced spend on

agency

• Workforce leading

the way on health and wellbeing

• Improved information

for clinicians with which to make clinical decisions

• Reduced duplication

for patients

• Releasing time for

patients and clinicians

The impact of our plans

• Patients receive a timely response in the most

appropriate setting

• Patients get quicker treatment because they get to the

right place, first time

• Reduced A&E and non-elective attendances
• Increased proportion of older people living

independently at home

• Delivery of care in alternative settings
• Coherent standardised pathways for specialist mental

health between community and inpatient services

Priorities

Each and every clinical contact to include brief advice, supported by face to face, phone and web based behaviour change support. Build on existing asset based approaches

Shift the focus of care from treatment to prevention

1

Access to the highest quality Primary, Community and Urgent care

2

Collaboration of the three footprint acute trusts to deliver equality and efficiency

3 4

Establish a flexible and collaborative approach to workforce

5

Digital interoperability to improve information flow and efficiency

6

Creating a single set of information sharing agreements across BOBW Develop a network of providers of specialist mental health care across a larger footprint of STPs coordinating inpatient and community based services

Maximise value and patient

• utcomes from

specialised commissioning

7

Significant variation in per capita spend on specialised services across the STP

A shared workforce plan to support rotation

• f staff across
• rganisations to

increase quality

• f care and staff

retention

Mental Health development to improve the

• verall value of

care provided

• Release funding to

invest in local services and so improve outcomes

• Reduced out of area

treatments

SLIDE 29

Any questions?

SLIDE 30

What happens next?

• Please stay informed and involved – leave us your

contact info/sign up online

• Please encourage your family and friends to

provide their views and questions online

• Views will be collated and used to inform more

specific proposals for community health and care services – we’ll tell you how

• Questions will be responded to and answers

uploaded on our website JOIN ‘LET’S TALK HEALTH BUCKS’ Register at https://www.letstalkhealthbucks.nhs.uk

SLIDE 31

Thank You!

www.aylesburyvaleccg.nhs.uk www.chilternccg.nhs.uk