Dagenham CCG Commissioning Strategy Plan Contents 1 Vision and - - PowerPoint PPT Presentation

Barking and Dagenham CCG Commissioning Strategy Plan

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Contents

Vision and strategic goals 1 Context 2 B&D CCG priorities 3 BHRUT viability: long term financial modelling 4 Appendices: 2013/14 commissioning timetable

Vision and strategic goals

“Improving health and health outcomes for local people through clinically led commissioning of sustainable, safe, high quality local health services”

• Address the health needs and health inequalities of our population by

prevention of ill health and promotion of wellbeing

• Improve the quality of health services, standards of care and outcomes for

local residents across all health services, hospital, primary and community services

• Deliver strategic and transformational change needed to ensure high quality

and sustainable services into the future

• Ensure financial sustainability and deliver best value for money for services

commissioned

• Develop an urgent care strategy that supports the public in using primary

care

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Contents

Vision and strategic goals 1 Context 2 B&D CCG priorities 3 BHRUT viability: long term financial modelling 4 Appendices: 2013/14 commissioning timetable

Population profile

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1 DH Expo Book 2012 2 NHS Information Centre 2010 3 IMD 2010 - average score SECTION 2. CONTEXT England NHS B & D CCG

Male Female

Map showing deprivation (IMD national quintiles) in Barking & Dagenham by LSOA (IMD 2010 Score) Total population1 173,375 Number registered with B & D GPs2 191,073 Barking & Dagenham has a relatively young population compared to the England average Barking & Dagenham has a deprived population compared to the rest of London

▪ Young population ▪ High proportion of children ▪ Particularly high number of

0-5s

▪ Low proportion of over 65s ▪ Barking and Dagenham is

8th most deprived area in London

▪ Large new housing

developments planned Key findings or issues

1 – most deprived quintile 5 – least deprived quintile

7th most deprived of 31 PCT areas in London3

WORKING DRAFT

SOURCE: Network of Public Health Observatories 2011, NHS IC 2010/11, ONS 2012

Provider landscape

• Main acute provider, BHRUT, is challenged financially,

and second largest acute provider, Barts Health, is running a deficit

• Main acute provider has serious quality issues
• 6th lowest number of GPs per weighted population in

London, 0.56 GPs/1000 weighted population, compared to London average of 0.66

• 74% of GP practices have 3 or fewer GPs, compared to

national average of 46%

Quality improvement areas for providers

BHRUT Overall progress has been made on the recommendations made by the CQC. Action is needed on:

• Health Acquired Infection
• Serious Incident Management:
• Eliminating Mixed Sex Accommodation
• Formal Complaints
• National Cancer Patient Experience Survey

2011-12

• National Hip Fracture database outputs

NELFT

• Infection Control and Prevention Training

Compliance

• Serious Incident Management
• Safeguarding Children Training Compliance
• Ofsted/CQC recommendations to B&D

Trust/PCT and LA

• Problems with Health Visiting Recruitment

National GP patient survey

• Impression of waiting time at surgery
• Rating of nurse giving you enough time
• Confidence and trust in the nurse
• Overall experience of out-of-hours GP

services

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Contents

Vision and strategic goals 1 Context 2 B&D CCG priorities 3 BHRUT viability: long term financial modelling 4 Appendices: 2013/14 commissioning timetable

BHR CCG priorities

• Commission safe, sustainable, high quality

services for the local population

• Integrate care
• Redesign urgent and emergency care services
• Staying healthy
• Increasing productivity

B&D CCG proposed priorities 2013-18

Developing a locality-led approach to provision

• f integrated health and social care services that

will have an early impact on:

• Urgent care
• Children and young people
• Integrated care – for older people and people

with long term conditions

Opportunities: Urgent care

• Developing a locality model for primary care

urgent care

• Review Walk in Centre provision in Barking
• Increase utilisation of urgent care centres at

KGH and Queen’s Hospital and review provision of UCCs

• Implementation of NHS 111 including Co-
• rdinate my Care (for end of life care)

Opportunities: Children and young people

• Review Child and Adolescent mental health strategy

including Improving Access to Psychological Therapies

• Implement CQC recommendations for Looked After

Children and Young Offenders

• Review speech and language therapy for children

with special educational needs and disabilities

• Short breaks for carers
• Review urgent care pathway for children (linked to

urgent care above)

Opportunities: Integrated Care Strategy

• BHR Integrated Care Coalition agreed Case for Change

and to develop integrated care strategy to achieve a viable sustainable health and social care system.

• Integrated care strategy focuses on frail, older people

and those with long term conditions

• Service model has been developed - based on locality

focus of delivery of care and more care provided closer to home

• Improved productivity for community services will

allow a reduced community bed-base for BHR to provide more activity in the community

Other key opportunities

• Planned care – reducing secondary care activity and managing demand
• Maternity – B&D births at Barking Birthing Centre and Newham
• Productivity - Medicines management and contract review
• Cancer – implementing London models of care and standardisation of

pricing

• Mental health – improving access to psychological therapies and

review of CAMHS services (see children and young people priority above)

• Primary care – continuous quality improvement and review of

enhanced services

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Contents

Vision and strategic goals 1 Context 2 B&D CCG priorities 3 BHRUT viability: long term financial modelling 4 Appendices: 2013/14 commissioning timetable

BHR CCG approach to achieving high quality and financial balance

• GP leaders and CCGs fully support the

HealthforNEL programme agreed in October 2011

• Collaborative commissioning across the

three CCGs has been designed to ensure a consistent and coherent integrated care strategy to wrap around BHRUT, reducing the complexity and enabling pathways to be streamlined.

• Collaborative BHR CCGs leadership team

established to drive whole system change focusing on 3 programmes:

– Implementation of integrated care and out of hospital strategy (many of BHRUT productivity gains will require system support e.g. LOS reduction requires all partners to ensure appropriate discharge and post acute care in place). – Acute reconfiguration programme driving up quality standards – BHRUT LTFM: delivering a viable Trust

Integrated Care Strategy Trust LTFM Acute reconfiguration

BHRUT viability: long term financial modelling

• CCGs want to see BHRUT become a

viable high quality local provider for their residents and recognise their role in supporting BHRUT to deliver .

• BHRT estimated “do nothing” financial

gap is c£126m by 2016/17.

• The Trust, supported by E&Y is

working on developing a more robust long term clinical and financial strategy.

• Discussions are ongoing about options

to bridge the remaining gap, e.g. potential to repatriate some work back to BHRT currently flowing into central London.

• Financial risk arrangements will be

considered through this process.

Trust productivity savings £94m

PFI funding £16m Gap £16m Closing the gap by 2016/17

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Contents

Vision and strategic goals 1 Context 2 B&D CCG priorities 3 BHRUT viability: long term financial modelling 4 Appendices: 2013/14 commissioning timetable

Commissioning Timetable for 2013-14

August 2012 September October November December January 2013 February March April

Integrated Care Coalition Meetings CCG board meetings Health and Wellbeing Board Meetings

Commissioning intentions and priorities agreed 1st draft Commissioning strategy plan agreed by CCGs CCG allocations expected EY support to development of integrated care commissioning strategy and outline business case Baseline of current services Options development Modelling of economic impact Options appraisal

• Dev. of

strategic

• utline case

EY support to development of BHRUT long-term financial model and clinical strategy Contract negotiations Production of detailed provider delivery plans Refinement of provider delivery plans Completion of provider delivery plans Contracts signed

NELC Board Meetings

Final Commissioning strategy plan agreed by CCGs

Comments

Members are invited to comment on:

• Progress made towards strategic goals
• Priorities for 2013-18
• The QIPP opportunities outlined in the

strategy