Earlier Presentation Pilot Including Earlier Home Visiting Service - - PowerPoint PPT Presentation

• Healthier. Stronger. Together

Earlier Presentation Pilot

Including Earlier Home Visiting Service

Live participation: How to use Slido

• Connect to Somerdale Pavilion wifi network
• n your laptop, tablet or smartphone:

Network: SOM_Guest Password: Aqu4t3rr4

• Open slido.com
• Enter the code: #GPclusterApril

Live participation: How to use Slido

• Click the ‘Questions’ tab to ask a question
• View other participants’ questions on the

screen

• Click the ‘thumbs up’ to vote for other

questions you ‘like’. These will move to the top

• f the presentation screen.

Earlier Presentation Pilot

• Earlier Home Visiting Service

– 3 pilots, 15 practices – 6 months

• Urgent Connect
• FAST transport service
• Ambulatory care enhanced in RUH

3 Pilots

• Keynsham

– 3 practices – GP model – Run by practices

• Bath

– 5 practices – Paramedic model – Run by BEMS+

• Norton Radstock

– 7 practices – GP model – Run by BEMS+

It has delivered…..

• 20% reduction in late presentations
• Wiltshire - rise in late presentations
• So pilots continuing till end of June
• Roll out across all of CCG
• £362k

– Allocated on population – Based on costs of pilots

• Evaluation will determine funding for next year

Roll out proposal

• Recommendation combination

– paramedic supported by GP triage – To identify most appropriate clinician

• Requirement that clinician has access to

records

• Reporting in line with pilots current reporting
• Needed to confirm impact

Timeline

• 6th April

Cluster meeting

• 7th April

Expression of Interest forms

• 21st April

Deadline for return

• 19th May

Notification of successful pilots

• 1st June

Virtual Pilots start

• 3rd July

Quarter 2 start of new pilots

• Healthier. Stronger. Together

GP Cluster Meeting

Thursday 6th April CCG Financial Position

Live participation: How to use Slido

• Connect to Somerdale Pavilion wifi network
• n your laptop, tablet or smartphone:

Network: SOM_Guest Password: Aqu4t3rr4

• Open slido.com
• Enter the code: #GPclusterApril

Live participation: How to use Slido

• Click the ‘Questions’ tab to ask a question
• View other participants’ questions on the

screen

• Click the ‘thumbs up’ to vote for other

questions you ‘like’. These will move to the top

• f the presentation screen.

How we spend our allocation

CCG Finances – Jargon buster

• CCG Allocation

– Based on complex formula – Weighted population

• Headroom (1% = £2.3m)

– “one off” investments

• Surplus (1% = £2.3m)

– Required under NHS finance rules

• Contingency (0.5% = £1.1m)

How did we get here?

• 1. Changes to CCG funding allocations in

2016/17 – BaNES now £6m below our “fair shares” allocation

• 2. Growing demand in secondary care
• 3. ONS population growth – not funded
• 4. Unfunded costs e.g. Funded Nursing Care

= £1.2m per year

• 5. Impact of Tariff changes

= £2.2m in 2017/18

Two ways of looking at the numbers

Headline numbers

• 16/17 financial outturn will be breakeven

– i.e. £2.3m off target surplus

• Non recurrent in year funding helped
• Underlying “operational deficit”
• Technical reporting of the 16/17 “headroom” –

may cause confusion

How does financial problem unfold?

2016/17 Surplus missed + 2016/17 non recurrent Support = Underlying Problem going into 2017/18 2017/18 new growth and cost pressures + 2017/18 1% surplus required + =

Full 2017/18 problem before Savings plan

i.e. Tariff impact and Demographic growth

So what if we have a deficit?

• “Turnaround” director appointed
• Slash and burn
• Cuts to all budgets possible
• Loss of local control
• Loss of control of destiny

Financial recovery

• To restore position fully in 17/18 would require

£14.6m efficiency savings

• Savings required to restore position over 3

years: – 17/18 £11.6m – 18/19 £5.7m – 19/20 £4.1m

What does this mean?

2 key messages:-

• CCG has to produce a detailed plan

– how we will make savings to reduce our spend to live within the budget allocated to B&NES

• We are protecting primary care budgets

2017/18 Savings Plan

• £11m = 5% of CCG budget
• 5% savings target is the maximum deemed

realistically achievable by NHSE

• If delivered, avoids a deficit
• Historically the CCG has delivered savings of

£4m per annum

Possible responses to funding pressures

1 Financial Situation 2 Spending decision 3 Response 4 Impact on patient care Budget does not cover demand Overspend Cut spending per patient Fund from

• ther source

Deficit Restrict access Dilute quality Improve productivity Access and quality maintained Reduced access Lower quality Equal/higher quality/access

2017/18 Identified Savings

Medicines Optimisation Urgent Care Elective Demand Management CHC/FNC MSK Finance & Business £1.9m £2.2m £1.4m £1.1m £0.5m £0.9m

Total £8.5m

What does this mean for primary care?

How can primary care help?

• 1. Your ingenuity & support
• 2. 4 key initiatives:-
• a. Urgent Care – Early Home Visiting Service
• b. Referral Support Service
• c. Medicine Optimisation
• d. Supporting patients be fit for surgery

Urgent Care – Early Home Visiting Service

• Earlier presentation
• Access to hospital if needed
• Assessed / sent home earlier (if appropriate)
• £362k NEW investment
• WIN for patient
• WIN for GPs
• WIN for CCG
• Further funding dependent on proof of concept

Referral Support Service

• Removes work from Primary care

– C&B – Smoothens out appointment process

• Reduces variation in referral criteria
• Supports delivery of new pathways
• NEW investment
• WIN for patient
• WIN for GPs
• WIN for CCG

Medicines Optimisation

OptimiseRx Software – go live in April with 13 practices

• Integrated into clinical system / supports clinical

decisions

• Optimises prescribing
• NEW investment
• WIN for patient
• WIN for GPs
• WIN for CCG
• Aim roll out to all practices in 2017/18

Gluten Free & OTC Medicines Update

Implementation Material to Practices : By Easter

• Clear Guidance
• Patient Leaflets
• Printed letters to practices
• Implementation to start after Easter

Key Messages: GF ONLY : for most vulnerable Short term Analgesics & Hayfever : Self Care Exceptions : medically necessary – prescribe

Supporting patients be fit for surgery

• Smoking cessation and weight loss
• Harrogate pathway

– Clinical evidence

• Pathway for this being developed
• Launch at GP Forum tbc

IFR review

• Clinical audit identified non- compliance
• 7 policies from Criteria Based Access to Prior

Approval from November 2016

• Significant additional administration
• Trial period - examination of Cataract policy
• From10th April, for cataracts, referrals direct to

secondary care via Choose and Book

• Later in 2017 Revision of the optometry service

Any Questions?