Annual General Meeting 2015/16 Dr Tim Spicer 12 July 20156
Agenda for today 5:00pm Arrival, tea and refreshments Market place stalls 5.30pm Introduction and scene setting Dr Tim Spicer 5:35pm Local achievements PPE / Community Trish Longdon Primary care transformation Dr James Cavanagh Planned care services Dr Tony Willis Mental health Dr Paul Skinner 6:05pm Working in collaboration across Clare Parker North West London 6.15pm Quality and Safeguarding Mary Mullix 6.25pm Annual Accounts 2015/16 Keith Edmunds and 2016/17 budget 6.35pm 2016/17 priorities Janet Cree 6.45pm Questions Dr Tim Spicer 7.00pm Close
Welcome This is our third 2015/16 was our The patient is at Annual General third year as a the centre of all Meeting fully authorised we do CCG We aim is to We continue to commission the work as part of an highest quality established care for the Collaborative of population CCGs in NWL
Introduction to the CCG We commission We have 31 Primary care is hospital care, member practices changing, urgent care, and a population providing more community & of around 200,000 services closer to mental health patients services We are facing Hospital care is challenging times changing, financially focussing more on requiring us to specialist care ensure we use our money wisely
Patient and public engagement Trish Longdon Governing Body Lay Member
Patient People have Participation to share Groups at GPs their should be experiences developed The CCG must improve links with groups in the community
Strengthened opportunities for residents to share their experiences
Widened and developed our relationships with the community
Developed and maintained Patient Participation Groups in primary care
Local Services Commissioning quality services closer to home James Cavanagh
Planned Care Services Commissioning quality services closer to home Tony Willis
Planned Care Services Ophthalmology New service launched April 2016 run by Imperial College Health Trust .
Changing mental health services Paul Skinner
• Current Transformation Programme • Mental Health Portfolio • Achievements 15-16 This is our second 2014/15 was our The patient is at Annual General second year as a the centre of all • A View of the Year Ahead 16/17 Meeting fully authorised we do CCG We aim is to We continue to commission the work as part of an highest quality established care for the Collaborative of population CCGs in NWL
Urgent Care Mental Health Service • Launched April 2016, £500k new annual investment • 24/7 Single point of access & emergency community response
Primary Care Mental Health Service • Enhanced services provided by GP & mental health professionals • Supporting transition of people from hospital based mental health services
Perinatal Mental Health Service • Pilot supporting pregnant women & new mothers with mental health needs • More nurses, psychiatrists and psychologists to offer mental health care
Children & Young People’s Services • Out of Hours Service pilot • Launch of Eating Disorder Service pilot • Development of Transformation Plan ‘Future in Mind
Working in Collaboration Across North West London Clare Parker Accountable Officer
Shaping a Healthier Future overview Two distinct parts to these plans: local service improvements, which includes primary care transformation and whole systems integration to better coordinate health and social care; and changes to our hospitals. Our plan was to: • make progress in local services as quickly as possible to improve care for patients and take pressure off hospital services, especially A&E • at the same time, there were a number of key hospital changes that needed to take place on safety grounds • we would then move to secure the capital funding needed to modernise our hospital and primary care facilities, through the ImBC. Local services will be in place before changes to hospital services are made. 21
Local service improvements: NW London-wide • NWL GP practices offer extended opening weekday hours (8am-8pm) and weekend access to over a million people in NW London • investment in new technology at 80 GP practices means they now offer online, email, video or telephone consultations to over half a million patients • Eleven primary care hubs are already providing access to primary care and social care services in one place • A single discharge agreement in place across NWL to get patients home quickly and safely reducing stays by up to three days • Nearly two-thirds (250 of 389) of NWL GP practices have signed up to an information sharing agreement 22
Maternity The implementation of new ante natal and post natal pathways, and the closure of Ealing Hospital’s maternity services took place in July 2015. A review of the changes found: • a complex service change was managed safely, with clear benefits to mothers and babies • an improved midwife to birth ratio now meets on average the London Quality Standards minimum staffing ratio of one midwife to thirty births • 122 hours of consultant cover against pre-transition average of 101 • 100 new midwives have been recruited • 79% of women now receive their postnatal care from the same hospital trust that provides their antenatal care, up by 21% The review was endorsed by the Royal College of Midwives and recognised by Baroness Cumberlege as it aligned with the national maternity review. 23
Paediatrics In order to improve children’s care across the whole of NW London the closure of Ealing Hospital’s paediatric inpatient services went ahead as planned on 30 June 2016. It has led to: • Far better access day and night, seven days a week, to more specialist children’s doctors • 27 new beds are opening at West Middlesex, Hillingdon, Northwick Park, St Mary’s and Chelsea and Westminster hospitals, 11 more than at Ealing Hospital • An extra 48 paediatric nurses and 10 paediatric consultants have been recruited • Four new paediatric assessment units opened to reduce admissions • A new rapid access clinic has been introduced at Ealing Hospital so GPs can access paediatric consultants for advice and same day patient appointments, reducing the need for a child to attend A&E • Over three- quarters of existing children’s services will remain at Ealing Hospital, including a 24/7 urgent care centre, day time clinics and outpatient services. 24
Mental health update • To improve mental health and wellbeing across NW London, we’ve established a new strategy called ‘Like Minded’, which is all about working in partnership to deliver excellent, joined up services that improve the quality of life for individuals, families and communities. • A new 24/7/365 single point of access was introduced for support, advice and information for people with mental health illness and carers and professionals received 4,700 calls, reducing A&E attendances and providing right and fast support for people in crisis • New specialist assessment, treatment and support service started for perinatal mental health services for pregnant women or women who have given birth in Ealing, Hounslow and Hammersmith and Fulham • New services for children and young people affected by eating disorders launched in June. • a coordinated approach to decriminalising mental health detention to help keep people out of police custody. 25
Sustainability & Transformation Plans (STP) Clare Parker Accountable Officer
What is the STP? • STPs were introduced by NHS England to support delivery of their Five Year Forward View strategy • The STP is an opportunity to radically transform the way we provide health and social care • 44 STP areas (footprints) across England • Main focus on how as a system we close the three main gaps identified in the Five Year Forward View: o Health and wellbeing – preventing people from getting ill and supporting people to stay as healthy as possible o Care and quality - consistent high quality services, wherever and whenever they are needed o Finances and efficiency - making sure we run and structure our services as effectively as possible
Health and social care in NW London is not sustainable Adults are not making healthy choices Increased social isolation Health & Wellbeing Poor children’s health and wellbeing Unwarranted variation in clinical practise and outcomes Reduced life expectancy for those with mental health Care & issues Quality Lack of end of life care available at home Deficits in most NHS providers Increasing financial gap across health and large social Finance & Efficiency care funding cuts Inefficiencies and duplication driven by organisational not patient focus. 20% of people have a long term condition 50% of people over 65 live alone 10 – 28% of children live in households with no adults in employment 1 in 5 children aged 4-5 are overweight Over 30% of patients in acute hospitals do not need to be in an acute setting and should be cared for in more appropriate places. People with serious and long term mental health needs have a life expectancy 20 years less than the average. Over 80% of patients indicated a preference to die at home but only 22% actually did.
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