NHS Croydon CCG Governing Body Tuesday 3 March 2020 Welcome to St - - PowerPoint PPT Presentation

NHS Croydon CCG Governing Body

Tuesday 3 March 2020

Welcome to St Mary’s High School!

NHS Croydon CCG origins

CCG concept laid out in 2012 by the Health and Social Care Act “Equity and Excellence: Liberating the NHS” Put commissioning into the hands of the GP

NHS Croydon CCG 2013-2020

Resilience and Resolve

• Doing things differently, putting clinicians at the heart of

decision making – pairing clinicians with managers

• Focus on transformation
• Re-designing pathways to ensure seamless transition

between Croydon-based levels of care

• QIPP / efficiency savings – over £100million saved

through emphasis on quality improvements

• Financial balance and surplus achieved 2018/19
• Our staff are central to this

Thanks to all our staff

• Strength, resilience and leadership from our team
• We’ve recognised many of our colleagues for living the

CCG’s values

Thanks to all our staff

• We hope to win big at the SWL “SAMs” awards later this month –

half of the 16 nominated colleagues have been shortlisted:

Nominee Award Category Aarti Joshi, Kamal Balakrishnan and team

Development of the ‘blue button’ initiative

Innovation Catherine Wallace

Support & development of nurses and HCAs in general practice

Leadership Daniel Dodd

Working with LAS for alternative care pathways

Partnership Daniele Serdoz & team

Living independently for everyone initiative

OOH team Croydon CCG

Remote assessments to support hospital discharges to care homes

Quality improvement Sudh Rai Sarah Blow's unsung hero Croydon Continuing Healthcare team

Performance against national targets and delivery against QIPP

Joint Pharmacy Team

Development of pharmacy team and QIPP

Team of the year

Our vision

Longer healthier lives for all the people in Croydon

Through an ambitious programme of innovation and by working together with the diverse communities of Croydon and with our partners, we will use resources wisely to transform healthcare to help people look after themselves, and when people do need care they will be able to access high quality services Our vision

Innovation – services

Huddles Integrated Urgent Care Personal Independence Coordinators FGM Telehealth

Innovation – technical and systems

• Mental health
• Primary Care Networks
• Integrated Care Networks plus and Localities
• Single IT system across Croydon GPs
• Protected Learning Time

The Living Independently For Everyone (LIFE) Team

Connecting your Care

Through an ambitious programme of innovation and by working together with the diverse communities of Croydon and with our partners, we will use resources wisely to transform healthcare to help people look after themselves, and when people do need care they will be able to access high quality services Our vision

Working together – with partners

 One Croydon Alliance

• Croydon Health and Care Plan

 Alignment with CHS

• Joint Control total
• Place-based leader and joint executives

 Health & Wellbeing Board  Croydon Transformation Board  Dementia Friends for Croydon  NHS 70  SWL CCGs working together

Working together – with Croydon Council

Working together – patients and public engagement

Andrew Brown Chief Executive Officer Croydon BME Forum

Through an ambitious programme of innovation and by working together with the diverse communities of Croydon and with our partners, we will use resources wisely to transform healthcare to help people look after themselves, and when people do need care they will be able to access high quality services Our vision

Use resources wisely

 Quality, Innovation, Productivity and Prevention (QIPP)

• Board made up of service managers, executive and GPs
• Clinically-led
• Focus on quality

13/14 14/15 15/16 16/17 17/18 18/19 Target £14m £11m £10.5m £18.4m £29.3m £27.6m Delivered £14m £11m £10.5m £14.5m £21.2m £26.7m

Use resources wisely

 Cost and Quality Oversight Board

• The new QIPP
• Brings together

– Partners (CCG and CHS) – Functions (finance and quality)

• The focus remains on clinically-led quality

Using Resources Wisely

Medicines Optimisation Team – 2013 to now

Team Core Activities

• Implementation of NICE guidance.
• Development of prescribing guidelines

& GP prescribing resources e.g. Vitamin D guidelines and Patient leaflets

• Input into service redesign: in relation

to use of medicines in new care pathways, transformation plans e.g. new urgent care model

• Delivery of Training events e.g. repeat

prescribing processes

• Medication Safety

Implementation of Best Practice

• Horizon scan for emerging drugs
• Managed entry of new drugs &

formulary development.

• Development of annual prescribing

workplan and Prescribing Incentive Scheme (PIS).

• Visits to all 57 GP practices to agree

annual prescribing targets

• Provision of hands on support and

advice by Practice Support Pharmacists to each practice

• QIPP

Financial Management

• Facilitation of safe seamless care across the

interface e.g. Hospital Discharge Referrals process.

• Integrated Care Networks Pharmacist

Service

• Falls Prevention
• Support to care Homes
• Community Pharmacy Support e.g.

Domiciliary medication reviews

Reduction In Waste and Polypharmacy

Using resources wisely

2013/14 – CQUIN with CHS to improve transfer of information post discharge

 216 patients referred via this pathway from August 2013 to July 2014  Anonymised data analysed for six months before and after each referral  184 fewer A&E attendances (35% reduction)  155 fewer emergency admissions (35% reduction)  968 fewer emergency bed days (53% reduction)  Cost avoidance of over £380,000

Between April to December 2018 the team:

• Managed 524 cases.
• Identified 867 medication related problems equating to an average of 1.7

per patient.

• Recommended 381 changes to medications to address clinical problems
• r waste resulting in a saving of £21,239.
• Provided 685 episodes of patient or carer education.
• Made 117 referrals to other professionals or services.
• Using an adapted RiO scoring tool to estimate the likelihood that a

medication related problem would have led to an admission had we not intervened, 65 admissions were avoided equating to an estimated saving

• f £205,786.
• 1. https://www.sps.nhs.uk/wp-content/uploads/2017/08/Croydon-explantory-doc.pdf

2017/18 – ICN Pharmacists

2018/19 – Self Care campaign

• Self Care Position Statement
• CCG Chair letters to key

stakeholders

• Self Care Briefings for 36

conditions

• Self Care Posters
• Referral to Community Pharmacy

Prescription Pads.

Engagement within the Local System Collaborative SWL approach to develop support material :

2019/2020 – Waste Campaign

Making the news….

Through an ambitious programme of innovation and by working together with the diverse communities of Croydon and with our partners, we will use resources wisely to transform healthcare to help people look after themselves, and when people do need care they will be able to access high quality services Our vision

Help people look after themselves

 Proactive and Preventative Care

• Group consultations
• NHS Parliamentary award
• HSJ Value Award shortlist
• Expert Patient Programme
• Proactive support for people at risk of long

term conditions

Help people look after themselves

• Social Prescribing
• Referral to local, non-clinical services to provide holistic

support for people

• Including exercise, social groups, debt advice and much

more

• Designed with residents to help people live healthier lives

Through an ambitious programme of innovation and by working together with the diverse communities of Croydon and with our partners, we will use resources wisely to transform healthcare to help people look after themselves, and when people do need care they will be able to access high quality services Our vision

High quality services

 Croydon Talking Therapies

High quality services

 Croydon Talking Therapies cont’d  Dementia diagnosis   Early Intervention in Psychosis

High quality services

 Cancer

National Target 2013/14 2014/15 2015/16 2016/17 2017/18 2018/19 2019/20 YTD

Cancer two weeks 93.0% 95.3% 95.6% 95.3% 96.7% 96.3% 96.9% 95.9% Breast symptoms two weeks 93.0% 95.5% 97.9% 95.3% 97.6% 98.5% 96.8% 97.8% First definitive treatment 31 days 96.0% 98.5% 98.1% 98.0% 97.7% 97.6% 97.6% 98.1% 62 days first treatment plus rare cancers 85.0% 82.8% 77.0% 82.4% 84.4% 84.7% 83.2% 81.6% First treatment 62 days, Screening 90.0% 95.3% 98.2% 92.4% 94.9% 89.3% 83.5% 92.7%

High quality services

 Learning disabilities

• Croydon CCG is 22 out of 190 CCGs for the proportion of

residents with an LD receiving an annual health check

The difference we’ve made – Joan

• Diagnosed with arthritis,

dementia, & Parkinson’s Disease

• Reduced mobility and

independence, history of falls, lack of confidence

• Lives with her daughter
• Improved mental wellbeing
• Enabled her to independently do

the stairs and make a cup of tea

• Able to have a bath with

supervision of her daughter

• Able to get up from floor safely

after a fall

• Improved mobility now allows her

to re-attend lunch group

• Signposted to assistive technology

to help her manage her Dementia

The difference we’ve made – Lucille

• Lives alone, isolated
• Had two recent fractures

from falls

• Known to MH team for

depression and struggling to cope and maintain personal hygiene

• Provision of equipment and

safety aid

• Support given to maintain

emotional wellbeing whilst antidepressants taking effect

• Increased emotional resilience

from relaxation techniques

• Signposted to community

resources e.g. mobile hairdresser

• Decreased isolation, more

contact with friends

Thank you to everyone who has contributed to the successes of NHS Croydon CCG

Looking to the future

• NHS South West London Clinical Commissioning Group from

1 April 2020

• Joining our CCG partners: Kingston, Merton, Richmond,

Sutton and Wandsworth

• A GP membership organisation of over 180 GP practices
• Serving 1.5 million people across our six diverse boroughs
• The statutory body for commissioning NHS services for our

communities

• Commitment to retain our borough focus and further support

local partnerships bringing together health and care

Croydon Place

Croydon Local Committee

GP majority Shared Executive Team with CHS Meeting in Common with CHS Board

Health Board

Croydon as a ‘place’ has already made significant progress

• Place based leader and joint

executive team and functions

• Responsible for the vision,

strategy and delivery of health services in Croydon

• Joint financial control total
• Step towards planning for

integration to ‘Total Place’

One Croydon priorities

Croydon’s Health and Care Plan highlights the work we will do together over the next few years in six priority areas

Croydon Place Clinical Leadership

Clinical Chair Dr Agnelo Fernandes Clinical Vice Chair Dr Mike Simmonds Clinical Senior Responsible Officers Dr Emily Symington Dr Rachel Tunbridge Dr John French Dr Nishal Velani Dr Vaishali Shetty Clinical Support Dr Tony Brzezicki Clinical Subject Matter Experts Dr Emily Symington Dr Rachel Tunbridge Dr John French Dr Bobby Abbot Dr Farhhan Sami Dipti Gandhi Dr Dev Malhotra Dr Henk Parmentier Dr Anna Clarke Dr Josephine Sheyin Clinical Digital and IT Lead Dr Sam Randle

Provisional Portfolio

Programme Clinical Senior Responsible Officer Key Lead Areas Proactive & Preventative

Dr Emily Symington

• 1. Croydon Local Committee
• 2. Quality Committee (CHS/CCG)
• 3. Proactive & Preventative Board
• 4. PCN Liaison / Variation support

Better Start in Life

Dr John French

• 1. Croydon Local Committee
• 2. CQOB (CHS/CCG)
• 3. Children (CYP) Board
• 4. PCN Liaison / Variation support

Better Mental Health & Wellbeing

Dr Vaishali Shetty

• 1. Croydon Local Committee
• 2. Mental Health Board (adult)
• 3. MH (CAMHs)/MH CQRG
• 4. PCN Liaison / Variation support

Better Life for People with Disabilities ( & LTC’s)

Dr Mike Simmonds

• 1. Croydon Local Committee
• 2. Finance Committees (Croy/SWLon)
• 3. Planned Care Programme Board
• 4. PCN Liaison / Variation support

Provisional Portfolio

Programme Clinical Senior Responsible Officer Key Lead Areas

Better Outcomes for Over 65s

Dr Rachel Tunbridge

• 1. Deputy Croydon Local Committee
• 2. Care Homes/ Workforce development
• 3. Out of Hospital
• 4. PCN Liaison / Variation support

Better End of Life Care

Dr Nishal Velani

• 1. Deputy Croydon Local Committee
• 2. End of Life Care
• 3. Homeless
• 4. PCN Liaison / Variation support

Vice Clinical Chair Croydon Local Committee

Dr Mike Simmonds

• 1. Croydon Local Committee
• 2. Deputy to Chair ( Croydon / SW London)
• 3. Primary Care GP/ CQRG
• 4. PCN Liaison / Variation support

Through an ambitious programme of innovation and by working together with the diverse communities of Croydon and with our partners, we will use resources wisely to transform healthcare to help people look after themselves, and when people do need care they will be able to access high quality services Our vision lives on

Looking forward together…

I Croydon