NHS Newham CCG Annual General Meeting Tuesday 25 September 2018 1 - PowerPoint PPT Presentation

NHS Newham CCG Annual General Meeting Tuesday 25 September 2018 1

Hello and welcome Dr Muhammad Naqvi 2

East London Health & Care Partnership and North East London Commissioning Alliance Jane Milligan, Accountable Officer 3 3

East London Health and Care Partnership ELHCP brings together 12 local NHS organisations (commissioners and providers) and eight local councils to improve health and care services and outcomes; highlights include: • Digital Technology • Workforce • Estates • Cancer early diagnostic centre • Patient Involvement 4

Collaboration across NEL – what this means for Newham CCG • NEL Collaboration • Joint Commissioning Committee • Outpatients • NHS111: Rollout of new integrated urgent assessment service (NHS111) • Commissioning strategy • London Ambulance Service • Winter planning 5

2017/18 Financial Overview and 2018/19 Progress Lei Wei, Interim Chief Finance Officer 6 6

2017/18 Financial Overview We achieved good value for money for our patients in 2017/18, and successfully delivered all the key financial duties and business requirements under the NHS Act 2006. Key Financial Duties and Business Target Target Performance 2% Requirement £'000 £'000 achived 21% Expenditure not to exceed Acute Services Yes 499,263 497,553 income Capital resource use does not Community Services 51% 9% exceed the amount specified in Yes 11 11 Mental Health Directions 10% Services Revenue resource use does not 8% Other Non-acute exceed the amount specified in Yes 494,854 493,144 Services Directions Primary Care Services Revenue administration resource use does not exceed the amount Yes 7,561 7,532 Running Cost Allowance specified in Directions The CCG secured an unqualified opinion from our independent auditors in 2017/18 that the financial statements. Represented a true and fair view of state of the CCG’s affairs and. - - Have been properly prepared in accordance with accounting policies. 7

2018/19 Progress • Assured by NHS England, the CCG’s 2017/18 activity and finance plans aligned with our main providers and key stakeholders, and we will continue to deliver all finance and business requirements Financial Year 2018/19 £'000 Total Planned Commissioning Spending 497,056 Total Running Cost Allowance Expected 7,619 • Key areas of investment includes a Newham-based integrated health and care system, primary care services, and collaborative initiatives to deliver financial efficiencies • Despite the significant financial challenges Newham CCG are facing, we are currently on track in delivering the financial plan for 2018/19. 8

AIRS Ministry Congolese Youth Choir 9

Quality Improvement Project Improving discharge from hospital to community services 10 10 10

in Community Health Services Feedback system at Falls Phlebotomy prevention - Supporting EPCT informal carers 10% reduction in follow- up DNAs MSK Physio Service ‘Are you listening?’ 50% reduction I felt reassured in grade 2 when the team pressure manager ulcers called me Before this it didn’t feel meaningful 11

Stimulus Local Authority: Barts Health Trust : Information and Complaints, Serious investigations Incidents, PALS, staff feedback Newham CCG: performance, CCG serious incidents, Quality complaints, patient Team feedback East London Foundation Trust: Complaints, Serious Incidents, staff Care Homes: Incidents feedback and staff feedback 12

Purpose To improve the safety of and patient/staff satisfaction with the discharge process from Newham University Hospital into East London Foundation Trust Community Services. 13

QI Team am • Newham CCG Quality Team • NUH Improvement Manager • NUH Discharge Team Manager • NUH Ward Managers • NUH Therapies Managers • ELFT Associate Director for Quality and Compliance • ELFT Deputy Director Community Services • ELFT QI Coach, Practice Educator and Nurse Adviser EPCT • ELFT EPCT Manager • ELFT Therapists • ELFT EPCT Community Staff Nurse • ELFT Telehealth • Service user Scope and Aim: Review data, Process Who, Measures, patient and Change Ideas Data, Where Mapping staff feedback and How

Themes arising and actions being undertaken Understanding of community services • Improve referral form • Resource folder for NUH staff outlining key contacts and referral criteria for services • Emergency admission cards for EPCT patients • Co-designed patient information leaflet – what to expect on discharge and how to escalate concerns Improved patient self-care • Self administration of medication encouraged on wards • Patient activity on wards • Use of interpreters prior to discharge Equipment and medication on discharge • Use of medication packs • Equipment ordering processes – who can order what and when • Policy outlining responsibilities 15

Outcomes so far... • Improved communication – improving patient journey between providers • Joint working – incident sharing arrangement and discharge policy to improve safety and shared learning • Impact further reaching 16

Quality in Primary Care Dr Naqvi, Chair Newham Clinical Commissioning Group 17 17 17

Quality in Primary Care • Primary care services provide the first point of care, day or night, for the vast majority of people who come into contact with the NHS. • GP surgeries are a core element of primary care, but are not the only element - it is also about coordinating access for people to a wide range of services in the local community to help meet their health and wellbeing needs. • Engaging primary care practices in quality improvement (QI) activities is essential to improving the health of the population and enhancing patient experiences and outcomes. 18

Quality can be described in the following context • Patient experience • Safety • Clinical effectiveness 19

Where we are now • GP access is one the biggest concern for the people of Newham. • Newham is ranked below other north east London CCGs in the CQC CCG ratings for Primary Care. • Newham has 41 practices (80%) that are rated good, however there is still a small pocket of practice that need improvement. 20

Why is this • Lowest number of full time GPs in the London • Most deprived wards in the country • Diverse and mobile population • Population growth • Chronic disease 21

So how can we achieve the quality outcome Newham deserves Extra funding given to east London • Estates will deliver new fit for purpose buildings • Commissioning projects • Two GP Hubs planned offering GP and Nurse appointment evenings and • weekends Integrated care partnerships • Developing the existing and up-and-coming primary care workforce • Five year retention initiative • Practice manager development • 22

QI in practice • Newham GP, Dr Nazmul Hussain, developed a passion for Quality Improvement (QI) through his involvement with UCLPartners ’ and Newham CCG’s partnership programme. • He and his team at Wordsworth Health Centre have used QI to improve their patient appointment system, upskilling reception staff and signposting to alternative community services. • The team credit their health centre’s turnaround to their adoption of QI methodology. • This project is one of many taking place in GP surgeries around Newham as a result of the GP development arm of the Newham Partnership Programme. 23

Quality Improvement at The Wordsworth Health Centre Dr Nazmul Hussain 24 24 24

The Wordsworth Health Centre 25

Quality Improvement video https://www.youtube.com/watch?v=IngpodLN67U 26

Fun Day Event 27

Fun Day Event 28

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Number of Documents sent to GP’s 100 120 20 40 60 80 0 11.9.17 process whilst staff familiarise with Large difference to start off with 13.9.17 14.9.17 DOCUMENTS SENT TO GP ’s BEFORE and AFTER QI 18.9.17 19.9.17 A COMPARISON OF THE NUMBER OF PAPER 20.9.17 21.9.17 26.9.17 27.9.17 28.9.17 where most post comes in Peaks represent Monday’s 29.9.17 2.10.17 3.10.17 6.10.17 9.10.17 10.10.17 11.10.17 confident staff become more Gap narrowed as 12.10.17 13.10.17 16.10.17 17.10.17 18.10.17 19.10.17 20.10.17 23.10.17 24.10.17 25.10.17 trained up member of staff gets Gap widens as new 26.10.17 27.10.17 30.10.17 2.11.17 3.11.17 6.11.17 7.11.17 8.11.17 9.11.17 10.11.17 13.11.17 14.11.17 15.11.17 16.11.17 17.11.17 20.11.17 22.11.17 With QI Without QI 30

Newham Primary Care Oscars 2018 winners Practice responding to service user requests award  Recognising contribution of service users award  Practice with most Quality Improvement award  Practice Staff Leadership award  31

CMC Uptake in Newham CMC 1100 1075 1069 1061 1055 1050 1041 1023 1015 1000 996 968 974 950 951 933 909 915 920 922 900 885 890 896 CMC 866 845 850 854 856 850 800 774 750 741 719 703 700 02/03/2018 02/04/2018 02/05/2018 02/06/2018 02/07/2018 02/08/2018 02/09/2018 32

Priorities, Challenges and Highlights Selina Douglas, Managing Director, Newham Clinical Commissioning Group 33 33