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

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NHS Newham CCG Annual General Meeting

Tuesday 25 September 2018

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Hello and welcome

Dr Muhammad Naqvi

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East London Health & Care Partnership and North East London Commissioning Alliance

Jane Milligan, Accountable Officer

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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

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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

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2017/18 Financial Overview and 2018/19 Progress

Lei Wei, Interim Chief Finance Officer

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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.

2017/18 Financial Overview

Key Financial Duties and Business Requirement Target £'000

Performance

£'000 Target achived Expenditure not to exceed income 499,263 497,553 Yes Capital resource use does not exceed the amount specified in Directions 11 11 Yes Revenue resource use does not exceed the amount specified in Directions 494,854 493,144 Yes Revenue administration resource use does not exceed the amount specified in Directions 7,561 7,532 Yes

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.

51% 8% 10% 9% 21% 2% Acute Services Community Services Mental Health Services Other Non-acute Services Primary Care Services Running Cost Allowance

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• 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

2018/19 Progress

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.

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AIRS Ministry Congolese Youth Choir

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Quality Improvement Project

Improving discharge from hospital to community services

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50% reduction in grade 2 pressure ulcers I felt reassured when the team manager called me 10% reduction in follow- up DNAs MSK Physio Service Before this it didn’t feel meaningful

Feedback system at Phlebotomy

‘Are you listening?’

Falls prevention - EPCT

in Community Health Services

Supporting informal carers

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Stimulus

Newham CCG Quality Team

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

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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.

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: Who, Measures, Data, Where and How Change Ideas Process Mapping Review data, patient and staff feedback

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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

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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

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Quality in Primary Care

Dr Naqvi, Chair Newham Clinical Commissioning Group

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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.

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Quality can be described in the following context

• Patient experience
• Safety
• Clinical effectiveness

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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.

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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

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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

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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.

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Quality Improvement at The Wordsworth Health Centre

Dr Nazmul Hussain

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The Wordsworth Health Centre

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Quality Improvement video

https://www.youtube.com/watch?v=IngpodLN67U

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Fun Day Event

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Fun Day Event

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30 20 40 60 80 100 120 11.9.17 13.9.17 14.9.17 18.9.17 19.9.17 20.9.17 21.9.17 26.9.17 27.9.17 28.9.17 29.9.17 2.10.17 3.10.17 6.10.17 9.10.17 10.10.17 11.10.17 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 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 Number of Documents sent to GP’s

A COMPARISON OF THE NUMBER OF PAPER DOCUMENTS SENT TO GP’s BEFORE and AFTER QI

Without QI With QI

Peaks represent Monday’s where most post comes in Gap narrowed as staff become more confident Gap widens as new member of staff gets trained up Large difference to start off with whilst staff familiarise with process

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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

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CMC Uptake in Newham

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

CMC

CMC

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Priorities, Challenges and Highlights

Selina Douglas, Managing Director, Newham Clinical Commissioning Group

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Achievements

• CCG rated as Good
• Outstanding for diabetes
• Green star for PPE
• No Recourse to Public Funding - tuberculosis in the homeless project
• Community Prescription joint with LBN
• 90% paperless referral ahead of 1 October deadline
• Discharge to community
• Latent tuberculosis infection (LTBI) screening and treatment programme

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Challenge and focus for 2018/19

• Quality in Primary Care
• Newham Well-being Partnership
• Early Cancer diagnosis
• Making Every Referral Count

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Highlights

• NHS70 birthday cards and letters from the Newham Show
• Newham’s community prescription programme 150Club
• East London Community Kidney Service
• NHS 70 Women Leader Award

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Q & A session

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Closing remarks

Dr Muhammad Naqvi

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THANK YOU