Transforming Primary Care Proactive Care 13 th April 2016 01 - PowerPoint PPT Presentation

WiFi Login Details Network: Hospitality Password: ovaltine89 Transforming Primary Care Proactive Care 13 th April 2016

01 Welcome and Introduction Transforming London’s health and care together 2

WELCOME AND INTRODUCTION Liz Wise, Director of Primary Care Commissioning & Programme Director, Transforming Primary Care, Healthy London Partnership Session Host Dr Tim Spicer, GP & Chair of Hammersmith and Fulham Clinical Commissioning Group 3

THE TRANSFORMING PRIMARY CARE PROGRAMME • The Healthy London Partnerships is a joint venture between NHS England and the London CCGs • The Strategic Commissioning Framework was published in March 2015 • Following consultation with over 1,500 patients, clinicians, commissioners and others , this sets out a new vision for Primary Care in London • This has been supported by all CCGs across London , and the focus is now on how it is delivered… 4

WELCOME AND INTRODUCTION #HealthyLDN @HealthyLDN 5

Using your App You can download the app by searching for ‘ Transforming Primary Care ’ in either app or google store Features to enhance your time at the event, such as:  Programme and general information  Speaker biographies  Access to presentations, including the ability to save, email and make notes alongside them  Voting and question submitting  Networking functionality  Note taking functionality Through each session you can Make Notes Vote Raise a question WiFi Login Details Network: Hospitality Password: ovaltine89 6

How many GP consultations are made in a year within England? (BMA, General practice in the UK, 2014) A. 100 million B. 60 million C. 340 million D. 10 million To Register your vote 1. Go to Programme 2. In the agenda click Welcome and Introductions 7 3. Click the voting button

Agenda for today WEL WELCOM COME E AND AND INT INTRODUCTIO DUCTIONS S Jane Lindo 12:45  Objectives of the day Dr Tim Spicer SESS SE SSION ION O ONE  London’s Health Needs Dr Shahed Ahmad 13:00  ‘Proactive Care, not Reactive Care’: The Strategic Commissioning Framework Dr Raj Karsandas  Table discussion: Patient Lens SESSION TWO Dan Hopewell  13:50 Primary Care and Co-production: The Bromley by Bow Experience Caroline Morison  Pro-active care planning : NWL Whole systems Integrated Care BREAK 14:20  Family Action Social Prescribing Jayne Stokes 14:35  What is the value of Social Prescribing? Dr Richard Kimberlee PANEL DISCUSSION 15:00 Kate Bowgett SESSION THREE  Samira Ben Osasi Saving Lives Saving Money: How Homeless Health Peer Advocacy Reduces Health Inequalities 16:25 Dr Josephine  Made in London: New Approaches to Self-Care for Young Adults Ruwende/ Julia Ozdilli  The Role Of General Practice In Improving Cancer Screening Uptake  ‘Somewhere to go, Something to do’: Mind Mental Health Day Hub Jacqui Dyce SESSION FOUR Dr Tim Spicer 16:45  Next Steps Dr Raj Karsandas  Closing Summary

02 SES SESSION SION ONE ONE Transforming London’s health and care together 9

LONDON’S HEALTH NEEDS Dr Shahed Ahmad, Director of Public Health for Enfield Council 10

Proactive primary care and London’s health needs Dr Shahed Ahmad Director of Public Health London Borough of Enfield Striving for excellence www.enfield.gov.uk

• Thanks to colleagues at PHE and NHS Rightcare • What are our big challenges at the moment and in the future? • Rightcare • Proactive primary care: We already do proactive primary care and there are lots of examples of excellence • Highlight some opportunities

Population of London • London’s population is 8,759,000 which is expected to rise to over 10 million by 2030 (an increase of 15%) • The biggest increase in London is in the 65+ age group (39%). • Unlike England there is a large increase in the 45-64 age group (22%) in London 13

Ethnic Composition • According to the 2011 Census, 44.9% of L ondon’s population is White British, compared with 79.8% of the England population • The largest percentage point differences in the ethnic composition of populations in London compared with England are in the White Other , Black African , Indian , Other Asian and Black Caribbean groups. 14

Ethnic Composition Change • According to the GLA, the largest proportional increases will be in the non- White groups of the population • However, the largest actual population increase will be in the White population, accounting for 26% of the growth 15

People in London are living longer, but many are in health; years of life lost have declined dramatically, but years lived with disability are now higher than years of life lost. All risk factors Behavioural risk factors 36.7% of DALYS can be attributed to risk factors; 25.7% of DALYs can be specifically attributed to behaviours 17

Male Female North East England 6.7 4.8 Increase in life expectancy at birth (in years) by region, North West England 6.2 4.4 Yorkshire and the Humber 6.2 4.3 1990 to 2013 West Midlands 6.3 4.5 East Midlands 6.3 4.4 East of England 6.0 4.3 London 7.0 4.9 South East England 6.3 4.2 Change in life expectancy gap between most and least deprived South West England 5.6 4.1 quintiles*, by region, 1990 compared to 2013 Male Female The change in the life 1.5 expectancy gap (1990 to 1.0 2013) between the most and 0.5 least deprived shows Change in gap (years) 0.0 London has narrowed this gap by over 1 year for both -0.5 men and women. West -1.0 Midlands also narrowed the -1.5 gap by more than 1 year for -2.0 women. Other areas have seen less change, with an -2.5 North North Yorkshire West East East of London South South increase in the South West East West and the Midlands Midlands England East West England England Humber England England * Deprivation quintiles were defined by area of residence ranked at national level by index of multiple deprivation score 2010 18

Main causes of DALYs • Back and neck pain • Heart disease

Main Causes of Premature Death • Heart disease • Stroke • Lung cancer • COPD

Top 5 causes of DALYs by deprivation level in London. Smoking, High body-mass index, High blood pressure, high fasting plasma glucose and alcohol use make up the top 5 causes. 21

London Assembly Health Committee: Blood Sugar Rush Diabetes time bomb in London “In London, there are an estimated 475,000 people diagnosed with the condition. Up to a further 200,000 people could be living with diabetes by 2025”

Hypertension in London Almost 2M people estimated to have hypertension 810,000 people diagnosed and controlled 940,000 people undiagnosed 210,000 people diagnosed but not controlled Source: Hypertension profiles for local authorities, PHE

• If London detected and managed hypertension as well as Canada, over 5 years we would • Prevent 5000 strokes • Prevent 2300 heart attacks • Save £137million • Savings from RRT in the same order

Detection rate by London CCGs Detection rate of hypertension varied between 38.6% in Westminster to 58.4% in Greenwich.

Hypertension: blood pressure management across London Note: Denominator includes exceptions Source: QOF 2014/15 HYP006

Variation in hypertension management by practice witin a CCG Note: Denominator includes exceptions Source: QOF 2014/15 HYP006

Diabetes: Blood glucose management in patients with diabetes across London Note: Denominator includes exceptions Source: QOF 2014/15 DM009

Diabetes: Blood pressure management in patients with diabetes across London Note: Denominator includes exceptions Source: QOF 2014/15 DM002

Diabetes: Cholesterol management in patients with diabetes across London Note: Denominator includes exceptions Source: QOF 2014/15 DM004

Hypertension management best practice newsletter

Breast cancer screening in London (2015) London coverage 68.3% England coverage 75.4% In London, a total of 474,914 women aged 53-70 were screened from an eligible population of 695,475 meaning 220,561 women went unscreened Sources: Public Health Profiles, PHE. Indicator number 2.20i ‘% of eligible women screened adequately within the previous 3 years on 31 st March’: http://www.phoutcomes.info/search/breast%20cancer%20screening#page/6/gid/1/pat/15/par/E92000001/ati/6/are/E12000007/iid/22001/age/225/sex/2 Original data from the Health and Social Care Information Centre (Open Exeter) 32

MMR, two doses by 5 th birthday in London (2014/15) London coverage 81.1% England coverage 88.6% • In London, a total of 104,368 children from a cohort of 128,688 had received two doses of MMR before their fifth birthday, meaning 24,320 children had not received two doses • Both the London and England rate were below the Department of Health’s benchmark of 90% coverage Sources: Public Health Profiles, PHE. Indicator number CI.10 ‘MMR vaccination coverage for two doses (5 years old)’: http://fingertips.phe.org.uk/search/MMR#page/6/gid/1/pat/15/par/E92000001/ati/6/are/E12000004/iid/30311/age/34/sex/4 33