Two year plan Welcome & Introductions Housekeeping Please - - PowerPoint PPT Presentation

Reading CCGs’ Two year plan

Welcome & Introductions

Housekeeping

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Agenda

Item Item Lead

1. 10.30 Welcome (5mins) Wendy Bower 2. 10.35 Reading’s Health & Wellbeing strategy 2017-2020(15 mins) Jo Hawthorne Reading Borough Council 3. 10.50 Reading CCGs’ two year plan (40 mins) Dr Bubbu Thava Dr Andy Ciecierski Dr Rupert Woolley Gabrielle Alford Debbie Simmons 4. 11.30 Questions (20 mins) Wendy Bower 5. 11.50 Refreshments (15 mins) 6. 12.05 Accountable Care System and STP (10 mins) Debbie Simmons 7. 12.15 Questions (15 mins) Wendy Bower

Health & Wellbeing Strategy 2017-20

Jo Hawthorne Head of Wellbeing Commissioning and Improvement

Whose strategy?

• Strategy will be overseen by the Reading Health & Wellbeing Board

– local authority – Clinical Commissioning Groups – local Healthwatch

• Developed and delivered in partnership
• Duties to improve and protect wellbeing cover the whole Reading

population

• The Health & Wellbeing Strategy sets out agreed priorities
• In times of austerity, health inequalities are widening, and there is

a need for more targeted approaches

Mission

“to improve and protect Reading’s health and wellbeing – improving the health of the poorest, fastest”

Reading at a glance

• 155,700 people
• Ethnically diverse
• Younger population than the England average
• Higher than average earnings
• Higher levels of homelessness
• High risk of premature death or poor health in

the most deprived areas – 10 year difference in life expectancy for men

• www.reading.gov.uk/jsna

Health and Wellbeing Underlying Principles

HWB underlying principles Possible commissioning intentions Developing an integrated approach to recognising and supporting all carers Carers information & advice services Carers breaks services Carer training inc.e-learning Carer healthchecks High quality co-ordinated information to support wellbeing Software platform to support knowledge management / facilitate public access Community navigation, e.g. Narrowing the Gap VCS providers Safeguarding vulnerable adults and children Training, awareness raising, developing capacity, preventing harm

Priorities

HWB priority Possible commissioning intentions

Supporting people to make healthy lifestyle choices MECC, Eat for Health, Let’s Get Going, Stop Smoking Services and tobacco control, Breastfeeding Support, National Child Measurement Programme, NHS Health Checks, Narrowing the Gap VCS providers (peer support / self advocacy) Reducing loneliness and social isolation Services which strengthen individuals’ community connections - e.g. Living Well Co-ordinators, Social Prescribers, Narrowing the Gap VCS providers (community connections theme) Mental health -reducing deaths by suicide Early intervention, support to prevent escalation of mental ill health

Priorities

HWB priority Possible commissioning intentions

Reducing the amount of alcohol people drink to safer levels IRIS, Community alcohol partnership, Drink Aware, brief advice training Promoting positive mental health and wellbeing in children and young people CAMHS development, in-school support e.g. PHSE; 0-19s(25s) public health nursing Making Reading a place where people can live well with dementia Funded co-ordinator for Reading Dementia Action Alliance Increasing breast and bowel screening and prevention services Primary care, secondary care, pick-up packs, Teachable Moments pilot– motivational behaviour change Reducing the number of people with tuberculosis New entrant screening, TB nursing, awareness raising campaigns

Adult Care Strategic Priorities

Adult Care strategic priority Commissioning intentions

Maximising Independence and recovery - we will use reablement, assistive technology, and aids for daily living as a first response. Assistive Technology and Emergency Duty Service Personalisation - we will support personalisation through personal budgets to ensure that people requiring longer term care can take as much control over their lives as their needs allow, in line with Care Act requirements. Personal Budgets, Direct Payment Support service, Day activities

Adult Care Strategic Priorities

Adult Care Strategic Priority Possible commissioning intentions

Home Care - we will seek to support sustainable homecare in the borough by working proactively and building on relationships with our Home Care Framework providers (HCF). New Homecare and Supported Living Frameworks for 2019. Reshaping Accommodation - we will continue to shift the balance of accommodation provision from residential care to extra care housing and supported living options. Extra Care Catering. New Extra Care provision at Green Park and Caversham 2018, support living options.

Adult Care Strategic Priorities

Adult Care Strategic Priority Possible commissioning intentions

Integration with Health Partners – we will continue to build upon partnerships with our colleagues in the health service in order to work closely together to meet the needs of our population. Nursing residential care, Joint Commissioning Strategy. Effective Commissioning and Sustainability – we will transform the way that we commission, ensuring that we have a service that is fit for purpose and able to play a key role in supporting the council to maintain a balanced budget. Joint commissioning and procurement with neighbouring local authorities and the CCGs including Transforming Care for people with learning disabilities/autism and challenging behaviour. Voluntary sector, Carers services, homecare, supported living, nursing.

Thank you for listening

Primary Care Urgent & Emergency Care Planned Care Mental Health

Priority areas for Berkshire West 2017-19

• Improved care for those with long-term

conditions, especially those with complex needs, through better use of technology and patient support

• Improved buildings and planning for the future
• New ways of accessing primary care across an

extended week

• New workforce models e.g. Clinical Pharmacists

and Physicians’ Associates

Primary Care

1) Premises Not purpose built Non CQC compliant Limited on capacity 2) Financial Contractual pressures Small list sizes 3) Recruitment and retention of clinical staff Same as everywhere but South Reading typically less desirable to work in. Majority single handed GPs close to retirement 4) Commissioning opportunities CCG commitment to improving access 5) Increasing demand from population increase

South Reading CCG – the need for change

South Reading GP Alliance

South Reading

19 independent practices working

• ut of 28 separate

buildings

South Reading Alliance

2 Organisations forming 4 geographical hubs

Whitley Hub Tilehurst Hub Central Hub

University Group

South Reading Alliance - structure

Member Practices and current affiliations Cluster meetings monthly chaired by Voted cluster lead Executive voted in. 4 Cluster leads + Chair

SRA EXECUTIVE BOARD Central Cluster Group 1) Pembroke Surgery 2) Kennet surgery 1) Melrose Surgery 2) Eldon Road Surgery 3) London Rd Surgery 1)Reading walk in Centre 2)Russell street x3 sites 3)Abbey Surgery 4)Chatham street 5)London Street Whitley Cluster Group 1) Milman Road A 2) Milman Road B 3) Longbarn lane 4) Chancellor House 5) Kennet st branch 6) Westwood road Branch Tilehurst Cluster Group 1) Tilehurst Village 2)Westwood road Surgery x2 sites 3) Groveland's Surgery

Dr Rab Mittal

Please click on the image below to watch Dr Mittal talk about the South Reading Alliance

• A new NHS 111 service from October 17.

– A single point of contact for anyone with an urgent care need – Call handlers will be supported by a clinical team who will be able to assess, advise and discharge or onward refer patients to the most appropriate service for their needs – From day 1 30% of calls will be handled by a clinician with plans to increase further – Service will be able to book patients into Westcall from day 1 and will be trialling booking into GP Practice appointments

Urgent & Emergency Care

• Expansion of access to GP services and GPs providing urgent

appointments within primary care hubs

• Increasing “hear and treat” and “see and treat” by the ambulance

service

• Further developing services within the hospital that allow patients

to be treated and go home within 24 to 48 hours

• Ensuring swift discharge from hospital by implementing “trusted

assessor” and “discharge to assess processes” and providing a range of resilient community health and social care options

• Continued focus on reducing Delayed Transfers of Care
• Continue to work closely with Berkshire Healthcare NHS Foundation

Trust and Reading Borough Council social services to ensure 95% of patients are admitted, transferred or discharged within and discharged from A&E within 4 hours of their arrival

Urgent & Emergency Care

Delayed Transfers of Care (DTOC)

Patients who are clinically ready and safe to leave hospital but are still occupying a bed as they need further health and/or social care. Just being in hospital for an extended period of time can increase a person’s reliance on longer term care

Reasons for delays in Reading

• Lack of carers to provide care at home
• Availability of nursing home placements
• Waiting for bed in Oakwood Community

Hospital

• Planning how best to continue care of patients

with complex needs

• Meeting patient’s/family’s choice of care

home

Action being taken in Reading to reduce DTOC

• Focused weekly telephone calls with health and social care

staff to expedite discharges

• 14 Discharge to Assess beds at the Willows
• Dedicated team of therapists and care workers to support

patients with their daily living skills enabling them to return home

• Same team also support people at home so they don’t need to

be admitted to hospital

• Team also identifies people who attend A&E who can safely be

transferred to the care of community services

Pre-booked hospital care

• Getting fit for surgery
• Fitter patients recover quickly after
• perations, have less complications and stay

healthier for longer

• Support to get active, lose weight and stop

smoking

• Aligned to Health and Wellbeing priority to

support people to make healthy lifestyle choices

Pre-booked care – CCG actions

• Redesigning outpatient services
• New care pathways in gastroenterology,

gynaecology, diagnostics.

• New technology - Virtual clinics, e-referral

system

• Ensure people with long term conditions have access to Talking Therapies
• Ensure at least 50% of adults start treatment within two weeks of their first

psychotic episode

• Alongside key partners aim for a 25% reduction in suicides across Berkshire

by 2020. There were 68 suicides in Berkshire in 2015/16.

• Greater emphasis on prevention & early intervention to reduce the number
• f children who experience poor mental health
• Reduce CAMHS waiting times and roll out new urgent care service
• Support perinatal mental health by investing £1.3m in additional dedicated

and specially trained nurses to provide early support to mothers

• Identify people with dementia to provide better support to them and their

carers

Transforming mental health

Financial Position

Funding has been allocated as below for the next two financial years : £140.5m and £143.8m for North and West Reading £155.7m and £159.1m for South Reading Based on current demand and current ways of providing services we anticipate a gap in funding of: North West Reading CCG - £4.9m South Reading CCG - £5.3m

Addressing the financial challenge

• Improving the quality of care for those with complex health needs in

care homes and the community

• Delivery of care outside of the hospital, closer to patients and their

homes

• Maximising the use of technology to deliver efficient services
• Minimising duplication and ensuring services are patient centred
• Working with partners as a single accountable care system

Refreshment break until 12.05pm

• Working together with Berkshire Healthcare and Royal Berkshire

Hospital to join community, mental health and hospital (acute) services to:

– Improve health and wellbeing – Deliver care differently – Manage finances

• Working together to make the best use of the NHS £ in Berks

West and developing new ways for the CCG to pay for health care

• Social care will join the ACS from April 2017

Accountable Care System

Questions?

Specific improvement projects:

• Transformation of outpatients

– Giving patients options for outpatient appointments, including their own homes – Reducing duplicate or unnecessary appointments – Giving patients the power to initiate their own follow up

• Support to vulnerable “high intensity” patients

– Supporting people who use A&E more than 20 times per year

• Better respiratory care

– Giving respiratory patients high quality care closer to home

Accountable Care System

Sustainability & Transformation Plan (STP)

The CCGs in Berkshire West work with partners in Bucks and Oxfordshire to deliver projects across a bigger area. These projects form the Buckinghamshire, Oxfordshire & Berkshire West (BOB) Sustainability and Transformation Plan (STP) 90% of activity to develop services in Reading will be led by the CCG working with partners - the STP will make a small contribution where we need to work across a bigger area

Alignment of CCG plans to STP priorities

• Priorities identified but STP delivery plan not due until June 2017 tbc
• Improving the wellbeing of local people by helping them to stay healthy, manage their own care

and identify health problems earlier, as described earlier

• Organising urgent and emergency care so people are directed to the right services for treatment.
• Using new technology to support patients, staff and organisations work more effectively together

– eg Connected Care

• Developing the workforce, improving recruitment and increasing retention with creation of new

roles

• Improving hospital services – for example making sure maternity services can cope with expected

rise in births

• Working with NHS England on pathways for specialised treatments to ensure our patients receive

the best possible care

• Developing mental health services, including low and medium secure services , more specialised

services for children and teens, and improving care for military veterans and services for new mums.

Your questions Opportunity for Questions about what you have heard today

Meeting close

Thank you for taking the time to join us today Ways to get in touch: Online: www.southreadingccg.nhs.uk www.nwreadingccg.nhs.uk Email: southreadingccg@nhs.net rccg.nandwreadingccg@nhs.net Phone: 0118 950 3094