Want to know what is happening with the future of health services in - PowerPoint PPT Presentation

Patient and Public Engagement Event Want to know what is happening with the future of health services in Enfield? Then come and talk to us. Wednesday 16 November 2016 Room 1, Community House, Fore Street, Edmonton N9 0PZ 1

Welcome Teri Okoro Lay Member for Patient and Public Engagement 2

Housekeeping • No fire alarm is planned today. If you hear the alarm, please make your way outside • Please turn your mobile phones off or put them on silent • The toilets are on the ground floor • You have a local GP and an NHS manager on each of your tables. They are here to lead the group discussions. We have two group work sessions today. • Please help yourself to refreshments throughout the afternoon. Local clinicians working with local people for a healthier future 3

Agenda 1:30pm - 2:00pm Sign in, refreshments and networking 2:00pm -2:05pm Welcome Teri Okoro, Lay Governing Body member for Patient and Public Engagement 2:05pm-2:20pm Enfield CCG update Dr Mo Abedi, Chair 2:20pm-3:00pm Adherence to evidence based medicine Clinical lead- Dr Jahan Mahmoodi, Medical Director Management lead - Gina Shakespeare, Project Consultant 3:00pm-4:20pm Workshops: Each topic is discussed for 40 minutes and then the facilitators will move to the next table. Session 1: 3:00pm- 3:40pm; Session 2: 3:40am-4:20pm GP Governing Body Members and CCG commissioners lead discussions on the following key areas: Sustainability and Transformation Plan (STP) - Clinical lead –Dr Mo Abedi; Chair Management lead- Deborah McBeal, Director of Primary Care/ Deputy Chief Officer Paediatric Assessment Unit (PAU) Consultation- Clinical lead - Dr Fahim Chowdhury, GP Governing Body member and clinical lead for maternity, children, young people and safeguarding children. Management lead - Claire Wright, Head of Strategy and Commissioning 4:20pm-4:40pm Feedback from the tables Clinical leads 4:40pm-4:55pm Questions and Answers session with the Governing Body 4:55pm-5:00pm Thank you and event closes Teri Okoro, Lay Governing Body member for Patient and Public Engagement for Patient and Public Engagement Local clinicians working with local people for a healthier future 4

5 Enfield CCG Update Dr Mo Abedi, Chair

Investing in Primary Care in Enfield • Access to GP primary care services 8am – 8pm 7 days a week- Enfield CCG has secured funding to deliver 8am – 8pm 7 day access to GP primary care services in line with the Governments’ General Practice Forward View . The funding will be used to establish up to 4 hubs across the borough • Delegated commissioning- NHS England has authorised Enfield CCG to proceed to apply for fully delegated commissioning of primary care GP services alongside the other four CCGs in north central London (Barnet, Camden, Haringey and Islington). This will mean that Enfield CCG will have a greater input into the decisions that are currently made by NHS England about primary care GP services in Enfield • Practice nurse training- Following the successful recruitment of five nurses onto the General Practice Nurse Trainee Programme last year, Enfield CCG has secured funding for a further eight places in 2017/18. Qualified nurses will undertake a year- long postgraduate training programme at the University of Hertfordshire while working within host practices in Enfield for the remainder of the week. • Four general practice nurses in Enfield will be undertaking the Advanced Nurse Practitioner Programme which will enable them to increase their range of skills and experience to see patients with a wider range of health conditions. 6 Local clinicians working with local people for a healthier future

Other developments in Primary Care in Enfield Family Nurse Partnership (FNP) programme - delivered by teams at Barnet, • Enfield and Haringey Mental Health NHS Trust (BEH) in partnership with NHS Enfield Clinical Commissioning Group and Enfield Council - is a home visiting service for first time mums, aged 20 or under, in Enfield • North Central London integrated 111 and out-of-hours service started in October 2016- The NHS in north central London – Barnet, Camden, Enfield, Haringey and Islington Clinical Commissioning groups (CCGs) – has launched an integrated 111 and out-of-hours service. Run by London Central and West Unscheduled Care Collaborative (LCW), a GP-led, not-for-profit social enterprise, this combines the 111 service, which LCW already runs, and the GP out-of-hours service. 7 Local clinicians working with local people for a healthier future

Primary Care Work In Progress • • IT Workforce – Digitalisation of records to free up – General Practice Nurse practice space for clinical services programme – 5 new GPNs by – Integrated Digital Care Record February 2017, 8 new GPNs – Patient online services by February 2018 – Electronic consultations – Practice Nurse and Practice • Manager mentoring schemes Estates introduced – Local Estates Plan developed – Space utilisation surveys – Workforce planning underway – Silverpoint opening in Autumn • Services 2016 – Integrated Commissioning – Feasibility studies planned for scheme from July 2016 Chase Farm, Alma and Ladders – AF and Pre-Diabetes scheme Wood regeneration areas from October 2016 – Potential new premises and extensions being scoped in all – GP See and Direct four localities – 8am – 8pm / 7 day GP Service 8 Local clinicians working with local people for a healthier future

Feedback and Questions Local clinicians working with local people for a healthier future 9

Adherence to evidence based medicine Dr Jahan Mahmoodi, Medical Director Gina Shakespeare, Project Consultant 10

Balancing our Finances • The CCG is obliged by the NHS Act 2006 to live within its annual budget and at the moment is in ‘special measures’ as it has not been able to so • The CCG has adopted polices concerning ‘Procedures of Limited Clinical Effectiveness’ – these are clinical treatments where the medical evidence suggests the benefits to patients might be limited and particular thresholds or conditions are set before the procedure takes place - our current policy can be down loaded from the CCG’s website • The CCG’s financial situation means it needs to explore ways to ensure it achieves the very best value it can from the money it spends, including making sure the services we pay for are based on clinical evidence • We are therefore comparing our clinical policies with the medical evidence and with those of other CCGs, under the direction of our clinical leaders 11 Local clinicians working with local people for a healthier future

Considering Clinical Policies We will start with areas where: a. Our research shows that other CCGs have adopted clinical polices and we have not or they have adopted different polices from ours b. Our clinical Governing Body members consider there is a case for change • Today Dr Mahmoodi, our Medical Director we will share with you three examples of where we think we can stick more closely to the clinical evidence and make savings as a result • We’d welcome your feedback: • Were the examples clearly explained - was the language used too technical or about right? How was the level of detail you were given? • What is important to you about the way we conduct our review? 12 Local clinicians working with local people for a healthier future

What does this mean in practice? Dr Jahan Mahmoodi GP and Medical Director, Enfield CCG Local clinicians working with local people for a healthier future 13

Hernia – Activity & Spend ENFIELD CCG Data Activity 2015/16 663 Cost 2015/16 £1,102,771 Local clinicians working with local people for a healthier future

Hernia – Policy/Criteria Comparison ENFIELD Enfield CCG has not adopted a policy / criteria for conducting elective hernia surgery North Central Other CCGs London Organisation Eligibility Criteria Exist Y CAMBRIDGE & PETERBOROUGH CCG Other North Central London (NCL) CCGs Y DEVON CCG do not have a Policy/Criteria regarding Hernia’s. Y MID ESSEX CCG Y WEST SUFFLOK HILLINGDON CCG Y Local clinicians working with local people for a healthier future