Welcome Housekeeping Please turn your mobile phones off or put - - PowerPoint PPT Presentation

Welcome

Housekeeping

• Please turn your mobile phones off or put

them on silent.

• No fire alarm is planned today. If you hear

the alarm, please make your way outside.

• Toilets are available at the back of the

main room

Aim of today

• To update you on the development of

Enfield CCG

• To inform you about our key plans and

priorities over the coming year

• To build relationships with our key

stakeholders and our local population

• To give you the opportunity to get more

involved in Enfield CCG

Today’s agenda

We will start with some presentations:

• About Enfield CCG
• Our Commissioning Strategy and QIPP plans
• Update on Healthwatch Enfield

Then we will have an opportunity for you to ask questions. We will break for some food and refreshments at 6pm. At 6:30pm we will ask you to take part in some workshops on our key strategic plans.

Listening to you

Your feedback is important to us today. We want to work closely with

• ur stakeholders and our local population in developing our plans for

the future.

We would like you to get more involved in the CCG. You can:

• Attend a Governing Body Meeting
• Join your GP practice’s Patient Participation Group
• Sign up to our mailing list
• Volunteer to help us improve services for local patients
• Visit our website www.enfieldccg.nhs.uk for more information

We will ask you to fill in a feedback form about today’s event and we will make a report available in a few weeks time summarising everything we have discussed.

About Enfield CCG

Presentation by Dr Alpesh Patel and Liz Wise

About CCGs

• Clinical Commissioning Groups (CCGs) were created as part of the

changes set out in the Health and Social Care Act 2012.

• CCGs are led by GPs and are intended to improve clinical leadership in

commissioning.

• Every GP practice is now a member of a CCG and have signed up to a local

constitution.

• All CCGs have recently been through a vigorous authorisation process led

by the NHS Commissioning Board which tested their ability to:

• commission services
• manage the funding
• improve quality, reduce inequality and deliver improved outcomes for
• ur patients within the available resources
• During the authorisation process, we were working in shadow form with our

PCT cluster NHS North Central London. PCTs closed on 31 March 2013.

• We have been authorised and on 1 April 2013, Enfield CCG became the

new statutory body responsible for planning and commissioning health services for patients in Enfield

Vision, mission and goals

Our Vision

• We are committed to commissioning services that improve the health and

wellbeing of residents of Enfield borough through the securing of sustainable whole system care Our Mission

• Local clinicians working with local people for a healthier future.

Our Strategic Goals

• Enable the people of Enfield to live longer fuller lives by tackling the

significant health inequalities that exist between communities

• Provide children with the best start in life
• Ensure the right care in the right place, first time
• Deliver the greatest value for money for every NHS pound spent
• Commission care in a way which delivers integration between health,

primary, community and secondary care and social care services

“Local clinicians working with local people for a healthier future”

Enfield CCG’s locality approach

• Population 2012: 312,000 (source:

ONS)

• Ethnically diverse: 154 languages

spoken in Enfield schools

• Coterminous with Enfield Council
• 54 GP practices
• 3 main local providers:

Barnet, Enfield and Haringey Mental Health Trust Barnet and Chase Farm Hospitals North Middlesex University Hospital

Governing Body sub committees: chairs and membership

Understanding our challenges

• Scope and complexity of clinical service and organisational change across

all three main providers

• Long history of an unsustainable system and scale of financial recovery
• Pace of leadership and organisational development of the CCG

Quality and safety: putting patients at the heart of everything we do

We will strive to improve the quality within our commissioned services through highly effective clinical leadership

Maintaining quality during strategic changes

• Scope and complexity of clinical service change across all three main

local providers

• Barnet Enfield Haringey Clinical Strategy
• Clinically supported
• Secretary of State approved: A&E, Maternity and Planned Care

changes, enabled by:

• Primary Care development strategy and
• Integrated Care Programme
• FT related organisational change:
• North Middlesex University Hospitals
• Barnet and Enfield Mental Health Trust, including Enfield Community

Health Services

• Barnet and Chase Farm Hospitals with Royal Free Hospital NHS FT

How we are making a difference

What motivates us to lead clinical change for member practices and patients?

• Connecting practices together in new and different ways through

primary care development networks signposting earlier opportunities to improve health and reduce outcome inequalities

• Getting the books back in balance through sustainable, clinically-led

re-design and re-shaping the provider landscape to work more productively, by integrating high quality care with and for patients

• Seeing patients increasingly as partners in their own care with their

practices by involving them more in lifestyle, self care, treatment and re- design decisions

Sustaining two way accountability

Involvement of Member Practices

Informing – named representatives

Keeping all Member Practices up to date on proposed

• r planned changes e.g. through Locality Leads,

Protected Learning Time,, CCG Newsletter, CCG Website, Patient Participation Groups, Clinical Network Leads.

Working in Partnership – clinically led change

Member Practices involved in decision making re: structure and governance arrangements and the planning and development of services. Locality Leads holding Locality Group meetings bi-monthly.

Consulting – locality and clinical networks

Gaining views of the practices and patients, e.g. through Locality Group meetings, Protected Learning events (PLTs),

Our Health Challenges

Dr Shahed Ahmad, Joint Director of Public Health

THE CHALLENGE

• Very high levels of poverty and child poverty
• High rate of childhood obesity
• Large gap in life expectancy
• Life expectancy for women in Upper Edmonton the worst in North

Central London

• Blood pressure control still below national average

THE GOOD NEWS

• Best improvement in Year 6 childhood obesity rates in London
• Improvement in blood pressure control
• Best improvement in life expectancy in North Central London

Our health challenges

Children living in poverty in north central London

Child poverty - August 2007

15600 17120 18555 24485 27050

5000 10000 15000 20000 25000 30000

Camden Islington Barnet Haringey Enfield

Enfield has amongst the highest rates of childhood obesity in the country

Obesity by local authority

• Reception 4th worst nationally 14.4%
• Year 6 – 5th worst nationally 25.1%

Position in England

Least deprived (38) Worst 10% (72) Worst 25% (37) Worst 50% (34)

Obesity in children aged 10-11 years

Our health needs

Life expectancy: female

Our health needs

Life expectancy: male

Causes of the life expectancy gap in Enfield

Causes of Life Expectancy Gap in Enfield

Approaches to tackling health inequalities: systematic and sustainable

• Short Term- Treatment of already existing

conditions or risk reduction in people already at high risk of developing the major causes of morbidity Medium Term - Lifestyle approaches. Long Term - Addressing Wider Determinants of Health.

Approaches to tackling health inequalities: commissioning for best outcomes

Health and wellbeing strategy Moving to Public Health Excellence A healthy start for every \child Narrowing the gap Healthy lifestyles Healthy places Strengthening partnerships and capacity

• Childhood obesity
• Immunisation
• Infant Mortality
• Teenage Pregnancy
• Cardiovascular

diseases

• Cancers
• HIV
• Screening
• Smoking
• Physical Activity
• Healthy eating
• Obesity
• Alcohol
• Healthy Ageing
• Healthy Parks
• Temporary

accommodation

• Healthy Enfield
• Health is everybody’s

business

• Health in every policy
• Making every

contact count

Health and Wellbeing strategy priorities

Improvement in controlling blood pressure and cholesterol levels

2008/09 149th 2009/10 134th 20010/11 110th

CHD 6 National Ranking for Enfield CHD 8 National Ranking for Enfield (1st being the best and 152nd the worst) Source: Informational Centre

2008/09

141st

2009/10

128th

20010/11

121st

Largest Percentage improvement in AAACM for males in NCL cluster 2008-2010

0% 2% 4% 6% 8% 10% 12% 14%

Barnet Islington Camden Haringey Enfield

Commissioning Plan 2013 – 2016

Richard Quinton Director of Finance and Commissioning

39.2 13.5 6.5 1.3 20.7

• 5

5 10 15 20 25 30 35 40 45

Opening Run Rate Deficit 2012/13 QIPP Saving Other Recurrent Savings & Contingency Other Non- Recurrent Benefits Non Recurrent Support via NCL Risk Pool

£m Deficit £m Surplus

Trajectory of Financial Position 2012/13

£2.8m Surplus

Trajectory of financial position 2012/13

19.2 5.9 9.0 1.7 6.3 15.4 11.1 7.6 5.9 2.1 5 10 15 20 25 30 35 40 45 £m Deficit

Trajectory of Financial Position 2013/14

Route to achieve balance 2013/14

Planned Break- even

Route to achieve balance 2014/15

8.0 4.0 12.0 2 4 6 8 10 12 14

Run Rate B Fwd 2014/15 New Pressures QIPP Deficit Year End £m Deficit

Trajectory of Financial Position for 2014/15

Acute Non-acute Prescribing Other

Budget £m

Acute 265.9 Non-acute 87.2 Prescribing 38.7 Other 7.9

Finance summary

Our commissioning plans

Stakeholder Engagement

Mandate

Preventing People from dying prematurely Enhancing the quality of life for people with long term conditions Helping people recover from episodes of ill health or following injury Ensuring people have a positive experience of care Treating and caring for people in a safe environment and protecting them from harm

JHWS Key Themes

Narrowing the gap – reducing Health inequalities Healthy lifestyles, healthy choices Healthy places Healthy places

ECCG Strategic Goals

Enabling the People of Enfield to live longer fuller lives by tackling significant health inequalities Commission care in a way that delivers integration between health and social care Ensure the right care, in the right place, first time Healthy Starts – Improving child health and providing children with the best start in life ** Deliver the greatest value for every NHS pound spent

ECCG Commissioning Intentions Prevention Primary Care Integrated Care Clinical and cost effectiveness Children and young people Mental health

Enfield Transformation Programme Prevention, Early Diagnosis and Primary Care Integrated Care for Older People Unscheduled Care LTC Management Maternity, Children and Young People Mental Health and CHC

PREVENTION AND EARLY DIAGNOSIS Helping people to stay well and identifying those who are unwell early PRIMARY CARE Improving access and reducing variations in quality of care and patient experience Joining up Health and Social Care to support Older People and people with Long-term Conditions (LTC) Delivering more care locally and helping people to stay out of hospital Understanding the needs of the population and commissioning effective and efficient services for people with Mental Health needs Joining up Health and Social Care to support children and young people

Clinically effective and safe services Patient centred – a good patient experience Most effective use of NHS resources

Delivering our commissioning plans (1)

Enfield Transformation Programme Prevention, Early Diagnosis and Primary Care Integrated Care for Older People Unscheduled Care LTC Management Maternity, Children and Young People Mental Health and CHC

Projects: Anti Coagulation DVT Home Oxygen Review Diagnostics Primary Care Programme Projects: MDT Case Management Admissions Avoidance/ESD Falls OPAU Community Services Review Projects: UCCs 111 and DoS OOHs Projects: ENT Cardiology Respiratory Pain Management Urology Dermatology C2C referrals Gastro T&O Projects: IAPT CHC beds Seacole Unit Out of Area Treatments Projects: Maternity Pathways Primary Care Paeds PAU

Cross cutting: BEH Clinical Strategy, Medicines Management, PoLCE, Acute Productivity, Referral Management, Other budget areas

Delivering our commissioning plans (2)

• Continued engagement on our

commissioning plans

• Reporting back to you on our progress and

achievements

• Continue to develop and deliver our 3 year

commissioning strategy plan

Next steps