Bracknell and Ascot CCG What we do What we achieve · PDF file•Breast cancer...

0 0 Bracknell and Ascot Clinical Commissioning Group

Bracknell and Ascot CCG

What we do What we achieve

Where we can learn

Dr M Kittel


NHS Primary Care Data B&A CCG

• 70% 4 week smoking quitters (compared with 51% nationally)

• 11.6% of patients receiving an NHS Health Check (compared 9.6 % nationally)

• 74% of CVD 20% risk patients treated with Statin (compared with 68% nationally)

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NHS Primary Care Data B&A CCG

• 80% of patients with AF are anticoagulated (compared with 74% nationally)

• 90% of patients with CKD receive an ACE1 (compared with 86% nationally)

• Lowest Alcohol Related A&E admissions in region due to successful campaigning.

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Challenges

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• AF prevalence too low – Advanced Healthchecks, Check Your Pulse campaign

• Hypertension prevalence too low and treatment outcomes need improving – practice comparison.

• Bowel cancer screening uptake too low. – Campaign with Self Care workstream

• Breast cancer presentations too late.


What is this presentation about?

• We are trying to do something different

• The presentation focusses on a few key points for every project

• It should give you a flavour of our clinical leadership

• Its about successes and challenges

• We don’t aim to be detailed or complete.

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Format – 60 seconds per slide

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? – What is this project about

– What is the biggest achievement

D/L - Difficulties and Learning points

1Y – Where do we want to be in a year


Extended Hours Service Pilot

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• ? – Providing 15 mins pre-bookable, primary care planned appointments including innovative services, Evenings Mon –Fri 18.30 – 20.00 and Sat 08.00 – 14.00

• - Project mobilisation, IT set up, overall patient satisfaction with the service

• D – IT, Workforce, Training. L: Saturday afternoons are not in demand

• 1Y - Increase appointment utilisation across all 15 practices, introduce more services


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Bracknell Forest Prevention and Self-Care Programme

• ? – provide effective integration and co-ordination for the wide range of preventative and Self-Care programmes across Bracknell Forest & Ascot

• - Reduction of avoidable non-elective admissions by 4.7% between March 2015 and March 2016, and winner of the National Self-Care Week award.

• D/L – Developing stakeholder buy-in, not duplicating work and engaging individuals who are hard to reach

• 1Y - Reducing avoidable non-elective admissions further and increasing the budget, scope and reach of the Programme


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BASE

• ? – Bracknell and Ascot Supporting Education • - 100% attendance to main events. Great nurse

and practice manager programmes through excellent local leadership. Introduction of lunchtime GP events for little extra money. Feedback Excellent or good >90%. High quality programme.

• D: Finance, Appreciation (by some), L – balancing individuals interests with BACCG needs

• 1Y – Federating the success of BASE with Bracknell & Ascot leading the process.


Advanced Community Nursing Pilot

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• ? – Delivering Long Term Conditions Reviews at home to the same standard as in the GP surgery. Proactive care to prevent problems.

• - Overwhelming support for the pilot from patients and carers, they appreciated the visits for reassurance and coping.

• D/L – Identifying patients at start was difficult (practice lists do not identify housebound people) and recruiting nursing staff.

• 1Y - Fully commissioned service visiting everyone in BACCG who cannot easily leave home staffed by nurses who work both in and out of surgery.


Nurse Revalidation Pilot

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• ? – Ensure all nurses have the information and ability to revalidate with the NMC to maintain their professional registration

• - 98% achieved success in pilot revalidation. BACCG put on the national map by speaking at other CCG and national conferences, making a film for NMC and published article in Nursing Times on the pilot experiences.

• D - Communication with and inspiration of the nurses. L: Modelling the value of revalidation was the most important part of getting it into nurse thinking.

• 1Y - All nurses being offered a 2 tier appraisal system which fits with the development needs of revalidation as well as organisational needs


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Pulmonary Rehabilitation in Bracknell

• ? –New Pulmonary Rehabilitation programme at the Open Learning Centre in Bracknell and continued service at Heatherwood.

• - No wait in Bracknell or Heatherwood (down from over 6 months wait). Excellent feedback.

• D: Getting patients to the service that need it! L: MRC 3 patient often housebound and don’t want to attend. Concentrate on MRC 2 patients.

• 1Y – Get as many MRC 2 patients as possible to service to reduce NELs for COPD. AIR service active.


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Community AIR service (Adult Integrated Resp) Project of B&A and WAM

• ? – Providing community AIR services

• - It started on Oct 10th. Nurse capacity significantly improved. Great leadership. Collaborative project.

• D – 3 years of fighting. Management inertia. Contractual issues.

• 1Y – Data to show admissions for COPD and Asthma have reduced. Healthier patients.


Urgent Care Centre (UCC) Darryl Braham

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• ? - Provision of urgent care and minor injuries services 365 days a year 8am – 8pm every day.

• - 80,000 patients seen [satisfaction]

• D - Helping patients to help themselves. Appropriate use of service. L - ? Increased demand by providing more access?

• 1Y – To be more integrated with OOH and 111


Home From Hospital Darryl Braham

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• ? – Rehabilitation at home following time in hospital

• - Establishing an integrated service with the voluntary sector, adult social care and our local health trusts to support people leaving hospital

• D – Working with the voluntary sector is new to the CCG and requires integration across many organisational boundaries. L: Working with the voluntary sector provides benefits but is often less easy to evidence success in terms of admission / re-admission avoidance.

• 1Y - Voluntary sector fully integrated in supporting discharges and admission avoidance across East Berkshire


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Green Gym Darryl Braham

• ? – A locally commissioned service through our innovations fund allowing patients with mental health problems to recuperate through work in groups out in open nature.

• - Successful start of project

• D: Getting patients into the project.

• 1Y – Learning about the opportunities this project gives to patients with Mental Health Problems and a better understanding of this kind of Therapy.


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Self-Care Events

• ? – Events in Bracknell & Ascot to educate patients and encourage patients to join HealthMakers

• - A great number of events by a good number of practices, well received.

• D: Getting patients to attend L: Good relationships and Mjog have proven invaluable.

• 1Y –Focus on PHE and CFV information and federated commissioning when planning events.


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Self Care Week Matthew/Martin

• ? – A week in November with a large number of self care related events. Supported by CCG, council and Public Health. This year focus on “Check Your Pulse” and “Bowel Cancer Screening”

• - Won National Award for Best Self Care Week. Lots of volunteers.

• D: None identified. L: How to get public interested.

• 1Y – Continue streamlining with workstreams of CCG and Public Health. Focus on PHE and CFV information when planning Self Care Week


Primary Care Integrated Care Teams

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• ? – Supporting patients with long term conditions, through multidisciplinary reviews and care planning - helping them to manage their conditions with their GP.

• - Expanding the service and working jointly across adult social care and local health trusts including the voluntary sector.

• D/L – Managing the expectations of clinicians and service users, whilst working across multi agency boundaries.

• 1Y - Fully integrated teams working as part of support discharge and admission avoidance pathways.


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Rapid Assessment Community Clinic and Falls Assessments

• ? – Supporting patients with long term conditions, frailty and falls through rapid geriatric assessments 5 days a week.

• - Opening a hub in the Bracknell Healthspace to support patients in a truly local setting.

• D – Providing robust services against the backdrop of a national shortage of geriatricians. L - Managing organisational relationships is an important part of the day to day operation of the service.

• 1Y - The service operating 5 days a week in Bracknell Healthspace providing a hub for people with long term conditions and for geriatric services locally. The service integrated across all BHFT services in East Berkshire.


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Total Knee and Hip Replacement Avoidance Specialist Physiotherapy

• ? – Bringing patients back to desired activity levels and reduce pain without surgery.

• - 80% of those who started the programme have successful outcomes .

• D – Contractual Quagmires (PIN notice etc), IT challenges, Federation Support. L: The right care data figures translate into real patients!

• 1Y – THR pilot to be rolled into an NHS standard contract. ? Federating project ?


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HealthMakers Karen Maskell

• ? – From the 2012 Olympic GamesMakers: – 1) Create strong peer support networks for self management

– 2) support commissioners with patient leaders

• - successful pilot, hundreds of trained HealthMakers, the level of commitment of the volunteers

• D/L – Keeping it all together and going, transition from pilot into mainstream. Involving patients in ALL commissioning workstreams.

• 1Y – 1 patient on every workstream. More trained HealthMakers. Better self care, reduced NELs. Please watch the film!


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MSK Services in Brants Bridge

• ? – A high quality local musculoskeletal service to reduce referrals to secondary care, admissions and operations and improve outpatients

• - High quality service with excellent patient satisfaction.

• D: Acceptance by some clinicians L: Triage does reduce referrals to hospital.

• 1Y – MSK service motivate all appropriate patients for the options of TKR and THR avoidance physio. A pain service (phase 2) and in 2-3 years local Rheumatology, too.


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GP Fellowship

• ? – A senior GP Registrar post to create local leadership, retain staff and support CCG succession planning.

• - Uptake by local GP Registrar, who integrated into the CCG team well. He stayed local. He is looking to lead for the federation on some projects.

• D – It took significant resource to get the project going. No lead position identified at end of his training L – Detailed Mentorship Vital and more resource for workforce planning needed at CCG level.

• 1Y – At least 1-2 federated GP Fellowships per year.


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CAMHS commissioning

• ? – improving access to Mental Health Services for Children and Young People

• - Increasing CAMHS capacity, KOOTH online councelling and Youthline grant.

• D – Starting services - L – Monitoring

• 1Y – Better waiting times and higher satisfaction rates. Better mental health for Bracknell & Ascot children.


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Public Health Achievements

• FallsFree4Life • Mental Health: School preventative sessions • Successful smoking cessation programme • 600% increase in weight management service

uptake • Back to Fitness Programmes • Health Checks at 12% (better than national) • Substance Misuse – top tier for treatment success • JSNA – Commissioning support – National

recognition


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Future

• Start of AIR service

• Primary Care Transformation

• Cardiology Commissioning

– Heart Failure Service (increase of community nurses)

– Anticoagulation project

• Ophthalmology Commissioning

• Neurology Commissioning


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Future

• Connected Care (Rohail, Rishi)

• NHS 111 re-procurement

• Dermatology in 3 steps – No 1: Telehealth

• MSK (ArthritisCare)

• Pain Services

• STP footprint liaison


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Conclusion

• Bracknell and Ascot is a successful CCG

• Right Care Data, CfV and PHE data all support this statement.

• There are areas we can improve.

• We need to continue our good work and close relationships with Public Health, the local authority and our Providers.

• We need to lead within the Federation

Bracknell and Ascot CCG What we do What we achieve · PDF file•Breast cancer...

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