Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic...

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Commissioning Plan refresh 2017-2019

Transcript of Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic...

Page 1: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Commissioning Plan refresh

2017-2019

Page 2: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Impact

Change Programmes

Foundations

Primary Care

Community

Elective

Specialised

Non-Elective

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Reducing Variation: Right Care

Priorities 2017/19 -

Page 3: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

• Review all commissioned services including access to community services, 24/7 crisis resolution and liaison

mental health services ensuring equity of access for vulnerable groups

• Continue to develop a workforce plan in partnership with CCGs in the Alliance Local Delivery System (LDS)

• Co-design new whole system service model/integrated pathways in line with the THRIVE model (new models of care)

• Further develop the joint agency approach between schools and CAMHS

• Work with NHS England to develop a joint LDS commissioning plan for provision of tier 4 beds

• Explore lead provider arrangement through a collaborative commissioning approach across the Alliance LDS

• Commission eating disorder services so that 95% of children and young people receive treatment within 4 weeks of referral for routine cases and one week for urgent cases

Impact: • Intervene early and build resilience by Improving access to achieve national

trajectories (reaching 35% by March 2020/21) • Virtual single point of access across providers including self referral access points • More effective clinical pathways (underpinned by Children and young people’s

Improving Access to Psychological Therapies (CYP IAPT), capacity and demand planning and improved patient flow (by 2018)

• Integrated pathways with Children’s services for managing and sharing risk • Achieve alignment of provision through integrated commissioning arrangements • Reduce substantially the use of specialist inpatient beds for children with an eating

disorder

Children and young people’s mental health (CAMHS)

Page 4: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

• Commission additional and expanded specialist perinatal community mental health services to increase access to more women within Warrington

• Additional psychological therapies will be commissioned to deliver treatments to support people with physical and mental health problems

• The CCG will continue to commission Early Intervention Services to ensure that more than 50% of people experiencing a first episode of psychosis start treatment within 2 weeks of referral

• Working with partners, the CCG will contribute fully to the local ‘Multi-Agency Suicide Prevention Plan’ to reduce suicides

• Develop effective 24/7 crisis response and home treatment teams as alternatives to acute admissions • Continue to reduce non-specialist mental health Out of Area (OOA) placements with the aim of elimination

by 2020/21 • Additional screening and physical health interventions will be commissioned for people with Severe Mental

Illness (SMI) on GP registers

• Working with acute providers to meet the ‘core 24’ standard for mental health liaison • Work with partners to increase access to placement support for people with SMI • The CCG will maintain and improve our dementia diagnosis rate • Use the ‘Local Digital Roadmap’ to facilitate improvements in data quality, transparency

and increase digital maturity in mental health services • In line with recommendations in “Building the Right support” maintain the achieved

reduction in the acute inpatient bed base (50% prior to March 2019). • Ensure that the revised and reissued care policy treatment plans and guidance remain

updated in line with published guidance • Maintain the dynamic support database in place across the footprint

Mental Health, Learning Disability & Dementia

Page 5: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Mental Health, Learning Disability & Dementia Impact

• Increased access to specialist community services for people with perinatal mental health issues

• Increased access rates to psychological therapies and an increase in co-located therapists in general practice

• Ensure national targets are met for first episode of psychosis start treatment alongside expansion of age range criteria from 14-35 to 14-65

• Reduce suicide rates

• Address identified gaps in provision of 24/7 CRHHT with a funded implementation plan and commence the collection of patient outcome data

• Commission services locally to meet non-specialist acute care needs through risk share arrangements and collaborative working e.g. locked rehabilitation

• Increased numbers of physical health checks in primary and secondary care for people with SMI will be delivered

• Achieve fully compliant ‘core 24’ service specification in local acute hospitals • Improve access to IPS employment support from 2018/19 for people with SMI • Increase dementia diagnosis rate and start treatment within 6 weeks of referral • Aim to achieve intra-operability of health care records, including mental health services • Support proactive intervention , including care and treatment reviews, of individuals with

a learning disability and/or autism thereby avoiding acute admissions for deteriorating mental health conditions

• Develop the spirit of “co-production” with emphasis on person centred planning and increase the number of personal health budgets

• Improved access to positive behavioural support • Enhance community services, and supported living using assisted technology

Page 6: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Cancer • Work with Public Health and Public Health England to reduce smoking prevalence

• Improve screening uptake for breast, bowel and cervical cancers and improve 1 year survival rate

• Model diagnostic requirements to meet NICE guidance and redesign / commission direct access diagnostics capacity in accordance with access requirements

• Expand Cancer Rehabilitation programme in 2017 to include survivorship and cancer recovery package, including tailored programmes of care and holistic needs assessments (HNAs)

• Work with providers and the C&M Cancer Alliance to review tumour pathways to incorporate risk stratified follow up for breast, colorectal and prostate

• Work across the system to address related workforce issues including all patients have access to appropriate key workers

• Work with Cheshire & Merseyside Cancer Alliance through STP and LDS areas on colorectal, lung, vague symptoms, imaging, endoscopy and pathology pathways

Impact: • Reduce smoking prevalence in line with national target • Increase in cancer screening uptake rates • More cancers diagnosed at earlier stages via non-emergency routes,

which will deliver better outcomes and experiences for patients & service efficiencies through coordinated streamlined pathways

• Supported self-management and support in the palliative phase using recovery package approach

• Stratified follow up pathways of care and appropriate key workers will be available for all cancer patients

Page 7: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

End of life • Scope existing service provision working with providers and patients to co-design optimum pathways of care

for general and specialist palliative care and end of life care

• Working with providers ensure people approaching end of life are offered timely personalised support for all their needs, including access to rehabilitation support services to maximise their independence and social participation for as long as possible

• Working with providers embed consistent quality use of newly developed palliative and end of life care documentation, for example Individual Plan of Care, Community Ceiling of Care, Advanced Care Plans and unified Do Not Attempt Resuscitation

• Support commissioning of education programmes for health, social and third sector to improve skill mix and have competent staff that are empowered to deliver quality care for people approaching end of life and their families/carers.

• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers

• Working with providers to achieve the Ambitions for Palliative Care, a framework for quality care 2015-2020

Impact: • Each person is seen as an individual and asked what matters most to them • Each person gets fair access to good quality care • Each person has maximised comfort and wellbeing with care regularly reviewed by

competent staff, who always offer compassionate quality care • Care is coordinated for all addressing individual needs and care plan wishes, with

access 24/7 • Each community is prepared to help and through engagement prepared to have

conversations about death and dying • To reduce inappropriate admissions to hospital at end of life through coordinated care

for all

Page 8: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Integrated ‘HUB’ for Out of Hours Primary Care

• Implementation of integrated Primary Care Out of Hours Hub incorporating extended GP access, pharmacy, Single Point of Access (SPA) and GP Out Of Hours services

• Working with North West Ambulance Service (NWAS) developing a virtual clinical hub / Clinical Advice Service (CAS)

• Developing mechanisms for transition of care between core/hours and out of hours services • Developing booking and communication systems which are robust • Developing working relationships between services working in similar timeframes including Paediatric

Acute Response Team (PART), Children’s Community Respiratory Team (CCREST), Emergency dental services, for delivery of care in the appropriate sector

Impact: • Reduce presentations to A&E for people with a primary care need • Increase choice for people in terms of time and location of care • Reduce pressure on primary care during core hours through

provision of increased capacity

Page 9: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Integrated Primary Care Clusters Working collaboratively across Warrington to develop general practice at scale, delivering new care

models that will ensure system integration of providers who will take responsibility for delivering a range of primary, community, mental health and hospital services for our local population.

New care model will offer provision of care to a defined population of between 30,000 and 50,000.

Improve co-ordination of services and move care out of hospital where appropriate

Develop the primary care medical and non-medical workforce by having different staff groups to deliver care, e.g. Clinical Pharmacists, GP Assistants, Physician Associates and Mental Health Therapists

Using Primary Care Infrastructure Funding we will implement the priorities identified in the CCG Estates Strategy

Demonstrate increased patient satisfaction by improving access to services with a combined focus on personalised care to improve population health and wellbeing outcomes.

Impact: • Increase accessibility of Primary Care Services whilst reducing acute activity. • Reduce GP Practice workload by alignment of wider services around the

registered patient list, and working towards sustaining Primary Care • Fit for purpose Primary Care Estates and technology • Integrated workforce to focus on population needs and provide care closer to

home • Improve the wellbeing and quality of life for patients and for the primary care

workforce

Page 10: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Accountable Care Partnership (ACP): The Model

• Scope & Scale: Health and Social Care services provided in Warrington for Warrington people

• Model: A system of delivery which is arranged via both horizontal and vertical integration

• Development of a Commissioning Prospectus that describes the case for change,

essential success factors and parameters of the model • New model of care may require new business models e.g. contracts

Impact • Supports care pathways and activity for the services in scope

within existing resource • Address population health management • Supports patient choice for place of care • Enables delegated decision making with regards to primary

care and specialised services • Offers single regulatory approach NHSE and NHSI • Offers the ability to redeploy attributable staff and related

funding from NHSE and NHSI to support ACP • Facilitates access to the development programme for “fast

followers”

Page 11: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Accountable Care Partnership: The Model

Horizontal

• Integration between services which are related

• Brings increased resilience

• Increased capability

• Economies of scale

Horizontal integration

Primary

Care Community Mental Health

Social Care

Prevention Hubs Outpatient Medical

Mechanisms for horizontal integration Primary Care Home Clusters Integrated out of hospital services Contractual remedy NHS standard contract with link KPIs Proposed MCP contract model

Page 12: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Accountable Care Partnership: The Model

Vertical integration

Acute

•Surgical Pathways

•Chronic and Acute ACS

•AEC pathways

•Comprehensive Geriatric Assessment

Community

•Tier 2 surgical

•Chronic disease management

•Step Up Nursing

•Early supported discharge

Mental Health

•Liaison Psychiatry

•Personality disorder service

•Outreach

Social Care

•Respite

•Step up

•ESD

Primary Care

•Chronic disease management for ACS conditions

•AEC pathways initiation

•Medical cover for proactive care and ESD

Mechanisms for vertical integration • Mergers and

Acquisitions • Lead contractor with

options arrangements • PACS model contract

development to start soon

Vertical • Integration of

different service within a supply chain under one organisation

• Resolves the

hold up problem

• Allows

maximising efficiency along the value chain

Page 13: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Control Programmes

Diabetes

Enhanced Care Home

Support

Patient Flow

Initiatives

Vanguards: Women’s & Children’s

Neuro-Vanguard

Right Care Programmes

Diabetes

Enhanced Care Home support

Patient flow initiatives

Women’s & children’s Vanguard

Neuro-Vanguard

Page 14: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Diabetes Care • The CCG appointed dedicated clinical lead for Diabetes continues to work with primary care on the

development of pathways

• National Diabetes Audit for 2015/16 audit shows an increase in the number of patients on the diabetic register who have received the eight care processes but there is significant variation within the system

• A Tier 3 service for weight management has been commissioned

• The CCG has successfully secured funding for the 4 available bids from NHS England National Diabetes Transformation Fund (2017/18)

• Working with public health and the STP regarding a Phase 3 bid for the National Diabetes Prevention Programme (NDPP)

• Both National and local predictions confirm increased levels of obesity and type 2 diabetes in the population

Impact • Provide high quality, consistent care for people with diabetes • Reduce variation in the care received by people with diabetes • Reduce complications associated with diabetes • Improve confidence levels to self-manage care • Reduce number of people progressing to a diabetes diagnosis • Improve aspects of care demonstrated to be weaker within the system

Diabetes

Enhanced Care

Home support

Patient flow

initiatives

Women’s & children’s

Neuro-Vanguard

Neuro-

Vanguard

Page 15: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Enhanced Care Home Support Service (ECHSS) • Deliver a proactive model of care across all care homes through a multi-disciplinary approach consisting of

GPs, Nurses and Pharmacists, supported where possible through telehealth

• MDT meetings in each café home

• Enhances the care currently delivered by a residents registered GP, thus The outcome for residents being they will be looked after well for their remaining days in their own home without the need to be admitted into an acute setting which is not the place for them

• Develop clinical pathways to aid care home staff in managing their residents and to access the most appropriate route to manage residents’ conditions

• Provide direct access fro the homes to the ECHSS through a dedicated help-line for triage, treatment or onward referral

• Develop greater integration across different staff disciplines, other services and development of the MDT’s within each home

Impact • Creates capacity in general practice, • Supports the patient to live as well as can be during their last 12-

18 months of life through robust advanced care planning • To reduce avoidable attendance and admission to A&E by

provision of educated and empowered care home staff • Reduce length of stay through supported discharge process • Supports residents to achieve preferred place of death • Increases completion of comprehensive care plans

Diabetes

Enhanced Care

Home support

Patient flow

initiatives

Women’s & children’s

Vanguard & Neuro-

Vanguard

Page 16: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Patient flow initiatives: An holistic approach to patient flow

• The community based Paediatric Acute Response Team (PART)

• Out of Hospital Services (step up and step down care)

• Ambulatory Emergency Care providing same day treatment for patients who would have otherwise been admitted for 1-3 days

• Acute Visiting Service reducing conveyance to hospital via ambulance reducing subsequent admission

• Clinical Advice Service reducing conveyance by ambulance and attendance for patients accessing 999/111 services by increasing the number of clinical conversations

• Crisis Care within the CAMHS local transformation plan intends to reduce unnecessary admissions and reduce length of stay

• RightCare commissioning for value

• Adopting new care models - Vanguards

Diabetes

Enhanced Care

Home support

Patient flow

initiatives

Women’s & children’s

Neuro-Vanguard

Page 17: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Patient flow initiatives: Ambulatory Emergency Care

Ambulatory Emergency Care (AEC) or ‘same day emergency care’ is a whole system approach that includes both primary and secondary care to ensure that, patients who are assessed as appropriate for AEC, are diagnosed and treated on the same day

• AEC Service went live in April 2016

• With support from the Ambulatory Emergency Care Network the service was embedded over the summer months

• Continue to refine the patient cohort to ensure only those patients who would otherwise have been admitted are seen and treated in the service

• Continue to work to refine and identify effective measures of success for the service

• Work towards a detailed and robust demand and capacity model for the next 3 years

• Continue to refine the financial value for the service delivering value for money and a sustainable future

Impact: • Reduced admissions for identified patient group • Improved quality of care offering same day treatment • Improved patient journey • A sustainable robust service offering high quality care and best

practice pathways

Diabetes

Enhanced Care

Home support

Patient flow

initiatives

Women’s & children’s

Neuro-Vanguard

Page 18: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Patient flow initiatives: Frailty

The challenge: To provide safe, compassionate care for Frail Older people using an integrated whole system pathway to ensure people live independently for longer.

• Develop and implement effective screening and assessment using recognised tools identifying demand

• Delivering an acute Frailty Unit ensures that where acute admission is unavoidable, patients are cared for by an MDT with a focus on short stay and safe discharge back to a community setting

• Working towards a seamless pathway across the health and social care system.

• The health and social care system is able to respond in a timely and targeted way to changes in demand targeting resources and utilising skills and expertise across traditional organisational boundaries

Impact: • Directing our most vulnerable patients to the most appropriate care

setting • Acute admissions for our frail and elderly population do not increase • Reduced LOS in an acute setting for patients • Improved outcomes for patients • Reduced risk of deconditioning whilst in an acute setting

Diabetes

Enhanced Care

Home support

Patient flow

initiatives

Women’s & children’s

Neuro-Vanguard

Page 19: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Patient flow initiatives: Primary Care Streaming

Upon entering the emergency department, patients will be streamed by an experienced clinician to the most appropriate service. One of these streams will be primary care.

• Deliver a re-design of the existing estate to accommodate new ways of working

• Develop a robust capacity and demand model ensuring the new space is fit for purpose and sustainable

• Work towards a refined value for this patient group ensuring effective use of resources

• Agree patient pathways from the point of arrival for this patient group

Impact:

• Reduced pressure within the main emergency department

• Improved performance against the 4 hour target

• More appropriate care

• Improved patients and staff experience

Diabetes

Enhanced Care

Home support

Patient flow

initiatives

Women’s & children’s

Neuro-Vanguard

Page 20: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Clinical Advice Service (CAS) The term Clinical Assessment Service outlines that the professionals delivering care can be either co-located or working virtually across the North West in a functional environment facilitated by technology.

• Refinement and best use of high acuity outcomes and services (999, ED)

• Deploy the most appropriate clinical skillset at the optimal place in the patient journey to improve outcomes and increase system capacity, particularly for complex calls

• Support decision making in difficult scenarios

• Enhanced Triage for high acuity patients

• Working with our Out of Hours service to create capacity to take more cases from the 111 service that may otherwise have advised to attend A&E

• CAS will in the future also be available to clinicians for the provision of immediate advice to support clinical decision-making for individual patients. Through the use of secure technology and collaborative working

Impact: • Support callers with complex needs and pre-existing care

plans • Streamline and improve the patient journey and outcome • Deploy clinical skill sets early in the assessment process • Increase the capacity for safe care closer to home • Make use of diverse clinical skills including mental health,

dental and clinical pharmacy • Reduce conveyance to hospital by ambulance

Diabetes

Enhanced Care

Home support

Patient flow

initiatives

Women’s & children’s

Neuro-Vanguard

Page 21: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Cheshire and Mersey Women and Children’s Vanguard Partnership

The Partnerships aspiration is to develop a ‘safe’ high quality, clinically & financially sustainable whole system model of care for women’s and children’s services. Initially focusing on gynaecology, maternity, neonatal & paediatric services.

Locally we will reflect and support these aspirations via:

• Our local ‘Children’s Community Team’ model development programme

• Working in partnership with local Maternity providers to deliver the aspirations of ‘Better Births’ and the ‘Saving Babies Lives Care Bundle’

• Our local ‘CAMHS Transformation’ plans

Impact: • Paediatric ‘Care Closer to Home’ and a reduction in unplanned hospital

admissions • Increased choice of maternity providers & place of birth • Financial & Clinical Sustainability of Care • Improvements in the interface between Primary & Secondary Care • Improved clinical outcomes and patient experience • Integration of care from the perspective of service users

Diabetes

Enhanced Care

Home support

Patient flow

initiatives

Women’s & children’s

Neuro-Vanguard

Page 22: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Neuro-Vanguard

• Early adopter working with Walton Centre Vanguard re implementation of the Back Pain Pathway

• Vanguard early adopter for Headache Pathway

• Vanguard early adopter for Epilepsy Pathway

Impact • Prescribed pathway with timely triage and treat

responses • Reduced avoidable diagnostic testing • Increased effectiveness of conservative, non-surgical

management of back pain • Reduced avoidable spinal surgery • Increased access to pain management service • Improved outcomes for patients with acute low back

pain and radicular pain • Supporting the management of patients with

headaches and the diagnosis, treatment and referral process for migraine

• Improved outcomes for patients attending A&E Department following a seizure

Diabetes

Enhanced Care

Home support

Patient flow

initiatives

Women’s & children’s

Neuro-Vanguard

Page 23: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Foundations Substantive work streams supporting the

CCGs overall strategy

Primary Care

Community

Reducing Variation: Right Care

Page 24: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

RightCare: Gastro-Intestinal

• A review of gastro-intestinal services across Warrington, based on the NHS Right Care Pack, with a view to enhancing the care provided to the people of Warrington through appropriate care pathways with a focus on diagnostics, endoscopy, prescribing cholecystectomy and prevention of alcoholic liver disease

• Working with primary and secondary care, public health and medicines management to review and develop optimum pathways of care

• Work with Public Health to raise awareness if alcohol harm

Impact

• Improved protocols and pathways to support best practice diagnostic testing

• Reduction in less invasive diagnostic procedures supported through appropriate pathways / work up of patients

• Improved awareness / education campaigns in relation to consumption of alcohol

• Long term aim of reduction in alcoholic liver disease and other associated health issues

Page 25: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

RightCare: Trauma & Orthopaedics

Using right care methodology to identify areas of focus where there is opportunity to improve Quality, value and outcomes for patients.

Use additional business intelligence for the focus areas to understand trends and opportunities for improvement

Agree key improvements for each focus area and implement in a phased approach

Maximise where possible the resources and experience of system partners aligning services where possible to ensure improvement patient experience

Impact: • Reduced variation against our comparator CCG areas • Improved Patient experience • Reduction in avoidable acute activity • Improved pathways and consistency in condition

management

Page 26: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

RightCare: Neurology

• Early adopter working with Walton Centre Vanguard for implementation of the ‘Back Pain Pathway’

• Vanguard early adopter for Headache Pathway

• Vanguard early adopter for Epilepsy Pathway

Impact • Prescribed pathway with timely triage and treat responses • Reduced avoidable diagnostic testing • Increased effectiveness of conservative, non-surgical management

of back pain • Reduced avoidable spinal surgery • Increased access to pain management service • Improved outcomes for patients with acute low back pain and

radicular pain • Supporting the management of patients with headaches and the

diagnosis, treatment and referral process for migraine • Improved outcomes for patients attending A&E Department

following a seizure

Page 27: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Community Acuity / complexity model of care

Page 28: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Primary Care Collaborative Clusters Model

Page 29: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Supporting Primary Care: Population health and wellbeing (Slide summary from the Director of Public Health, Warrington Borough Council)

Five Year Forward View prevention priorities • Improve high blood

pressure diagnosis and management

• Integrated alcohol

prevention and treatment pathway

• Tackle antimicrobial

resistance and variation in prescribing practice

Starting Well • Integrated

delivery of the Healthy Child Programme 0-5 & 5-19

• Prevention and early intervention for Risky behaviours in particular alcohol

• Support young people’s emotional health and wellbeing through early help and Thrive model.

Living Well • Invest in

prevention through Warrington Wellbeing service

• Reduce

unwarranted variation in primary care following a health check and for long term conditions

• Promote Healthy NHS providers and maximise NHS CQUINs

Ageing Well • Improve

pathways for frail elderly, including falls prevention

• Promote Safe

and Well Checks and the Winter Warm, Well and Safe Campaigns

• Support Dementia friendly communities and tackle social isolation

Protecting health • Reduce

unwarranted variation in screening and immunisation programmes

• Support care

homes to enable residents to stay independent and resilience

• System

assurance for the Health Protection Forum risks

Page 30: Commissioning Plan refresh 2017-2019 NHS Warrington CCG...• Support implementation of Electronic Palliative Co-ordinated Care Systems (EPaCCs) across all providers • Working with

Commissioning Plan Refresh

2017/19

Key documents

Publications Gateway Reference: 05829 ‒ NHS Operational Planning and Contracting

Guidance (2017- 2019) ‒ Technical Guidance for NHS planning 2017/18 and

2018/19 (Publications Gateway Reference: 05829)