Welcome to NHS Greater Preston CCG

Dr Ann Bowman

Welcome to NHS Chorley and South Ribble CCG

Dr Gora Bangi

Why Are CCGs different • Clinicians lead commissioning • CCGs are membership organisations • Organisations with a focus on outcomes and delivery • Learning organisations –

– need to be adaptive to thrive, ethos will be about continuous improvement and learning, the model will be about distributed leadership

• Running costs - £25 per head of population • Health & Social Care Act 2012 (its new we don’t all

fully understand the changes, freedoms, flexibilities & constraints)

The new system

• 34 Practices • Population 220,000 – large proportion

ethnic minority and hard to reach groups • Relate to four borough councils • Part of a wider county council partnership, 14

districts, 1.4m population, and two unitary authorities • Highly complex • Little history of collaboration • 17 Single handed practices (50 per cent) • MoU with NHS Chorley & South Ribble CCG with joint

management and risk sharing.

Dr. Ann Bowman Statutory Functions - Complaints / HR / Acute Contracts / Estates / Declaration of Interest / Strategic Partner Engagement / Patient and

Community Engagement / Strategy / Clinical & Corporate Governance / CSO Executive Lead /

Lancashire & Local HWB / CCG Network Overall Delivery / Primary Care Strategy

Dr. Brigid Finlay Quality / Patient Safety Lead / Community Contract

/ Clinical Risk Community Services / Long Term Conditions /

Health Inequalities

Dr. Zak Patel Finance & QIPP / Acute Contracts / Performance /

Audit / Financial Risk Planned Care / Orthopaedics / Specialised

Commissioning

Dr. Dinesh Patel Mental Health Contract / IMT & Business

Intelligence / Continuing Health Care / Individual Funding Requests

Mental Health/ Cancer / Dementia / End of Life

Dr. Manjit Jandu Equality & Diversity

Urgent Care / Medicines Management / Maternity, Children & Newborn

Dr. Sandeep Prakash Education / PETs / Peer Groups / Community

Contract / Safeguarding / Deprivation of Liberty / Mental Capacity Act

Clinical leadership, roles and responsibilities

• 32 practices • 172,500 population • Collaboration with NHS Greater Preston CCG • High rates of CVD, cancer deaths, diabetes and alcohol • 1 in 5 people are carers • Growing elderly population • Health inequalities

Dr. Gora Bangi Corporate functions

Statutory Functions / HR / Acute / Legal / Contracts / Estates / Declaration of Interest / Partner

Engagement / Strategy / Clinical / Corporate Governance / CSO Executive Lead / Organisational

development / SIRO Lead Clinical functions

Overarching accountability / lead for planned care / primary care

Dr. Bob Bennett Corporate functions

IM&T / Finance & QIPP / Mental Health Contract / Audit / CHC / IFR Clinical functions

Long term conditions / Lancashire Health and Wellbeing

Dr. Paul Blake Corporate functions

Quality / Education / PETTs / Performance / Organisational Development

Clinical functions Community services / long term conditions

Dr. Richard Kelsall Corporate functions

Acute Contract / Community Contract / Peer Groups / Stakeholder Engagement

Clinical functions Community Service Redesign / Planned Care /

Cancer / End of life

Dr. Sigrun Baier Corporate functions

Performance / Communications & Engagement / Community Contract / Medicines Management

Clinical functions Local Health and Wellbeing (Chorley & South Ribble) / Urgent Care / Community Services

Dr. Satyendra Singh Corporate functions

Risk Management / Assurance Framework / Mental Health Contract / Equality and Diversity /

Safeguarding Clinical functions

Mental Health

Clinical leadership, roles and responsibilities

The CCGs vision

The purpose of a CCG

To increase the healthy life expectancy of our citizens and to reduce the health differences that exist between communities, improve quality and the

experience patients have of health services

The Health & Social care Act 2012 makes CCGs directly responsible for commissioning services they consider appropriate

to meet reasonable local needs

Rebalancing the health economy

Health improvement

Communication & relationships

Effective commissioning

Integration

How we will deliver and a few examples … • A shift of care closer to home - Examples are LTC, dementia,

diabetes, new tier 2 services (ENT, neurology, gynaecology) • A new strategy for what health care needs to look like in 5-10 years

time.

• Strong effective partnerships upper and lower tier health and well being board delivering on joint priorities to reduce inequalities in access and outcomes.

• Effective challenge – Delivery groups • Close working with colleagues in public health

• Clinically led change via the Clinical Senate • Clarity about our commissioning intentions • Public and patient involvement – ownership council, patient

participation groups with every practice

• Delivering Quality Innovation Productivity & Prevention • Working closely with all providers, voluntary and charity sectors • Clinically led – delivery groups, urgent care strategy & model • Evidence based – intelligence led • Supported by excellent commissioning support

• Greater levels of joint working – e.g. LTC developing neighbourhood teams; end of life care

• Primary mental health services • To deliver new whole system pathways e.g. dementia, pain

management.

What the data tells us…..

Elective admissions Gt.Preston

Chorley & S. Ribble

Access rate / average cost in Preston

14

15

Access rate / average cost in Chorley & S. Ribble

Summary of our plans for 2013/14… • We need to deliver at local level all of the national

requirements as a minimum

• In addition, our local data and evidence indicates that we also need to:

– Prevent avoidable admissions: especially unplanned

hospitalisation for asthma, diabetes and epilepsy in Under 19s – Tackle long term conditions including dementia: plan in place

already with specific targets

– Improve access to diagnostic services: move to 7 day working; speed up reporting of results; GP direct access

Some examples of what we are doing… • Improving quality in primary care

and reducing variation • Peer groups in place to support

improvement and learning • Supporting GPs to deliver many

more services in practices eg. diabetics on insulin, patients on anticoagulants

• Reviewing frequent A&E attenders prevent inappropriate A&E attendance

• RAIDR being implemented – system to identify at risk patients

Health inequalities

Continued …… • Rebalancing the health economy –

shift services closer to home via integrated neighbourhood teams and investment in primary care and Tier 2 services

• New pathway and services for people with dementia: diagnosis, treatment and support will be mostly in primary care

• Improving access to diagnostics • GPwSI for Gynae (10% reduction in

out patients) • GPwSI for Neurology (community

service/reduced waiting time) • Major review of urgent care

pathways in primary and secondary care

Health inequalities

Mostly NHS

Lancashire level District level

Public services working together

CCG collaboration around service redesign

and rebalancing the health economy

Reducing variation and improving quality in

primary care

Lancashire CCG network

collaborative work programme

Lancashire HWB Reducing health

inequalities

Neighborhood management

Preston Healthy

Cities Alcohol cquin

We are partnering strategically to navigate the challenges

Clinical Senate • The CCG has established a clinical senate which includes

Lancashire Teaching Hospitals NHS Trust, Lancashire Care NHS Foundation Trust and the Local Authority

Agreed priorities include: • To stimulate the modernisation of local health services ( Key

work includes Dementia , Admission Avoidance , Long Term Conditions)

• To develop close working relationships between all partners, • To work together in the interest of the public purse maintaining

and improving standards including three priorities Long Term Conditions , Dementia and admission avoidance

Health and Well Being Board • This strategy commits to a series of

priorities which are to;

• Work towards interventions that prevent ill health and reduce demand for hospital and residential services

• Build and utilise the assets, skills and resources of our citizens and communities

• Promote and support greater individual self-care

• Commit to delivering accessible services

Partnership Working Established Partnerships and joint working with the following Group • District Council Event • Local Health and Wellbeing Groups • Public Health • Voluntary Community Network • Local Partnership Groups (Preston

Strategic Partnership)

How do patients & public engage • Ownership Council - over 1500 members • Practice patient participation groups – every

practice will have one • Working and strategy groups – a developing

area • Visit our stands at local health melas • On line – website address

www.chorleysouthribbleccg.nhs.uk & www.greaterprestonccg.nhs.uk

• Write to us at Chorley House, Lancashire Business Park, Centrurion Way, Leyland

Any questions …..