26 September 2017 Annual General Meeting (AGM) Our Annual Report - - PowerPoint PPT Presentation

Annual General Meeting

26 September 2017

Annual General Meeting (AGM)

• Our Annual Report and Accounts for

2016/17 is available online, on request and also here today on our stand

• The minutes of our last AGM are enclosed

in the information pack

112,000 population 18 GP practices Three neighbourhoods: Ormskirk and Aughton Skelmersdale Burscough and Northern parishes £163m Funding allocation £1,455 per person

Merseyside from a West Lancs perspective

• Acute patient flows are largely

towards Merseyside (Southport Hospital) - but also Greater Manchester (Wigan)

• Urgent Care Board (A&E and

Emergency Care) is North Mersey

• Cancer and end of life care
• Maternity and children’s

vanguard

Lancashire from a West Lancs perspective

• County and district councils
• Public health and social care
• Third sector network
• Mental health, largely in

Lancashire

• Community health services
• GPs in Lancashire
• Regulated care sector in

Lancashire

• Out of Hours GP and Walk in

Centres

• Ormskirk site in Lancashire
• Edge Hill University

How we spend your money

Financial Duties

• Delivered our statutory duty to break-even on our revenue

allocation

• Managed within our cash limit
• Operated within running cost allocation
• Achieved our Better payment practice code
• Clean audit report from External audit, including value for

money opinion

Mike Maguire Chief Officer, NHS West Lancashire CCG

Opportunities and challenges

Primary Care Commissioning

• Level three co-commissioning is the highest

level of commissioning available to a CCG

• The CCG now leads on decisions on how

funding shall be spent across primary care

• Primary Care Committee established – no

voting rights for GPs

• Steve Gross appointed, lay member for

primary care and leads on Primary Care Committee

Patient Participation Groups (PPGs)

• The PPG Forum was established in 2016
• Every practice has a PPG and anyone registered can

sign up and join the forum

• Chaired by Greg Mitten, lay member for patient and

public involvement

Mental Health

• The CCG has completed a scoping exercise to get views of

people on how we can transform mental health services

• Two mental health beds available at Birchwood Crisis Centre
• Eating Disorder Service is now an all age service
• The CAMHS service extended the age of referrals to 19
• Children’s A&E now includes a low stimulae, safe area

Joint Health

• Integrated MSK Service (Redesign of the Musculoskeletal Clinical

Assessment Service (MCAS) and Routine Musculoskeletal Physiotherapy Service)

• Specialist service which consists of doctors, physiotherapists and

podiatrists who specialise in orthopaedic/MSK medicine

• Provided by Southport and Ormskirk Hospital NHS Trust
• As of winter 2016, all GP orthopaedic referrals went directly into Joint

Health

• CCG recently decided to extend pilot

Social Prescribing

• Big focus on prevention and health inequalities
• Not every request for support requires a medical prescription
• Need to support patients with a holistic view
• Starting a social prescribing pilot in Skelmersdale
• Carrying out a procurement process to identify suitable

provider

Extended Hours

• Patients now have greater

access to a GP at evenings and weekends

• This meets the requirements of

NHS England’s GP Forward View

• Currently a pilot scheme rolled
• ut across West Lancashire in

Skelmersdale, Upholland, Tarleton and Ormskirk

Community Health Services/Urgent Care Services

• Services delivered by Virgin Care since 1 May 2017
• No changes have been made to local services since the

transfer

• All services remain FREE for patients to access
• Local residents can join the new Citizen’s Panel to help shape

future services

• To sign up, please visit: www.citizenspanel.co.uk or visit the

Virgin Care stand today.

Ophthalmology

• Identifying a new ophthalmology tier 2

service and a Age Related Macular Degeneration service

• Many patients travel outside of the area for

treatment

• Need to bring care closer to home that is

accessible

• New provider will be announced late

2017/early 2018

• Holding a patient focus group in October

Medicines management

• Prescribing pod pilot

launches in Skelmersdale

• Changes to prescriptions to

gluten free products and items of low clinical value.

• Self-care programme

launched this month

Urgent care

• Improvements being made to urgent care
• Falls Car pilot extended summer 2017
• Aims to reduce hospital admissions by responding to

patients that have fallen at the scene

Primary Care Transformation

• GP Practice Forward View focuses on easing pressures while

also providing access to primary care services for patients

• CCG concentrating on areas such as technology and workforce
• New roles emerging such as Care Navigators, Clinical

Pharmacists and Physician Associates

• Integration of services through CCG’s vision for joined up care

and schemes like extended hours will increase access

Chronic pain

• Many patients living with chronic pain
• Currently visit their GP or hospital treatment
• Invited views from patients in early 2017
• Procuring a new specialist chronic pain service (with Innovation

Partnership)

• Service will be called iHELP
• Intention that new provider will be delivering service from early

2018.

Patient and Public Participation

• Committed to involving others in our work
• Sign up to My View via our market stall today
• We publish an annual Duty to Involve Report –

copies of the 2016/17 report are available online and via our stand

• Patient story forms are available today if anyone

would like to share their experiences

Any questions?

Please submit your question by writing it on a post it note and handing it to a member of our team Submitting questions before lunch in advance of the Q&A session will help us make sure we can offer a full response from the most appropriate member of our team. If we are unable to answer your query here, we will follow it up after the event All Q&As will be published on our website after the event and distributed to you via the CVS.

Get in touch NHS West Lancashire CCG T: 01695 588 000 Email: myview@westlancashireccg.nhs.uk @WestLancsCCG @NHSWestLancsCCG www.westlancashireccg.nhs.uk To receive regular health advice and news, please visit our stand and ask about joining our My View group.

Thank you

Meeting the challenges - The wider system – our partners & us

Jackie Moran Karen Tordoff NHS West Lancashire CCG NHS West Lancashire CCG

The Challenges

• People living longer - projections show over 75s will

increase by 64% between 2017 and 2037 (ONS).

• Increase in Long Term Conditions (e.g. Diabetes,

COPD, Heart Failure etc) and the role of Mental Health.

• Role of Health Inequalities – differences across the

West Lancashire patch.

• National direction: Joining-up care.

Role of the different ‘jigsaw pieces’

What we know … ‘Do nothing’ isn’t an

• ption …

A new model of care - Voice of our partners & the community; You said…

When using more than one system, better co-ordination is needed

Joining up systems and processes

We did…

Began in 16/17 … Through 17/18 Standardising IT systems E – transfer of data Single Point of Access (SPA) developed –

• ne telephone number for community

services

The voice of our partners and the community - You said,

• Bringing care closer to home / the community

We did…

Began in 16/17 … Through 17/18 Recruit extra staff into IV team Identify high risk respiratory patients & begin to support Recruited more staff – IV, Tissue Viability, Extended Respiratory team in operation

• Increased the scope of the community services

The voice of our partners and the community - You said,

• Having access to information & support to help understand

how to manage your own health

We did…

Began in 16/17 … Through 17/18 Introduction of Flo across the WL patch Support of the VCFS. Focus on prevention Increasing role of pharmacists / pharmacies Well Skelmersdale – social prescribing pilot embedded

• Increased focus on self care

The voice of our partners and the community - You said,

• Joining up care

We did…

Began in 16/17 … Through 17/18

Intermediate care step up / step down Early supported Discharge 111, AVS, Walk in Centre, Out of Hours – working collaboratively

• Working to create a seamless service

Measuring success -

• Governance established which oversees delivery of these

initiatives

• Outcomes framework – what public and partners told us was

important to them has been fed into a document with various measures to monitor delivery

• Importance of co-design – your voice has resulted in the

improvements we are focusing on now. We will continue to listen, develop and continue on our journey

The challenge to joining up care

• We know there are challenges
• We know that ‘Do nothing isn’t an option’
• As partners in a system are all working towards common

goals; Primary Care, Community Care, Acute Care, Specialised care, Community Partners, Council, Ambulance service (NWAS), Police, Fire etc.

• We know that by working collectively the benefits can be all

the greater.

• We are on a journey that requires us to work

together to create a coherent whole

Final thought ….

Thank you for listening and for your time

Meeting challenges for primary care

Dr Peter Gregory GP Executive Lead, NHS West Lancashire CCG

Primary Care

• All health care delivered by General Practice
• Role of General Practice include:

– Managing long term conditions – First point of contact for any new problems – Referring conditions requiring hospital support – Co-ordinating care with hospitals, district nurses, social care, mental health

Increasing Demand

• 15 per cent increase in demand for GP

appointments between 2011-2014

• 340 million consultations occur every year in

England

• Average person sees their GP six times per year,

Twice that of 10 years ago

Decreasing workforce

• In 2015, there were 600 GP trainee vacancies across

the country (the highest ever shortfall)

• Number of GPs continues to decrease (reduced by

100 at last count in March 2017)

• 40 per cent of practices have a GP planning to retire

in five years

• 9/10 practices rely on a locum cover

Decreasing funding

• Since 2008:

– GP income has decreased by 10 per cent – Cost of running practices has increased by 2.3 per cent

• In 2016, 300 practices felt were under threat of imminent

closure

• “If General Practice fails, the

whole NHS fails” Simon Stevens Chief Executive NHS England

Time for care

• NHS England’s plan to improve patient care by making

General Practice more efficient

• Part of NHS Five Year Forward View
• From 2016 to 2021, investment to:

– Boost the workforce – Meet demand in different ways – Encourage self care and self referral schemes – Work together to improve efficiencies

Its not just GPs anymore

As well as GPs and Practice Nurses, there are:

• Advanced Nurse Practitioners
• Healthcare Assistants

Emerging professions in practices include:

• Clinical Pharmacists
• Social Prescribers
• Physician Associates

Right Person, Right Time

• Care Navigation
• Specially trained reception staff to help you get care

quicker

• Self referral to:

– Counselling services – Podiatry – Physiotherapy

• This shortens waiting times to see GPs

Working together

• GP surgeries grouping into localities to extend

care possibilities

• Extra GP appointments at evening and weekends
• Improve web based patient information
• Future aim to bring more hospital care into GP

surgeries

Thank you