Deliver Today : Shape Tomorrow

Dr Nicolas Small, GPChairman

Margaret StockhamStrategic Adviser

Getting StartedWhether a clinician or

manager this is how it felt

The Journey

National Direction, Local Action

4

NHS East of England

Adapting existing Strategies

Improving Lives; Saving Lives

Looking to the Future

Our NHS, Our Future

Towards the Best Together

Darzi – direction for the8 clinical groupings

Maternity

HC

L B

usin

ess

Pla

n

Children

Planned care

Mental health

Staying healthy

LTCs

Acute Care

End of Life

Our Business Plan

Needs of population

Plans & Proposals

Programmes

Initiatives

Service changes +

Better health

Vision

Context

Strategy

Delivery

A picture of the future health for Hertsmere people

Analysis of the current status and grasp of the challenges

A description of the goals and initiatives to deliver the vision as

set out in the Business Plan

Development of implementation plans for delivering the strategy plus Performance Management

Making it Real in HertsmereMaternityMaternity

ChildrenChildren

Planned carePlanned care

Mental healthMental health

Staying healthyStaying healthy

LTCsLTCs

Acute careAcute care

End-of-lifeEnd-of-life

Midwives key to ‘Maternity Matters’ – no changes proposed

Roles for health visitors in the new Child Health Promotion Programme - improving immunisation rates

Key role for CATs in only referring the right people – diagnose to refer not refer to diagnose

Secured resources to work with 3rd sector, improve counselling, support Graduate Mental Health Workers & IAPT

Plans underway to pull together services for young adults in Borehamwood

Redesign programmes underway including care pathways for MSK (including physio review), COPD, Diabetes & Ophthalmology

Focus on referral management, consultant to consultant referral and early discharge for inpatients

Undertook short review to see whether there is a need to increase resources for hospice care

Looking Forward

We must

• Control acute spend

• Improve local access

• Ensure safety and good patient experience

Future programmes to control acute spend

Achievements

• Mental Health• CATS• Performance

Management• SPA• Innovation Fund• Website• Community Nursing• Children’s Services

• Prescribing• Patient Group• COPD• Physiotherapy redesign• In- house Phlebotomy• Increased resources for counseling• Strategic Management• Public Health

Mental Health

• Established subgroup – monthly meeting of GPs, PM, HPFT, Patient Groups, Voluntary Groups e.g Viewpoint/ Mind & Carers in Herts

• CBT/ Psychological Therapies/ IAPT - first PBC group in W Herts to deliver these services and maintain existing counseling resources

• Persuaded HPFT to respond to locality needs e.g address counseling waiting times

• Innovation Fund £47k in 3 Hubs addressing carers needs / premises shaped by local groups

• Shaping the future Mental Health Commissioning with a Hertsmere focus

CATS

• Innovative and robust approach to Performance Management including representation from PCT Finance and Contracting, Patient Group and Practices

• Developed monthly Report Card• Appointed lead - Jayne Taylor• Partnership with local acute

Trust - Barnet & Chase• GP buy-in to performance

MSKMSKDermatologyDermatologyOphthalmologyOphthalmologyUrologyUrologyRespiratory Respiratory GeriatricsGeriatricsCardiologyCardiology

SPA

• Awarded Nov 2007

• £100k project

• Working with UH UK

• Only PBC group to be awarded in UK

• Shaping services for the future

• Engagement with stakeholders

• Lessons learned

Website

www.hertsmerecommissioning.co.uk

• Portal for clinicians & public

• Information on CATS

• Public Participation “Your Say”

• Library for all documents/ minutes etc

• Link into Hertsmere council website

• Putting Hertsmere and PBC on the map

Community Nursing / Children’s Services

• Engaging with local team

• Shaping Provider Service Contract

• Enhanced resources / manpower for Community Nursing team

• Monitoring performance of contracts

• Monthly dialogue

Fast track proposals

• Direct Access Physiotherapy pathway & integration with MSK

• In house Phlebotomy

• Fair distribution of extra counseling resources

• COPD

Patient & Public Involvement

Hertsmere Patient and Public Involvement Group• Trailblazer for Herts PCT• Aim is to involve patients and members of the public in our

commissioning decision-making processes.• Initial group has met twice.• Group is in the process of agreeing a range of ‘involvement’

activities such as:– Reader panel– Leaders of disease specific patient interest groups including

linking with existing local groups to be involved in monitoring specific contracts, service redesign

– Committee membership e.g. performance management– Possible member of contributor of the accreditation process for

GPwSIs and services in which they work– Representative of the HCL PPI group on the LINk.

Public Health initiatives

• Obesity

• Smoking

• Exercise on prescription enhanced

• Local Retinal Screening service delivered by Optician

• Engagement with Council/ partnership working

Next Steps

• Efficiency … Developing specific role descriptions for each formal role within HCL - including time commitment

• Development … Establishing training and support needs of the group and individuals

• Governance … revising our robust systems based on best governance principles e.g. conflicts of interests, voting, confidentiality etc

• Review of structure … Enlarging the size of the group and establishing differing levels of involvements

Thank You

Any Questions?