the turnaround challenge workshop in swf, 5 december 2012
TRANSCRIPT
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The Turnaround ChallengeWorkshop in SWF, 5 December 2012
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Brief introduction to Mid Essex Clinical Commissioning Group (CCG)
Your local NHS – the current position The “turnaround challenge” How we are tackling the challenge Your views?
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New organisation to take over from PCT Board led by GPs, senior nurse,
public health, social services rep, 3 lay members
Working in shadow since 1 April 2012 “On the job” managing & planning 50 member practices
Applying for authorisation – Nov 2012 Establishment - 1 April 2013
Dr Lisa Harrod-RothwellChairman, Mid Essex CCG
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Commissioning – planning & buying healthcare Not providing – that’s Central Essex Community
Services (CECS)
Assess local needs, listen to people Plan in partnership Design services, agree contracts Manage quality & performance Manage the annual budget –
£540m in total for mid Essex in 2012/13CCGs responsible for around £390m
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Brief introduction to Mid Essex Clinical Commissioning Group (CCG)
Your local NHS – the current position The “turnaround challenge” How we are tackling the challenge Your views?
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Performance & quality among best in region Over 95% patients treated within 18 weeks Over 98% cancer patients treated within 31 days 90% stroke patients on specialist stroke unit Over 99% mental health patients followed up within
7 days of leaving hospital Patient experience survey shows improvement
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Brief introduction to Mid Essex Clinical Commissioning Group (CCG)
Your local NHS – the current position The “turnaround challenge” How we are tackling the challenge Your views?
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If we took no action… We would be overdrawn by £12.8m at end of year Bigger challenge in 2013/14 – an ever widening gap We would be unprepared for ageing population
▪ 12% increase by 2035▪ Increase in frailty, long term conditions, dementia
So we are managing two things… 2012/13 - quick action to finish year in balance 2013/14 & beyond – transform services & secure the NHS
for the future
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Overall three main factors …
Managing with limited funds – our allocation one of the lowest
The activity we can afford – we spend more than other similar areas
Service transformation – plans take time to putinto practice
£1.3k per head (PCT spend last
yr)Others up to
£2.2k
£1.3k per head (PCT spend last
yr)Others up to
£2.2k
Need to review and “ramp up”
Need to review and “ramp up”
Activity increase not always right for good care
Activity increase not always right for good care
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Brief introduction to Mid Essex Clinical Commissioning Group (CCG)
Your local NHS – the current position The “turnaround challenge” How we are tackling the challenge Your views?
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Savings solutions £000
Existing service transformation schemes 1,803
Tighter criteria for some NHS services 1,687
Ensure contracts adhered to 465
Stop expenditure where possible 1,008
Budget underspends 2,118
Technical accounting adjustments 1,949
Draw down on reserves 3,787
12,817
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Examples of existing schemes
Health & social care for people at home Rapid assessment for frail& older people
– avoid hospital emergencies Multiprofessional teams for end of life
care at home Closer work with nursing homes to avoid
hospital emergencies Practices managing referrals working with
central team of clinicians Prescriptions for less expensive drugs
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Examples of tightening criteria
Team to manage treatment at A&E Reduce unnecessary use of ambulance Review clinical policies, ensure they are
adhered to “Stop before the op” smoking restriction Improve physio self-care, reduce wasted
appointments Comply with national guidelines on drugs Mental health rapid assessment to reduce
admissions
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We are not talking about “cuts”
Don’t be misled by the press
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Urgent care •Redesign out of hours services and NHS 111•GPs working in A&E•Rapid assessment for older people•Working with nursing homes •Integrated teams for people at home•Mental health rapid assessment
Frailty •Proactive care for high risk patients•Integrated care teams – community matrons•24/7 single point of contact for frail people•Tele-health
Long term conditions
•Prevention and early diagnosis•24/7 single point of contact for people with long term conditions•Care plans and shared records
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Brief introduction to Mid Essex Clinical Commissioning Group (CCG)
Your local NHS – the current position The “turnaround challenge” How we are tackling the challenge Your views?
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Group discussion
Short term:▪ Your views on what should we stop or change?
Long term:▪ Your ideas for doing things in a different way?▪ What do you want us to pay attention to?