What will a cross boundary CCG mean for

patients?Colin Renwick, GP Townhead Surgery ,Settle.

Board Member of Airedale Wharfedale and Craven Shadow CCG

Airedale Wharfedale and Craven CCG

‘We believe that GP practices should have the flexibility withinthe legislative framework, subject to having the geographic focus describedabove, to form consortia in ways that they think will secure the best healthcareand health outcomes for their patients and locality.’

Commissioning for Patients Consultation Document 2010

Responsibilities of CCGs Elective care e.g. outpatient referrals/planned

operations. Non elective emergency care. 111 service and urgent primary care. Mental health services. Community services – nurses, podiatry, health visitors. Maternity services. Prescribing budgets. Will NOT be responsible for General Practice, Dentistry,

Opticians, Ambulance service, specialised commissioning eg forensic psychiatry – National Commissioning Board.

AN

HS

FT

Deprivation – Airedale Wharfedale

Deprivation - North Yorkshire

Health and wellbeing boards

Key Functions To assess the needs of the local population and

lead the statutory joint strategic needs assessment

To promote integration and partnership across areas, including through promoting joined up commissioning plans across the NHS, social care and public health

To support joint commissioning and pooled budgets where all parties agree it makes sense

NHS Constitution

“We put patients first in everything we do by reaching out to staff, patients, carers, families, communities and professionals outside the NHS. We put the needs of patients and communities before organisational boundaries”

Challenges 2 Health and wellbeing boards – political agenda. Unwarranted variation in quality, outcomes, activity Rising demand, limited funds and limited workforce Too many older people in the wrong part of the system

for their needs or becoming avoidably dependent or ill Avoidable admissions to hospital or long term care, and

staying too long Health services, institutions, professional values and

training not geared to the needs of the (older) people who actually use them

Crossing of Local authority boundaries –different availability of services.

In our favour

CCG is majority user of local DGH which is both innovative and realistic –ANHSFT.

Common Mental Health Trust.-BDCT. Shared providers of Community nursing services

ANHSFT. Single Ambulance Trust –YAS. Working towards integrated 111 and urgent care

provider. Significant shared public engagement work already

underway

Potential benefits of integration

• Better outcomes for service user

• More efficient use of resources: “right care, right place, right time”

• Improved access, experience and satisfaction

GPCommunity Nurses

Social services

Ambulance service.111 Directory of services

Voluntary sector

Point of contact

Telehealth

Outcome

Independent living continues

+/- support

Intermediate care

Palliative care

Long term care

Acute hospital care

Early discharge

Integrated team, single point of contact

Patient/client

Social worker

Family, friends

neighbours

Re-ablement worker

GP services

Voluntary sector

Mental health worker

Hospital based services through

telemedicine

Occupational therapist

Physiotherapist

Community nurse

Advanced nurse practitioner

How will we view success?

Reduced numbers of occupied beds. Reduced emergency bed days. Reduced delays in transfer from hospital. Increased use of home care services. Decrease in number of people in long term

residential or nursing care. Improved patient experience. Financial sustainability.

How will patients view success?

Seamless pathway of care reduced confusion in secondary care.

Same services available to all –no local postcode lottery. Improved integration between primary, secondary health

care and social care. Reduction in acute admissions. Reduction in hospital length of stay. Less need for long term care. Locally responsive, clinically led and managed CCG. A CCG that has its sight firmly set on the local health

economy.