Patient and Public Engagement Event Wednesday 1 March :30am-1pm. Conference Room 3, Dugdale Centre, Enfield

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1 Patient and Public Engagement Event Wednesday 1 March :30am-1pm Conference Room 3, Dugdale Centre, Enfield 1

2 Welcome Teri Okoro Lay Member for Patient and Public Engagement 2

3 Housekeeping No fire alarm is planned today. If you hear the alarm, please make your way outside Please turn your mobile phones off or put them on silent The toilets are on this floor. You have a local GP and an NHS manager on each of your tables. They are here to lead the group discussions. We have two group work sessions today. Please help yourself to refreshments throughout the morning Local clinicians working with local people for a healthier future 3

4 Agenda 9:30pm-10:00am 10:00am 10:10am Sign in, refreshments and networking Welcome Teri Okoro, Lay Governing Body member for Patient and Public Engagement 10:10am-10:30am Enfield CCG update - our plans for 2017/18 Dr Mo Abedi, Chair 10:30am-11:30am Adherence to evidence based medicine consultation Clinical lead- Dr Jahan Mahmoodi, Medical Director Management lead Mark Eaton, Director of Recovery 11:30am-12:30pm Primary Care Developments workshop Clinical lead Dr Mo Abedi; Chair Management lead- Jenny Mazarelo, Head of Primary Care 12:30pm 12:50pm 12:50pm-1:00pm Questions and Answers session with the Governing Body Thank you and event closes Teri Okoro, Lay Governing Body member for Patient and Public Engagement Local clinicians working with local people for a healthier future 4

5 Enfield CCG Update Dr Mo Abedi, Chair 5

6 Feedback from last event Following on from discussions at our last event: Your feedback on the Adherence to Evidence Based Medicine was reviewed. Today is the launch of our public consultation and we would like your feedback on our proposals in the group session. We also have copies of the consultation document and questionnaire with us today. The CCG also has two further consultation events after today : Wednesday 22 March pm-4pm Community House, Edmonton Hosted by Healthwatch Enfield Thursday 30 March pm-4pm Community House, Edmonton Hosted by Enfield Voluntary Action PAU Consultation A final decision will be taken at our Governing Body meeting on 15 Mar :30pm-3:30pm. Strategic Transformation Plan (STP) - we will provide an update on developments later in this presentation.

7 Recovery and Finance Update Enfield CCG is still in special measures. We are planning to close this financial year with a 7.7m deficit, with some help from the North Central London risk share agreement. This compares to an in-year deficit of 14.4m last year. 2017/18 - Plan is for a 2.1m surplus in 2017/18 really breakeven 16/17 forecast out turn for QIPP has improved by 699k in month 10 (January 2017) 17/18 QIPP Target 24.7m Gross 6.8% of allocation. We are currently designing our QIPP programme for

8 North Central London (NCL) Commissioning Management Arrangements A new shared management team is being appointed to work across the five CCGs Barnet, Camden, Enfield, Haringey and Islington: Helen Pettersen, Accountable Officer designate was appointed January 2017 The interviews for the NCL Chief Finance Officer, NCL Director of Strategy and NCL Director of Performance and Commissioning are expected to be March 2017 The next steps are to recruit the local Chief Officers, followed by the Directors team. Finally, an Independent Chair will be recruited. Each CCG will still be the statutorily responsible organisation and have regular Governing Body meetings, but will delegate some powers to a Joint Committee. Each CCG will be equally represented on the Joint Committee.

9 About the Sustainability & Transformation Plan (STP) STP triple aims: 1. Close gaps in Health & Wellbeing 2. Close gaps in Care and Quality 3. Close gaps in Finances

10 What is North Central London (NCL)? Enfield CCG / Enfield Council 320k GP registered pop 48 GP practices Barnet CCG / Barnet Council 396k GP registered pop 62 GP practices Stanmore Hospital Barnet General Hospital Chase Farm Hospital St Michael s Primary Care Centre Haringey CCG / Haringey Council 296k GP registered pop 45 GP practices Islington CCG / Islington Council 233k GP registered pop 34 GP practices Camden CCG / Camden Council 260k GP registered pop 35 GP practices Central Middlesex Hospital Edgware Community Hospital Finchley Memorial Hospital Highgate Hospital Royal Free Hospital University College Hospital London Ambulance Service East of England Ambulance Service North Middlesex Hospital St Ann s Hospital The Whittington Hospital Tavistock Clinic, Portman Clinic, Gloucester House Day Unit St Pancras Hospital Moorfields Eye Hospital Great Ormond Street Hospital

11 Our vision Our vision is for North Central London to be a place with the best possible health and wellbeing, where no one gets left behind

12 North Central London Clinical Cabinet Chair - Clinical Lead for the NCL STP programme Meets every 2 weeks, reporting to the NCL Transformation Board Clinical representation is across health and social care in NCL at a senior level The purpose of the clinical cabinet is to review, advise and direct transformation across North Central London from a clinical and patient perspective. The clinical cabinet works closely with the Clinical Reference Group (CRG) and provides updates, leadership and steer to the group as well as incorporating the outputs from the CRG in their programme of work.

13 The NCL case for change Health and care practitioners across NCL have been working together to understand and analyse the current issues across the system. This has been developed into a case for change. The case for change identified the following major gaps: Health & Wellbeing Gap Care & Quality Gap Financial Gap You can find the Case for Change on our website: ge.september% pdf

14 NCL STP workstreams Prevention Achieving the best start in life Maternity Health and Care closer to home Urgent and Emergency Care Mental Health Cancer Planned Care Specialised Commissioning Commissioner savings Provider savings System-wide productivity All the information about the plan including the summary version can be found on our website: e.september% pdf

15 Feedback and Questions Local clinicians working with local people for a healthier future 15

16 Workshop sessions 10:30am-11:30am Adherence to evidence based medicine consultation Clinical lead- Dr Jahan Mahmoodi, Medical Director Management lead Mark Eaton, Director of Recovery 11:30am-12:30pm Primary Care Developments workshop Clinical lead Dr Mo Abedi; Chair Management lead- Jenny Mazarelo, Head of Primary Care Local clinicians working with local people for a healthier future 16

17 Adherence to Evidence Based Medicine (AEBM) Dr Jahan Mahmoodi, Medical Director 17

18 Overview As an organisation in Special Measures we are required by NHS England to look at everything we spend to enable us to live within our means and ensure we can continue to fund essential services and treatments. As part of this on-going review we are looking at the evidence associated with a number of procedures and treatments to see where clinical evidence supports changing thresholds and access criteria. Whilst we are doing this because of our financial position the work is clinically led and evidence based. Enfield CCG are also leading this work across North Central London with our CCG Colleagues. Today is the start of our formal consultation period lasting until the 31 st March. Local clinicians working with local people for a healthier future 18

19 Scope of Review We are looking at four main areas: The thresholds and criteria associated with existing Procedures of Limited Clinical Effectiveness where the evidence has changed. Additional areas that others have identified as being PoLCE that are not currently in the North Central London policy and where we consider it appropriate to review. Procedures where the clinical evidence suggests we should make changes to thresholds to improve outcomes for patients. The decommissioning of homeopathic treatments at UCLH. Local clinicians working with local people for a healthier future 19

20 Preparing for the Consultation Process In preparing for the consultation commencing today we have done a wide range of pre-engagement activities including: Discussing this with the Enfield Health & Wellbeing Board and Health Overview and Scrutiny Committee. Engaging with Local GPs via a range of events and with our Secondary Care Consultants via the North Central London Clinical Cabinet. Undertaking Pre-Engagement Work with our public. Working with our CCG colleagues in North Central London and with the NCL Sustainability & Transformation Plan Team. Local clinicians working with local people for a healthier future 20

21 Procedure List in Full PROCEDURE Bunions Hearing Aids Knee Replacement Surgery Hernia Vasectomy Uterovaginal Prolapse Revision Mammoplasty Revision of Hypertrophic Scars PROPOSED OUTCOME Introduce new evidence based criteria for treatment. Local clinicians working with local people for a healthier future 21

22 Procedure List in Full PROCEDURE Penile Procedures (Penile Implants) Cholecystectomy for Gallstones Chalazions Correction of Ptosis Homeopathy PROPOSED OUTCOME Introduce new evidence based criteria for treatment. Decommission Treatment Local clinicians working with local people for a healthier future 22

23 Next Steps Today we are launching our consultation and are seeking your feedback on our proposed changes. We are here to answer your questions and to help you complete the consultation document or you can take the document away and use freepost to return it or alternatively use our online survey. We are holding two further public events during the month and also discussing the evidence with Local GPs at our Locality Meetings. We will also be taking our NCL CCGs through the same process we are currently undertaking. Local clinicians working with local people for a healthier future 23

24 Primary Care Transformation Jenny Mazarelo, Head of Primary Care Peter Lathlean & John Piesse, Primary Care Development Managers

25 Primary Care Access Hubs Open from 18:30 to 20:00 Monday to Friday Open from 08:00 to 20:00 Saturdays, Sundays and Bank Holidays Book through your registered practice or direct on Access hub locations: Carlton House Surgery (Enfield Town) Woodberry Medical Practice (Winchmore Hill) Evergreen Primary Care Centre (Edmonton)

26 Medical Records To provide continuity of care, the hub can access your medical records Patients will be asked if they consent to their medical records being viewed by the GP or Nurse providing their care A summary of the consultation will be returned to the patient s own practice for adding to their medical record

27 Patient Online Services Practices are contractually obliged to offer patients the opportunity to book an appointment, order a repeat prescription or access their medical records online. This is a means of increasing choice and convenience for all patients Ambition ~ 20% of patients with an online account with 10% of patients using one or more online services by 31 st March 2017

28

29 iplato Text Reminder Messaging Service You can send a SMS text reply this informs the system to release your appointment for others to book GP Practice records your mobile number into your patient record You book an appointment with the GP Practice via your preferred method The system automatically sends you a SMS message reminding you of your appointment date and time (typically 2 days before your designated appointment). The text includes details on how to cancel this appointment if required without the need to phone the practice. You attend your appointment as per usual

30 Fully Delegated Commissioning of GP Services

31

32 Panel questions and answers session Ask us anything! Local clinicians working with local people for a healthier future 32

33 Key dates for your diaries Governing Body Meetings All the dates for 2017 can be found on our website: 15 Mar :30pm-3:30pm Venue: Committee Room, Holbrook House, Cockfosters Road, Barnet EN4 0DR 17 May :30pm-3:30pm Venue: Millfield House, Silver Street, Edmonton N18 1PJ Patient and Public Engagement Meetings For all Enfield residents and local stakeholders details available on our website: Wednesday 21 June am-1pm, venue to be confirmed Wednesday 25 October am-1pm, venue to be confirmed Wednesday 7 March am-1pm, venue to be confirmed Patient Participation Group (PPG) network meetings For Chairs and members of PPGs and staff at member practices who support patient groups only. Tuesday 7 March 2017, 6pm-9pm, Executive Suite, Dugdale Centre Tuesday 6 June 2017, 1.30pm-4pm, Conference Room 2, Dugdale Centre Tuesday 5 September 2017, 6pm-9pm, Executive Suite, Dugdale Centre Tuesday 5 December 2017, 1.30pm-4pm, Executive Suite, Dugdale Centre Details are on our website: Please communications@enfieldccg.nhs.uk to be added to our and be notified of news and events. All events are advertised on our website: and in the local press. Local clinicians working with local people for a healthier future 33

34 Listening to you Your feedback is important to us today We want to work closely with local people to develop our plans Today we are going to focus on our plans for the next year We will ask you to fill in a feedback form (in your pack) about today s event. Please tell us what you what think of today and tell us about topics you would like to see at future events. We would like you to get more involved in the CCG: Join your GP practice s Patient Participation Group (PPG). Ask your practice if you can join. We have an active PPG network and an elected PPG representative Litsa Worrall who sits on the Governing Body Volunteer to be a patient representative and help us improve services for local patients forms are available. Attend a Governing Body Meeting dates are advertised on our website, on Twitter and in the Enfield Independent Follow us on Sign up to our mailing list contact communications@enfieldccg.nhs.uk Visit our website Local clinicians working with local people for a healthier future

35 Thank you for attending today s event For more information Follow us on Contact: communications@enfieldccg.nhs.uk Local clinicians working with local people for a healthier future 35

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