Annual Report Summary 2016/17

Transcription

1 Wolverhampton CCG Annual Report Summary 2016/17 1

2 ANNUAL REPORT SUMMARY 2016/17 Wolverhampton CCG What we did in 2016/17 This is a summary of the key work done by Wolverhampton CCG during 2016/17. You can find a full annual report, including financial accounts, on our website. 2

3 Wolverhampton CCG Chair s foreword Wolverhampton CCG has had a very successful year in 2016/17. We have continued to build on our achievements as we work to improve the healthcare that the NHS provides for the people of Wolverhampton. We have improved the provision of healthcare services across our city and at the same time operated within the governance and financial requirements set for us by NHS England. In doing so we have used the public funds we have been allocated as wisely as we can, whilst maintaining and improving the quality and safety of delivery wherever possible. In 2017/18 we will continue this work, alongside developing our Primary Care services in line with the GP Five Year Forward View. The CCG works across the city and with a wide range of partners and supporting organisations. In November 2016 we launched a new End of Life Strategy in conjunction with The Royal Wolverhampton NHS Hospital Trust (RWT), City of Wolverhampton Council (CWC), Macmillan Cancer Support, Healthwatch Wolverhampton and Compton Hospice. The quality and accessibility of good end of life care is something that will affect all of us at some point in our life. We set out our vision to ensure that the population of Wolverhampton approaching end of life, can be confident that they will receive person centred, integrated care from all professionals involved in the delivery of their care. Recognising and respecting the wishes of the patient and those closest to the patient, together with their health care needs, is paramount in all we seek to achieve. Our Stay Well in Wolverhampton campaign also reflected this partnership approach by working across the city in conjunction with Public Health, CWC, the voluntary sector and RWT. We believe this approach vastly increased the campaign s reach. In particular the contribution and commitment of the voluntary and community sector and support groups helped us to engage seldom heard groups more effectively. In September 2016 we were finalists for a HSJ Award under the category of the Most Effective Adoption and Diffusion of Best Practice with our PEARS eye care scheme. It is fantastic for our staff and all those involved to be recognised for a prestigious national award. Similarly, we were also delighted to win the 2016 West Midlands Patient Safety Innovation Award for the ASSKINE toolkit (Assessment, Surface, Skin inspection, Keep moving, Incontinence, moisture, Nutrition and hydration and Escalate/communicate). The toolkit was skilfully put together by our Quality Team for use by care homes across Wolverhampton. In March 2017 Dr Dan De Rosa, Chair of the Governing Body, stepped down from his role. Dan expertly led the CCG since its formation in We wish Dan well as he continues to work in the health sector in Wolverhampton. Since 1 April 2017, I have taken on the role of Chair on an interim basis, whilst a Clinical Chair is appointed. I am supported in my role clinically by a deputy chair, and a GP Accountable Officer, Dr Helen Hibbs. Our people are the very best. Harnessing their skills, experience and knowledge, together with a drive to succeed, has helped deliver a very successful year for the CCG. Jim Oatridge Chair 3

4 ANNUAL REPORT SUMMARY 2016/17 Money Matters Our budget for the year was m. This included money to run the CCG, which came to 5.477m. 47,059 prescribing 19,486 other programme 5,477 running costs Overall we managed to stay within the budget we d been allocated. We did overspend on some things, mainly hospital services, in part because of an increase in emergency admissions. However, the number of planned operations and procedures have been much lower than anticipated. 13,241 Continuing Care/FNC 36,412 community services 35,256 mental health services where we spent the money: k 184,649 acute services total = 341,581 4

5 Wolverhampton CCG There was not enough money to do everything we wanted to, but a lot of changes we have been progressing over the past three years will continue to help us to gain the best value from the funds that we have. 184 prescribing 52 Continuing Care/FNC 76 other programme 21 running costs How Much we Spent on Services per Head of Population: 721 acute services 142 community services 138 mental health services total = 1,334 5

6 ANNUAL REPORT SUMMARY 2016/17 Primary care The CCG s vision for primary care is to achieve high quality out of hospital care which is accessible to everyone. This will, in turn, promote the health and wellbeing of our local community. We want to ensure that the right treatment is available in the right place at the right time and to improve the quality of life of those living with long term conditions and reduce health inequalities across the city. 6

7 Wolverhampton CCG Our Primary Care Strategy Our Primary Care Strategy has been co-designed with our member practices. As a membership organisation we are committed to working with our GPs. We would like to continue to work together over the coming years as primary care develops in Wolverhampton. From 1 April 2017 we became fully delegated from NHS England. This means that the CCG has taken on full responsibility from NHS England for Primary Care. This includes contract management of GP Practices, new models of care and delivery of the Primary Care Strategy. In Wolverhampton our GP Practices have split into four different groups to help us shape primary and community services for the future. Our priority is to provide care that is easier to access with a continuity of care throughout the patient journey. The majority of practices in Wolverhampton have formed three groups. These are Primary Care Home 1, Primary Care Home 2 and Medical Chambers (Unity), all three groups will work under the Multi-Specialty Care Provider Model. This will mean that patients may access services through community care hubs and joint teams across practices. The introduction of care hubs will help to increase access as well as co-ordinate care so that, where possible, care can be given closer to home and in a community setting. A small group of five practices, covering approximately 30,000 patients, have decided to join a new project with our local NHS Trust, RWT. This model is called a Primary and Acute Care Model or Vertical Integration and it means that there is a collaboration between RWT and GP Practices to meet the needs of patients. Part of Vertical Integration is a greater level of back office support which will take care of the business element of General Practice. All staff, including the GPs of these Practices will become employees of RWT. The CCG is committed to supporting each model of care with Project Manager(s) who actively support both Primary Care Home(s) and the Medical Chambers groups of practices to help them prepare for this new style of working. 7

8 ANNUAL REPORT SUMMARY 2016/17 Developing mental health services This year we have continued to work towards giving mental health services the same priority as physical health services across all age groups. In order to improve clinical outcomes, particularly for people with continuing and longer-term needs, we have continued to develop urgent and planned mental health care pathways as part of our Better Care integration. This work will be aligned with the Wolverhampton Crisis Concordat. We are working with our colleagues in the other Black Country CCGs to align and develop care pathways on an STP footprint. This is to improve and develop specialist services and care pathways, such as Eating Disorders and Peri-natal Mental Health. with providers and colleagues within CWC to commission community services based care pathways and care packages that provide safe, sound and supportive care for people of all ages. At the same time we will focus on bringing patients closer to home where they are currently being cared for outside of Wolverhampton. This will improve their experience and outcomes. We also commission services in a way that will improve value for money and financial sustainability. We will develop services in line with the CCG Improvement and Assessment Framework and Mental Health Five Year Forward View. This includes developing Improving Access to Psychological Therapy (IAPT) services to improve our care pathway to older people and people with long term conditions. We have also built on the positive impact of existing schemes, such as the Hospital Discharge Service, the Liaison Psychiatry Service, and the Street Triage Service. These improve urgent mental health care across mental health, police, ambulance and acute hospital services. Looking forward into 2017/18, the mental health urgent and planned care pathways will include a focus on dementia, including mental health liaison as part of our CORE 24 offer. To ensure that, wherever feasible, people from Wolverhampton can access mental health care as close to home as possible, we continue to work 8

9 Wolverhampton CCG Better Care Programme Community Matrons making a difference A retired 67 year old gentleman was referred to the Community Matrons via his GP for management of his social conditions in relation to his alcoholic dementia. On the initial assessment by the Community Matrons there were several issues identified: The patient lives alone and only has support of his ex-wife Had many episodes of forgetfulness Had only had three baths in a year Had previously had a house fire Was sleeping on the sofa and hadn t been to bed for years Was not taking any medications despite dementia diagnosis and blood pressure problems Had extremely dry skin on his feet, unkempt nails (not washing) The team referred the gentleman to the Fire Brigade who performed a home visit and installed smoke alarms and provided full fire retardant bed linen. The Community Matrons have helped the patient to accept help from a care company after years of refusal. This care company is from his cultural background which helped the patient to feel more comfortable and he now readily engages with them. As part of this care he now has a weekly shower, help with his cleaning and a weekly walk or trip to the shops. The Matrons have also referred the gentleman for foot health and have worked closely with the GPs and to prescribe medication for his blood pressure and cream for his legs and feet. They have also helped him to find a way to remember to take his tablets and his blood pressure is now a greatly improved. The Matrons and the GP are slowly considering medication to help with his alcoholism. They have made a referral to Telecare to request a Pivotel medication system (medication reminder machine) and a personal alarm in case he had a fall at home. The gentleman received community based person centred support to prevent his admission to hospital. 9

10 ANNUAL REPORT SUMMARY 2016/17 The Wolverhampton Integrated Respiratory Lifestyle (TWIRL) Project The Wolverhampton Integrated Respiratory Lifestyle (TWIRL) is a pilot project which launched in July 2016 as part of Coventry University Ripple Project. TWIRL holds a meeting once a week for people who suffer from Chronic Obstructive Pulmonary Disease (COPD). The weekly group offers advice and support from healthcare professionals as well as the opportunity to socialise with others living with COPD. The Wolverhampton partners involved in TWIRL alongside the CCG are RWT, Wolverhampton Age UK, Compton Hospice, West Midlands Fire Service, Wolves Community Trust and The Health Foundation. The feedback from TWIRL has been extremely positive with a lot of patients finding the social nature of the group has helped to increase their confidence and helped to reduce social isolation. The group now has over 50 people on the list of attendees, most of whom attend every week. TWIRL: Claire s Story Before the TWIRL group began Claire felt isolated, having lost her husband and having several medical conditions. Suffering from depression since she was a child, Claire had little desire to leave the house and became very secluded. During one session at Compton Hospice, Claire was told about TWIRL via a friend who already attended the group who relayed how it had helped him. However, knowing that the sessions were being held in the centre of Wolverhampton, Claire was worried about the journey as she is not able to drive very far herself. Compton recommended that Claire phone for transport organised from Age UK. To Claire s surprise her query was dealt with immediately by the first person she spoke to and within a few minutes transport was arranged quickly and was booked for the following Wednesday. Since attending the group from August, Claire has found the group invaluable, with her situational problems being dealt with straight away as well as providing her with a network of friends. TWIRL suits Claire well at the moment with the group being exactly what she wants it be and is something to look forward to every week. 10

11 Wolverhampton CCG Improving quality Quality is at the heart of everything we do, you may have heard that phrase before, but at Wolverhampton CCG we have a clear commitment to driving quality, improved patient experience and safety. Quality is a golden thread through all our commissioned services, we see quality in clinical effectiveness, patient and service user safety and experiences. So it is important that we have robust quality schedules which are built into all contracts, along with a well-applied governance and assurance framework to address concerns. We are committed to: Improving patient involvement, feedback and dignity: Learning from the national reports and inquiries: The Friends and Family Test (FFT): Infection Prevention: Commissioning and delivering services that are compliant with National Institute for Health and Care Excellence (NICE) guidance and quality standards: Safeguarding. Patient safety We continue to monitor serious incidents that arise involving our patients. This is now done through Scrutiny Groups that include our Providers of healthcare services We encourage an open dialogue, and in the spirit of openness and transparency, a fluid conversation takes place regarding all root cause analyses. This enables us and our health care services to identify learning opportunities and be assured that care in those settings has been investigated to identify what went wrong and what action is required to prevent further occurrences. We strive to ensure that the care provided to our patients is as safe as possible. We have seen two Never Events reported this year and continue to work with our providers to ensure sufficient controls are in place to prevent further incidents of this type occurring again in the future. This has formed a structured programme of quality visits, both announced and unannounced, and table top reviews that have included national regulators/organisations. 11

12 ANNUAL REPORT SUMMARY 2016/17 Digital transformation journey Wolverhampton CCG has worked hard to become an early adopter of new technologies. In November 2016 the CCG requested to become an early adopter of Wi-Fi for patients, public and staff. In December the CCG were officially accepted to join the NHS Digital Wi-Fi programme. The CCG in partnership with RWT rolled out the project. The initial test sites went live on the 30 January 2017 with the full Wi-Fi go-live on 17 February Wolverhampton was the first area in the country to be fully live with Wi-Fi in all its GP practices in the country. The availability of the free Wi-Fi has also greatly supported the CCG s proactive work in the rolling out of online services to patients. These services allow patients to access other online tools such as booking appointments, seeing their clinical record, reviewing letters and test results. We are currently developing the Wolverhampton Shared Care Record to include an End of life Shared Care Plan with a plan to make it accessible to all health and social care workers. The update of the software will include additional support for mobile working and the addition of a patient portal that will provide data for patients from primary and secondary care. In the future, the portal will also be developed to support patients inputting data from wearable devices. We have also worked on the roll out of remote consultation for Practice groups. This will support extended opening hours and the ability of practices to see patients from other GP practices, and then record their GP appointment against the patient s own GP record 12

13 Wolverhampton CCG Accountable Officers conclusion During , despite the difficult financial situation that the NHS finds itself in, we have been able to maintain financial stability which in turn, has helped us to continually drive improvements for the people of Wolverhampton. We were delighted to be one of the few CCGs to have been awarded Green Star status, the highest level of achievement nationally for We are also pleased to have been named as an exemplar for Patient and Public Involvement by NHS England (NHSE). This reflects the fact that in Wolverhampton we value the patient s opinion, to this end we regularly look to involve patients in the commissioning process in many different capacities and so are proud to have received this recognition. We are an active member of the Black Country and West Birmingham Sustainability and Transformation Plan (STP) working towards driving system changes across the region. There are 18 partners including NHS commissioners and providers and the local authorities in the Black Country STP, looking to address the health and well-being gap, Care and Quality gap as well as the financial gap. The four CCGs in the Black Country, Sandwell and West Birmingham, Dudley, Walsall and ourselves, have begun to work towards Collaborative Commissioning. This will mean commissioning some services at scale for the people across the Black Country, whilst some services will continue to be commissioned on a place based approach. For the people of Wolverhampton, this means locally determined services. At a local level, as part of our commitment to the GP Five Year Forward View, we have worked to mobilise our Primary Care workforce into groupings and our local practices have joined up to form New Models of Care; this has taken the form of four different groups looking at different Care Models which they are testing out. As we end this year, we have undertaken some necessary changes to the CCG s constitution as we become fully delegated for primary care commissioning from April These changes were made to better reflect our membership in their current groupings. We look forward to continuing to work with our members in the coming year to further develop these groupings and to promote sustainability in our GP practices so that they can provide even better patient care. Helen Hibbs Accountable Officer 13

14 ANNUAL REPORT SUMMARY 2016/17 Timeline 2016 Awarded Green Star Status (April 2016) APRIL Commissioning intentions events (May 2016) FEBRUARY Wi-Fi live in all GP practices (February 2017) 2017 DECEMBER MARCH Collaborative Commissioning Joint committee meet for the first time (March 2017) 14

15 Wolverhampton CCG MAY The Wolverhampton Integrated Respiratory Lifestyle (TWIRL) Project launched (July 2016) GP practices form groups under New Models of Care (July 2016 March 2017) STP public event (December 2016) OCTOBER - MARCH Stay Well (October March 2017) JULY APRIL Assumed full responsibility for commissioning of GP services (1 April 2017) THE FUTURE 15

16 Annual Report Summary 2016/17 ANNUAL REPORT SUMMARY 2016/17 Wolverhampton Clinical Commissioning Group Technology Centre Wolverhampton Science Park Glaisher Drive Wolverhampton WV10 9RU Telephone: Recognised as an outstanding CCG for 2016/17 1