WORKING T OGET HER T O BUILD T HE BEST AFFORDABLE HEALT HCARE FOR SUT T ON. Annual Report Summary 2015/16

Transcription

1 WORKING T OGET HER T O BUILD T HE BEST AFFORDABLE HEALT HCARE FOR SUT T ON Annual Report Summary 2015/16 1

2 CONT ENTS WHO WE ARE AND WHAT WE DO 3 Who we are and what we do 4 Welcome from our Chair NHS Sutton CCG is a clinically-led membership organisation responsible for commissioning healthcare services for the population of Sutton and monitoring and ensuring their quality. We commission hospital, community, mental health and GP services to meet the needs of over 190,000 people in Sutton. 5 Clinically-led commissioning 6 Our GP practices OUR VISION 7 How we spend your money 8 Working in partnership 9 Our progress against our priority health areas 10 Sutton homes of care 11 Working with practices / Sutton uplift 12 Our performance 13 Investing in the future of health services As doctors, nurses and other healthcare professionals, we work together to put patients first and improve health services in Sutton. Our vision is to commission high quality healthcare for the people in Sutton through joint working with health and social care organisations to ensure that patients physical, mental and social wellbeing needs are met. It can be summed up as: WORKING T OGET HER T O BUILD T HE BEST AFFORDABLE HEALT HCARE FOR SUT T ON We believe that patients should be at the centre of our decision-making and we will work in partnership with individuals, patient representative groups, families and carers to deliver high quality, accessible services that tackle inequalities and respond to personal needs. We are working to ensure an efficient and financially stable local healthcare system over the longer term. We are doing this by improving primary care and community services and working closely with secondary care to redesign and deliver integrated services that bring healthcare into the community and closer to our patients homes. 14 High quality services 15 How we use patient feedback in our planning 16 How to get involved / How to get in touch 2 3

3 WELCOME FROM OUR CHAIR We have come a long way over the last twelve months, and it has been an action-packed and successful year for NHS Sutton Clinical Commissioning Group (Sutton CCG). We have seen a number of projects launching new services and pathways that will really make a difference to the health of our residents and the services available to them. At the start of the year we found out that we had been successful in our bid for Vanguard status, the national programme set up to develop innovative solutions for improving health systems across the country. Our Vanguard programme, Sutton Homes of Care, aims to improve the quality of care across care homes in Sutton through a range of new partnership initiatives read more later. We have launched the Sutton Integrated Digital Care Record (SIDCR), enabling staff across a number of services to share information securely from their patients and clients GP and social care record, so that they can provide much more joined up and effective treatment and care. During the year we successfully re-tendered for the provision of our community health services, now called Sutton Community Services, and still run by Royal Marsden NHS Foundation Trust. We also rolled out the new primary mental health care service, Sutton Uplift, which was launched on 1 July Nationally the NHS has seen a considerable shift in its landscape, which has impacted on us at local level. The CCG has decided to take on the role of delegated primary care commissioning, meaning that as well as planning and buying hospital, community and mental health services, from April 2016 the CCG has taken on the same role for primary care (i.e. GP practices). This brings with it a clear requirement for very robust governance arrangements and we are working with colleagues in south west London to help provide independent assurance for each other. We know that as we move further into 2016 and beyond, the challenges facing GP practices are going to be immense; but this also provides opportunities and we are pleased that the majority of our GP practices have agreed to come together to form a single GP federation. We are also working with other south west London CCGs, provider trusts and local authorities to develop a five-year Sustainability and Transformation Plan for the wider NHS area, in line with NHS England s national guidance. I would like to take this opportunity to thank all of our partners, our committed CCG staff and others in the community who together have enabled us to achieve such great results. Dr Brendan Hudson Chair, NHS Sutton Clinical Commissioning Group CLINICALLY-LED COMMISSIONING We are a clinically-led membership organisation bringing together 26 GP practices into one commissioning organisation. We are made up of three geographically based localities, each with a GP lead who is also a member of our Executive Committee. The three localities are: Carshalton Sutton and Cheam Wallington CLINICAL LEADS Our local clinicians work together as a membership organisation to plan and commission health services for Sutton. This means that we can focus on the quality and clinical effectiveness of the services we commission more than ever before and achieve change at a pace which would not have been possible without our clinicians taking the lead. OUR LOCAL CLINICIANS WORK TOGETHER AS A MEMBERSHIP ORGANISAT ION 4 5

4 GP PRACT ICE SIT ES HOW WE SPEND YOUR MONEY St Anthony s Hospital Cheam Rose Hill Sutton 1 2 St Helier Hospital Carshalton 5 Beddington Park Wallington Carshalton locality Sutton and Cheam locality Wallington locality NHS Sutton CCG spent some 240 million in 2015/16 in commissioning and managing healthcare services for the population of Sutton. An analysis of expenditure is shown below: Acute Healthcare 139.5m Mental Health and Learning Disability services 23.3m Community Services 36m Primary Care 3.5m Prescribing 23.8m Other Programme Expenditure 9.2m 19 Sutton Hospital Running Costs 4.1m Faccini House Surgery Bishopsford Road Medical Centre Green Wrythe Surgery Wandle Valley Health Centre Hackbridge Medical Centre Chesser Surgery Wrythe Green Surgery Sutton Medical Centre Carshalton Fields Surgery Well Court Surgery GP Centre - Dr Brennan/Dr Mukta/Dr Longley Cheam Family Practice Robin Hood Lane Health Centre (Dr Seyan) Dr Grice and Partners Benhill & Belmont GP Centre Grove Road Practice Mulgrave Road Practice Beeches Surgery Park Road Medical Centre Manor Practice Maldon Road Surgery Wallington Family Practice Shotfield Medical Practice Beddington Medical Centre Wallington Medical Centre 2015/16 FINANCIAL PERFORMANCE In spite of a number of financial challenges, the CCG met all its financial targets in 2015/16, including: achieving its target of a 1% surplus operating within its running cost allocation meeting its cash limit targets operating within its capital allocation. Challenges and achievements included: Hospital services expenditure was very close to planned and contract value, reflecting contracts set at realistic levels of activity at the start of the year The costs of continuing care services, for example in care homes, and of mental health placements rose significantly mainly due to increases in demand Prescribing costs were on plan due to successful medicines management All other health care services costs were on plan Quality, Innovation, Prevention and Productivity (QIPP) savings targets were met. 6 7

5 WORKING IN PART NERSHIP We work alongside other health practitioners from nursing, pharmacy and secondary care and local partner organisations, such as London Borough of Sutton, Sutton Health and Wellbeing Board and the voluntary sector. HEALT H AND WELLBEING BOARD We work with organisations from across Sutton as part of the Health and Wellbeing Board. The Board s strategy focuses on improving health and wellbeing so that individuals and communities are able to live healthier lives, have better health outcomes, and have a better experience of using the health and care system. We are working with the London Borough of Sutton and other partners on the Board to develop a new joint health and social care strategy that sets out our shared vision for the integration of health and social care services locally, to address the challenges we face in our Borough. PUBLIC HEALT H We work collaboratively with the public health commissioners in London Borough of Sutton to deliver the priorities set out in the developing joint health and social care strategy and ensure the best health outcomes for local people. on a five-year Sustainability and Transformation Plan for their local NHS. The six south west London CCGs (also including Croydon, Kingston, Merton, Richmond, and Wandsworth), local provider trusts and local authorities have formed a Strategic Planning Group to deliver this work. The plan will be published later this year. Final decision-making on any changes to local health services continues to rest with the local CCGs. If significant changes to local services are proposed, these would be subject to public consultation. HEALT HWATCH SUT T ON Healthwatch Sutton (HWS) has provided independent support for the development of Patient Participation Groups (PPG) that represent patients views in GP practices across Sutton. HWS has also actively engaged with the CCG s Patient Reference Group (PRG). All of Sutton s GP practices now have a PPG and most are represented on the PRG. SOUT H WEST LONDON SUSTAINABILIT Y AND T RANSFORMAT ION PLAN In December 2015, NHS England published new planning guidance requiring all NHS regions across the country to work together, and with local councils, OUR PROGRESS AGAINST OUR PRIORIT Y HEALT H AREAS In 2015/16 we made significant progress against our priority areas: Out of hospital care Long term conditions management and end of life care Mental health Hospital care Integration We have highlighted on the following pages three areas where we have made real progress over the year towards achieving success or improving our performance. 8 9

6 SUT T ON HOMES OF CARE Sutton CCG was one of only two sites in London chosen to become a vanguard site as part of the national New Care Models Programme Five Year Forward View in March Over the last year we have been working with local partners in health, social care and the voluntary sector, to provide support to local care homes, with the aim of improving safety and quality of care for residents and enhancing their health and wellbeing. Partners include: NHS Sutton Clinical Commissioning Group, London Borough of Sutton, Epsom and St Helier University Hospitals NHS Trust (Epsom and St Helier), St Raphael s Hospice, Sutton Community Services, Age UK Sutton, South West London and St George s Mental Health NHS Trust, The Alzheimer s Society, London Ambulance Service and Sutton Centre for the Voluntary Sector. The Vanguard is focused on developing three key components: A number of schemes to prevent unnecessary hospital admissions are already improving the quality of care provided, for example, new care coordinators to provide continuity of care and nursing leadership within homes, and health and wellbeing reviews where care home nurses and a dedicated GP proactively review residents care, health and wellbeing on a weekly basis. Another successful project within the programme has been the Red Bag, which aims to help people living in care homes to receive quick and effective treatment should they need to go into hospital in an emergency. The Red Bag contains standardised information about the resident s general health, their existing medical conditions and medications as well as highlighting the current health concern. This means that ambulance and hospital staff can easily access all relevant information and determine the right treatment quickly and more effectively. WORKING WIT H PRACT ICES T O IMPROVE QUALIT Y In January 2015, following routine inspection by the Care Quality Commission (CQC), two Sutton GP practices were rated Inadequate and placed in special measures - a framework within which CQC and NHS England work together to ensure a timely and coordinated response. Sutton CCG worked with both organisations and the practices to ensure that action plans were put in place and improvement delivered within six months. This took considerable CCG time and resource, and following re-inspection both practices were removed from special measures. In response to this, Sutton CCG put together a small team of individuals with a wide skill set and relevant experience to help practices with CQC Inspection Readiness. From January to March 2016 the team ran several workshops for GPs, nurses, practice managers and receptionists to provide them with more detailed knowledge of the inspection process and how to properly prepare themselves for it. Between January and March 2016 six further CQC inspections were carried out in Sutton and all achieved a Good rating. Thank you for supporting general practice in this way. It feels really positive and collaborative working with the CCG in this way. (Sutton GP) integrated care education and development quality assurance and safety SAM JONES, DIRECT OR NEW MODELS OF CARE, NHS ENGLAND SAID: IMPROVING OUR MENTAL HEALT H SERVICES: SUT T ON UPLIFT Launched in July 2015, this innovative new primary care mental health service is an integral part of our commitment to offer enhanced primary care mental health services and evidence based psychological therapy services to Sutton s communities. The service is mainly provided at the Jubilee Health Centre (East) but also operates from a range of community venues to ensure borough-wide coverage and more access. The service offers out of hours appointments, including evenings and Saturdays. I came away [from my visit] invigorated, enthused and very very positive about the work you are leading with the team in Sutton. The partnership working shines through and it is that that is making the difference, as well as a lot of hard work day in day out! Eothen Care Home in Sutton was the first to use the Red Bag. KIM KERWOOD, EOT HEN CARE HOME MANAGER SAID: The Red Bag is a simple idea that makes a big difference. On the day it was launched, one of our residents fell and we suspected that sadly he might have a fracture. We got the Red Bag ready and completed the forms for the ambulance crew and hospital staff. The resident and Red Bag went off to hospital and to our delight two weeks later he returned home fit and well and, importantly, with the Red Bag complete with a discharge letter and medication. The service - Sutton Uplift - is provided by South West London and St George s Mental Health NHS Trust and voluntary sector partners: Imagine, Age UK Sutton, Off the Record and the Sutton Carers Centre. It operates in the heart of the community and provides a holistic approach to promoting positive mental health and wellbeing focusing on early intervention in line with national guidelines. It offers the following: Single point of access (SPOA) Mental health triage and assessment A wellbeing hub Psychological therapy (IAPT) Recovery support For more information on our progress in 2015/16, please see our full Annual Report

7 INVEST ING IN T HE FUT URE OF HEALT H SERVICES OUR PERFORMANCE The CCG is required to commission health services that are safe, that maintain or improve quality and offer information to inform patients choice on how, when and where they receive their health care services. We have a range of performance measures by which we judge whether we have delivered what we set out to do see page 28 in the full Annual Report. We performed well across many areas; we have been working with Epsom and St Helier NHS Hospitals Trust (ESH) to maintain the Referral to Treatment standard all year. This meant that 93.3% of Sutton patients on an incomplete pathway had been waiting less than 18 weeks from referral (against a threshold of 92%) and we expect to maintain this performance in 2016/17. Working closely with colleagues at ESH, we have also been able to ensure that patients needing key diagnostic tests do not wait longer than six weeks (99.8%). There are several areas that we need to improve; these include: Nationally our local performance against the A&E four hour target compared favourably; we still missed the delivery of the A&E target of 95% by just under 1%. This means that more patients waited longer than 4 hours to be transferred, admitted or discharged than the NHS aspires to as a whole. We monitor the London Ambulance Service (LAS) on a London-wide basis alongside the other London CCGs. During 2015/16 the LAS did not meet any of the three standards London-wide for response times in 8 minutes and 19 minutes and have an improvement plan in place. However, locally their performance is significantly better; response times have been improving towards the action plan trajectory for the 8 minute standard and we will continue to work with them to improve this. They continue to meet the 19 minute standard. In 2014/15 we achieved our local target for the proportion of people accessing our psychological therapy (IAPT) services, but fell short of the national target of 15%. Consequently we had an ambitious recovery trajectory set for 2015/16, which we achieved late in the year. We have invested additional funding into the IAPT service enabling it to expand, and in 2016/17 we will be working to promote the service to GPs, community groups and the public in order to increase the number of people using the service. In 2015/16 we received an increase in allocation of 7%, which meant an actual increase of around 15m in the funds we have to commission health services. This enabled us to invest in new services, mainly in primary and community care and mental health care. These investments took into account local feedback from our Patient Reference Group and HealthWatch Sutton, and included: Improving services to help keep patients out of hospital Support for patients to understand and access NHS services more effectively, an initiative to improve harm from catheterisation, and improving treatment of patient falls in the community. Managing demand in primary care A comprehensive community-based patient education programme and also an on-line patient diagnosis tool to help reduce initial demand on GPs and nurse practitioners. Support for additional demand pressures during winter Including additional nurse, administrative and clinical support to help manage discharges effectively from St Helier hospital (for patients with continuing healthcare needs). Sustained investment in mental health Investment in mental health education, a proactive review of the perinatal mental health pathway and a specialist nurse to support end-of-life care for people with learning disabilities. Hospital care Improving the model of care at St Helier for acutely unwell patients who also have dementia. Investment plans for 2016/17 In spite of a lower increase in our allocation, 3% rather than the 7% we received last year, next year we will continue to invest a further 2 million in local health and health services in a range of services: continued investment in continuing healthcare to help identify and manage our most vulnerable patients. sustained investment (around 1m) in mental health

8 HOW WE USE PAT IENT FEEDBACK IN OUR PLANNING HIGH QUALIT Y SERVICES We expect quality to be central to all of our commissioned services, whoever provides them, to ensure patients experience of services and outcomes are the best they can be. We play a pivotal role in monitoring the performance of our providers and ensuring that Sutton residents receive the best possible healthcare. Performance is managed primarily through contract monitoring meetings, urgent and planned care working group meetings and clinical quality review group meetings. These meetings report into the Quality and Executive Committees (sub-committees of our Governing Body) that monitor governance, performance and compliance across all commissioned services. Patients and local people are at the centre of our decision-making and we work in partnership with individuals, patient representative groups, families and carers to deliver our vision of high quality, accessible services that tackle inequalities and respond to personal needs. We believe that effective public participation and patient engagement is delivered through organisationwide ownership. As such, it is a core competency requirement across our senior management team, clinical leads and membership practices and forms part of our strategic objectives. During the year we engaged with a variety of stakeholders, for example: Healthwatch Sutton facilitated an annual Patient Participation Group Forum in November 2015, where members of PPGs from across Sutton came together to meet and hear from others, share ideas, concerns and good practice. We continued to engage with carers and a number of stakeholder groups in the development of the Joint Carers Strategy In early 2015 we ran a further consultation with residents about the Pharmaceutical Needs Assessment, to check that the document reflected the issues that local people had identified as important in a previous survey. A response from residents concerned about the future of their local pharmacy was raised with NHS England and residents are currently involved in an ongoing review of the service. COMMISSIONING FOR EQUALIT Y For the second consecutive year, Sutton CCG implemented the national Equality Delivery System (EDS2) as part of its programme to reduce inequalities. In 2015/16, the following services were reviewed for Goals 1 and 2 of the EDS2 (better health outcomes and improved patient access and experience): Admiral Nursing Services for Families Living with Dementia and Enhanced Optometry Services for People with learning disabilities. As a result, clear plans have been developed to promote both services to encourage take-up from minority ethnic groups. Plans are underway to promote the enhanced optometry service through GP Practices, link nurses and special schools to increase uptake among young people

9 NHS Sutton CCG Summary Annual Report 2014/15 HOW T O GET INVOLVED We want to hear from you and there are lots of ways you can get involved: Go along to your GP practice patient participation group (PPG). For more information, please ask at the reception of your GP practice. Representatives from each PPG attend our Patient Reference Group. The group provides patients with a forum for dialogue with us and helps deliver an effective patient voice. Our Governing Body meets regularly in public. You are very welcome to attend these meetings to find out more about what we do and the decisions we make about local health services. Dates are advertised on our website. or write to us. Our contact details are on the back of this leaflet. Follow us on FOR MORE INFORMAT ION ON HOW YOU CAN GET INVOLVED VISIT NHS Sutton Clinical Commissioning Group Priory Crescent Cheam Sutton Surrey SM3 8LR sutccg.office@nhs.net If you would like to read our full Annual Report and Accounts for 2015/16 and a comprehensive glossary of terms please visit our website: 16