Kingston Governing Body Primary Care update

Transcription

1 Kingston Governing Body Primary Care update Kingston CCG Governing Body Tuesday 6 th March 2018

2 Kingston Medical Services Transformation programme covering Kingston primary care Kingston CCG has agreed the framework and content of the local contract named Kingston Medical Services This local contract underpins the delivery of the Kingston primary care transformation strategy Established a set of key priority areas of quality and QIPP Referral management Paediatric same days appointments Complex needs Weekend additional capacity It provides investment for Kingston general practice to meet the transformation challenge It enables PMS practices to move onto the new nationally mandated PMS contract Provides the platform for the equalisation of the service offer to patients across all Kingston practices There will be a period of mobilisation year in 2018/19, allowing learning, review, updates and improvements Formal PMS and KMS offers were issued to practices by the end of January. PMS returns 28 th February GMS returns 7 th March 2

3 Extended Primary Care Access Currently we have three extended primary care hubs Surbiton Health Centre Kingston Health Centre Merritt Medical Centre Weekday usage across all of the hubs is at expected levels (82%). Weekend usage is now up (78%). This has meant total utilisation is at 80% Currently looking at ways of increasing weekday capacity and fair allocation of appointments to practices. 3

4 Extended Primary Care Access Utilisation is improving at the Kingston and Chessington Hubs for the weekend slots. NHS 111 can now book appointments directly. KHFT UTC is redirecting patients at the weekends. 4

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6 Extended primary care Kingston Hospital UTC has begun trialing redirecting UTC appointments into the Extended Primary Care Service on weekends to maximise use of the spare capacity on the weekend. The Extended Access Hub provided by Kingston GP Chambers is the first service in SWL to have direct bookings into the service from 111. Kingston GP Chambers, will be sharing with practices on a weekly basis what the number of appointments per practice would be if appointments were based on capitation and the weekly usage. GP Chambers will also be sharing with practices how they release their appointments. 6

7 Kingston CCG Operating Plan Referrals To December 2017 Referrals Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 YTD Actual Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Kingston Hospital 2,990 3,590 3,525 3,408 3,332 3,459 3,679 3,696 2,987 30, % -1.9% -8.1% -6.8% -13.0% -5.5% -3.9% -3.5% -9.6% -6.3% St George's Healthcare , % -24.7% -19.6% -24.6% -29.7% -24.4% -23.7% -20.1% -20.6% -22.4% Epsom and St Helier , % -33.0% -37.7% -41.5% -46.3% -38.5% -41.7% -54.4% -46.0% -40.0% Other Providers , % 20.7% 14.2% 24.5% 10.1% 22.8% 12.1% 25.4% 15.6% 17.5% Grand Total 4,137 4,835 4,831 4,651 4,518 4,704 4,932 5,009 4,097 41, % -4.8% -9.3% -8.4% -15.1% -7.4% -7.2% -5.8% -10.8% -8.2% GP Referrals Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 YTD Actual Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Kingston Hospital 2,252 2,709 2,656 2,560 2,481 2,612 2,822 2,809 2,278 23, % -4.4% -10.6% -9.5% -16.4% -7.8% -4.8% -5.3% -11.0% -8.5% St George's Healthcare , % -38.9% -27.3% -34.0% -35.5% -30.7% -29.4% -28.6% -28.4% -30.3% Epsom and St Helier % -36.5% -43.2% -41.3% -50.0% -41.1% -48.1% -58.3% -51.1% -43.9% Other Providers , % 17.6% 21.0% 27.0% 1.8% 31.9% 6.6% 26.3% 9.7% 15.9% Grand Total 2,880 3,335 3,367 3,216 3,101 3,295 3,486 3,490 2,855 29, % -9.9% -13.3% -13.0% -20.0% -11.1% -10.0% -10.0% -14.7% -12.4% Other referrals Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 YTD Actual Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Kingston Hospital , % 6.7% 0.5% 2.7% -1.5% 2.5% -0.9% 2.5% -5.0% 1.3% St George's Healthcare , % 3.0% -4.7% -6.1% -18.4% -12.1% -12.6% -3.6% -5.4% -6.9% Epsom and St Helier % 0.0% 13.6% -42.9% -13.0% -14.3% 18.2% -18.2% 0.0% -4.2% Other Providers , % 22.6% 10.1% 22.9% 15.1% 17.3% 15.5% 24.8% 19.1% 18.5% Grand Total 1,257 1,500 1,464 1,435 1,417 1,409 1,446 1,519 1,242 12, % 8.9% 1.5% 4.2% -1.7% 2.3% 0.3% 5.3% -0.3% 3.0% YTD % Diff YTD % Diff YTD % Diff 7

8 Referral Rates Other referrals have reduced YTD to 3.0% from 3.3% in YTD November 2017 Total/ GP referrals have reduced against plan yet again. There has been an overall reduction in Total referrals of -4.1% A comparison between the actual numbers for April December 2017 against April December 2016 shows a reduction in Total referrals of -4.1%, GP referrals decreasing by -5.5% and a small decrease on Other referrals of -0.8% 8

9 Referral management Kinesis: 19 specialties on Kinesis for Kingston Hospital. More to follow Highlights: GP Practice (YTD Figures) SAVED TOTAL % of Saved REFERRAL CONFERRALS Conferrals Kinesis Usage by weighted list size Savings Made by Practice West Barnes Surgery % 1.55% 12,600 Brunswick Surgery % 1.31% 10,400 The Groves Medical Centre % 1.05% 15,400 Hook Surgery % 0.84% 7,000 Churchill Medical Centre % 0.82% 14,800 Sunray Surgery % 0.71% 3,200 Langley Medical Practice % 0.49% 4,400 Claremont Medical Centre % 0.42% 3,000 Canbury Medical Centre % 0.40% 2,800 Village Surgery % 0.38% 1,400 Holmwood Corner Surgery % 0.38% 4,200 Red Lion Road Surgery % 0.38% 1,200 Central Surgery % 0.37% 5,600 Berrylands Surgery % 0.35% 1,600 Roselawn Surgery % 0.33% 1,200 Kingston Health Centre % 0.32% 3,400 Manor Drive Surgery % 0.30% 3,800 Chessington Park Surgery % 0.28% 1,200 Fairhill Medical Practice % 0.27% 7,000 Orchard Practice % 0.25% 1,800 St Albans Medical Centre % 0.23% 1,400 Grand Total % 108,000 There has been a slight decline of Kinesis Usage in December (90 in October, 114 in November, 92 in December). Out of the 92 conferrals in December, 36 resulted in a saved conferral. West Barnes, Brunswick & Groves continue to be the highest users based on Usage by weighted list size. Cardiology still remains the most used specialty area at both Kingston & St George s Hospitals. In December again, Kingston GP practices have used Kingston Hospital s advice & guidance more than St George s. 9

10 Referral management (contd) DXS: Training provided at 19 practices Quarterly review of documents started to ensure content is current As of Nov 2017 report, there have been 236 documents with 925 total views Kinesis: Diabetic Nurses are available on Kinesis for KHT for GP s to request advice One of the lead diabetic nurses is talking to a consultant over the next couple of weeks regarding joining to offer consultant advice Radiology is not yet available but the CCG is expecting to progress this over the coming weeks. e-referral Starting to work with and support practices to increase utilisation in line with the Paper Switch Off (PSO), which is scheduled for October 2018 KCCG has a target to get to 100% utilisation by 31st March 2018, submitted a change request to June 2018 Utilisation for KCCG is currently 41% (as at end October 2017) 10

11 e-referral Utilisation by Practice Nov

12 2018/19 work Mobilisation year of Kingston Medical Services Continue the transformation programme Continue the provision of extended access Refresh the current primary care Develop Integrated Primary Care Networks Support primary care at scale 12