Appendix 2.1 MEETING: Haringey Clinical Commissioning Group Governing Body Meeting DATE: Thursday, 28 July 2016 TITLE: Chief Officer s Report LEAD DIRECTOR/ Sarah Price, Chief Officer MANAGER: AUTHOR: Sarah Price CONTACT DETAILS: Sarah.price@haringeyccg.nhs.uk SUMMARY: This report updates the Governing Body on developments in the local NHS and wider policy issues. SUPPORTING PAPERS: There are no supporting papers. RECOMMENDED ACTION: The Governing Body is asked to: NOTE the Chief Officer s Report. Objective(s) / Plans supported by this paper: This report is for information only. Audit Trail: This report is for information only. Patient & Public Involvement (PPI): This report is for information only. Equality Impact Assessment: This report is for information only. Risks: This report is for information only. Resource Implications: This report is for information only.
Chief Officer s Report Governing Body Appointments We are delighted to announce two recent appointments to the Governing Body. Lionel Sherman is the new Central Member on the Governing Body, following the resignation of Sherry Tang. Lionel went through the selection process and as he was the only applicant, based on the previous advice of Electoral Reform Services Ltd we did not need to have a formal vote, so Lionel is considered to have been automatically elected. Lionel is a partner at the Bounds Green Group practice and will formally take up his post in August 2016. Following an external recruitment process, Sarah Timms has been re-appointed to the role of Nurse Member on the Governing Body for a three year term. Commissioning Intentions Haringey CCG will issue our commissioning intentions for 2017/18 at the end of September. These intentions have been discussed with GPs via the Clinical Cabinet and Collaborative meetings. They are strongly informed by ongoing discussions with the patient engagement network. This year, the CCG will jointly articulate our intentions with the Local Authority in many areas and coordinated process is being followed across the five NCL CCGs to ensure consistency with the Sustainability and Transformation Plan and in order that we express the collective impact of our plans for providers. As part of the STP process, commissioners are developing a single commissioning strategy. So, increasingly, our Borough based process will both inform and be informed by this over-arching commissioning strategy. Notification letters are issued every September. However, the process of planning, reviewing services, re-commissioning and monitoring quality and performance is ongoing. Our planning and intentions are based on our health needs analysis and benchmarking. This has highlighted areas for focus in order to drive improvements in health outcomes and efficiency: cardiovascular disease and diabetes; musculoskeletal services; mental health (enablement and recovery); learning disabilities; older people; cancer and gastroenterology. The Haringey and Islington Wellbeing Programme will, in many areas, be the vehicle for developing detailed plans. Through 2016/17 our focus for implementation has been on enabling quick and safe discharge from hospital; helping to support people in their homes and avoiding crises and re-admission. We will continue this through 2017/18 working to develop an Integrated Discharge Team; continuing to evolve our multi-professional locality teams; bolstering our commissioning of bed and non-bed based intermediate care and expanding our Rapid Response Team. We will also continue our work with Enfield CCG and North Middlesex University Hospital to optimise the pathway for both adults and children who go through the urgent care centre. During 2016/17 we are continuing to work closely with our partners to test new models of primary care and community support for mental health and improved crisis pathways, including for those with co-existing physical health conditions. In 2017/18 we intend to 2
implement or roll out these models. These developments will be supported by more integrated commissioning arrangements and more outcomes-based contracting. Through 2016/17 we have worked very closely with providers across NCL on Value Based Commissioning, a significant step towards commissioning for outcomes rather than activity. In 2017 we will be shadowing this approach, brining professionals from all organisations together to work towards an agreed trajectory for improving outcomes and gathering information about our spend and activity for people aged over 75 and for people with diabetes, to build capacity and confidence in this approach. Haringey CCG has commissioned a range of services to bring outpatient clinics into community settings. 2017/18 will see Whittington Health taking responsibility for managing the intermediate dermatology services (provided by GPs with a special interest). Our community urology service will be up and running by 2017. Our contracts for ENT and ophthalmology clinics are due for re-procurement in 2017/18. We will be reviewing our use of medefer for gastroenterology and our community gynaecology service. In addition, a range of existing services are being reviewed and evaluated. Haringey CCG is leading an NCL-wide review of the stroke pathway. We are reviewing the impact of our existing paediatric community services (allergy and learning together clinics) and the services within the paediatric community contract. We are also continuing to work closely with Whittington Health on the service level specifications and budgets for the community services that they provide. Partnership working The CCG is involved in partnership working at three levels. A brief update is provided for each. North Central London Sustainability and Transformation Plan The draft NCL Sustainability and Transformation Plan was submitted to NHS England on 30 June 2016 and the STP leadership team met with Simon Stevens on 14 July 2016. The STP consisted of a five year financial plan across health organisations; a clinical case for change and appendices setting out detail on primary care and our estates strategy. Between July and September additional work will be undertaken on the financial plan in order to present an account of achieving financial balance over the five year period and the submission will be turned into a plan for implementation. A more detailed summary of progress to date is provided under Item 4.1. Haringey and Islington Wellbeing Partnership Good progress continues to be made within the Wellbeing Partnership. The objectives for this partnership is to take a whole population approach to health and care delivery; to focus on improving outcomes and reducing costs for population groups who are currently high consumers of health and care whilst also shifting care upstream by supporting people to stay and be healthy, to reduce the level of ill health within our population. Workstream leads have now been assigned for our work on older people, CVD and diabetes, learning disabilities and mental health. Initial scoping documents for CVD and diabetes and older people with frailty have been presented to and approved by the Wellbeing Sponsor Board. Outline business cases will be presented for the Partnership Board in September/October. Examples of how this work is being progressed are given below: 3
In the next phase of work on CVD and Diabetes we will focus on developing options for a new model of care for the prevention, identification and management of diabetes and cardiovascular disease (CVD) in Haringey and Islington. At the moment we spend more money than similar areas on emergency care for CVD conditions, whilst also having high rates of early death from stroke and heart disease. The outline business case being developed will include a detailed assessment of where we currently spend money on CVD and diabetes care and the value we get for this spend. We will look at national and international best practice and will develop potential options for transforming our local model of care. In our next stage of work on frail elderly we will understand the current and future project costs of care. We will map the work that is already in place and identify areas of good practice on the ground that can be developed at scale. We will redefine services so that they fit together and are aligned towards achieving our shared outcomes and objectives. Haringey CCG and Haringey Council We are continuing to strengthen and develop our structures for joint working between health and social care. A Joint Executive Team is now in place and the membership of the regular joint Finance and Performance Partnership Board has been broadened to ensure full local authority representation. Further details are available under item 6.7. Progress continues to be made towards pooled budgets for mental health and learning disabilities. We have also been working collaboratively on an integrated Target Operating Model which articulates the shared approach that we are taking towards prevention; enabling independence and improving service delivery. CQC Report on Whittington Health Following a series of planned and unplanned inspections of Whittington Health during December 2015, the CQC published its report on 8 July 2016, which gave the Trust an overall rating of good. This makes Whittington Health one of only 8 London Trusts which have been inspected by the CQC (out of 27) to achieve this rating, which is an excellent achievement. The Trust was rated overall outstanding for caring services and good for effective, wellled and responsive domains. Most core services were rated good, and community, end of life care and community dental services were rated as outstanding. An action plan is in place to address a number of required improvements which were identified. This will be formally monitored by the CQC, and additionally by the Whittington Health Clinical Quality Review Group. CQC Report on North Middlesex University Hospital (NMUH) The CQC also issued a report on NMUH on 6 July 2016. More detail is available under item 3.1. 4
New staff The following staff have recently been appointed and are now in post: Kathryn Collin, Commissioning Lead, Children Charlotte Holt, Organisation Development Officer Meera Shah, Medicines Optimisation Pharmacist Ritta Popat, Receptionist/Administration Assistant Part II Meeting of the Haringey CCG Governing Body In the Part II session the Governing Body will receive: The minutes of the Part II meeting held on 26 May 2016 - for approval Sustainability and Transformation Plan development update. 5