NHS Corby CCG Public Event 1 October 2013
Welcome & Introductions Tansi Harper Lay member, Patients and Public Corby CCG Governing Body
Housekeeping Please turn mobile phones to silent/off No fire alarm is planned, if you do hear the alarm, make your way to the fire exit Group discussions: an opportunity for everyone to have their say
Aims of Today To keep you up-to-date with what s happening in Corby To give you the opportunity to have your say on health services To build the relationships between the CCG and our local population
Lakeside Surgery Access to GP appointments Dr Adam Crowther
Patients Concerns Difficult to access GP routine appointments Waiting times can be up to 3 weeks to see the doctor of your choice Lack of patient information regarding health services Website needs updating Telephone difficulty in getting through
Capacity Audit July/August Demand for GP appointments 3981 per week GP appointments available between 2256 3000 per week Did not attend (DNA) appointments per month 1100 on average
Proposed Action Plan No time out unless cover provided Executive to meet out of surgery time Work smarter; more efficient use of doctors time Revamp HM Clinics and bookable 2 Months in advance GP appointments bookable 4 weeks in advance Reception Managers training Tackle the did not attends - write to those patients Text results to free up appointments Registrar feedback outside surgery times Stop in house second opinion referrals Work with our Patient Participation Group
Implementation This plan was implemented in two weeks and fully supported by our PPG 2 additional locum GPs were employed The plans provided 600 additional appointments per week Outcome routine appointment 2-3 days
Medium Term Plans Employ locum GPs at pressure points in service Additional New Partner July 2014 Discuss with Partnership to employ additional GPs now Consider alternative approach to appointment systems (at least for the Same day clinic) Longer Term What can we do to ensure patients get the right treatment at the right time in the right place?
Patient Participation Group Patient Participation Group to help us understand patients needs Suggest PPG run patient questionnaire based on access What does the PPG think we can do regarding patients who don t attend getting the message to patients on how to use the services properly Partnership agreement regarding using locum cover when pinch points in cover Winter pressure escalation policy to provide more cover during the winter months
National GP Patient Survey Results Dr Peter Wilczynski Chair Corby CCG
National GP Patient Survey Results 2013 National survey run by NHS England between July 2012 March 2013 Patient experience of their GP surgery including: their own experience of making an appointment satisfaction with opening hours quality of care received from GPs and surgery nurses
National GP Patient Survey Results 2013 National survey run by NHS England between July 2012 March 2013 Patient experience of their GP surgery including: their own experience of making an appointment satisfaction with opening hours quality of care received from GPs and surgery nurses
Corby CCG Results The results of the survey placed Corby CCG 59 out of 211 CCGs in England Corby CCG performed as well or in some cases, better than the England average across four indicators: Ease of getting through on the phone 83% Overall experience of making an appointment 81% Overall experience of GP surgery 90% Recommend GP surgery to someone who has just moved to the area 82%
The Frail & Elderly Programme Introducing a Crisis Hub for Northamptonshire Angela Hillery Chief Executive, Northamptonshire Healthcare NHS Foundation Trust
Frail & Elderly in Northamptonshire 7.15% of Northamptonshire s population is over 75 years old (16.08% over 65) In Northamptonshire we currently spend 184m per year on services The frail and elderly occupy approximately 2 out of 3 hospital beds The frail and elderly have complex health and social care needs 53.4% of 75+ year olds in Northamptonshire have a limiting long-term illness
Expected Growth
Corby Population increase SOURCE: Northamptonshire and Districts Population Estimates (PANSI and POPPI, 29 September 2013)
New Model for the Frail & Elderly Programme Staying Healthy Maintaining Independence Proactive Care Discharge to Assess Crisis Intervention In Hospital Care SOURCE: Frail & Elderly Programme Phase 1 Final Report (PricewaterhouseCoopers LLP, 12 October 2012 )
Supporting the Frail and Elderly during a Crisis Frail and elderly people who are in crisis (which will include a physical health component and may also include mental health or social care components for them or their carer) who, without IAT rapid intervention would be admitted to secondary care services within the same day
Crisis Hub 1. It will operate 07:00 to 23:00 every day (last referral at 22:00) 2. It will comprise health and social care professionals Existing Intermediate Care Team, Crisis Response Team, Health Partnerships Team staff and new staff 3. It will provide two types of intervention: Admissions Avoidance avoid unnecessary admission to hospital Facilitated Discharge support people to return home from hospital 4. It will provide a programme of care for up to 14 days (maximum) 5. It will maintain current presence in A&E from 08:00 to 21:00 every day 6. Ward presence will increase target 2 wards for discharge to assess
Phase One will Launch in November 2013 August September October November 4. Crisis Hub Launch July 3. Establish Service / Engagement 2. Agree model / confirm funding June 1. Build and test model
Benefits Easy to Use A single point of access and coordination for the service Safe and Effective Experienced health and social care professionals working together as one team Convenient Caring for frail and elderly people at home avoiding unnecessary and/or lengthy spells in hospital Sustainable A cost-effective community service
but what is the difference for patients?
Ethel s Current Experience Ethel, aged 91, is currently living with her friend. She has a UTI and becomes confused. Ethel s friend calls an ambulance and she is taken to hospital. Once in A&E Ethel is admitted. One night Ethel tries to go to the toilet and has a fall breaking her hip which requires surgery. 2 weeks later Ethel is still disorientated and her family acknowledge her memory has been deteriorating for months but not to a degree that has caused concern. A psycho-geriatrician assesses her on the ward and makes a formal diagnosis of dementia. Because of her memory difficulty and length of time in hospital Ethel becomes anxious and her mobility doesn t return. Following her prolonged admission a nursing home place is arranged and Ethel has to move there. She continues to live in the nursing home for the remaining years of her life.
Ethel s Future Experience Ethel, aged 91, is currently living with her friend. She has a UTI and becomes confused. Ethel s friend calls an ambulance. The ambulance crew calls the crisis hub who deploys a senior nurse to see Ethel at home. The nurse makes a full assessment of Ethel and informs a Geriatrician who agrees that Ethel can be looked after at home with an extensive short term package of care but her memory problems need to be addressed once she has recovered. 5 days later Ethel has recovered from her infection but is still disorientated, working with her GP she is referred to a memory clinic and a formal diagnosis of dementia is made. As her friend copes well with the day to day domestic chores no further social support is required.
Introduction to Healthwatch Northamptonshire: Rosie Newbigging Chief Executive
Introduction to Healthwatch POWERFUL CHAMPION IMPROVING LIVES High profile visible and dynamic Credible and independent Diverse, engaged, connected, listening Powerful voice, resolute champion Evidence informed, driving change Making a different improving lives
Rights and responsibilities Researching and reporting user/patient experience Enter and view health and social care Information and signposting Rights to refer to overview and scrutiny committee Right to sit on Health & Well-Being Board
Local challenges NHS - 44 million of savings Local government facing 27% of cuts Quality of A&E and urgent care Increased demand for social care
Make Your Voice Count 8 Roadshows around the County Surveys Attended events Heard from nearly 600 people
MYVC ~ How Northamptonshire rate their services 60 GP surgeries 50 40 30 20 10 0 Extremely good Good Satisfactory Poor N/A
MYVC ~ How Northamptonshire rate their services 35 Hospitals 30 25 20 15 10 5 0 Extremely good Good Satisfactory Poor N/A
What we heard - good I took my husband to Kettering Hospital A&E. We were treated with the utmost care and efficiency from the moment we arrived, he made a full recovery. We cannot speak highly enough of them, all the staff were wonderful. Arrived at A&E Kettering with ankle problem, sent round to Xray on my own steam, when returned to A&E found out had broken ankle and was then plastered
What we heard good news Recently visited Corby Urgent Care Centre, was seen quickly and given great advice and reassurance First class treatment at Abingdon Ward, NGH, lovely food, surgical staff and physio s could not be faulted
What we heard not so good As a foster carer, shocking social worker support Appointment waiting times at GPs Recent A&E admission at KGH staff concentrating on trying to discharge patients at end of 4 hours irrespective of health condition Lack of support for parents of children with learning disabilities
What next Continue to engage with community Work with service commissioner and providers to improve outcomes, services and experiences Use community opinion to shape our plans
The Big Health Conversation Dr Joanne Watt
What do we do? NHS Corby Clinical Commissioning Group is responsible for planning and designing local health services in Corby We do this by 'commissioning' or buying health and care services including: Planned hospital care Urgent and emergency care Rehabilitation care Community health services Mental health and learning disability services
What don t we do? We don t commission the following health services: General Practice Pharmacy Dentists Specialist services (i.e. those required by a limited number of people) These are commissioned by NHS England NHS England oversee CCGs on a national level. They ensure that we have the capacity and capability to successfully commission services for their local population, as well as ensure that we meet their financial responsibilities
Who do we work with? Other CCGs including Nene CCG on joint commissioning projects across Northamptonshire Health and social care partners (e.g. local hospitals, local authorities, local community groups etc) to ensure services meet local needs Northamptonshire Health and Wellbeing Board. This brings together CCGs and the local councils to understand the health, social and wellbeing needs of its community Corby Health and Wellbeing Fora recently looking at alcohol issues and how we localise the Frail & Elderly programme Patients and public patients can join their GP Practice Patient Participation Group, Corby Older People s Health Forum and online membership group
How much do we spend? We are responsible for spending approximately 75million of NHS money on health services for Corby and across the County in joint service provision with Nene CCG We need to look to deliver efficiency savings, whilst at the same time driving up the quality of services We, like all bodies in the NHS need to spend this money carefully to ensure that the providers of the services we commission are providing the best quality care that is efficient and sustainable
What are the nationwide challenges? An ageing population Rise in long term conditions ie heart disease, diabetes Rising expectations ie 7 days a week care Increasing costs drugs, technologies and therapies Shift the focus from buildings to services
What are our challenges in Corby? Preventing people from dying early Enhancing quality of life for people with long term conditions Helping people to recover from episodes of ill health Ensuing that people have a positive and safe experience of care Providing care closer to home the right care in the right place at the right time Supporting people to maintain their own health
The Challenge The future doesn t just pose challenges, but also presents opportunities How do we ensure the NHS remains a HEALTH SERVICE and not an ILLNESS SERVICE?
For discussion Based on the challenges outlined in this presentation, we would like your feedback on the following: What is most important to you and your families and why? Where would you like the CCG to spend their money and why?
Group discussions Meet your facilitators
Feedback
Questions Summary and Close