Prospectus 2013/14
2 NHS Bromley Clinical Commissioning Group Prospectus 2013/14 Contents Welcome 2 Who are we? 3 How do we spend your money? 4 What NHS services are there in Bromley? 4 Bromley GP practices 5 What are we doing well in Bromley? 6 What are we working on in Bromley? 7 How can you have your say or get involved? 8 Contact us 8 Welcome Welcome to the NHS Bromley Clinical Commissioning Group (CCG) prospectus. A series of changes had taken place within the NHS in England recently, so we have written this prospectus to explain what has changed in Bromley, and what NHS Bromley CCG is doing for local people. Dr Andrew Parson, Chair of Bromley CCG, has a strong vision moving forward: To provide the best services for Bromley residents, we need experts on local healthcare at the heart of decisions. GPs are now responsible for buying healthcare locally, as they are in an ideal position to see everything that is going on within their community. GPs across Bromley now work closely with other partners, such as local hospitals, to make a real difference to the delivery of healthcare services for people in Bromley.
NHS Bromley Clinical Commissioning Group Prospectus 2013/14 3 Who are we? On 1 April 2013, the responsibility for commissioning (planning and buying) health services moved from Primary Care Trusts (PCTs) to Clinical Commissioning Groups (CCGs), led by GPs. NHS Bromley CCG became the new organisation responsible for commissioning healthcare services for everyone in the borough. NHS Bromley CCG is responsible for commissioning hospital, community and mental health services for people who live and work in Bromley. Another organisation, NHS England, is responsible for commissioning primary care, which includes GP and pharmacy services, specialist services, and health services for young children, including health visiting and immunisation programmes. More detailed information on the services we buy for people in Bromley are available on our website www.bromleyccg.nhs.uk Bromley CCG is a membership organisation made of all the GPs in Bromley. There are 47 GP practices in the borough which has a registered population of about 326,000. We are led by a Governing Body, who meets in public every two months, which includes: six local GPs one of whom is the Governing Body chair an independent nurse a hospital doctor three lay members who are not clinicians the Chief Officer the Chief Finance Officer the Director of Healthcare System Reform and the Director of Quality and Patient Safety. We also have some non-voting members: Director of Public Health from Bromley Council Executive Director Education Care and Health Services Healthwatch representative
4 NHS Bromley Clinical Commissioning Group Prospectus 2013/14 How do we spend your money? NHS Bromley CCG has been allocated 362.3 million this year to spend on commissioning healthcare services. This money has been given to us by the Department of Health to spend on patient care in hospitals and in the community, on prescribing and other services. As a CCG we have a duty to deliver 10.5million of savings as part of our Quality, Innovation, Productivity and Prevention (QIPP) programme. This is a government initiative to improve quality and also value for money. Our QIPP savings mean that we are able to reinvest money in service and quality improvements. Planned expenditure by area 2013/14: Acute Hospitals 206.4m Mental Health 36.4m Community Health 36.8m Continuing Healthcare 12.4m Prescribing 43.8m What NHS services are there in Bromley? General practice A range of core primary care, including nursing care and medical services are available at each general practice with some practices providing enhanced services, for example flu vaccinations. Your GP will have details on the services available or you can look on the NHS Choices website at www.nhs.uk Community services As well as the GP services, which are commissioned by NHS England, we commission healthcare in the community, and work with other organisations such as the London Borough of Bromley, social care services and the voluntary sector so that patients receive care that works well together. This means that people with ongoing health problems can live at home and be well supported. These services are linked to your GP practices. They include services such as health visiting, physiotherapy, district nursing and school nursing, speech and language therapy, smoking cessation, specialist dentistry, and emergency and out-of-hours care. Hospital services Should you need hospital care, our main local hospital is the Princess Royal University Hospital in Farnborough, which provides a wide range of outpatient services, diagnostics and in-patient beds. It has an A&E that is open 24 hours a day. Mental health Mental health and learning disability services for adults and children in Bromley are provided by Oxleas NHS Foundation Trust. Some of the services they run for us include support groups for carers and families, day services, alcohol and drug treatment and services for people with dementia. In Bromley we also work with local providers for a variety of services including South London and Maudsley NHS Trust and the charity Mind.
NHS Bromley Clinical Commissioning Group Prospectus 2013/14 5 Bromley GP practices 27 17 31 32 1 33 2 19 20 3 4 5 18 36 37 12 13 14 40 6 16 46 43 45 11 7 34 35 38 41 44 42 49 48 47 26 25 Bromley 15 30 39 28 22 29 1. Anerley Surgery Dr C Pattapola 2. Park Group Practice Dr M Fagbohun 21 24 23 3. Cator Medical Centre Dr KPC Carroll 4. Elm House Surgery Dr KPC Carroll 5. Cornerways Surgery Dr M Norton 6. Manor Road Surgery Dr R Vella 7. Bromley Park Surgery Dr Navaratnarajah 9 10 8. Southborough Lane Surgery Dr M Collins 8 9. Stock Hill Surgery Dr J Rawcliffe 10. Norheads Lane Surgery Dr N Sabharwal 11. Bromley Common Practice Dr Chagarlamudi 12. South View Lodge Dr J Heathcote 13. South View Lodge Dr N Payne & Dr Matthews 14. Dysart House Surgery Dr E De Cothi 15. Chelsfield Surgery Dr J Sharif 16. Chislehurst Medical Centre Dr R Fry 17. The Woodlands Practice Dr M Choong 18. Links Medical Practice Downham Surgery Dr S Chavvakula 19. St James s Practice Dr P Dunachie 20. Eden Park Surgery Dr Neve 21. Bank House Surgery Dr H Abbasi 22. Summercroft Surgery Dr L Bailey & Dr M Essop 23. Family Surgery Dr Mackenzie & Dr V Parker 24. Green St Green Medical Centre Dr P Barker 25. Forge Close Surgery Dr Young 26. Pickhurst Surgery Dr A Mahendrarajah 27. Links Medical Practice Mottingham Surgery Dr S Bird 28. Charterhouse Surgery Dr D Williams 29. Knoll Medical Practice Dr Pushparajah 30. The Surgery Tubbenden Lane Dr S Gnanachelvan 31. Oakfield Surgery Dr S Hazra 32. Robin Hood Partnership Dr O Obafemi 33. Trinity Medical Centre Dr M Sahi 34. Tudor Way Surgery Dr Navaratnarajah 35. Whitehouse Surgery Dr A Perera 36. London Lane Clinic Dr MacCann 37. Sundridge Medical Practice Dr A Arora 38. Ballater Surgery Dr J Tavabie 39. Gillmans Road Surgery Dr FJJ Balaratnam 40. The Surgery Highland Road Dr S Gnanachelvan 41. Crescent Surgery Dr K Ring 42. Derry Downs Surgery Dr A P S Bindra 43. Poverest Medical Centre Dr W Okonji & Dr Y T Bahru 44. The Surgery (Begum) Dr M Begum 45. Cross Hall Surgery Dr S Balachandran 46. Broomwood Road Surgery Dr Bamberger 47. Addington Road Surgery Dr S Robertson 48. Wickham Park Surgery Dr D Young 49. Station Road Surgery Dr D Whittaker
6 NHS Bromley Clinical Commissioning Group Prospectus 2013/14 What are we doing well in Bromley? There have already been some key achievements in Bromley. There has been the continuing improvement of services such as the musculoskeletal physiotherapy service and the development of completely new out-of-hospital services, including community dermatology and gynaecology. Case study 1: Musculoskeletal physiotherapy At GP practices across Bromley, over a third of all patients visit with musculoskeletal complaints, such as arthritis and lower back pain. Many of these patients had to be referred to hospital. In Bromley, the number of GP referrals to hospitals was significantly higher than the national figure. It was discovered that: 1. There weren t enough physiotherapy services in Bromley, which created a waiting time of 26 weeks. 2. Because of the length of wait, some GPs were referring patients to orthopaedics or rheumatology consultants in an effort to speed the process up. 3. Patients were also extremely unhappy with the physiotherapy service on offer to them, with many complaints arising. We recognised the potential to improve the delivery of services through new pathways in community settings, such as GP practices, which is often more convenient for patients and a more popular choice. From this we engaged in depth with GPs, hospital doctors and patients to design the best possible new service. Initially, a pilot was undertaken in one area of Bromley, where it was most needed, to test what would happen when additional physiotherapy was offered in the community rather than in hospital. It ran for 12 months and showed positive results. Patients were pleased with the new service so we decided to make them permanent across the borough. Some of the key results of the service have been: A reduction in incorrect referrals An increase in physiotherapy services available A reduction in waiting times for hospital appointments Improved access patients are seen in familiar local settings and offered a wider range of clinic appointment times. The benefits of the service in both quality and financial terms have been significant. Waits for adult musculoskeletal physiotherapy have reduced from more than 20 weeks to approximately four weeks. The number of people needing hospital appointments has decreased and patients and GPs have given overwhelmingly positive feedback about the service. Over 90 percent of patients rated it excellent or good. Case study 2: Leg ulcer clinic A leg ulcer assessment clinic pilot was launched in December at the Princess Royal University Hospital to increase the healing rate for patients with leg ulcers whilst also reducing waiting times. Originally, 15 practices participated from Orpington and Beckenham. They had access to specialist advice and support from the Tissue Viability Nurse where they would also have the opportunity to shadow the District Nurse at the clinic. At the clinic, patients received a comprehensive assessment and treatment plan. Since implementation, the average healing rate for patients with leg ulcers have reduced from 21 weeks to 6. This means that, on average, patients leg ulcers are healing 15 weeks earlier. A patient satisfaction survey was also carried out. It showed that patients and practices valued the clinic and the majority wanted it to continue. This successful pilot led to a full roll out of the leg ulcer clinic for all Bromley residents from August 2013.
NHS Bromley Clinical Commissioning Group Prospectus 2013/14 7 What are we working on in Bromley? We at Bromley CCG have taken into consideration the health needs of the people who are registered with local GPs to help us decide what services we should improve. Some key areas that we will be working together with Bromley Council to improve are: Obesity High blood pressure Diabetes Dementia Smoking Mental health Cardiology Some examples An example of this is that Bromley has a large population of young children aged under 10 years and so we work with Bromley Council to make sure that together we look after the health and wellbeing of the next generation. Another area where that Bromley CCG plans to put improvements in place is the care of older people. This is to ensure their care is handled more proactively to prevent their conditions from deteriorating. This in turn will mean they will need fewer emergency admissions to hospital. This will be accomplished through working with our partner, Bromley Council, to identify patients that are at risk and to put more and better services in place that work together in a joined up way. As a result, patients should feel more supported to manage their own conditions. Some of the changes include: More effective urgent care centres at the Princess Royal University Hospital and at Beckenham Beacon to meet patients needs so that they don t have to go to A&E when they don t need to. A rapid response service that is able to care for patients with complex needs, in their own homes or in other community settings instead of in hospital. Telehealth services will be put into place so that diagnostic readings (such as blood test results) can be communicated direct from patients homes to their GPs and so if the patient seems to be getting worse, the GP can act quickly to alter their treatment. More dementia sufferers diagnosed and treated to slow down disease progression and support for their carers. A greater range of services located at Beckenham Beacon and in at range of other community settings. Examples include clinics for leg ulcers and diabetes. A new health and wellbeing centre is to be opened in Orpington to provide a range of day services to patients.
How can you have your say or get involved? NHS Bromley CCG aims to put the patient at the centre of all that we do. We want you to feel that you are being listened to, and that your views are making a valuable contribution in setting health priorities for Bromley. Through getting involved, you can have a say to help shape the healthcare services that you use. There are many ways to get involved with Bromley CCG: You can participate in patient feedback on services. For more information contact: Patient.Query@bromleyccg.nhs.uk Join your GP practice patient group just contact your GP for details Come along to one of our CCG Governing Body meetings which are held in public. Details and dates are available on our website www.bromleyccg.nhs.uk Through HealthWatch Bromley, the independent consumer body for health and care services. You can contact Healthwatch Bromley by visiting their website at: www.healthwatch.co.uk/directory/bromley Contact us Bassetts House Broadwater Gardens Farnborough Orpington BR6 7UA Phone: 01689 880339 E-mail: info@bromleyccg.nhs.uk