Matthew Webb, Chief Officer (Acting) Commercially Sensitive For the Public or Private Agenda To be publically available via the CCG Website

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Subject: Meeting: Chief Officer s Report NHS Milton Keynes CCG Board Date of Meeting: 24 th November 2015 Report of: Matthew Webb, Chief Officer (Acting) Is this document: Commercially Sensitive For the Public or Private Agenda To be publically available via the CCG Website N Public Y This report provides the Board with an overview of work programmes within the CCG during October and November 2015. 1.0 Milton Keynes and Bedfordshire Healthcare Review 1.1 Programme Executive Milton Keynes and Bedfordshire healthcare colleagues continue to work together to find the right solution to fully address the current and future challenges across both healthcare systems. This process has been overseen by NHS England, Monitor and NHS TDA with the latest Tripartite meeting held on 23 September. Activity undertaken in recent months has included: Further analysis of the detailed modelling that the CCGs have carried out to date, including a clinical and financial review of Bedfordshire s third option; further definition and activity mapping of services within the models; review and agreement of financial viability including revenue assumptions and capital costs; review of adherence to quality and safety standards; and a preliminary review of the clinical viability and sustainability of the models proposed by the East Midlands clinical senate The key focus for the next phase is: to outline and plan work packages to ensure compliance with NHSE assurance requirements prior to public consultation Page 1 of 17

understand and rationalise the capital investment required and transition costs assess the possibility/impact of the IACS model in Milton Keynes consider recommendations from the Clinical Senate understand the impact of proposed changes on local people to help refine and eliminate options establish a Joint Overview and Scrutiny Committee A timetable outlining the key milestones leading up to consultation in 2016 will be available by the middle of November 2015. Healthcare Review work stream updates: 1.2 Clinical Working Group The Clinical Working Group received the East Midlands Clinical Senate report on the Health Care Review. The Group discussed the recommendations and how they would be addressed within the Programme as it goes forwards. The Group agreed that initial work specifically on the clinical standards could be started by the Programme Team prior to the Joint Clinical Working Group being established. The Clinical Working Group chair provided an update on the initial discussion with colleagues in Bedfordshire. Arrangements were now in hand for establishing the Joint Clinical Working Group, and the Group discussed the potential configurations of the Task and Finish Groups that would support this joint working. The Health Care Review Programme Director provided an update on the Tripartite discussions highlighting the input provided on the key clinical elements which focused upon the recommendations from the Clinical Senate and the conclusions provided by Milton Keynes clinical leaders. A short discussion was held on the provision of healthcare across Milton Keynes and Bedfordshire to meet clinical standards. The Group agreed that further work was needed, supported by the hospital to refresh the previous work undertaken almost two years ago. The Programme Team will report back to the Group on the Joint Working Arrangements at the next meeting. 1.3 Financial Working Group The Financial Working Group concluded its joint review with Bedfordshire of the financial models and their assumptions during September. Weekly Joint Finance meetings continued during August and September and the working group produced the following outputs:- Revised 2b & 4 model financial outputs following alignment of the various assumptions driving the models. Page 2 of 17

Amendment to the financial outputs of Bedfordshire s IACS Model following scrutiny and alignment of methodology. Final response to a number of challenge questions regarding the model assumptions and output issued by the three regulators Completion of a detailed analysis of the activity flows by specialty across all of the models being considered, ensuring consistency between each model. A report produced by the NHS England Capital Assessment Team following engagement with both Providers and site visits to aid the Regulator scrutiny of the capital calculations in the financial models. Production of a bridge analysis for revenue to show the reason for any changes either from the McKinsey output or in the case of the IACS model the original baseline position to now. This work was presented to the Tri-partite regulator meeting on 23 September, to enable to them to take a view on which models to take forward to the next stage. 1.4 Communications & Engagement Group The HCR Communication team have maintained a relatively low profile during September, and focused on preparing for the outcome of the tripartite meeting and upcoming events. This included MK CCG and the Healthwatch AGM, which both had Healthcare Review representation. In addition to this, we have led on developing messaging/materials for the respective oversight and scrutiny committees on behalf of Milton Keynes and Bedfordshire, which took place late September/early October (BCCG JHOSC on 28 September and MK HASCC on 6 October). These meetings attracted local media interest and resulting coverage focused on the lack of information and progress, and the significant costs already incurred. In response, we issued a reactive statement which highlighted recent works undertaken/ still to be done and committed to a revised timeline being available mid-november leading up to consultation in 2016. This message was also shared with staff at MK CCG and MKUHFT. An initial draft of the review of pre-consultation engagement activity was received and the team have sought to provide further information as highlighted to support that process, providing evidence of previous engagement activity. The outcome from that piece of work will be a paper recommending further activity that may need to take place, in readiness for public consultation. This was not a formal evaluation or Quality Assurance activity but a sense check carried out by Participate who have previously been involved in the Review and are well placed to provide this type of external guidance and advice, endorsed by the Consultation Institute. Finally, work is currently underway to update the Communications and Engagement strategy, in partnership with our Bedfordshire colleagues, in preparation for moving into the next phase. A key focus of this will be preparing a Page 3 of 17

communications plan to support the strategic sense check and future announcements / stakeholder engagement when a decision has been reached around which option(s) will be taken forward to consultation. 2.0 Urgent Care 2.1 A&E Performance The 4 hour standard was achieved for both quarters 1 and 2. Performance has slipped as we move into autumn/winter months with performance year to date (as at 2 November 15) of 94.9%. The majority of breaches are due to a lack of availability of beds when needed. Accordingly, MKCCG and partners across the system continue to focus on supporting flow through the hospital and into the community. The hospital continues to work to its Flow Action Plan. 2.2 A&E activity A&E activity continues to be above last year (approx. 3.5%). The extended hours of GP access provided via the Prime Minister s Challenge Fund should help to address some of this activity. 2.3 Integrated Urgent Care The CCG continues to work through potential contracting and financial models whilst the clinical working group has met again. Individual task and finish groups have been set up to walk through the different clinical pathways (paediatrics, mental health etc). The final clinical model will be signed off by the Clinical Design Group on 25 November 2015 and ratified at the Programme Steering Group the following day. Building work is to be completed on 14 December Page 4 of 17

2015. The full business case will be considered by the Commissioning Delivery Group (CDG) on 1 st December 2015 and potentially by the Board in January 2016. 2.4 Getting People Home The Getting People Home trial continues with 2 patients a day being discharged for assessment in the community. Detailed capacity modelling is underway to inform the final financial commitment required from all parties in order to make a more substantial impact from this initiative in the Milton Keynes Health Economy. 2.5 Self-care and 111 Communications Campaign MKCCG have worked closely with GEMCSU on a communications campaign to increase awareness and utilisation of self-care, 111 and pharmacy. There have been numerous outreach events with the general public and specific input to some of our local Child Health Centres. A survey has also been circulated to local carers via the local charity Carers MK which will help commissioners better understand the urgent care needs of our local carers. 3.0 Primary Care Development Work Stream 3.1 Referral Management Service (RMS) As e-rs reports have not been available since June, it has not been possible to vet the usage of the RMS service by MK GP Practices. However, based solely on regular activity summaries provided by the RMS, usage of the service remains high and on track with overall usage expected in the region of 80-90% by year end. Again with reports only available from the RMS, deflection rates to community services continue to perform well across all triaged specialties. With the performance and instability of the e-rs system, a backlog developed within the RMS with routine referrals mainly with the booking stage. This resulted in the service not meeting its contractual timescales for booking appointments resulting in some KPIs not being met. This backlog has now been cleared and the service is once again back on track. The CCG will continue to work with the service and monitor performance across both e-rs and the RMS service. 3.2 Practice Based Budgets There are 3 audits that are being completed/have been completed. Feedback from these will be presented in the relevant Neighbourhood meetings in November. The PBB steering group is planning the new budget lines for 2016/2017 with the relevant paper to be presented in January/February next year. Current new budget lines being scoped are a. A+E majors out of hours b. A+E majors in hours Page 5 of 17

c. A+E minors out of hours d. UCS out of hours e. Emergency admission HRG K (general medicine) f. Length of Stay for emergency admissions, 0 days and 1 days g. Excess bed days h. Direct access diagnostics i. NHS 111 j. Prescribing k. RMS to acute to community usage per practice l. Investigate inclusion of LoCoS in budget Further meetings are also being scheduled to discuss the PBBs in the context of Public Health and where the budget and related health conditions both appear as outliers. 3.3 Musculoskeletal (MSK) The procurement of Community Musculoskeletal Physiotherapy services has recently been completed and recommendations have been made by the evaluation panel to the Programme Board. Once final approval has been given to award contracts, in line with the CCG s governance processes, formal notification will be issued late November 2015. This service is on plan to commence 1 April 2016. 3.4 Quality in Primary Care Transformation Schemes for patients over 75 years of age A report summarising all of the learning from the projects is being prepared to share with health and social care partners and all practices in MK later in the autumn. All of the practices who participated in the pilot project have been thanked for their contribution, the improvements they have made in the care of their patients aged over 75 years and for the learning they have generated about delivering change in primary care. An options paper (including a lessons learned report) has been submitted to the Care Pathways and Primary Care Board and subsequently to the Commissioning Delivery Group. Page 6 of 17

3.5 Primary Care Developments Co-Commissioning Primary Care Services NHS England (Central Midlands) Primary Care Commissioning Panel (PCCP) reviewed MKCCG s submission for Joint Co-Commissioning and gave their formal approval at the end of September. The outcome will be reported to their Executive Committee and NHS England National Team. There have been shadow meetings of the Co-Commissioning Joint Committee over the summer and the first formal Co-Commissioning Joint Committee meeting took place on 19 October 2015. Procurement Phoenix Primary Care has commenced as the new provider with an APMS contract for the Kingfisher practice, following a procurement process which was led by NHS England and involved the Chair and Director of Transformation and Delivery from the CCG. The new provider took over on 1 October 2015. Preparation for the procurement process for Broughton Gate / Brooklands practice is underway with jointly NHSE. Primary Medical Services (PMS) Reviews PMS practices, of which there are 13 within MKCCG, have submitted their preferred PMS contracting option to NHS England. All 13 have chosen option 3 return to GMS with transitional support (over 5 years from 1 April 2016) NHS England and MKCCG have set up PMS Task and Finish groups to identify the reinvestment of PMS monies which are from PMS contracts. The Task and Finish Group is a joint NHS England and CCG group and has representatives from GMS, PMS contractors, the CCG, NHS England and the LMC. The Task and Finish Groups have considered and made recommendations for the reinvestment of PMS monies for year 1 and will now carry out more work to consider the criteria for years 2-5. The following proposal has been agreed for the reinvestment for year 1 (2016/17): A fixed sum per patient, based on raw list size and capped by the total monies released via PMS reviews in year 1, will be allocated to all PMS and GMS practices in Milton Keynes in return for the practices undertaking a data collection exercise about services which Milton Keynes GPs consider are not funded by the core GMS contract and actively engaging in discussions with the CCG to develop the reinvestment criteria for year 2 and beyond. Page 7 of 17

3.6 Prime Minister s Challenge Fund A Collaboration of 22 GP practices in MK was successful in securing a bid for 1.8m from The Prime Minister s Challenge Fund to improve access to primary care in MK. Since the last Board report, work has continued in the following areas: Extended access to GP appointments Children s primary care team GP and pharmacy input to the rapid response team Implementation of SystmOne Development of the Collaboration Phase 1 of the extended access to GP appointments started in September. This involves the hub practices (see below) offering extended access appointments to their own patients: Broughton Gate CMK Wolverton The Grove Parkside Phase 2 of extended access is the full implementation of the scheme, whereby MKUCS will manage the delivery of the extended access appointments open to patients from all 22 practices in the collaboration. It is expected that these appointments will become available in early December, although this is subject to achievement of CQC registration for the service and implementation of SystmOne, both of which may be challenging for the programme to achieve in the timescale. There is an added risk around the national issue of GP recruitment that also challenges this project. Good progress has been made with the introduction of the children s primary care team. The service commenced on 14 October with the first referral received from a morning GP consultation. The Team Leader started in late September and further members of the nursing team have been recruited all with differing start dates. The roll out of SystmOne has happened and the service will use the community module which has also been secured and in place. Clinical pathways are being developed and the project has secured consultant input to the project from Milton Keynes Hospital Foundation Trust. In addition a GP Champion has also been appointed and there are regular meetings of the Task and Finish Group. Page 8 of 17

Milton Keynes Hospital Foundation Trust will be providing the pharmacy sessions into the Rapid Response Service and is undertaking medicine reviews to support the Rapid Access Intervention Team (RAIT). A start date of 23 November has been agreed. The service is currently advertising for GP sessions. NHS England is accountable for performance managing the Prime Minister s Challenge Fund Programme in MK and formal progress reports are being reported to the Co-Commissioning Joint Committee on a monthly basis. 3.7 Medicines Management The Pharmaceutical Advisers have completed their annual round of visits to practices. These visits provided the opportunity to discuss prescribing hot topics, reflect on performance during the previous year and ensure practices are working on the 2015-16 Prescribing Incentive Scheme. The visits have generated some good discussions and re-enforced the need for prescribers to make cost-effective as well as clinically effective choices of medicines. Discussions are currently under way with each practice to understand how they use OptimiseRx (a prescribing decision support tool), what the barriers are and what improvements could be made. The team is working closely with First Databank to develop software functionality. Over 70% prescribing is for repeat prescriptions issued every month or two months and so these are driving the prescribing expenditure. It is important to minimise waste and help patients use their repeat medication effectively. The Pharmaceutical Advisers have adopted a campaign to encourage patients to Open Up about their medicines and tell their healthcare professional if they are having problems or no longer using certain items. The campaign will go live on the CCG website shortly. Patient Congress and Healthwatch are helping with a patient survey to gather information about how patients order repeat medicines. This will be used to inform discussions with practices and community pharmacies about managing repeats The Advisers are also working with AgeUK to see how their team can support patients at home who may have difficulty ordering appropriate quantities of repeat medicines. There are several significant pieces of work underway with clinicians from primary and secondary care. The Adult and Paediatric Vitamin D Guidance has been finalised and circulated. There is a focus on diabetes as a therapeutic area. Work includes Review of blood glucose meters and strips to ensure choices are cost effective and meet International Standards Revision and re-issue of blood glucose monitoring guidance Audit of the use of GLP1s against NICE Guidance; results will inform discussions with practices Page 9 of 17

Agreed that Diabetes Lead will support practices to use NPH insulin ahead of insulin analogues Considering possible formulary changes Looking at the evidence for biosimilars insulins Medication pathways for COPD and Pain Management remain key areas for agreement between primary care and secondary care. Work on these areas is continuing. 3.8 Respiratory Pathway Respiratory referrals via RMS Respiratory Medicine referrals from RMS are clinically triaged by the local GP Respiratory lead. From January to August 2015 there were 365 referrals sent to the RMS from primary care for triaging. Approximately one third of these referrals were managed outside of secondary care services: 13% of referrals were returned to the GP s with advice and guidance 21% of referrals managed within the respiratory intermediate service (PCOC) Although 66% of referrals were directed through to MKUHFT, a large proportion of these referrals were due to complex respiratory conditions such as intestinal lung disease, Bronchiectasis and abnormal chest x-ray findings. It is worth noting that MKUHFT Respiratory Medicine activity plan (August 2015) indicates a decrease in first attendances down to 87 against a plan of 104. Respiratory PCOC: The PCOC still continues to see and treat patients following discharge from MKUHFT following unplanned admissions due to exacerbation of COPD. This pathway has been further revised and now includes referrals from A&E and AECU attendances with appointment times approximately two weeks from receipt of the discharge summaries. In October 2015, the Respiratory MDT session was launched. These sessions are held jointly between the hospital respiratory team (Respiratory consultant physician, respiratory specialists nurses and physiotherapist) together with the PCOC GPwSI s. By utilising the Vidyo conferencing IT platform, GPwSI s now are able to have face to face discussions on individual cases, view diagnostic images and pathological results. This collaborated approach between the hospital Respiratory team and the GPwSI s increases the cohort of patients that can be deflected from secondary care and treated within the PCOC. Keep Active-Keep Well Programme MK/BLF/Sports for England: Page 10 of 17

The BLF/Sports England funding has now been secured to develop a 12 week behaviour change programme for people with lung disease. This project will be delivered in two phases with Phase 1 commencing in January 2016. As a pilot site for BLF, MK will become a showcase for BLF in developing a legacy tool to support in the treatment of COPD. Respiratory Education Programme for HCP A half day teaching programme is planned for the New Year which will focus on the management of respiratory medicine within primary care with the topics delivered by MKUHFT Respiratory consultant, GP clinical lead and MKCCG Pharmacy team. 3.9 Diabetes Adult Care Pathway Clinical Lead MKCCG has now successfully appointed a clinical lead for Diabetes who will provide clinical expertise to support the new model - a patient centred integrated hub for Diabetes care in MK. This will be a phased implementation rollout with a scheduled completion date of April 2017. This role will also provide clinical representation as MK membership at the Thames Valley Steering Clinical Network (TVSCN). Patient Education Programme DAFNE Type 1 education programme is now at the tendering process with a contract award scheduled for December to allow service mobilisation early next year. Type 2 elearning modules have been evaluated by the panel of expert services users and clinicians with a recommended option for implementation. A full business case to support this recommendation is being developed which will provide a blended learning approach for Type 2 education, one of the recommended approaches identified by TVSCN for commissioning education and support for self-management care. Primary Care Support Bespoke education programmes will be rolled out to individual practices where there has been a variation of the 9 care processes for Diabetes. This programme will be delivered by the Consultant Diabetologist with support from diabetes specialist nurses and pharmacists, the main focus will be on the management of risk factors associated with diabetes (blood glucose levels, blood pressure & cholesterol). This will also include a review of medicines to help support practices with optimisation of medications. Page 11 of 17

Prevention Programme Black Asian Minority Ethnic (BAME) Diabetes awareness programme will commence from November with awareness training sessions being delivered by service users from Diabetes UK-MK to approximately 20 BAME Health Ambassadors. BAME Health Ambassadors will be empowered to cascade awareness sessions within their communities over the next three months. This is a collaborative programme which has shared responsibility from MKCCG, Public Health and MK Equality Council. 3.10 Atrial Fibrillation (AF) Opportunistic Screening Project GRASP Atrial Fibrillation training has now been carried out for all Milton Keynes practices. Autumn AF Campaign October 2015 to raise awareness of AF and to opportunistically screen patients by taking their blood pressure with a monitor that detects AF carried out. 4.0 Quality & Safeguarding 4.1 Female Genital Mutilation Milton Keynes CCG has been leading multi-agency work on behalf of the Milton Keynes Safeguarding Children s Board (MKSCB) to count female genital mutilation (FGM) cases. FGM is one of the MKSCB priority areas for 2015/16. The CCG Head of Safeguarding established and chaired a multi-agency task and finish group to develop and implement a strategy based around 3 key themes; Care for those who have undergone FGM Protection for those at risk of FGM Prevention of FGM through engaging with communities. A range of resources for Health, Social Care and Education have been developed. This includes guidance and training for practitioners, pathways for responding to health needs, safeguarding procedures and screening tool, and access to a multi-agency panel. http://www.mkscb.org/mkscbprofessionalsandvolunteers/displayarticle.asp?id=93724 A conference to launch the resources was held on 29 th September and attended by over 180 people from across Milton Keynes agencies. The conference included a powerful performance by a Sierra Leone drama group, who had been affected by FGM. The drama group also presented to community and faith leaders as part of our community engagement work. Following the successful launch, Milton Keynes has had very positive reviews from other areas and requests to share the work undertaken. Page 12 of 17

4.2 Nursing and Midwifery revalidation On the 8 th October 2015, The Nursing and Midwifery Council (NMC) confirmed and formalised the decision to introduce revalidation for all nurses and midwives in the UK: the most significant change to nurse regulation for many years. Revalidation requires all register nurses and midwives to demonstrate on a regular basis that they are able to deliver care in a safe, effective and professional way. All registrants will have to show they are staying up to date in their practice and applying the NMC Code of practice, by reflecting on their practice and engaging in discussions with colleagues. For the first time, they will also have to obtain confirmation that they have met all the requirements before they apply to renew their registration every three years. Nearly 16,000 nurses and midwives will be the first to revalidate in April 2016. All 685,000 nurses and midwives on the NMC s register will go through the new process as their registration becomes due for renewal over the course of the next three years. The CCG is working with CCG staff, providers, care homes and GP practices to ensure that nursing and midwifery registrants are supported to meet the new regulatory requirement. 4.3 Continuing Healthcare MKCCG in-housed the Continuing Healthcare (CHC) service from Arden GEM on 1 st September 2015. The team are improving adherence to the National Framework through rigorous application of the fast track process and commissioning packages of care based upon need. The CCG has agreed to enter a joint procurement exercise with the Local Authority for Domiciliary Care services. This procurement is expected to be completed by September 2016. 5.0 Workforce & Organisational Development 5.1 Recruitment & Resourcing The CCG is constantly operating in a challenging environment and is required to ensure it is resilient in terms of capacity and capability. Further to the September update, the CCG continues to drive forward initiatives to support the changing requirements of the CCG, comply with government directives around the use of contractors and ensure its resourcing will withstand financial scrutiny. In this reporting period, the total number of personnel engaged is 86 (substantive, contractor, secondment), 73 of which are substantive. As can clearly be seen from the chart below, the number of new starters within the CCG has increased substantially over the last reporting period; these posts are primarily roles which will enhance capacity and competency within the CCG to deliver on statutory requirements or support the delivery of a newly in-housed Page 13 of 17

Continuing Health Care service. The remaining roles are replacement for staff members who left earlier in the year. Chart 1: Workforce Breakdown November 2015 During recent weeks, the CCG has initiated plans to move some Contractors onto Fixed Term Contracts, helping to reduce staffing costs, in the long-term, and ensure compliance with HMRC regulations. The CCG will continue to drive this initiative forward and discuss options with other Contractors, currently engaged with the CCG, where appropriate. The CCG continues to recognise the requirement to minimalise the use of contractors across the NHS and ensure there are defined plans and justifications for each role where an agency worker or Contractor is engaged. To support a review of resource costs, the CCG has initiated a Vacancy Freeze. All posts, which do not impact directly on patient safety or care, have been placed on hold. Any variance to this must be approved by the Chief Officer. New Starters o Continuing Healthcare Nurse Assessor & Case Manager o Continuing Healthcare Pathway & Placement Officer o Children s Commissioning Development Co-ordinator o Clinical Quality & Effectiveness Facilitator o Head of Performance o Head of Programme Management Office o Whole System Programme Manager o Programme Manager Getting People Home & Integrated Urgent Care (Fixed Term Contract) Page 14 of 17

Leavers o Deborah Henriksen, Head of Programme Management Office 5.2 Lay Board Member Recruitment Following a robust selection process, the CCG is pleased to announce the formal appointment of Mike Rowlands, Peter Kara and Will Perks to Lay Member roles on the CCG Board. Mike Rowlands, a previous Lay Member for the CCG, will continue to undertake responsibility for Patient & Public Involvement. Peter Kara has substantial experience of Financial and Audit matters and will have responsibility for Governance. Will Perks has a wide consultancy background working with a number of different health providers and will focus on Primary Care and Co-Commissioning. The CCG welcomes them to the CCG Board. 5.3 Training and Development The CCG continues to consider the training and development of its staff as important. Work has begun on the 2015/16 round of Appraisals which is a principal source of information as to development needs within the CCG. The CCG is also developing a draft high level training plan for the remainder of 2015/16 which considers CCG staff needs, alongside current financial constraints. In October, a Board Development workshop was held focusing on the Board Assurance Framework. This highlighted process, best practice and the role of the Board in reviewing the document. Mandatory, Information Governance and Fraud & Bribery show a downward trend in the chart below, however this is partially explained by technical issues which have resulted in staff unable to complete training. This matter is being progressed with IT and the training providers. The CCG will also continue to stipulate to staff the requirement to complete mandatory training. Jan, 2015 Mar, 2015 May, 2015 July, 2015 Sept, 2015 Nov, 2015 Mandatory 86% 77% 79% 80% 78% 67% Training Information 86% 78% 81% 84% 84% 65% Governance Fraud & Bribery Training 83% 83% 83% 85% 85% 79% Baseline Downward Trend Upward Trend Static Table 1: Training compliance 5.4 NHS National Staff Survey The NHS National Staff Survey was launched on 23 rd September. The survey is split into several categories which encourage staff to share their views about their Page 15 of 17

job and the organisation where they work. The National Staff Survey is also an important way of ensuring that the views of staff working in the NHS inform local improvements and support national assessments of quality and safety, and delivery of the NHS Constitution. The survey ends on 30 th November 2015 and following the publishing of results, in early 2016, the CCG will be able to use the survey findings to improve working conditions and staff experiences. 6.0 Communications & Engagement 6.1 Annual General Meeting (AGM) Our AGM took place at the Oldbrook Christian Centre on 15th September. Presentations included highlights from 2014-15, an overview of our accounts, a view from a CCG GP Board Member and a video about the new Multi- Disciplinary Team. We also welcomed partners including Milton Keynes University Hospital Foundation Trust, Carers MK and HealthWatch to share some of their ongoing work and projects at a market place. The CCG also had stands to showcase end of life advanced care planning, young people s views on health, our urgent care campaign and the Healthcare Review. 6.2 Urgent Care Campaign Our Urgent Care Campaign came to a close in October. The campaign had two key strands NHS 111 and MK Pharmacy First. The campaign aims were to: Reduce low level A&E attendance through increased use of NHS 111 and Pharmacy First. Increase awareness and understanding of NHS 111 and Pharmacy First. Increase awareness and understanding of self-care. There were two main target audiences parents/carers of young children (0 10 years) and carers of people with long term conditions. We have engaged CarersMK as a key campaign partner and they will help us access carers. A survey of carers to understand their issues with urgent care and any barriers to self-care is underway and we are looking forward to seeing some valuable insight from that piece of work. To reach our target audience of parents and carers of young children, we have been attending family events, shopping centres and children s centres over the last few weeks. We attended 17 events in total. An evaluation of the campaign is underway. Page 16 of 17

6.3 Winter Campaign We will be supporting NHS England s Stay Well This Winter Campaign this winter. The campaign runs from late October until the end of January. In October the campaign focusses on promoting the flu vaccination to pregnant women, children under 5 and the elderly and frail. From November onwards key messaging will be around keeping well over the winter and preventative messages. We will be using our social media channels, website and campaign materials such as posters and leaflets to promote messages alongside a detailed PR programme with local media. 6.4 Media Working with the local media is an important part of our work. We value their support in sharing our news stories and health messages that we want to get out to local people. The work of the CCG continues to be covered in local media. As flu season begins, we have joined up with Public Health to issue joint flu messages. Our media releases to date, which focussed on at-risk groups and then specifically pregnant women, both gained local media coverage. Throughout the period, we have continued to push NHS 111, self-care and Pharmacy First messages as part of our Urgent Care Campaign. We used social media to support all of our media releases as well as the national Stoptober campaign, mental health awareness day, back care awareness week and messages on World Heart Day linked to our Autumn AF (Atrial Fibrillation) campaign with GP practices. Over the last two months we have gained 84 new followers across our social media accounts to add to our network of individuals and organisations we communicate with daily. 6.5 HealthWatch Event We attended the annual HealthWatch Event at Centre MK in early November where we had a stand with information about the CCG, local urgent care services and the Healthcare Review. We spoke to members of the public who were interested in finding out more about the CCG and being updated on the progress of the Healthcare Review. We also conducted surveys with members of the public on how and when they order repeat prescriptions. Page 17 of 17