Prospectus 2013/2014 Improving health services for the people of Greenwich
Contents Page Welcome 3 Your NHS 4 Who we are 4 What can you expect in Greenwich? 5 How we spend your money 6 What is working well? 8 What needs to change? 9 What are we going to do about it? 10 Ways you can have your say 12 Our Governing Body 14 How to contact your local services 15 2 NHS Greenwich Clinical Commissioning Group Prospectus 2013-14
Welcome Welcome to the NHS Greenwich Clinical Commissioning Group prospectus. We hope that you will find it interesting and useful. The NHS in England has recently changed and so this booklet has been produced to help people in Greenwich understand what has changed and how to get the best out of the NHS locally. GPs are now at the heart of local healthcare decisions. As local clinicians we know and understand our patients needs from their healthcare services. We take these responsibilities given to us extremely seriously and together with experienced colleagues on our Governing Body and other local partners, we are ready, able and enthusiastic about making real change to the delivery of healthcare services to the Greenwich population. Dr Hany Wahba, Chair, NHS Greenwich Clinical Commissioning Group Governing Body Improving health services for the people of Greenwich 3
Your NHS The NHS is vital for all of us. To protect the NHS and make sure that it will always do the things it was set up to do in 1948, the NHS Constitution has been created. The NHS Constitution ensures that the NHS will provide high-quality healthcare that is free for everyone and this continues to be the case throughout the NHS today. On 1 April 2013, the responsibility for commissioning health services has moved from Primary Care Trusts (PCTs) and Strategic Health Authorities (SHAs) to newly formed Clinical Commissioning Groups (CCGs) and NHS England. Commissioning is the process of ensuring that health and care services are provided effectively, and meets the needs of the whole population. Clinical Commissioning Groups are formed of general practices. NHS Greenwich Clinical Commissioning Group is now the organisation responsible for commissioning hospital, community, and mental health services for the local population of Greenwich. NHS England will be commissioning more specialised services (such as specialist cancer services from the Royal Marsden hospital or specialist procedures such as heart valve replacements from specialist cardiac centres), primary care services including GP and pharmacy services, and health services for the under fives, including health visiting and immunisation programmes. Who we are The NHS Greenwich Clinical Commissioning Group is made up of all the GP practices across the borough. Our aim is to secure the best possible health and care services for the people of Greenwich, specifically in primary care settings and in hospitals as necessary. In doing this, we will work with patients and the wider public to develop the services that we offer, reduce health inequalities and improve health outcomes. There are 42 GP practices serving the borough with a registered population of approximately 275,000. Each practice belongs to one of five Syndicates (groupings of GP practices). These Syndicates are formed around natural partnerships, which share a combination of being near to each other and the ability to work closely together and share good clinical practice across all GP practices. We have a Governing Body, details of which are provided towards the end of this booklet. 4 NHS Greenwich Clinical Commissioning Group Prospectus 2013-14
Greenwich GP Practices 24 As At March 2013 1 Abbey Wood Surgery 2 Alder Wood Road Surgery 3 All Saints Medical Centre 4 Anglesea Medical Centre 5 Bannockburn Surgery 6 Basildon Road Surgery 7 Blackheath Surgery 8 Briset Corner Surgery 9 Burney Street Practice 10 Burrage Surgery 11 Carnbrook Medical Practice 12 Clover Health Centre 13 Coldharboursurgery 14 Conway Medical Centre 15 Dr D N Char s Practice 16 Dr M Baksh s Practice 17 Dr M Hashim 18 Dr Mostafa PMS 19 Dr Ns Guram s Practice 20 Eltham Palace Surgery 21 Eltham Park Surgery 22 Escreet Grove Surgery 23 Ferryview Health Centre 24 Gallions Reach Health Centre 25 Glyndon Medical Centre 26 Henley Cross Medical Practice 27 Manor Brook Medical Centre 28 Millenium Village Health Centre 29 New Eltham Medical Practice 30 Plumstead Health Centre 31 Rochester Way Surgery 32 Shawbrooke Road Surgery 33 Shooters Hill Medical Centre 34 South St Medical Centre 35 St.Marks Medical Centre 36 Thamesmead Nhs Health Centre 37 The Fairfield Centre 38 The Mound 39 The Slade Surgery 40 The Trinity Medical Ctr 41 The Waverley Practice 42 Vanbrugh Group Practice 43 Well Hall Surgery 44 Wellbrook Practice 45 Westmount Road Surgery 46 Woodlands Surgery 17 34 9 46 42 28 7 19 27 44 26 32 What can you expect in Greenwich? 37 33 11 31 8 NHS Greenwich Clinical Commissioning Group has the responsibility of ensuring that patients receive good quality services and to do this GP members review the quality of care of patients and work with doctors, nurses and therapists to improve the service provided to you. A range of core primary care medical services are available at each practice with some practices providing enhanced services. Your GP will have details on the services available or you can look on NHS Choices www.nhs.uk. Greenwich healthcare services are provided across the borough by GP practices, hospitals, dentists, pharmacists, optometrists (opticians), and a range of community health services, mental health services, and specialist services. Access to NHS services is free and residents have a large choice across Greenwich. 22 20 23 45 3 4 21 43 13 38 12 40 29 41 35 25 14 2 36 18 5 15 30 39 6 1 Improving health services for the people of Greenwich 5
We have healthcare services in the community that work together with other organisations such as the Royal Borough of Greenwich, social care services and the voluntary sector so that patients receive integrated care that is joined 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. Should you need hospital care, our main local hospital is Queen Elizabeth in Woolwich, which provides a wide range of outpatient services, diagnostics, and in-patient beds. It has an A&E department that operates 24 hours a day and an Urgent Care Centre open from 8am to 11pm, seven days per week. This is one of two hospitals run by Lewisham and Greenwich NHS Trust. Another key hospital facility for Greenwich residents is Queen Mary s Hospital, Sidcup which is run by Oxleas NHS Foundation Trust. Queen Mary s also provides a wide range of outpatient services, diagnostics and day case in-patient beds and has an Urgent Care Centre which operates 24 hours a day, seven days a week for minor injuries, burns and illnesses. Patients can choose which hospital they go to and should seek advice from their GP at the point that a referral is made. All hospitals have websites or direct access phone numbers and a list is available at the end of this booklet. There has been a lot of news about changes to hospital services and your GP will be kept informed about any changes made. All services are continuing as normal for now. Our integrated community services are provided by Oxleas NHS Foundation Trust, together with the Royal Borough of Greenwich. Oxleas NHS Foundation Trust also provides mental health and learning disability services for adults and children. 6 NHS Greenwich Clinical Commissioning Group Prospectus 2013-14
How we spend your money Our total budget for this financial year is 341.8million. This is the money that 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 costs. We also have a duty to deliver around 9.9million of savings which our Quality, Innovation, Productivity and Prevention (QIPP) programme enables us to do. The QIPP programme is a government initiative to improve quality whilst we save money. Our QIPP savings mean that we are able to reinvest in service and quality improvements. Budgeting for a surplus (underspend) of 1% is a national requirement for all Clinical Commissioning Groups and this is returned to us in the following year. Acute Hospitals: 174.9m Mental Health: 44.7m Community Health: 25.1m Continuing Health Care: 17.6m Prescribing: 37.2m Primary Care Enhanced Services / Out of Hours: 1.8m Other Programme: 15.5m Other corporate costs (non-running): 0.6m Running Costs: 6.6m Reserves: 14.4m Key Acute Services General hospital services that treat people for specific conditions for a short time. Mental health Money to pay for mental health services in the community. Community Health The provision of general community based and out of hospital care services. Continuing Health Care The cost of packages of care that are arranged and funded by the NHS for individuals who are not in hospital but who have complex ongoing healthcare needs. Prescribing Prescription costs. Primary Care Enhanced services, and the cost of out of hours provision. Other Programme Items of spend that can t be categorised within main headings, such as sexual health and support for local social services. Running Costs Expenses associated with administering a business on a day-to-day basis. Other corporate costs other corporate costs besides normal running costs. Reserves reserves and contingencies, including the requirement to create a surplus. Improving health services for the people of Greenwich 7
What is working well Our new integrated services aim to provide easy access to high quality, responsive primary and community care for all and we have made it easier for patients to reach the professional healthcare they need. We make sure that everyone has equal access whilst giving high priority to those who are in high risk groups. These include those people suffering from longterm conditions such as heart conditions, chronic obstructive pulmonary disease (COPD), and diabetes, the frail and elderly, and people who require end of life care. Patients with long-term conditions now have more services to help them manage their own condition supported by clinical experts and caring staff in the community. We have also designed services around the needs of patients in their last year of life, ensuring that the right equipment, support and care is available so that they can live their remaining days in their preferred care setting, including their own homes. An enhanced community service is being developed and tested, for those children and young people who suffer from mental health problems so that they can remain with their families before their needs become such a problem that they need to go into hospital. We strongly believe in prevention. For people suffering from short-term ill health we have commissioned a number of services in the community in more convenient locations. These services include dermatology, gynaecology and minor surgery, which are now provided across a number of providers, offering greater choice for patients and better value for money. We have made some changes in the past, which have improved services in Greenwich over time. A good example of this is the diabetes service, which provides better GP and community services and now Greenwich has one of the lowest admission rates for diabetes complications in London. Similar services have been developed for people who have chronic obstructive airways disease (COPD) and heart failure. There is more to do and here are a few service improvements that have come into existence in 2013: We now have a new Early Supported Discharge for Stroke Patients team in place. This is made up of physiotherapists, occupational therapists and nurses and enables people who want to come home for their rehabilitation to do so. We have enhanced the GP service that supports people in old age when they are living in residential homes. Greenwich and Bexley Community Hospice has been awarded the contract for services in the last year of people s life. They manage services delivered by the Hospice, together with Oxleas NHS Foundation Trust and Marie Curie so that services are fully integrated. 8 NHS Greenwich Clinical Commissioning Group Prospectus 2013-14
What needs to change? Every year we complete a local health needs assessment with the Royal Borough of Greenwich, and look at how well we are delivering our services to local people. We listen to what people tell us and, as a result, we have identified a number of health conditions and diseases that have the greatest impact on the health of Greenwich residents. This shows us where we need to take action to improve services. For instance, we know that we need to do more to help local people to stay healthy, especially given the large number of years of life that are still lost due to cardiovascular disease (for example, heart attack and stroke), cancer, and as a result of obesity. People tell us that they have problems accessing services and they would like access to be less complicated. They want urgent access to advice and care, need to be able to access GPs and primary care services more easily, and would like to have increased telephone support. At the moment, too many people go to A&E departments in hospitals for conditions that are not caused by accidents or are not emergencies because they feel unable to access primary care. Those people with long-term health problems also ask for more help in managing their conditions, especially those with mental health problems. In addition, an increasing number of people living with Alzheimer s disease and a growing number of people being diagnosed with diabetes would also like some help. In turn, local carers looking after those people with long-term health conditions need extra support to help deal with their own health needs as caring for someone can stop people from caring for themselves. Improving health services for the people of Greenwich 9
What are we going to do about it? In order to address the issues raised locally, we have developed guiding principles intended to improve the quality of the patient experience in Greenwich. NHS Greenwich Clinical Commissioning Group will apply these principles when making decisions by: Improving health outcomes with a special focus on the seven main health conditions and diseases in Greenwich. These are cardiovascular disease, cancers, respiratory disorders, mental health, falls and fractures in older adults, alcohol related harm and diabetes. Reducing health inequalities by taking a preventative, proactive approach and focusing on the health needs of black and minority ethnic communities and hard to reach groups. Improving collaboration between healthcare providers in order to ensure closer integration with Social Care, Public Health and other partners. Ensuring service improvements in areas where we link clinical services with primary care. Focusing our efforts and the money available on changing those services that can have the biggest impact for all patients if provided in a different way right place, right care, right time. 7 Integration & Competition Working with a range of organisations that provide healthcare to make sure that all these services work together effectively. We may use competition to choose who provides services where we can identify a clear benefit to patients. 1 Improving Health Outcomes Reducing Health Inequalities 2 Simplifying clinical care pathways and designing an integrated approach to accessing and using services. Encouraging self-management of long term conditions wherever possible and reducing avoidable hospital admissions. 6 Improving Collaboration 5 Promoting Self Management OUR APPROACH Right Service Right Place Right Time 4 Simplifying Care Pathways 3 In the community when possible, in hospital when necessary 10 NHS Greenwich Clinical Commissioning Group Prospectus 2013-14
Our clinical priorities are: Staying healthy Improving children s services including maternity Improving mental health care Improving long term conditions care for all ages Coordinating the provision of urgent and out of hours care Increasing the capacity in high quality, cost effective alternative to hospital based planned care Enhancing end of life care. Schemes and plans that we are working on are aimed at improving services for all. We have developed two major schemes that will help our continued focusing on moving services closer to people s homes: Greenwich Centre. This new development is currently under construction. It will provide increased GP practice space and increased space for community and mental health services on the old Greenwich District Hospital site. As well as a health facility, this Centre houses a swimming pool and leisure services, a library and the Council s Service Centre. It is planned to open by 2015. Eltham Community Hospital. This development will provide facilities for GP services and community services. It will provide patients with direct local access to a range of services including diagnostics, outpatients and day surgery. It will also include a 40 bedded intermediate care unit for people needing time to recover following admission to hospital or as an alternative where they need 24 hour nursing care under the supervision of their GP. This will also be open by 2015. Both of these schemes will allow us to move more services from hospital to community settings and this will enable the hospitals to focus on the needs of those people who are most ill. We are also responding to needs expressed by service users and their carers. We have introduced service user involvement programmes to allow for greater user involvement, and have introduced a carers budget so that carers can be supported to maintain healthy personal and work lives. Improving health services for the people of Greenwich 11
Ways you can have your say NHS Greenwich Clinical Commissioning Group will design health services around the needs of patients and carers and this can only be done with local knowledge. As a new organisation, we aim to improve engagement with patients through working in partnership with Practice Patient Groups (PPGs). You are always welcome to join these groups and have your say in shaping all current and future service delivery. Just contact your GP for details. Healthwatch Greenwich is a new independent consumer champion for patients, carers and all those using health and social care services, including members of the public. Healthwatch Greenwich is building on the work of Greenwich LINk and provides fresh opportunities for people to have their say about the quality and development of their local health and social care services. In turn, it creates new opportunities to influence the commissioning of services and provides a voice to challenge service providers. You can contact Healthwatch Greenwich by visiting their website at www.healthwatch greenwich.co.uk. By sharing your experiences and ideas with Healthwatch you can influence the way services are run, whether that s by writing a letter, sending an email, phoning, or attending a public meeting. Complaints As commissioners it is our priority to ensure that our patients receive the highest quality care in line with best clinical practice. However, sometimes things can go wrong and you may not be happy with the treatment or service you, or a person close to you, has received or about the decisions related to commissioning of services. Who can I talk to about my concerns? In the majority of cases the best way to resolve your concerns as quickly as possible is with the front-line staff of the service or organisation you are complaining about. It is helpful if the NHS organisation/primary care practitioner providing the service is made aware of your concerns as they may be able to sort these out to your satisfaction at the time. You can do this immediately by speaking to a member of staff in that organisation. Where the complaint is complex or you wish a more considered approach to be taken you will be directed to the Compliance Manager for advice and information. How do I go about making a complaint? You can make a complaint verbally, in writing or via email. If you wish to complain about a hospital, community or mental health provider please contact them directly using the contact details below but you may also wish the commissioner of the service to know about your concerns so do please copy the commissioner into your complaint. 12 NHS Greenwich Clinical Commissioning Group Prospectus 2013-14
If you have a concern or complaint about a GP, dentist, pharmacist or optician that can t be resolved locally with the Practice, please contact NHS England at nhscommissioningboard@hscic.gov.uk. You can also contact NHS England on 0300 311 22 33. If you have any comment or complaint relating to the commissioning of a service please contact the CCG s switchboard on 020 3049 9000. Please stay in touch with us through the NHS Greenwich Clinical Commissioning Group website www.greenwichccg.nhs.uk. Public meetings are advertised on this site and copies of the NHS Greenwich Clinical Commissioning Group Board meeting papers appear there too. The public are encouraged to attend meetings where all formal decisions are taken regarding health services, and there is usually an opportunity for members of the public to share their views and help shape the healthcare services in their local community. Some patients want to work more directly with hospital and community services and this can also be done. Details of how to take part are given on the websites of the Lewisham and Greenwich NHS Trust www.lewishamandgreenwich.nhs.uk and Oxleas NHS Foundation Trust www.oxleas.nhs.uk. Improving health services for the people of Greenwich 13
Our governing body The NHS Greenwich Clinical Commissioning Group has a Governing Body made up of GPs elected by Greenwich practices, a Chief Officer and Chief Financial Officer and some non-executive representatives. The function of the NHS Greenwich Clinical Commissioning Group Governing Body is to ensure strong and effective leadership, management and accountability. It is managed in an open and transparent way, meeting in public six times a year and making its decisions available through the website. GP Members are elected to the Board, and each serves for a term of office. Other members, including lay members, a nurse, a secondary care specialist doctor, plus non-voting members, are appointed and are accountable to the Chair and the Governing Body is held to account by NHS England. I hope that you found this booklet a useful introduction. The NHS is important to all of us and we want to hear what you have to say. If you have any comments on this booklet please do not hesitate to contact us. NHS Greenwich Clinical Commissioning Group www.greenwichccg.nhs.uk 31-37 Greenwich Park Street Greenwich London SE10 9LR Tel: 020 3049 9000 NHS Greenwich CCG Governing Body Dr Hany Wahba, GP Chair of the Governing Body Dr Rebecca Rosen, GP Clinical Commissioner Dr Nayan Patel, GP Clinical Commissioner Dr Eugenia Lee, GP Clinical Commissioner Dr Junaid Bajwa, GP Clinical Commissioner Dr Ellen Wright, GP Clinical Commissioner Mr Tan Vandal, Secondary Care Specialist Doctor Yemi Osho, Registered Nurse Annabel Burn, Chief Officer Chris Costa, Chief Finance Officer Jim Wintour, Vice Chair and Lay Member Dr Greg Ussher, Lay Member Cllr John Fahy, Royal Borough of Greenwich nominee Mr Steve Whiteman, Greenwich Acting Director of Public Health Simon Hall, Director of Integrated Commissioning, NHS Greenwich CCG Nicola Havutcu, Director of Integrated Governance, NHS Greenwich CCG 14 NHS Greenwich Clinical Commissioning Group Prospectus 2013-14
How to contact your Local Services All NHS Hospital and Community providers have a website which will give you information on the services they provide, directions on how to get there, and how to contact them. NHS Choices is the main website that provides local information on a range of NHS Hospital, GP and Dental services. You can search the website for your nearest service by putting in your post code. NHS Choices provides and A-Z index of information on conditions and treatments, as well as lifestyle information on how to live well. Their website is at www.nhs.uk Hospitals: Lewisham and Greenwich NHS Trust www.lewisham andgreenwich.nhs.uk Queen Elizabeth Hospital Woolwich Stadium Road London Greater London SE18 4QH Tel: 020 8836 6000 Lewisham Hospital Lewisham High Street London Greater London SE13 6LH Community: Oxleas NHS Foundation Trust www.oxleas.nhs.uk Pinewood House Pinewood Place Dartford Kent DA2 7WG Tel: 01322 625700 Health and Social Care: Royal Borough of Greenwich www.royalgreenwich.gov.uk/ in fo/100010/health_and_ social_care Royal Borough of Greenwich The Woolwich Centre 35 Wellington Street London SE18 6HQ Tel: 020 8854 8888 Hospice: Greenwich and Bexley Community Hospice www.communityhospice.org.uk 185 Bostall Hill Abbey Wood London SE2 0GB Tel: 020 8312 224 Primary Care: NHS England www.england.nhs.uk PO Box 16738 Redditch B97 9PT Tel: 0300 311 22 33 Monitor www.monitor-nhsft.gov.uk 4 Matthew Parker Street London SW1H 9NP Tel: 020 7340 2400 NHS Trust Development Agency www.ntda.nhs.uk NHS TDA Southside 105 Victoria Street London SW1E 6QT Tel: 020 7932 1980 Improving health services for the people of Greenwich 15
NHS Greenwich Clinical Commissioning Group 31-37 Greenwich Park Street Greenwich London SE10 9LR Tel 020 3049 9000 www.greenwichccg.nhs.uk