Wolverhampton CCG Commissioning Intentions

Wolverhampton CCG Commissioning Intentions 2015-16 * Areas of particular focus and priority CI Ref Contract Provider Brief CI001 CI002 CI003 Child Protection Information Sharing Implement the new Child Protection Information Sharing solution, CP-IS, which has been developed to give the NHS a higher level of protection to children who visit unscheduled care settings by enabling local authorities to share child protection information with the NHS, at a national level. Childrens Continuing Care & Transition to Adult based health services Compliance with the National Framework for Children and Young people s Continuing Care and ensure that all children with complex health needs are assessed for entitlement to packages of continuing care. Looked After Children To ensure a coherent and comprehensive approach is taken to meeting Looked After Children s health needs for compliance with Statutory Guidance on promoting the Health and Wellbeing of Looked After Children (2009) and any guidance which supersedes current guidance. * CI004 CI005 SEND Implementation of new legislation relating to health service provision for children and young people with special educational needs and disabilities (SEND) and including those with complex health needs and continuing care plans. Electronic Palliative Care Co-ordination System (EPaCCS) Implementation of EPaCCS system. The purpose of EPaCCS is to support the co-ordination of care so that people s choices about where they die, and the nature of the care and support they receive, will be respected and achieved wherever possible. In addition to communicating key medical information to healthcare professionals involved in patient care, EPaCCS supports conversations about end of life care wishes. Expert Patient Programme To explore programmes which are designed as a self -management programme for people with long term conditions. The aim is to support people by: Increasing their confidence and manage the day to day impact of living with a LTC. CI006 CI007 CI008 CI009 CI010 CI011 CI012 The programmes lead people to self -manage symptoms & health and wellbeing Share responsibility for their own health Know when to ask for help, early enough to avoid a hospital visit Makes less visits to the GP The patient becomes less anxious and more confident Use their acquired skills and knowledge to lead full and more active lives Infection Prevention Toolkit Inclusion of Infection Prevention Indicators Step Down & CHC framework To develop and go out to procurement for a local Stepdown / CHC Framework to ensure a quality and consistent approach to placements. 2015/16 Reablement funding As part of the 2015/16 reablement funding scheme, the provider of the projects will be required to complete regular monitoring and evaluation reports for each individual project. Advice and Guidance Increase the number of specialties offering Advice and Guidance via the Choose & Book system. CDU On-going monitoring and reporting of the CDU Chronic Wounds Project Implementation of the pathways and practices from the Chronic Wounds Project which demonstrate a positive impact on chronic wounds management

CI013 CI014 CI015 Consultant - to - Consultant Policy To review and update where appropriate the existing Consultant to Consultant policy. Dementia Stratergy Implementation of work programmes as outlined by the Joint Dementia Strategy Review effectiveness of current acute inpatient services Review Memory Clinic service Development of Community Based Health and Social Care MDT teams Improve timely Diagnosis Rates and post diagnosis support End of Life Care specifically advanced care planning for those patients that have Dementia Ensure stakeholder employees receive Dementia training to become Dementia friends To not continue with the additional funding related to supporting the Dementia Ward within Royal Wolverhampton Trust Diabetic Testing Strip RWT Diabetes service to implement Wolverhampton formulary choice of blood glucose meters, lead the process to implement regional guidance and participate in future reviews. * CI016 CI017 CI018 CI019 * CI020 CI021 CI022 CI023 CI024 CI025 CI026 CI027 CI028 Home In Reach Team (HIT) To continue to implement and review effectiveness of the home in reach team and expand if and when appropriate. Independent Domestic Violence Advisor Service Continued commissioning of the Independent Domestic Violence Advisor service. Infant Mortality (including maternity services) A multi-agency working group including members of Public Health, the CCG and Royal Wolverhampton NHS Trust, has been established with the objective of producing a multi-agency action plan. Commitment is required from all parties to implement the action and reduce infant mortality in Wolverhampton. Infection Prevention Review To further develop and sustain 2014/15 IPC review. Out-Patient Services Consider the outcomes of the RWT Outpatient review and where appropriate implement changes to cost and coding e.g nurse led clinics. In addition also look to explore speciality areas where New to Review Ratio's are higher than expected against nationl data. Outpatient Waiting Lists Undertake a review of the outpatient follow up waiting lists in line with current priorities at Modernisation Programme Board eg Dermatology follow ups Post Operative Cataract Appointments Review current pathway for Post-Operative Cataract Follow Ups. Primary Care in A&E Proposal for RWT to include Primary Care clinicians with A&E services Procedures of Limited Clinical Value (Harmonisation and Localisation) Continue to ensure compliance of POLCV with all providers and ensure harmonisation of the POLCV policy across the West Midlands. Quality Investment Scheme The CCG has invested 2million in 2013/14 and 2014/15 on an annually non-recurring basis to assist the trust in improving clinical quality. This investment is on a non-recurring basis and therefore will not be available in 2015/16. Review of Falls Service (Phase 2) To work with with the Falls prevention team to develop gold standard service Secondary Care Service review Consideration of hospital services that could be delivered in another setting i.e. community Serious Incidents Revision to the Serious Incidents monitoring and reporting in relation to maternity incidents

CI029 CI030 CI031 * CI032 * CI033 CI034 CI035 / Community CI036 / Community CI037 / Primary Care CI038 Community Service Development Improvement Plan To roll forward existing workstreams as identified within the current Service Development improvement plan. Stroke Reconfiguration Continue to support and be part of the Stroke Reconfiguration programme. Surgical Clinical Thresholds To agree and ensure compliance of surgical clinical thresholds T&O and OCAS Review To complete a review of the OCAS & T&O pathways and implement agreed changes. Urgent Care Implementation of the Urgent Care Strategy. WUCTAS Review to be undertaken of the existing WUCTAS service with a view to either decommission, amend/reconfigure or expand. & Community Palliative Care Services To review current delivery of palliative care by consultants and district nursing to ensure appropriate effectiveness and value for money. Tissue Viability Support To implement Tissue Viability Support for Primary Care (GP Practices), in light of the new NICE Guidance. Anti-Coagulation Services Review and redesign of Anti-coagulation services Community Dietetic Service To continue to commission and support the development of the Community Dietetic Service. To continue commissioning a service after a successful first year were growth has reduced from 18% each year to 0.9%. Latest figures show -4% reduction in growth for Q1 2014/15 To continue facilitating a comprehensive malnutrition screening service in Wolverhampton to work with all GP practices and care homes To continue promoting the use of Wolverhampton guidelines and screening materials together with training To detect malnutrition as identified by Malnutrition Universal Screening Tool (MUST) and treat effectively. To continue promoting a Food First approach to management of malnutrition and ensure oral nutritional supplements (ONS) are prescribed appropriately according to ACBS indications e.g. disease related malnutrition for new and existing patients. To minimise oral nutrition supplement waste. To continue supporting primary care health professionals to implement cost effective management of malnourished patients on their caseloads. To continue to develop relationships between Nutrition and Dietetics department RWT, Care Homes and general practices in Wolverhampton to promote hospital admission avoidance. CI039 Community * CI040 Community * CI041 Community CI042 Community Reporting Community Stroke Services Reporting of both inpatient and community based services separate from Neuro from 1.4.15. Respiratory Rapid Response Redesign of Respiratory services to develop a Rapid Response Team (community based). RWT Community Services Complete a review of all community services within the community contract with the aim to streamline services, streamline patient pathways and create efficiencies. Intermediate Care Review current pathways with a view to moving to more community facing services.

CI043 Mental Health Learning Disabilities Deliver the Winterbourne concordat and deliver the most cost-effective efficient specialist health services for adults with learning disabilities who are the responsibility of Wolverhampton CCG by:- Cease the current block purchasing arrangement for inpatient provision at Pond lane from April 2015 Block purchasing 2 beds all in-patient provision from April 2015 Work with BCPFT to develop and implement a programme to consult on the decommissioning of Pond lane as an in-patient service Re-model the existing community team to target resources at those people with the most significant needs who are at risk of hospital admission, placement / family breakdown or ill-health Create a specific function of behaviour support and a behavioural pathway as part of the learning disability community team Re-evaluate the role of the forensic nurse and embed this post within the behavioural element of the community team * CI044 Mental Health CI045 Mental Health CI046 Mental Health CI047 Primary Care CI048 Primary Care CI049 Primary Care CI050 Primary Care CI051 Primary Care * CI052 Primary Care CI053 Primary Care CI054 Primary Care CI055 Primary Care Mental Health Strategy In line with the Mental Health Strategy Implementation Plan the commissioner will work with the provider to implement Steps 0-5 of an all age approach across the service model that incorporates the needs of people under 18 years and over 65 years. This will require the CCG to work with the provider to develop care pathway/s that align Adult, CAMHS and Older People s Services so that services are consistent, seamless, age related and inclusive. This will also be aligned with approaches to implement simple tele-health and FLO. Quetiapine XL Patients on the antipsychotic quetiapine will be individually reviewed by the service provider with a view to a switch to the standard release formulation Neurologoical Condition Pathways To develop an all-age diagnostic pathway and assessment provision, to assess people who may have a neurological conditions ( specifically Autistic Spectrum Disorder / Attention Deficit Disorder) and to provide a diagnosis and prescribing support, along with onward referral for community care assessment and/or signposting where appropriate. To review the way in which mental health services respond to the needs of people with ASD and/or ADD and have a co-occurring mental health problem to ensure that reasonable adjustments are made and that services are appropriate and responsive to the very specific needs of this patient group. Care Home Support Alignment of GP practices to residential homes to undertake proactive regular ward rounds. Service to be available 7 days 8-8pm. Eclipse GI Implementation and use of Eclipse Live by all practices to review patients at highest risk of GI perforations and bleeds Increased access in Primary Care Continued work in primary care to improve access to urgent GP appointments Obesity & & Weight Management To explore programmes and opportunities to work across stakeholders in ensuring appropriate commissioned services around obesity and weight management. Primary and Community Delivered Services Review all existing locally commissioned services to ensure efficient and effective delivered services, but also to identify any gaps or future areas for local commissioning. Primary Care - Palliative Care Scheme Development of a palliative care scheme to enable GPs to visit patients at home, improve patient experience and ensure their preferred place of death at home is achieved. Primary Care Access Additional dedicated on the day urgent care appointments during core hours within GP practices. Primary Care Medicines Team Primary Care Medicines Team to support implementation of Elcipse and provision of prescribing training of GP registrars and other health professionals Primary Care Support Utilise Practice Support Visits to manage variations and maintain good quality standards.

CI056 Primary Care * CI057 Primary Care Telephonic Clinical Health Coaching/ Health Services Implementation of Telephonic Clinical Health Coaching/ Health Services DXS To Support Primary Care through the development of a Pathway Information Centre which will require a review and agreement of pathways by clinicians across organisations.