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The Turnaround Challenge Workshop in SWF, 5 December 2012. Dan Doherty Sepcialist Physiotherapist and Board Member Mid Essex Clinical Commissioning Group (CCG). What’s in this presentation. Brief introduction to Mid Essex Clinical Commissioning Group (CCG)

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The turnaround challenge workshop in swf 5 december 2012

The Turnaround Challenge

Workshop in SWF, 5 December 2012

Dan DohertySepcialist Physiotherapist and Board MemberMid Essex Clinical Commissioning Group (CCG)


What s in this presentation
What’s in this presentation

  • Brief introduction to Mid Essex Clinical Commissioning Group (CCG)

  • Your local NHS – the current position

  • The “turnaround challenge”

  • How we are tackling the challenge

  • Your views?


Ccg who we are
CCG - who we are

  • New organisation to take over from PCT

  • Board led by GPs, senior nurse, public health, social services rep, 3 lay members

  • Working in shadow since 1 April 2012

  • “On the job” managing & planning

  • 50 member practices

  • Applying for authorisation – Nov 2012

  • Establishment - 1 April 2013

Dr Lisa Harrod-Rothwell

Chairman, Mid Essex CCG


CCG – what we do

  • Commissioning – planning & buying healthcare

  • Not providing – that’s Central Essex Community Services (CECS)

  • Assess local needs, listen to people

  • Plan in partnership

  • Design services, agree contracts

  • Manage quality & performance

  • Manage the annual budget – £540m in total for mid Essex in 2012/13CCGs responsible for around £390m


Where we fit in the system
Where we fit in the system


What s in this presentation1
What’s in this presentation

  • Brief introduction to Mid Essex Clinical Commissioning Group (CCG)

  • Your local NHS – the current position

  • The “turnaround challenge”

  • How we are tackling the challenge

  • Your views?


Current position
Current position

  • Performance & quality among best in region

  • Over 95% patients treated within 18 weeks

  • Over 98% cancer patients treated within 31 days

  • 90% stroke patients on specialist stroke unit

  • Over 99% mental health patients followed up within 7 days of leaving hospital

  • Patient experience survey shows improvement


What s in this presentation2
What’s in this presentation

  • Brief introduction to Mid Essex Clinical Commissioning Group (CCG)

  • Your local NHS – the current position

  • The “turnaround challenge”

  • How we are tackling the challenge

  • Your views?


The challenge
The challenge

If we took no action…

  • We would be overdrawn by £12.8m at end of year

  • Bigger challenge in 2013/14 – an ever widening gap

  • We would be unprepared for ageing population

    • 12% increase by 2035

    • Increase in frailty, long term conditions, dementia

  • So we are managing two things…

  • 2012/13 - quick action to finish year in balance

  • 2013/14 & beyond – transform services & secure the NHS for the future


Why is this so
Why is this so?

£1.3k per head (PCT spend last yr)

Others up to £2.2k

Overall three main factors …

  • Managing with limited funds – our allocation one of the lowest

  • The activity we can afford – we spend more than other similar areas

  • Service transformation – plans take time to putinto practice

Activity increase not always right for good care

Need to review and “ramp up”


What s in this presentation3
What’s in this presentation

  • Brief introduction to Mid Essex Clinical Commissioning Group (CCG)

  • Your local NHS – the current position

  • The “turnaround challenge”

  • How we are tackling the challenge

  • Your views?



Short term 2012 131
Short term - 2012/13

Examples of existing schemes

  • Health & social care for people at home

  • Rapid assessment for frail& older people – avoid hospital emergencies

  • Multiprofessional teams for end of life care at home

  • Closer work with nursing homes to avoid hospital emergencies

  • Practices managing referrals working with central team of clinicians

  • Prescriptions for less expensive drugs


Short term 2012 132
Short term - 2012/13

Examples of tightening criteria

  • Team to manage treatment at A&E

  • Reduce unnecessary use of ambulance

  • Review clinical policies, ensure they are adhered to

  • “Stop before the op” smoking restriction

  • Improve physio self-care, reduce wasted appointments

  • Comply with national guidelines on drugs

  • Mental health rapid assessment to reduce admissions


Short term 2012 133
Short term - 2012/13

We are not talking about “cuts”

Don’t be misled by the press



What s in this presentation4
What’s in this presentation

  • Brief introduction to Mid Essex Clinical Commissioning Group (CCG)

  • Your local NHS – the current position

  • The “turnaround challenge”

  • How we are tackling the challenge

  • Your views?



Priorities possibilities
Priorities & possibilities

Group discussion

  • Short term:

    • Your views on what should we stop or change?

  • Long term:

    • Your ideas for doing things in a different way?

    • What do you want us to pay attention to?


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