Eleanor Davies Associate Director Joint Mental Health Commissioning

1. Commissioning after the Health and Social Care Act, 2012(Commissioning = designing and buying services based on need)7th February 2013 Eleanor Davies Associate Director Joint Mental Health Commissioning Lewisham Clinical Commissioning Group and London Borough of Lewisham

2. Lewisham Joint Mental Health Commissioning • 2 jobs are moving to the Lewisham Clinical Commissioning Group. One part funded by the Local Authority. • c.£90m budget • Covering: • Adult Mental Health – for health and social care • IAPT service • NHS Specialist services (Mother & Baby, Eating Disorders etc) • NHS Forensic services (Mentally Ill Offenders) • Mental Health of Older Adults – for health and social care • Dementia services – for health and social care • Adult Mental Health Voluntary sector – for health and social care • £4.5m health savings and £600k LA savings required from 2011/12 – 2013/14. More savings to come….

3. The Health and Social Care Act in a nutshell What does the Health and Social Care Act do? GPs will order and buy services (carry out commissioning). Frees up organisations to find new and better ways to provide services. Gives more power to patients Gives new spotlight on public health. Service providers and NHS staff will have to answer criticisms It is possibly the biggest shake up of the NHS. It has the most far-reaching changes to the NHS since it started.

4. Why change? More people are asking for treatment The treatment costs more Need to make the NHS better Less money from the government.

5. Key changes in the law GPs will play lead role in organising services for patients. New rules will encourage services to be more creative. Patients will have a greater voice Public health will have a bigger role The NHS will have to say why patients do not get the treatment they need, locally and nationally Fewer semi independent health organisations.

6. The new NHS commissioning system The focus of new commissioning system is Accountability and Outcomes = If patients do not get the treatment they need, the people that organised the service will have to say why. Clinical Commissioning Groups (CCGs) are the new statutory (legal) bodies for most commissioning Primary Care Trusts (PCTs) and Strategic Health Authorities (SHAs) have gone. The NHS Commissioning Board (NHSCB) will make sure Clinical Commissioning Groups act in the right way. The Board will also arrange for NHS treatment in the community and specialised services. Clinical Commissioning Groups have £25 for each person in England to spend on their organisations (we call this commissioning support) Clinical Commission Groups have to decide the best way to spend this, for example it could be spent on their staff.

7. What’s happening in London…

8. There are 32 emerging CCGs in London, who will need to demonstrate they have robust commissioning support in place Enfield Barnet Harrow Haringey Waltham Forest Hillingdon Brent Redbridge City & Hackney Camden Camden Islington Ealing Havering Newham Barking & Dagenham Hammersmith & Fulham Central London Tower Hamlets West London Commissioning Hounslow South- wark Richmond Greenwich Wandsworth Lambeth Lewisham Bexley Kingston Merton Bromley Sutton Croydon Wave 1 – 3 CCGs Wave 2 – 15 CCGs Wave 3 – 11 CCGs Wave 4 – 3 CCGs 8

9. The 2013 NHS will be different • Clinical Commissioning Groups will be small and light • Commissioning Support Units will be extremely important in getting Clinical Commissioning Groups up and running and to the success of the whole commissioning system. • Commissioning Support Services are funded by Clinical Commissioning Groups and by others. • CCGs and CSUs accountable to the NHS Commissioning Board • 23 Clinical Support Services in England, 3 in London NHSCB Accountability CCG CSU Services What type of organisation is a Commissioning Support Unit?

10. Three Commissioning Support Units are taking shape in London North Central and East London North West London South London

11. The South London Commissioning Support Unit - Story so far • South London Commissioning Support Unit is designed to give the Clinical Commissioning Groups benefit of working on a large scale to save money • £30m+ organisation, 300 staff, all 12 Clinical Commissioning Groups will buy core services e.g. finance, communications, IT, HR etc

12. Development of South London Clinical Commissioning Groups • Well prepared for the change • Progress towards authorisation to be a CCG • Exist in shadow form ready for April 2013 • All staff employed

13. What’s it really like…. Stressful! People are applying for new jobs or their old ones The NHS has to save £20 billion across England Local Authorities have had their money cut In Lewisham GPs are becoming more aware of how to be a commissioner However it is difficult for GPs to change from being a GP to commissioning/buying a service

14. How can the you influence the health and social care agenda Tell Clinical Commissioning Groups and Health and Wellbeing Boards what you need. Support commissioners in their role – not just GPs Find gaps in the services Share best practice Share evidence of what works best Give ideas on how money can be saved to improve care Help the public to understand the changes Help the public become more involved Influence big decision makers