Medlinc GP Commissioning Consortia Dr Peter Stott MA FRCGP Tadworth Medical Centre

1. Medlinc GP Commissioning Consortia Dr Peter Stott MA FRCGP Tadworth Medical Centre Executive Lead GP Medlinc GPCC Neighbouring groups in East Surrey Mid Surrey Commissioning Group Dorking Elmbridge Total population 320,000

2. New NHS Structure Regional Health Authority (8) South Thames Strategic Health Authority (10) South East Coast PCT NHS Surrey GP Commissioning Consortia (500 in the UK - Av pop 120,000) 14 in Surrey PBC Groups 14 in Surrey

3. Mental Health Trusts Surrey Borders GPs Acute Hospital Trusts ESHUT, KH, SASH Opticians Dentists Pharmacies Foundation Trusts RMH Community Nurses School Nurses, Podiatry Dieticians, Family Planning Physiotherapy Community Hospitals (Central Surrey Health) Social Services Charities Princess Alice Relate

4. The 2013 NHS Landscape: roles and responsibilities Monitor (Financial accountability) Care Quality Commission (Quality Standards) NHS Commissioning Board (Commissioning) STATUTORY BODIES GP Practices Community Services GP Consortia PROVIDERS Budget-sharing Hospital Providers Local Authorities (now including Public Health) Alternative Providers COMMISSIONERS

5. 2009-2010 (Total 1.6B)

7. The QIPP Agenda • Quality, Innovation, Prevention, Productivity • £38M overspent – historic deficit • Requirement for 8% savings year on year against expected spend • Cost pressures: inflation; ageing; technology • Rising expectations Evaluation by QIPP will the basis for introducing change 3 QIPP areas: Prescribing; long-term care; urgent care

8. Joint Commissioning Intentions • Spend set at a historic level • 2011-2012 contract to include strategies for change in 2012-2013 (SDIP) • Repatriation of long-term conditions into community (eg diabetes, glaucoma, rheumatology, COPD) • Development of ‘virtual ward’ • Community alternatives to acute hospital admission • Developing efficiencies by removing overlaps in care pathways • Introducing health outcome measures to aid patient choice • Working with others to develop EGH site into a health campus with a mixed economy

10. New responsibilities of GPCC • Commission NHS services • Determine healthcare needs • Determine service requirements to service needs • Enter into contracts with providers • Monitor and improve quality of healthcare • Provide an oversight of provider training and education • Manage budgets and establish priorities on meeting healthcare needs • Meet all necessary reporting and audit responsibilities • Promote equalities of work with local authorities • Engage patients and the public

11. The Local Authority Perspective Healthcare Commissioning Social Care Commissioning Health and Well-being Board Providers

12. The Local Authority Perspective Healthcare Commissioning Social Care Commissioning Health and Well-being Board Providers If we get it right, we can combine global NHS values with local strategies “Think global – Act local”

13. NHS Surrey Governance Plan • 4 levels – Aware/Active/Arbitrate/Accountable • 3 realms Structure/Relationships/Performance

14. Service Development Improvement Plan (SDIP) – EGH and CSH • Collaborative, transparent working to achieve overall governance of the transition • Referral numbers • Knowledge of waiting times and current activity by practice • Financial control • Defined clinical pathways (QIPP) • Move some LTCs into community (diabetes, rheumatology, ophthalmology, paediatrics) • Develop alternatives to A&E attendance • Reduce fragmentation between health and social care • Focus upon quality of care

15. Transformation Board 8 coordinated workstreams lead by an executive and a coordinating board • Continuing Care/ Long term conditions • Frail and elderly (King’s Fund Project) • Unplanned care • Women and Children • NEECH working group • Leatherhead Working group • Information (Community care) • Information (Acute care)