Deliver Today : Shape Tomorrow

1. Deliver Today : Shape Tomorrow Dr Nicolas Small, GP Chairman Margaret Stockham Strategic Adviser

2. Getting Started Whether a clinician or manager this is how it felt

3. The Journey

4. Towards the Best Together National Direction, Local Action Maternity HCL Business Plan • NHS East of England • Adapting existing Strategies • Improving Lives; Saving Lives • Looking to the Future • Our NHS, Our Future Children Darzi – direction for the 8 clinical groupings Planned care Mental health Staying healthy LTCs Acute Care End of Life 4

5. Vision A picture of the future health for Hertsmere people Context Analysis of the current status and grasp of the challenges Strategy A description of the goals and initiatives to deliver the vision as set out in the Business Plan Delivery Development of implementation plans for delivering the strategy plus Performance Management Our Business Plan Needs of population Plans & Proposals Programmes Initiatives Service changes + Better health

6. Making it Real in Hertsmere Midwives key to ‘Maternity Matters’ – no changes proposed Maternity Roles for health visitors in the new Child Health Promotion Programme - improving immunisation rates Children Key role for CATs in only referring the right people – diagnose to refer not refer to diagnose Planned care Secured resources to work with 3rd sector, improve counselling, support Graduate Mental Health Workers & IAPT Mental health Plans underway to pull together services for young adults in Borehamwood Staying healthy Redesign programmes underway including care pathways for MSK (including physio review), COPD, Diabetes & Ophthalmology LTCs Acute care Focus on referral management, consultant to consultant referral and early discharge for inpatients Undertook short review to see whether there is a need to increase resources for hospice care End-of-life

7. Looking Forward Future programmes to control acute spend • We must • Control acute spend • Improve local access • Ensure safety and good patient experience

8. Achievements • Mental Health • CATS • Performance Management • SPA • Innovation Fund • Website • Community Nursing • Children’s Services • Prescribing • Patient Group • COPD • Physiotherapy redesign • In- house Phlebotomy • Increased resources for counseling • Strategic Management • Public Health

9. Mental Health • Established subgroup – monthly meeting of GPs, PM, HPFT, Patient Groups, Voluntary Groups e.g Viewpoint/ Mind & Carers in Herts • CBT/ Psychological Therapies/ IAPT - first PBC group in W Herts to deliver these services and maintain existing counseling resources • Persuaded HPFT to respond to locality needse.g address counseling waiting times • Innovation Fund £47kin 3 Hubs addressing carers needs / premises shaped by local groups • Shaping the future Mental Health Commissioningwith a Hertsmere focus

10. CATS • Innovative and robust approach to Performance Management including representation from PCT Finance and Contracting, Patient Group and Practices • Developed monthly Report Card • Appointed lead - Jayne Taylor • Partnership with local acute Trust - Barnet & Chase • GP buy-in to performance MSK Dermatology Ophthalmology Urology Respiratory Geriatrics Cardiology

11. SPA • Awarded Nov 2007 • £100k project • Working with UH UK • Only PBC group to be awarded in UK • Shaping services for the future • Engagement with stakeholders • Lessons learned

12. Website www.hertsmerecommissioning.co.uk • Portal for clinicians & public • Information on CATS • Public Participation “Your Say” • Library for all documents/ minutes etc • Link into Hertsmere council website • Putting Hertsmere and PBC on the map

13. Community Nursing / Children’s Services • Engaging with local team • Shaping Provider Service Contract • Enhanced resources / manpower for Community Nursing team • Monitoring performance of contracts • Monthly dialogue

14. Fast track proposals • Direct Access Physiotherapy pathway & integration with MSK • In house Phlebotomy • Fair distribution of extra counseling resources • COPD

15. Patient & Public Involvement Hertsmere Patient and Public Involvement Group • Trailblazer for Herts PCT • Aim is to involve patients and members of the public in our commissioning decision-making processes. • Initial group has met twice. • Group is in the process of agreeing a range of ‘involvement’ activities such as: • Reader panel • Leaders of disease specific patient interest groups including linking with existing local groups to be involved in monitoring specific contracts, service redesign • Committee membership e.g. performance management • Possible member of contributor of the accreditation process for GPwSIs and services in which they work • Representative of the HCL PPI group on the LINk.

16. Public Health initiatives • Obesity • Smoking • Exercise on prescription enhanced • Local Retinal Screening service delivered by Optician • Engagement with Council/ partnership working

17. Next Steps • Efficiency … Developing specific role descriptions for each formal role within HCL - including time commitment • Development … Establishing training and support needs of the group and individuals • Governance … revising our robust systems based on best governance principles e.g. conflicts of interests, voting, confidentiality etc • Review of structure … Enlarging the size of the group and establishing differing levels of involvements

18. Thank You Any Questions?