CCG Clinical Commissioning Forum

1. CCG Clinical Commissioning Forum Thursday 1st November 2018

3. 2019/20 Commissioning IntentionsPlanned Care Workstream Rob Palmer Siobhan Harper

4. Planned Care - Intentions (1)

5. Planned Care - Intentions (2)

6. Planned Care - Intentions (3)

7. Planned Care - Intentions (4)

8. Planned Care - Intentions (5)

9. Planned Care - Intentions (6)

10. Planned Care - Intentions (7)

11. Notes

12. Clinical Lead Vacancies • Respiratory • 2 sessions per month • Send CV and short statement on your suitability for the role to chccgrecruitment@nhs.net by Friday 23 November 2018 • Dermatology • 2 sessions per month • Send CV and short statement on your suitability for the role to chccgrecruitment@nhs.net by Friday 23 November 2018 • More information about these roles on the GP websitehttps://gps.cityandhackneyccg.nhs.uk/job-vacancies

13. 2019/20 Commissioning IntentionsUnplanned Care Workstream

14. Unplanned care – overview of main transformation areas Deliver an urgent care system in City and Hackney which best meets patients’ urgent needs at all times and joins up the range of different services on offer. joins up the range of different services on offer Improve how we discharge people from hospital by ensuring that they have the right services in place at the point of discharge, and that that they do not sit in acute or mental health trusts for longer than is medically required Delivery of a neighbourhood model in City and hackney to provide locally integrated services that support patients with complex needs and address the wider determinants of health

15. Urgent Care

16. Discharge

17. Neighbourhoods We will progress the development and delivery of the City and Hackney Neighbourhoods Model, scheduled activities over the next year include: ---significant engagement with local residents -continued work with providers to deliver local integrated services within each Neighbourhood -developing a multi-disciplinary and multi-agency model of care for patients with complex needs -ensuring that neighbourhoods deliver on addressing the wider determinants of health in supporting the prevention agenda -working with prevention to implement an effective model of navigation Increasingly neighbourhood working will be reflected in contracts, with a large portion of community services’ contracts being amended in 2020 as part of the neighbourhoods health and care programme.

18. Notes

19. 2019/20 Commissioning IntentionsPrevention Workstream Clare Highton Nicole Klynman

20. Prevention – overview of the ‘ask’ Support all care workstreams to embed prevention principles in their plans to achieve a system shift towards prevention and early intervention Early intervention to avoid or delay future poor health Early identification of risk factors Early diagnosis & condition management Reduce exposure to the main preventable risk factors for poor health Smoking, diet, inactivity, obesity, alcohol, substance misuse Support & enable people to manage their own health and wellbeing Advocacy and partnership to tackle the social, economic and environmental drivers of health and health inequalities (‘Marmot principles’)

21. LTC contract and NHS Health Check – GP Confed

22. LTC Issues • Hypertension • COPD support spirometry training, new regulations and register • What if a practice can’t? Pay a neighbour £50 per test?

23. Care navigation - VCS Overlap of social prescriber and health coach? Overlap of social prescriber and health coach?

24. Overlap of social prescriber and health coach? In practices?

25. MECC in primary care, how to record what we do... • Pill repeats • 800 attendances at DGUM • Need to be very easy please allow duty doc Use on line self help form

26. Smoking and alcohol screening and very brief advice – Homerton & ELFT

27. Mental health prevention CIs – ELFT and VCS

28. Supporting other workstreams • We will be working closely with the Planned Care workstream to support the development/delivery of a number of their CIs, specifically: • co-design a service for very obese adults with complex needs as part of an integrated obesity care pathway (a similar joint CI with the CYPM workstream is also outlined for children) • review/recommissioning of the post stroke community rehabilitation pathway (implementing recommendations from the Right Care stroke review) • implementation of the findings of the adult type 2 diabetes healthcare needs assessment (needs assessment recently completed by Public Health) • explore options for a collaborative commissioning approach for women’s health services (services in scope include gynae, GUM, fertility, contraception, breast, menopause)

29. Notes

30. Level 3 Child Safeguarding Training expressions of interest for additional date Register your interested for the final L3 Child Safeguarding Training Session. The proposed date will be Monday 10th December. This is the final chance for those who may have missed attending an event earlier this year. Register your interest on the GP website: https://gps.cityandhackneyccg.nhs.uk/education/events

31. Cancer Update Dr Rob Palmer CCG Cancer Clinical Lead

32. Cancer Update: Overall 2ww referrals • Highest increases in: • Dermatology • Gynae • Respiratory • Breast 30-40% increases

36. Feedback from cancer office, HUH • Inappropriate referrals? • Patients not aware they are under suspected cancer 2ww pathway • Patients unavailable for tests / travelling • Head and neck vs ENT • Respiratory 2ww: need up-to-date bloods, CXR

37. Gateway C

38. CtheSigns

39. CtheSigns

40. CtheSigns PRACTICE UPTAKE

41. Patients going travelling/unable to attend appts…

42. Head & Neck 2ww: ENT or OMF Through eRS: 3 options: 2ww - ENT - OMF - Thyroid

43. Respiratory Referrals • Need up-to-date CXR, U&Es • Don’t forget direct access CT chest service

44. Notes

45. Contact Sheet

46. Encourage your patients to attend our annual ‘Stay Healthy’ event • The event coincides with Self-Care Week • It’s a great way for residents to find out what services are available locally to keep them fit and well