Who we are and what we do? Simon Hairsnape Chief Officer

Background Health and Social Care Act 2012: – Abolish Primary Care Trusts; – Abolish Strategic Health Authorities; – Create NHS England (NHS Commissioning Board); – Create 212 Clinical Commissioning Groups (CCG); – Including NHS Wyre Forest CCG.

What is a Clinical Commissioning Group? New local NHS organisations: – Health and Social Care Act 2012; Became full statutory bodies on 1 April 2013; 212 CCGs nationally, three in Worcestershire; Responsible for planning and securing the majority of health care needs; Led by local GPs and other health professionals; Accountable to NHS England.

Our Area 112, GP practices Our GP practices are broadly within the geographic boundary of Wyre Forest District Council, which covers the three main towns of Kidderminster, Bewdley and Stourport-on-Severn and several surrounding villages including Arley, Rock, Chaddesley Corbett and Wolverley.

NHS Wyre Forest CCG Board

CCG Responsibilities Commissioning healthcare services to meet the reasonable needs of the persons for whom they are responsible. £120 million budget.

Services commissioned by CCGs

Services not commissioned by CCGs

NHS Wyre Forest CCG Challenges The NHS faces significant challenges – nationally if we continue as we are then the growth in budgets will be outpaced by growth in costs of £20 billion nationally (£40million locally); Health needs are also changing; The Clinical Commissioning Group will need to plan and secure new and different services to meet future needs: Joint Services Review – Next Steps; Out of hospital care – care closer to home; Integrated care; Partnership working – existing and new partners; Prevention; Patient and Public Involvement.

How did we agree our priorities? It is a complex process with responsibilities ranging from assessing population needs to prioritising health outcomes; Health and Wellbeing Board and national priorities; Annual planning cycle; Every September; Who's involved? – Member Practices; – Public health – JSNA; – Health and Well Being Board; – Patients; – Voluntary Community Sector Organisations.

NHS Wyre Forest CCG Priority Areas 2013/14 Priority OneEnsuring financial balance Priority TwoReduce un-needed referrals into hospital Priority ThreeReduce Elective Care Spend Priority FourIntegrate health care  GP / Consultant pairing,  Virtual Ward,  Integrated Care meetings,  EMIS WEB.  Care Plans for patients with long term condition.  Tele health. Priority FiveCommission district nursing services Priority SixWork to support and improve general practice and community services Priority SevenSupport General Practices to release more clinical time for commissioning and primary care Priority EightEMIS WEB project Priority Nine Improve mental health services Priority TenWork to reduce health inequalities

Urgent Care in Wyre Forest Dr Tony De Cothi Assistant Clinical Chair

Virtual Ward Project Supporting Kidderminster MIU and Worcester Royal Hospital A/E Responsible for managing Out of Hours contract for Worcestershire

Support the Admission Prevention Team in looking after patients in their own homes who do not need Acute Hospital Care Positive feedback and evaluation Wyre Forest Hospital admission rates are lowest in Worcestershire.

Represent Wyre Forest as Urgent Care Lead at County meetings with Worcestershire Acute Trust and Ambulance service. Attend Kidderminster Hospital Board which focus ‘s on local developments and improvements.

Meet monthly with Harmoni who hold the Out of Hours contract for Worcestershire ensuring quality of care and dealing with any complaints. Support The GP with West Midlands Ambulance Service project which has resulted in less patients needing to be taken to A/E

Plans for this year Increase use of Virtual Ward Maintain low hospital admission rates Improve care to local Care Homes

Mental Health Dr Paul Williams GP

What did we want to do Rebuilding Local Relationships across primary and secondary care 2.Simplifying the referral pathway into secondary care 3.Earlier intervention to prevent long pathways 4.Increasing specialist support within GP Practices 5.Improve pathways for those with mental health and substance misuse problems

What have we actually Done Electronic service directory commissioned from Community First( via CCG website) Psychological Therapies- more provided within primary care Dedicated same day telephone consultant psychiatry support/advice for GPs Community Mental Health team workers attachment to WFCCG GP practices Treatment pathway for patients with mental health/substance misuse needs

What are we doing this year Consolidating what we have already done Deliver equal access to psychological therapies- IAPT( CBT) Explore how we can work with voluntary sector to help support mental health work-

What are we doing this year Focus on recovery and self help Encouraging patient involvement in decisions about their care- Standard – ‘ No decision about me without me’ Educational online material for primary care

Commissioning Continuous Quality Improvement Jo Galloway Executive Nurse, Quality and Patient Safety

What is Quality? Quality Patient experience Clinical effectiveness Patient Safety

Our Providers Worcestershire Acute Hospitals NHS Trust Worcestershire Health and Care Trust 12 nursing homes in Wyre Forest Specialist placements in and out of county Domiciliary Care Hospice care Associate commissioner contracts Out of Hours & NHS 111 Supporting NHS England Area Team with Quality Assurance of Primary Care

Quality Strategy Create a culture of continuous quality improvement across CCGs and all commissioned services; Develop a quality framework that brings together quality, safety and patient experience information from a range of sources and provides assurance regarding the quality of care delivery in commissioned services; Commission services that are both clinically effective and represent good value for money; Include clinicians and patients in the monitoring, inspection and quality improvement of commissioned services; Encourage feedback and value the role of patients in shaping and improving services.

What did we do?

What did we achieve? Improvement in stroke and TIA national outcomes Reduction in pressure ulcers Reduction in falls causing harm to patients Improvement in screening for dementia Improvements in referral to treatment time particularly for cancer

Areas of Improvement Infection Prevention and Control Accident and Emergency – waiting times for treatment and admission where appropriate

Next Steps Development of a Quality Strategy Five key priorities 1.Create a culture of continuous quality improvement, openness, transparency and candour across the healthcare system 2.Commission services that are safe, clinically effective and support a positive care experience 3.Commission services that reflect individual needs, are accessible and delivered in the most appropriate setting; with a specific focus on the care of the most vulnerable groups 4.Encourage feedback and value the role of patients and healthcare professionals in shaping, monitoring and improving services 5.Build upon the quality framework to bring together patient safety, clinical effectiveness and care experience information from a range of sources to provide assurance regarding the quality of care delivered in commissioned services

Quality Plan on a page Quality throughout the Patients Journey Recommendations from Francis Report Early Warning System Pressure Ulcer reduction Prevention of falls Championing of best practice Commissioning for change and quality of life Engagement with patients and carers Quality in primary care Shared vision and goals CCG Values Caring and listening organisation Value clinical input Safe, seamless care delivered close to home Value partnership with other organisations Aware of risk and able to manage it

Supporting the 6Cs initiative

How will this improve care for the public and patients? Improve openness and transparency across the health care system Monitoring of concerns from patients, public or professionals through to the CCG and providing feedback and actions Provide an early warning system Learning from patient stories and experiences to shape and improve services

Patient and Public Engagement Stella Baldwin Lay representative

The Structure

Our key achievements last year…. Advisory group – Strength to strength – Membership – Role Voluntary Sector Events – June 2012 – Mental Health CCG Planning session – September 2012

What else and what next ??? Follow up Voluntary Sector Event – June 2013 ‘Health Together’ newsletter- April 2013 Community Wellbeing Buddies- Sept 2013 – Face to face signposting in GP practices Membership Scheme – Soft online launch -March 2013 – Health and Recruitment Event – 30 th May

Our Membership Scheme for patients and public of Wyre Forest Wyre Forest Clinical Commissioning Group (CCG) have launched their membership scheme. “The membership scheme enables Wyre Forest CCG, patients and the public to work together to better understand and help shape our local health services.”

The aims of our membership Scheme is to give you the opportunity to: have your say and debate issues access up to date information about your CCG help us improve the future local health services learn more about your areas of your interest

Membership Scheme