Tessa Sandall - Managing Director Ealing Health Summit – Working in partnership with the Voluntary Sector Tessa Sandall - Managing Director

Context The CCG has a history of working in partnership with local statutory organisations, non-statutory organisations and with local residents/patients. Non-Statutory organisations can add something distinctive to the delivery of health care that statutory organisations cannot such as reaching out into hard to reach communities, or innovative solutions to holistic care. The can also be a source of feedback from isolated communities, and a valuable partner in sharing important health messages However, as a statutory organisation, the CCG has to deliver against its statutory responsibilities, which means healthcare for the population of Ealing, within the funding envelope provided. As you will have heard in the media, this is becoming increasingly difficult within the budget we have. As a result all commissioning decisions are being heavily scrutinised to assess value for money to ensure front line service can continue to deliver. 2

National Drivers of Transformation Given this however, the CCG has delivered against many of its transformational programmes in order to ensure the health economy in Ealing continues to be able to sustainably deliver services in the borough. National drivers for change: Sustainability and Transformation Plans (STP) – To address the 1) Health and Wellbeing Gap 2) Care and Quality gap 3) Funding and Efficiency gap The STP plan builds on local plans in Ealing and NWL Accountable Care Partnerships and Multi-speciality community partnerships – Partnerships delivering care beyond boundaries of their organisations under new contract forms Better Care Fund – as a key driver to integrated health and care delivery NHS Five Year Forward View

Health and social care in NW London is not sustainable if nothing changes Current Population Future Population (2030) % Increase

STP Priority Areas

Local work is supporting the delivery of the strategic aims and meeting the needs of local people – some examples Out of Hospital Services (OOHS) - The OOHS programme - 19 clinical services delivered in general practice, which include ECGs, Blood tests, Diabetes management etc. GP Access Centres In March 2017 3 new ‘GP Access Centres’ were mobilised to improve access 8am to 8pm, seven days a week across three sites in Ealing. Diabetes Due to strong diabetes care through out of OOHS, Community and Acute Service the Ealing Diabetes patients are experiencing better health outcomes Ealing’s Diabetic foot amputation rate is now 1.2 amputations per 1000 diabetes patients in comparison to The UK average is 2.6 6

Continued… Perinatal Mental Health Service Implementation A new perinatal mental health service was launched in Ealing in early 2016, from community bases or in the woman’s own home – with positive feedback from users and professionals Wheelchair Service Ealing CCG has mobilised the new integrated wheelchair service in collaboration with Barnet, Brent, Central London, Hammersmith & Fulham and West London CCGs Community Cardiology Service The CCG has increased the number of specialist heart failure nurses from 2 to 7 staff, offering an improved community service for patients including home visits. In 16/17 the service successful managed patients with Heart Failure to reduce NEL admissions by 30% 7

Continued… Community Transport Community transport commissioned since 2014. The service helps patients travel between their homes and GP surgeries. The service aims to reduce the number of GP house calls and missed appointments, while improving the wellbeing of patients by offering them an opportunity to leave their homes and meet new people. 8

Tessa Sandall – Managing Director Priorities for 2017/18 Tessa Sandall – Managing Director

17/18 Priorities The CCGs 17/18 Business Plan is structured around delivering the NWL strategic objectives, NHS England’s priorities for improving A&E, Primary Care, Mental Health, Finance and Cancer performance and meeting local needs CWHHE Objects Ealing CCG Priorities 1. Radically upgrading prevention and wellbeing. 1.1 Deliver Transforming Care (LD) , financially sustainable with LA and partner CCGs. 1.2 Implement prevention and self-care agenda in partnership with LA. 2. Eliminating unwarranted variation and improving long term condition management. 2.1 Ensure the primary care commissioning offer delivers a sustainable and resilient General Practice. 2.2 Implement a quality improvement programme to address unwarranted variation in General Practice as part of a wider system. 2.3 Optimise planned care pathways, enabling standardisation across NWL ensuring quality and efficiency. 3. Achieving better outcomes and experiences for older people. 3.1 Commission a lead provider model for adults (>18 years of age) local services. 3.2 Pilot NWL wide Frailty Model in Ealing Hospital. 3.3 Provide system leadership to reduce unnecessary non elective admissions with system partners.

17/18 Priorities CWHHE Objectives Ealing CCG Priorities 4. Improving outcomes for children and adults with mental health needs 4.1 Lead local implementation of ‘like minded’ and ‘future in mind’ models of care with WLMH in partnership with H&F, Hounslow with financial viability. 5 Ensuring we have safe, high quality sustainable services. 5.1 Sign off OBC for East and North primary care hubs. 5.2 Maximise opportunities for ‘one public estate’ 5.3 NWL Reconfiguration of acute services. 6 Ensuring the system has the capacity and capability to deliver (workforce, OD, IT, primary care etc) 6.1 Ensure providers are delivering high quality, high performing services for residents of Ealing. 6.2 Deliver financial control including full delivery of local and NWL QIPP. 6.3 Enable the CCG to become high performing and ensure improved outcomes.

17/18 Priorities Single Contract for Out of Hospital Services Two large priority commissioning programmes include: Single Contract for Out of Hospital Services Ealing CCG currently commissions a number of community Out of Hospital services with different providers, which are often delivered in isolation and silos with multiple handoffs and with variation in service delivery, quality, configurations and efficiency.  Patient experience data and feedback suggests that services are fragmented, complex and difficult to navigate for the service user, primary care and acute care. It is the CCG’s intention to commission a single contract for Out of Hospital care for adults and children in Ealing over a ten year period A Patient Reference Group (PRG) is in place to test the developing model of care and the outcomes frame work from a patient perspective.

17/18 Priorities The Ealing Standard The Ealing Standard presents us with a unique and exciting opportunity to directly influence the transformation of Primary Care in Ealing in a way that we have not been able to do in the past. By delivering The Ealing Standard practices and patients in Ealing can expect: More resilient general practice Improved access for patients Improved health outcomes Reduction in variability Long term sustainability

Partnerships Ealing CCG continues its active involvement in a wide range of partnerships with the VCS, including LBE,ECN,ECCG VCS Panel, Information and Advice Network, Self Care Steering Group, Mental Health Forum, Physical Disabilities Forum and the Partnership Boards The Compact -The CCG has signed up to The Compact. The Compact is the agreement between Ealing Council ,Ealing Community Network and Ealing Clinical Commissioning Group towards an open and respectful working relationship.  A new Patient Engagement Reference Forum for local residents to feedback on experiences and key issues relating to health care services.

Partnerships – Self Care Self-Care is an approach to health which helps people to keep themselves well, by providing them with the knowledge to share in decisions about illness, from diagnosis to treatment and recovery. Self-care covers a spectrum of activities and extends from making healthy lifestyle choices, such as eating a healthy diet, to learning strategies that enable people with long term conditions to manage their illnesses effectively.

Self-Care Spectrum

What the CCG has done so far Appointment of a Self-Care Development Officer Created the Healthy Ealing website Installation of Health Promotion Screens in GP practices Delivery of Know Your Numbers campaign in 2016 and 2017 Delivery of Self-Care Week in 2016 and 2017 Patient Activation Measure assessment introduced to GPs Delivery of Expert Patient Programme

What we plan to do in 2018/19 Expansion of Know Your Numbers and Self-Care week campaigns Working collaboratively with Patient Participation Groups to engage them in the self care agenda and messaging Developing a case for the implementation of a Social Prescribing pilot, working closely with the VCS. Introduction of digital tools including a my COPD pilot

What we want to use today for Gain feedback Develop a further understanding of where the voluntary sector can support the CCG outside of hospital All ideas welcomed……