CCG Update Dr Katie Stead Clinical Lead Primary Care

Central Sussex and East Surrey Commissioning Alliance? Brighton and Hove Crawley, Horsham and Mid Sussex High Weald Lewes Havens work closer together to commission services more efficiently and effectively for our local populations. From April 2018, the Alliance will also include East Surrey CCG

Alliance The Alliance is organised in two ‘places’ the North place the South place Wider plans to improve health and social care for the whole of Sussex and East Surrey (through the STP - Sustainability and Transformation Partnership). Planned Care commissioning best done once across the Alliance. Better leverage for the contract with BSUH Agreed policies across the Alliance to ensure use best evidence and end of postcode lottery

What the Alliance means for CCGs The Alliance not a formal merger of the organisations CCGs are statutory bodies, which means it would need a change of law by the Government for them to cease to exist The individual CCG Governing Bodies remain accountable for healthcare commissioning to meet the needs of our local populations Our local clinical leads ensure clinical focus remains at the forefront of our work

Primary Care Challenges Workload Workforce Finance Model; Independent Contractor status works for some, not for all low morale Change is hard to achieve Pressure on other local services (acute, community, mental health) places further pressure on practices

Caring Together Programme Caring Together - Single transformation programme for integrating health and social care across the city Seven Care Programmes: Community/Prevention Planned Care/Cancer Urgent Care/Access Mental Health/Learning Disability/Children and Families Medicines Optimisation Future Models of Care (Hospital-Based and Out of Hospital models) Primary Care Development Plus Enabling Programmes (Estates, Informatics, Workforce, Comms)

Primary Care Strategy Eight Key Areas Stabilisation/Resilience New Ways of Working/New Models of Care/Access Workflow/Workload Workforce Informatics Estates Primary Care at Scale (Federation) Investment (to achieve Provider/Commissioner Role Development)

General Practice Five Year Forward View (2015) – 10 High Impact Actions

The Productive General Practice Quick Start Programme This programme is delivered by an NHSE partner company over a period of 12 weeks. The programme is comprised of 4 group sessions where the practices support each other and share their learning, and 6 practice-based sessions where coaches go into the practices to work on specific projects with the staff to initiate time saving and quality improvement. Practices choose 2 modules from the following 8 to work on with their coaches: Frequent Attenders Helps practices undertake regular, focused reviews of their frequent attenders to decide where to focus their attention to support these patients differently within practice to reduce attendances. Appropriate Appointments Uses the Avoidable Appointments Audit Tool to effect fundamental long-term changes and reduce avoidable appointments over time. Clear Job Standards Uses visual management techniques to ensure daily tasks are completed as a team in a timely manner, increasing safety. Emails, Meetings and Interruptions Focuses on effective communication and reducing time wasted by interruptions. Team Planning Uses visual representation of peaks and troughs in demand and workforce capacity annually to provide insight into how practices could re-distribute their capacity throughout the year to respond to demand most effectively. Well Organised Practice Aims to look at how reception and consultation areas can be organised differently to save time daily. Common Approach Designed around delivery of clinical services in practice and aims to reduce unhelpful variation in processes. Efficient Processes Uses process mapping techniques (for example on prescription processes) to explore how the process could be streamlined and improved.

Benefits gained from Productive General Practice Programme An average saving of 147 hours (3.92 full- time weeks) of administration time per practice, per year. An average saving of 33.8 hours (0.90 full-time weeks) of clinician time per practice, per year, making wait times for GP appointments shorter. Increased patient safety due to a reduction in errors. Improved patient experience through increased ease of access in booking appointments, improved access to appropriate professionals at the right time and less delays in prescription processing. Improved staff morale - expected to reduce the number of practice vacancies in the long-term. Potentially, a contribution to the improvement of CQC ratings, as experienced by one practice that has already completed the Productive General Practice Quick Start Programme.

Active signposting training Receptionists and other patient-facing administrative staff from 13 practices attended a series of facilitated workshops to identify the top 6 services that their patients would benefit from and could refer themselves to, without seeing the GP or nurse first. Active signposting gives patients a choice to self-refer to a more appropriate service, but if they wish to, they will still be given an appointment within their practice. The services identified were: Midwifery The British Pregnancy Advisory Service Community Pharmacy Sexual health services The wellbeing service (for mental health) Pavilions (for drug and alcohol misuse)