Clinical Commissioning in Oxfordshire What does it mean for Goring and Woodcote ? Dr Stephen Richards Chief Executive Oxfordshire Clinical Commissioning

Clinical GPs Practice Nurses Physiotherapist Community nurses Hospital doctors Psychiatrists ……more allied health care professionals

Commissioning = “shopping” What do I need? What might I buy to address the need? How much money have I got? What quality can I afford ? Where can I buy what I need? - Asda or Waitrose How do I make sure that the service I get is good and stays good?

Now think of Health Services as they are Now…… Joint Strategic Needs Assessment (JSNA) Tells us what we should be buying It looks closely at health inequalities Demographic change – aging population Multiple health and social needs A Commissioning Board = OCCG – currently part of NHS Oxfordshire makes the decisions

NHS Oxfordshire might buy “Elective Care” list might look like this; 5000 New Hips and 2000 knees 500 Heart operations 6000 Cataract operations 3000 Bowel or bladder procedures 5000 new hearing aids 83 GP surgeries (all figures are for example only)

More “Shopping” Urgent care A+E Ambulances 999 Out of hours GP services Emergency hospital admissions …………………..111

Where do you come in? Relatively few members of the public helped draw up the JSNA Now YOU can inform this practice what the NHS should have on its shopping list Through Patient Participation Group Through Healthwatch…… Through the OCCG website

The New OCCG system Doctors and Nurses making decisions with NHS managers One top team in the county = OCCG 6 Locality Groups South East = 8 surgeries, led by Dr Andrew Burnett G+W rep = Dr Angela Rowe Informed by our growing PPG! Easy!!!

Draft vision We will work with you, the people of Oxfordshire, to champion your needs and develop quality health services fit for the future “The NHS belongs to the people” (The NHS Constitution )

Draft mission Through clinical leadership we will : achieve good health outcomes for us all within the money available. balance the needs of you as individuals with the needs of the whole community. improve the current system and develop new ways that enable us to do more with no new money

Patient Participation Groups Some of you …….. ALL of you? You need to tell US how this should work for you, please……..

Why Bother with all that mission stuff? To have a goal that everyone can recognise and believe in To tie whole system together – health and social care To lead change To ensure we work “with” and not “against” We must build; Relationships, Relationships, Relationships …that means YOU

A bit about Oxfordshire…….. 83 practices with 600 GPs 670,000 population Single County Council with 5 districts councils University of Oxford and Brookes……………….at a distance Cochrane Library…………..…………………………..at a distance £1300 per person per year = VERY LOW! £900m budget

The process Nov 2010 o 83 practices voted for a single Oxfordshire Consortium o 1 st wave Pathfinder and Early adopter for Health and Wellbeing Board July 2011 o OCCG responsible for £300 million o For all planned care o For all prescriptions = £80 Million o For the complicated older people, children and mental health

Complex Care SHA  PCT Drive System Change Clinical Front-line Top down ideas and targets The old world Planned Prescribing Self Care Urgent Mental Health

GP ownership of commissioning objectives, plans and delivery Create clinical momentum and drive system change QIPP 1QIPP 2 QIPP 3 QIPP 4 QIPP 5 QIPP 6 Successful System Change Public

The Population –6 public meetings in May/June- about “us” –6 this Autumn about how to involve the public in OCCG and the localities Doctors, nurses and other health professionals leading the way Working with the Local Authority in partnership Working with Brookes andThe University –A Centre for Evidence Based Commissioning? So what is different?

Next Steps

Our Recipe for success Stop doing what is not delivering improved health Buy services based on them providing sufficient health gains Build rewards for health and social care working together to improve patient experience Belief in ‘One Oxfordshire’

Goring and Woodcote A surgery in both villages GP services from 2 sites – 3 mile corridor! 8:00 to 6:30pm Dr Rowe on Locality group Dr Rowe telling Dr Goode, Dr Morris, Dr Lamb, Dr Ed and all others what is going on The Docs suggesting how we can do better

Beyond Goring and Woodcote Townlands development Changed services at Wallingford More out-patients at both…….fewer trips for you and Woodcote Volunteers to Reading! More services closer to home

“ no decision about me, without me” YOU telling us what we can do better You developing a different relationship with us and vice versa You designing and delivering surveys Working with us to improve health and social care in G+W, Checkendon, Ipsden the Stokes – the population of South Oxon

And finally a bit about me……. Senior Partner for the practice - Seeing as many patients as possible every Wednesday and helping to run the surgery on Fridays Chief Executive of the Oxfordshire Clinical Commissioning Group - Aiming at full authorisation before April 2013 I cannot do both – and will be dropping the partner role but still at Woodcote on Wednesdays…..

Thank You – any Questions?