1. ICIS AND CENTRAL LCG WELCOME TO OUR JOINT MEETING 15 APRIL 2010

2. TODAYS AGENDA  ENT REFERRALS REFLECTION ACTION PLAN AND LES SUBMISSION  CLINICAL PRIORITIES 2010/11  ICIS PRIORITIES AND YOUR FEEDBACK  PBC LES 2010/11  WHITTINGTON CONTRACT  YOUR ISSUES

3. ENT REFERRALS REFLECTION  20 PRACTICES RESPONDED  201 OPD REFERRALS AUDITED CITY RD  10 PRACTICES  38 CASES AUDITED SECONDARY CARE  17 PRACTICES  163 CASES AUDITED

4. GENERAL FEEDBACK CITY ROAD  Positive feedback around quality and timeliness of communications  Used by practices as convenient and to “save PBR tariff”  Used more by Central practices than North

5. SECONDARY CARE  Variable quality/timeliness of communications  Poor feedback on urgent clinic refs

6. REASONS FOR REFERRING TO SECONDARY CARE NOT CITY RD  Patient access/choice – particularly for North patients  Lack of awareness of what City Rd offers Particular issue re F2/locum referrals  Urgent clinic  Limited procedures/no children

7. 2010 CITY ROAD  Local tariff from September 2010  TBA SECONDARY CARE  New referral £154  Followup £80

8. CLINICAL ISSUES AND ACTION PLAN

9. CLINICAL PRIORITIES  Neurology Pathway for headaches  Cardiology Better reporting on diagnostics  COPD More outreach from Myra Stern  Urology Pathways for UTI, Haematuria?

10. ICIS PRIORITIES  Joint working with Acute Commissioning Agency  Clinical work with Whittington  Shaping polysystems Ensure doesn’t increase activity and spend Ensure clinical models make sense locally  Growing membership Governing Council  Joint work with Whaco

11. PBC LES 2010 COMMISSIONING PLAN  Collective ICIS plan  No money ATTENDING PBC MEETINGS  £3000 per practice  Based on attendance sheets

12.  DATA VALIDATION 4 Exercises on areas chosen by Commissioning 50p per patient (list size)  PATIENT JOURNEY Reviewing patients with multiple hospital activity £1 per patient (list size)

13.  PATIENT INVOLVEMENT 30p per patient 3 consultation events over year Could be met by growing pt membership ICIS  PAYMENT 50% on signing up 50% year end

14. WHITTINGTON CONTRACT  WE RAISED IT  THE ACUTE COMMISSIONERS LISTENED  ITS IN THE CONTRACT!

15. TARGETS  REDUCTIONS IN OPD FOLLOWUPS 10 specialties targeted ICIS and hospital clinician audit  REDUCTIONS IN C2C REFERRALS ?Some audit in year  IMPROVEMENTS IN DISCHARGE COMMUNICATIONS In year audits?

16. CARDIOLOGY  FIRST OPD £274  FOLLOWUP£131  DIRECT ACCESS ECG£31  DIRECT ACCESS ECHO£111

17. OTHERS  DEXA£85  DIABETES EDUCATION£750  GTT£41  MATERNITY USS£85  DIETETICS£63  ANTICOAGULATION£27 We will circulate full list of prices…

18. Feedback from Away Day. What we’ve achieved so far?  Better practice engagement  Clinically relevant dialogue  Built/building relationships  Efficiencies/working smarter e.g. delivery of LES, commissioning / data issues  Educational focus & provision  Better Clinical leadership/pathway

19.  GP voice in shaping services  More GP ownership of PBC  Innovative  Good building block for future?