1. Changes in the NHS and Nottingham City CCG
Dawn Smith
Chief Operating Officer
&
Ian Trimble
Executive GP
NHS Nottingham City CCG

2. Changes in the NHS and Nottingham City CCG
Background – Why all this change?
NHS Nottingham City CCG
CCG structure
Authorisation
What does this mean for you?

3. The NHS was facing a complex mix of pressures-
Demographics – ageing population
Expectations – increasing
Technology – rapidly accelerating
Costs and growth – unsustainable
But also ideology of choice and competition (building on changes introduced by previous Labour government)

4. The Coalition government’s response - Equity & Excellence:
Liberating the NHS
Government’s long term vision for NHS
Put patients at the heart of everything the NHS does
Focus on the continuous improvement of the things that patients (clinical outcomes)
Empower clinicians to innovate and improve healthcare services (greater role for clinicians in setting direction for delivery of services)
Less top down control from government

5. The Health and Social Care Bill, 2011
Provision covers 5 themes;
Strengthening commissioning of NHS services (clinically led commissioning)
Increasing democratic accountability and public voice (limiting political micromanagement, increasing LA oversight)
Liberating provision of NHS services
Strengthening Public Health Services
Reforming health and care arm’s length bodies (decrease NHS admin. by a third to increase resources going to frontline services)

6. How does this look in Nottingham City?
Formation of shadow CCG mandated by practices.
Retaining clusters with their history of practice co-operation.
Nottingham City and Nottinghamshire County PCT (Cluster) still exists and remains the statutory authority until April 2013.
CCG staff are formally employed by PCT until April 2013.
Responsibility for commissioning of healthcare services has been delegated by the PCT to the CCG.
New CCG executive board consisting of 9 Nottingham City GPs and some senior staff from the PCT

7. Terms of Engagement Timeline

8. What’s the difference between the CCG and the PCT?
Primary care contracts
Manages commissioning budgets
Dental and optometrist contracts
Will work with PCT cluster on primary care performance
Community Pharmacy
Links with LA & Public Health

9. CCG proposed Vision: Our proposed Values:
Our purpose is to work together with compassion and caring to improve health and reduce health inequalities through the provision of high quality and value-for-money services that are patient-centered. 
This will be achieved by:
Our proposed Values:
Taking an active and inclusive approach to involving patients, carers and the public in all aspects of our work.
Understanding and responding to the needs of our diverse population.
Continually improving the quality of services through collaborative and innovative clinical commissioning.
Enabling, supporting and encouraging development of the local workforce to deliver health improvements.
Securing cost effective and integrated services within available resources.

10. Structure

11. NHS NOTTINGHAM CITY CLINICAL COMMISSIONING GROUP
Chief Operating Officer
Dawn Smith
Director of
Contracting,
Quality &
Delivery
Teresa Cope
Company Secretary
Lucy Branson
Director of
Finance
& IT
Terry Allen
Director of
Cluster
Development
& Performance
Maria Principe

12. We have come a long way already - - Really effective GP Executive - High quality management support in depth - Comprehensive organisational structure at £25/head - Stable Financial basis - And of course practices and clusters really working well and supporting our commissioning work
Working together for a healthier Nottingham

13. And also - - Understand and on track to deliver QIPP - with a particular focus on the Quality part of QIPP - Good handle on 'day job' of commissioning - Building links with other CCG's and clinicians - Sound governance of our organisation This is all illustrated by Sir David Nicholson’s visit and by our short-listing for CCG of the year
Working together for a healthier Nottingham

14. So what are the next steps
So what are the next steps? The key task will be to demonstrate our competencies in order to be authorised - that is fully approved to commission by ourselves in We also need to keep doing the 'day job' over the next 12 months and beyond Develop a longer term vision and plan
Working together for a healthier Nottingham

15. Authorisation
Submission of evidence to demonstrate capability across six domains
Assessment of track record
Discussion with CCG
Annual assessment
Board validates evidence degree review

16. Timeline July - Oct 2012 NHS Commissioning Board established
Risk assessment of configuration Oct – Dec 2011
July - Oct 2012 NHS Commissioning Board established
Consideration of applications from Oct 2012
Establishment of CCGs from Oct 2012

17. What does this mean for practices?
+ve
-ve
CCG lead by clinicians – controlling the agenda
Practices more accountable for use of NHS resources and financial pressures / risks of QIPP
Opportunity to get involved in designing services
Performance management over broader area
More collaborative working and support for practices
Need to up-skill in terms of corporate governance
Clinical representation at contract negotiations
Market management challenges
Expansion of primary care role
Dealing with time, cost and capacity constraints to make this shift

18. How can PMs and the primary care administrative team become involved
How can PMs and the primary care administrative team become involved? What can you contribute?
Key role in supporting practice clinicians in managing practice budget – inc eHealthscope.
Cluster boards – support and feeding back to the Executive on ideas and issues.
Supporting the voice of patients.

19. What does the group think about our proposed Vision and Values
What does the group think about our proposed Vision and Values? Does it capture how we should be working?
What support would PMs and the primary care administrative team like the CCG to give?

20. Any Questions ?
Working together for a healthier Nottingham