1. Commissioning Adult Mental Health Services in a Primary Care setting WatCom, the background third year of commissioning 28 member practices 187,000 registered population £163m devolved budget for 08/9 £762K under spend in 07/08 WatCom PBC Ltd

2. Community Services – District Nursing Late 2006 WatCom concerns about standards/levels of DN Jan 2007 Project group – defined principles - Teams - Accommodation - Named nurse with 2 i/c -> PHCT - Single point of contact - Referral form - Time periods - Training and development WatCom PBC Ltd

3. Community Services – District Nursing WatCom PBC Ltd June 2007 Project group – specification - standard core services - agreed clusters and staffing levels Nov 2007 Discussions with PCT commissioner and provider services started

4. Community Services – District Nursing Changes Agreed Old staffing level New Staffing level* 74.23 wte 89.31wte *additional 4 community matrons and *2 DN student sponsored placements Additional costs Pay £375k Non pay £60K Community Matrons £190K Students £70K Implemented from April 2008 WatCom PBC Ltd

5. Community Services – District Nursing Progress in 08/9 - Major recruitment campaign - only 7.5wte vacancies - Funding on stream as required - Monitoring outcomes  quantative  qualitative Next steps - rebuild working relationships - LCP - Secondary to primary care shifts WatCom PBC Ltd