1. Deliver Today : Shape Tomorrow
Dr Nicolas Small, GP
Chairman
Margaret Stockham
Strategic Adviser

2. Whether a clinician or manager this is how it felt
Getting Started
Whether a clinician or manager this is how it felt

3. The Journey

4. National Direction, Local Action
Maternity
HCL Business Plan
NHS East of England
Adapting existing Strategies
Improving Lives; Saving Lives
Looking to the Future
Our NHS, Our Future
Children
Darzi – direction for the
8 clinical groupings
Towards the Best Together
Planned care
Mental health
Staying healthy
LTCs
Acute Care
End of Life 4

5. Our Business Plan Needs of population Service changes + Better health
Vision
Context
Strategy
Delivery
A picture of the future health for Hertsmere people
Analysis of the current status and grasp of the challenges
A description of the goals and initiatives to deliver the vision as set out in the Business Plan
Development of implementation plans for delivering the strategy plus Performance Management
Plans & Proposals
Programmes
Initiatives
Service changes +
Better health

6. Making it Real in Hertsmere
Midwives key to ‘Maternity Matters’ – no changes proposed
Maternity
Roles for health visitors in the new Child Health Promotion Programme - improving immunisation rates
Children
Key role for CATs in only referring the right people – diagnose to refer not refer to diagnose
Planned care
Secured resources to work with 3rd sector, improve counselling, support Graduate Mental Health Workers & IAPT
Mental health
Plans underway to pull together services for young adults in Borehamwood
Staying healthy
Redesign programmes underway including care pathways for MSK (including physio review), COPD, Diabetes & Ophthalmology
LTCs
Acute care
Focus on referral management, consultant to consultant referral and early discharge for inpatients
Undertook short review to see whether there is a need to increase resources for hospice care
End-of-life

7. Looking Forward We must Control acute spend Improve local access
Future programmes to control acute spend
We must
Control acute spend
Improve local access
Ensure safety and good patient experience

8. Achievements Mental Health Prescribing CATS Patient Group
Performance Management
SPA
Innovation Fund
Website
Community Nursing
Children’s Services
Prescribing
Patient Group
COPD
Physiotherapy redesign
In- house Phlebotomy
Increased resources for counseling
Strategic Management
Public Health

9. Mental Health
Established subgroup – monthly meeting of GPs, PM, HPFT, Patient Groups, Voluntary Groups e.g Viewpoint/ Mind & Carers in Herts
CBT/ Psychological Therapies/ IAPT - first PBC group in W Herts to deliver these services and maintain existing counseling resources
Persuaded HPFT to respond to locality needs e.g address counseling waiting times
Innovation Fund £47k in 3 Hubs addressing carers needs / premises shaped by local groups
Shaping the future Mental Health Commissioning with a Hertsmere focus

10. CATS
Innovative and robust approach to Performance Management including representation from PCT Finance and Contracting, Patient Group and Practices
Developed monthly Report Card
Appointed lead - Jayne Taylor
Partnership with local acute Trust - Barnet & Chase
GP buy-in to performance
MSK
Dermatology
Ophthalmology
Urology
Respiratory Geriatrics
Cardiology

11. SPA Awarded Nov 2007 £100k project Working with UH UK
Only PBC group to be awarded in UK
Shaping services for the future
Engagement with stakeholders
Lessons learned

12. Website www.hertsmerecommissioning.co.uk
Portal for clinicians & public
Information on CATS
Public Participation “Your Say”
Library for all documents/ minutes etc
Link into Hertsmere council website
Putting Hertsmere and PBC on the map

13. Community Nursing / Children’s Services
Engaging with local team
Shaping Provider Service Contract
Enhanced resources / manpower for Community Nursing team
Monitoring performance of contracts
Monthly dialogue

14. Fast track proposals
Direct Access Physiotherapy pathway & integration with MSK
In house Phlebotomy
Fair distribution of extra counseling resources
COPD

15. Patient & Public Involvement
Hertsmere Patient and Public Involvement Group
Trailblazer for Herts PCT
Aim is to involve patients and members of the public in our commissioning decision-making processes.
Initial group has met twice.
Group is in the process of agreeing a range of ‘involvement’ activities such as:
Reader panel
Leaders of disease specific patient interest groups including linking with existing local groups to be involved in monitoring specific contracts, service redesign
Committee membership e.g. performance management
Possible member of contributor of the accreditation process for GPwSIs and services in which they work
Representative of the HCL PPI group on the LINk.

16. Public Health initiatives
Obesity
Smoking
Exercise on prescription enhanced
Local Retinal Screening service delivered by Optician
Engagement with Council/ partnership working

17. Next Steps
Efficiency … Developing specific role descriptions for each formal role within HCL - including time commitment
Development … Establishing training and support needs of the group and individuals
Governance … revising our robust systems based on best governance principles e.g. conflicts of interests, voting, confidentiality etc
Review of structure … Enlarging the size of the group and establishing differing levels of involvements

18. Thank You
Any Questions?