1. NHS Leeds West CCG Stakeholder Meeting 27 th June 2013 WELCOME

2. Leeds CCGs We work together to commission our local providers

3. The Leeds Health and Wellbeing Strategy

4. Our member practices and patients have told us: We need to better manage long term conditions We need to help people to stop smoking and to lose weight We need primary care to change to be able to do this We need to have less patients going to hospital People want to be treated with dignity and respect We need to have better services for people with mental health problems We need to have better outcomes for people with cancer People wanted us to include children in our plans People want their views to be taken into account

5. OLDER PEOPLE ADULTSCHILDREN AND FAMILIES Improve cancer services Reduce the gap in life expectancy in west Leeds Long term conditions management Sexual health Improve mental health support / services Choice and access for elective care services Increase choice and control at End of Life Improve urgent care services Access to IAPT Dementia pathways Early detection and diagnosis of cancer Clinical value in elective care Prescribing End of life programme AEC pathways Implement - 111 Improving cancer pathways Mental health initiatives Risk stratification of people with LTC Integrated H&SC teams Healthy living programme - children Healthy living programme - adults LTC self management Sexual health projects Practice Initiatives - LTC Leeds West CCG Priority Health Goals USE OF RESOURCES To use commissioning resources effectively QUALITY AND SAFETY To transform care and drive continuous improvement in quality and safety ORGANISATIONAL DEVELOPMENT Members can meet their obligations as clinical commissioners at practice level and to have the best developed workforce we possibly can PRIORITY HEALTH GOALS To tackle the biggest health challenges in west Leeds, reducing health inequalities Our Strategic Objectives Working together locally to achieve the best health and care in all our communities Our Vision Our Purpose To work for members to improve the health of our populations through effective commissioning, collaboration and primary care development Organisational Development Plan Plan on a Page

6. Priority Health Goals - Member Practice Actions Improvecancerservices Reduce thegap in life expectancy in westLeeds Long termconditions management Sexualhealth Improvementalhealth support /services Choice andaccess for electivecareservices Increasechoice and control atEnd of Life Improveurgent care services Priority Health Goals Practice Actions LWCCG Clinical Commissioning Scheme Local QP Indicators (QOF) DES Schemes (examples) Diabetes treatment (23 practices) Increase referrals to alcohol services (5 practices) Respiratory disease management (3 practices) Increase early diagnosis of cancer (3 practices) Prevention of CVD (2 practices) Increase referral to weight management services (1 practice) Diabetes treatment (23 practices) Increase referrals to alcohol services (5 practices) Respiratory disease management (3 practices) Increase early diagnosis of cancer (3 practices) Prevention of CVD (2 practices) Increase referral to weight management services (1 practice) Stroke review 6 months post discharge Preconceptual advice for diabetes Prophylactic prescribing for COPD Self management programmes Every Contact Counts training Increase bowel cancer screening Peer reviews for: - Outpatient referral data - Emergency admissions - A&E attendances Develop action plan for frequent attenders at A&E Stroke review 6 months post discharge Preconceptual advice for diabetes Prophylactic prescribing for COPD Self management programmes Every Contact Counts training Increase bowel cancer screening Peer reviews for: - Outpatient referral data - Emergency admissions - A&E attendances Develop action plan for frequent attenders at A&E Alcohol related risk reduction scheme Risk profiling and care management scheme (risk stratification) Timely diagnosis for people with dementia Remote care monitoring prep scheme Learning disabilities health check scheme Shingles Rotavirus Patient participation Extended hours Childhood immunisations HPV Improving patient online access Flu and Pnemococcal Alcohol related risk reduction scheme Risk profiling and care management scheme (risk stratification) Timely diagnosis for people with dementia Remote care monitoring prep scheme Learning disabilities health check scheme Shingles Rotavirus Patient participation Extended hours Childhood immunisations HPV Improving patient online access Flu and Pnemococcal

7. Healthy Lifestyles What do we know? This is a priority for us because we know that we have the widest life expectancy gap in Leeds and we want to continue encouraging and promoting healthy lifestyles. Alcohol misuse is a key area of concern; and we know that we have a high number of emergency admissions to hospital for alcohol related liver disease. Reduce emergency admissions for alcoholic liver disease Develop new and innovative ways of reducing smoking rates with a particular focus on parents that smoke Put plans in place to tackle childhood obesity Continue to support and deliver health checks and refer those who need to adopt healthier lifestyles into services that can help Improve the support for people who regularly visit A&E as a result of alcohol or substance misuse What are we going to do?

8. Sexual Health What do we know? Large Student Population Meets the health and wellbeing strategy’s priority to support people to choose healthy lifestyles. Improve access to, and uptake of, a range of sexual health services in partnership with the local authority who has the main responsibility for commissioning these services. In particular, focus on improving the sexual health in those populations that have high STI (sexually transmitted infection) and unplanned conception rates. Work with primary care to improve the uptake of these services. What are we going to do?

9. Managing Long Term Conditions What do we know? Improving care and managing long term conditions is a shared priority for all organisations across the city that provide health and social care. It is particularly important for us as we have a high number of patients with long term conditions who are admitted to hospital as an emergency when they could have been helped at home. Our GP practices, and information from the JSNA have highlighted diabetes as a major cause for concern. Continue to roll out a process called ‘risk stratification’ in our GP practices. Make it easier for people to get primary care health services in normal working hours and out of hours. Improve the way and how quickly we identify people at risk of developing long term conditions. Increase and improve how diabetes is managed in primary care. Improve how we help people to manage their long term conditions themselves. Put processes in place to identify people earlier with respiratory illness Improve how we manage and prescribe medicines. What are we going to do?

10. Improve cancer services What do we know? We have a higher than average number of people aged under 75 who die from cancer, in particular breast, bowel and lung cancer. Members of the public have told us that this is one of the health issues that is important to them, and reducing premature death is also one of the health and wellbeing strategy’s priorities Work closely with national screening programmes to plan services and make sure that there are enough. Improve the numbers of people taking up bowel screening, particularly in harder to reach groups. Build on the successful lung cancer screening campaign and develop further marketing campaigns to support bowel and ovarian cancer screening. Involve patients to improve the numbers of people taking up screening, and use their experience to understand how effective our commissioning processes for cancer services are. What are we going to do?

11. Improve mental health services What do we know? High suicide rate in our area, in Leeds 12 and 13 (Armley, Wortley and Bramley). Members of the public have told us that improving people’s mental health and wellbeing is important to them. Priority for Leeds Health and Wellbeing Board. There is also a growing need to support an ageing population with dementia. Commission more mental health support services. Enable our member practices to work closely with the community and voluntary sector to offer holistic care to patients. Improve access to IAPT( Improving Access to Psychological Therapy) services in our area. Improve the diagnosis of patients with suspected dementia more quickly and refer them for treatment. Contribute to reducing the suicide rate in our area by increasing access to primary care and support more people in high risk groups by referring them to a range of services that can help. What are we going to do?

12. Improve Choice and Access for Elective Care Services What do we know? Providers and monitored on 18 week referral to treatment times. National drivers have created the Choose and Book system and this is likely to develop into an e-referral service in the near future. Use of Choose and Book in LWCCG practices is high. Working with our providers to ensure compliance with nationally mandated targets Working through the MOT and QP peer review around referrals to understand and educate more around more appropriate referrals Working on pathway redesign and developing local pathways on the Map of Medicine What are we going to do?

13. Improve urgent care services What do we know? Urgent care services are a priority because of the pressure on A&E departments, access to primary care and feedback from our member practices who are telling us that demand on their services is increasing. Patients have told us that the system is confusing so we are committed to making improvements. Reduce unnecessary A&E attendances and people being admitted to hospital unnecessarily by offering local alternatives and better information. Reduce unnecessary hospital visits for people with long term conditions by improving support at home and closer to home What are we going to do?

14. Improve care for people at the end of life What do we know? This is important to both our member practices and members of the public in terms of dignity and respect. It is also an important priority for Leeds and we will work closely with our partners to ensure that we put plans in place to improve this locally. Support more people to die in the place where they choose at the end of their lives, including support for their families and carers. What are we going to do?