1. Our plans for co-commissioning primary care in South Worcestershire Wednesday 21 January 2015

2. Agenda Welcome and introductions Housekeeping Setting the scene: challenges and opportunities Background to primary care commissioning How could primary care look in the future? Getting involved and next steps Q&As

3. Housekeeping

4. Challenges 1.Increasing number of people 2.Increasing number of over 75s 3.Increasing number of people with multiple long term conditions 4.Patient expectations 5.Static funding 6.Work force planning and recruitment 7.Fragmented care 8.Fragmented commissioning Setting the scene

5. Opportunities 1.Awareness of the challenges! 2.Greater integration – commissioning of primary care 3.Greater integration – providing 4.New models of primary care 5.Five Year Forward View Setting the scene

6. Commissioning primary care GP services previously commissioned by NHS Worcestershire Long history of collaborative and innovation in Worcestershire 2012 – NHS Reorganisation - NHS England manages GP contracts CCGs joint statutory responsibility to improve quality of primary care Proposed options o Greater involvement o Joint commissioning o Co-commissioning and delegation South Worcestershire CCG proposal

7. Co-commissioning Aim: ‘‘To harness the energy of CCGs and clinical commissioners to create a joined up, clinically-led commissioning system which delivers seamless, integrated out-of-hospital services based around the needs of local populations.’’

8. Why do we want to do this? Deliver the best outcomes for people in South Worcestershire through integrated commissioning Sustainable primary care – at scale Promote innovation Alignment of contracts and incentives Better decisions about how primary care resources are deployed Greater consistency between outcome measures and incentives used in primary care services and wider out-of-hospital services A more collaborative approach to designing local solutions for workforce, premises and IM&T challenges

9. Conflicts of interest Need for transparency in decision making Primary Care Committee will not have local GP members and chaired by Lay Representative Involvement of HealthWatch, Health & Wellbeing Board Will meet quarterly in public Maintain register of interests Public register of procurement decisions and actual conflicts of interest Registers included within CCG annual report Publication of GP earnings

10. So how might this look? Nuffield Trust: ‘Is General Practice in Crisis?’ Different types of appointments Rapid access to appointments Use of Skype and other forms of communication Continuity of care for people with long term conditions (LTCs) Co-production – ‘we are patient advocates’

11. Involvement & co-production Communication and engagement plan developed to: o communicate changes to wider public o seek feedback from patients on what improvements they would like to see made to primary care Public events being held to communicate these changes Workshops over coming months to look at detail Creation of Co-commissioning Patient and Stakeholder Group to co-produce service specification To register your involvement please contact Helen Perry- Smith at helen.perry-smith@worcestershire.nhs.uk

12. Next steps Application for co-commissioning submitted on 5 January Expecting to learn whether application successful in February/March 2015 Consider feedback and use this to shape commissioning plans for 2015/16 and 2016/17

13. Any questions? Do we need to change primary care? What do you think of proposals? Do you want to help shape this? Do you understand our proposals?