Summary Annual Report 2014/15
www.walsallccg.nhs.uk
Introduction Welcome to the summary of the Annual report from NHS Walsall Clinical Commissioning Group (CCG). It has been an exciting second year and we are pleased with our progress in making sure the people of Walsall receive the best possible healthcare within the resources we have available.
“I hope this summary version of our annual report will give you an insight into our successes and challenges as well as a look to our future plans.�
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Throughout the year we have worked hard with our GP members, patients, carers and partners to improve the way health and social care services are organised and delivered. To keep patients at the centre of all we do; we have engaged with them on issues of concern as well as seek their input and support in areas where service redesign has been considered and implemented. I hope this summary report will give you an insight into our successes and challenges as well as a look at our future plans. We are very keen to hear from people, not just on what you think about the contents of this report, but what you want from your local health services. Please see the contact details at the end to learn more about our work and how to get involved. We look forward to building upon our achievements and continue with new challenges as we improve the health and wellbeing for the people of Walsall.
Dr Amrik Gill Chair NHS Walsall Clinical Commissioning Group
NHS Walsall Clinical Commissioning Group Summary Annual Report 2014/15
About Us NHS Walsall Clinical Commissioning Group has been operating since April 2013, when it was fully approved by NHS England. Our role is to commission hospital, community and mental health services for the people of Walsall. Commissioning is a process of planning and buying services to ensure that the people who live in the borough have the right healthcare. Along with commissioning services, we are responsible for monitoring how well these services are provided. The CCG is made up of 63 GP member practices and serves aproximately 274,000 population of Walsall. The area is very diverse and includes areas of deprivation and health inequalities – which means there are wide variations in people’s health and wellbeing. We work with all of our ‘providers’ of services including the local GPs, and pharmacies, local healthcare professionals and a range of other local partners. We are committed to working with our neighbouring NHS services, where we need to, to ensure that local residents receive high quality healthcare.
Our corporate objectives are to: • Involve patients and public in decision making •C ommission high quality care • Ensure value for money •E nsure strong leadership and good governance •P romote good health and sound treatment of ill health • Work in partnership
63 GP Member Practices NHS Walsall Clinical Commissioning Group Summary Annual Report 2014/15
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w
Making it happen in Walsall
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Our vision Improve the health and wellbeing for the people of Walsall
274,000 approx population of Walsall
Strong
Clinical representation
63
GP Member Practices
Patient Representative Groups
£368m
Sign up to
Safety
Registered with
Sign up to
Safety
£368m
Reduced increase in
2014/15
National target
emergency admission
Budget
£1,318
spent on average per person registered with a GP practice
Twitter followers
4445 @WalsallCCG
C.diff
for managing Clostridium Difficile (C.diff)
achieved Launched
Health checks
from GPs and pharmacists for patients aged
40-73 years old
68%
H
Hospital
Services Review
diagnosis rate for dementia
above national average Active partner in
Better Care Fund Programme
No cases reported Financial & QIPP
Dementia
Improved support for patients once received diagnosis
jointly commission
Primary Care services with NHS England
Care home Enhanced model of healthcare for Care homes
targets met
against the 18 week RTT threshold for admitted patients below targets
Public urgent care consultation and plans for new Urgent Care Centre approved
Approval to
of Category 4 Pressure Ulcers at Walsall Manor Hospital
Referral and Treatment Times (RTT) Performance
Urgent Care
Diagnostic waits Lengthy waits for diagnostics (x-rays, MRI scans etc) continue
A&E standard
A&E standard for patients waiting less than 4 hours not met
H
A+E
Reduction in patients
Falls
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Integrated Locality Teams in Walsall
Making good progress with
5 year plan Highly
commended
in prestigious awards for our public value approach to commissioning
Making it better
The CCG is working with partners and taking action to recover performance in all these areas. See our Annual Report for a list of the measures we have in place. www.walsallccg.nhs.uk
Walsall
CCG
We have a proactive Patient and Participation Liaison Group that meets on a regular basis
Involve patients & public in decision making The CCG is committed to putting the voice of patients and the public at the heart of all its decision-making and in the evaluation of current health services. In fact ‘listening to patients’ and acting on this feedback is critical in helping us to continually improve services. The involvement of patients and the public also plays an important part in building and shaping health care services in Walsall to ensure they meet the needs of the local people. Over the past year we have developed a draft Engagement and Communications plan which sets out how we as a CCG engage and involve staff, partners, patients and our local community. We have an active Patient Participation Liaison Group that meets on a regular basis and well established links with our GP surgery based Patient Representative Groups, many of which we have supported over the last twelve months. Patients and partners who are not part of any of the formal groups have also had the opportunity to engage and be involved with the CCG through the website, our social media channels, the local media and the CCG Newsletter. Engagement with our member GP practices takes place at monthly locality meetings and through regular visits to practices by the locality Chairs to provide support to them if needed.
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NHS Walsall Clinical Commissioning Group Summary Annual Report 2014/15
Involve patients & public in decision making
Making it happen in Walsall
Review of Urgent Care Services The CCG led a review and public consultation into Urgent Care across Walsall which was completed in November 2014. This successfully involved and engaged local people and many other stakeholders in shaping and informing the longer term plan for urgent care and the shorter term options available for getting us there. There were open debates and exhibitions, opportunities for everyone to voice their opinions from the healthcare professionals, the public and many organisations. As a result of the consultation a new Urgent Care Centre will open in Walsall where patients will be able to receive treatment for injuries and illnesses that are urgent but not life-threatening, from 8am until 8pm, seven days a week.
Urgent Care Centre
will open
8am-8pm 7days a week
A wide selection of service-user groups have also been involved in helping advise on the design of the new Urgent Care Centre. This feedback has proved to be valuable and helped to inform plans for the layout, access arrangements and general environment. This involvement will continue and develop further as work to improve urgent care services in Walsall progresses. NHS Walsall Clinical Commissioning Group Summary Annual Report 2014/15
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3 year plan
Sign up to
Safety
The CCG is currently developing its 3 year plan to save lives and reduce harm for patients. 8
NHS Walsall Clinical Commissioning Group Summary Annual Report 2014/15
Commission high quality care A key area of our work is to improve the quality of the services we deliver. As a clinically-led organisation, we are passionate about ensuring patients get safe, high quality care. We monitor and make efforts continuously to improve the quality of healthcare we commission.
We are pleased to report the following successes:
• Reduced increase in emergency admissions compared to the previous year. This has been possible through the investment we have made over the last two years in redesigning community services and other health schemes. • Reduction in Category 4 Pressure Ulcers. We are pleased to report no cases at the Walsall Manor Hospital over the last year. • Developed a local internal “quality concerns” system to cover a wider range of providers and improved the internal communication of information gathered and lessons learnt. • Overall reduction in the number of patient falls throughout 2014/15. • As part of the CCG’s commitment to ensuring a high quality service, it has registered with “Sign up to Safety”, a national initiative to make the NHS the safest healthcare system in the world by creating a system devoted to continuous learning and improvement. The CCG is currently developing its three year plan to save lives and reduce harm for patients.
• An enhanced model of healthcare has been designed with the care home sector and key partners to raise quality standards and transform the delivery of services to residents. • National target for managing Clostridium Difficile (C.diff) has been achieved. • An increased number of Primary Care staff have been trained to Level 3 in Safeguarding. • Implemented Communications and Engagement Strategy and increased the number of Patient Representative Groups. • Health checks are now offered by all GPs and pharmacists for patients aged 40-73 years. There are also health checks offered for people with learning disabilities and for people with mental health problems. • A scheme for the over 75’s has been launched which offers health checks to all patients with regular medication reviews and care plans. We recognise we also have some challenges particularly around meeting standards for patients waiting for elective treatment (Referral & Treatment Times) and meeting the four hours A&E standard. We are working hard with our local partners to achieve higher performance levels in these areas. A Systems Resilience Group, made up of health and social care partners has been set up to monitor the situation and we are putting in place initiatives to help reduce pressure on admissions and smooth the transition for patients from hospital to home with social care services.
The CCG maintains a strong focus on safeguarding children and vulnerable adults, being aware of the increase in its statutory duties and seeking to learn from the experiences of those who use the services. Working closely with other agencies is essential, and the CCG Lead Nurse as the Executive Lead for Safeguarding is a member of both the Children and the Adults Local Safeguarding Boards to support this need. Overseeing and monitoring of CCG Safeguarding activities rests with the Quality and Performance Committee of the Governing Body.
The CCG maintains a strong focus on safeguarding children and vulnerable adults NHS Walsall Clinical Commissioning Group Summary Annual Report 2014/15
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Commissioning high quality care
Making it happen in Walsall
Dementia Friendly Walsall We are pleased to report the following successes:
national ambition
67% diagnosis exceeded
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• Walsall achieved the national ambition to have a 67% diagnosis rate for dementia. The CCG had a rate in excess of 68% by end of March 2015. • Walsall Manor Hospital now provides a dementia café to support patients and their carers, as well a Mind Matters café for older people with mental health issues, such as depression, something which will affect up to 25% of all older people in Walsall.
This includes introducing Personal Assistants for dementia, who will work alongside dementia patients from first diagnosis, as well as offering guidance as how best to access additional support and highlighting the benefits of the seven dementia cafés.
• We are working alongside our mental health provider, Dudley and Walsall Mental Health Partnership Trust which has brought together district nurses and social workers to join forces, in order to look after • Accord Housing Association and Age a person as a whole. This has involved UK have come together to introduce developing an Intensive Support Team, Pathways4Life to work with St Giles which will visit a person in crisis within Hospice to improve their care in homes a two-hour period and will make every across the region, for people with dementia effort to avoid hospital admission, with the and end of life care. aim of supporting the person to remain at home where possible.
NHS Walsall Clinical Commissioning Group Summary Annual Report 2014/15
Ensure value for money All CCGs have to meet the same statutory and financial duty to ensure expenditure in a financial year does not exceed the allocated budget. NHS Walsall CCG received a £368m budget for the 2014/15 financial year. We can report we met our statutory financial duties, remaining in financial balance, and delivered a 1.5% surplus of £5.5 million. This surplus will be carried forward and may be available for the CCG to invest in patient services during 2015/16. We spent an average of £1,318 per person on providing healthcare to people who are registered with a Walsall GP Practice. The NHS has been required to make up to £20 billion worth of efficiency savings over the past few years to free up funds to treat patients and allow medical teams to respond to changing demands and new technologies. This programme is known as Quality, Innovation, Productivity and Prevention (QIPP). The CCG had a challenging savings target of £5.998 million for 2014/15. At the end of the year we had exceeded this target and delivered £8.115 million – which was a considerable achievement in a complex environment.
How we spend each penny in every pound Community Service Ambulance Service
9p Primary Care Services 3p Learning Difficulties
Mental Health
2p
9p
3p
14p
Continuing & Intermediate 5p Care
Prescribing
6p
Other
49p General Acute
We spent an average of £1,318 per person NHS Walsall Clinical Commissioning Group Summary Annual Report 2014/15
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Ensure strong leadership & good governance NHS Walsall CCG Governing Body has a very strong clinical membership and focus, with a GP as Chair, eight additional GP Board members, a hospital consultant and a lead nurse member. The Governing Body also includes three independent lay members, representatives of Walsall Borough Council’s Public Health Team and senior members of the CCG management team. Governing Body members and senior staff are required to make a declaration of interests which is reviewed on a quarterly basis. This information is available on our website The CCG is committed to operating in a culture of openness and transparency, as such all of our Governing Body meetings are held in public. Meetings take place bi-monthly and members of the public are able to attend and submit questions. Papers, including minutes from the meetings are available on the CCG website. The CCG also has strong clinical leadership and engagement from our member practices. The GPs lead in a number of areas including Urgent Care, Dementia, Pharmacy and Mental health.
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NHS Walsall Clinical Commissioning Group Summary Annual Report 2014/15
Promote good health & sound treatment of ill health Our vision ‘Improve the health and wellbeing for the people of Walsall’ The CCG works closely with Public Health to tackle health inequalities across Walsall. ‘Health inequalities’ refers to the differences in health outcomes between different populations groups (for example the population groups in different parts of Walsall). The main focus of this is on improving life expectancy, reducing infant mortality, alcohol consumption, providing tools on stopping smoking and drug use, whilst increasing physical activity, encouraging a positive diet and lifestyle, and community management of long-term conditions such as diabetes and heart disease. Our immunisation programmes and routine screening will continue, identifying early symptoms to ensure positive health outcomes will steadily rise.
Promote good health & sound treatment of ill health
Making it happen in Walsall
Integrated Locality Teams When patients get ill we try to support and treat them at home if possible. The CCG has invested in Integrated Locality Teams, which brings together current community health teams and adult social care teams to work jointly around a patient. They deliver joined up, patient-centered care for patients with long-term chronic and medically complex conditions within the areas in which they are located in Walsall. Five locality teams, made up of health and social care staff which includes a District Nurse, a Community Matron, a Rapid Response Worker and Social Worker, have been introduced in Walsall and each of the teams serve a population of about
50,000 people. Working closely with social care, community nursing teams, local GPs and other organisations specific to a patient’s needs, the teams support people to stay well. The Integrated Locality Teams work closely with the Rapid Response Service. They provide care to patients who need immediate, intensive intervention to avoid a hospital admission, or to support their discharge from hospital as soon as it is safe to do so. This service has continued to expand in Walsall and each team now looks after approximately 200 people and by establishing a specific care package for each person, can in many instances, avoid the need for hospital admission.
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Integrated Locality Teams in Walsall
NHS Walsall Clinical Commissioning Group Summary Annual Report 2014/15
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Working in partnership As a CCG we recognise the importance of working jointly and in partnership to successfully improve the health and wellbeing of local people. During 2014/15 we have worked closely with other CCGs, our providers, local authorities, Safeguarding Boards, Joint Committees (e.g. Children’s Joint Commissioning Partnership), NHS England, Public Health, Healthwatch Walsall and most importantly local people and patients to shape services for the future. We have an active partnership with Walsall Healthcare NHS Trust and the Walsall and Dudley Mental Health Partnership NHS Trust which supports improved service quality as well as better organised and joined up care. The Walsall Health and Wellbeing Board is the most important way we come together with the Council to look at improving the health and wellbeing of local residents. We also work closely with Walsall Council to jointly commission a number of services for people with mental health, dementia, and learning disabilities. We are an active partner in the Better Care Programme. This is a significant programme of work which will transform the health and social care system in Walsall. The Better Care Programme brings together partners, including local NHS organisations, councils and the voluntary sector to ensure that services become more joined up to meet the needs of local people.
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NHS Walsall Clinical Commissioning Group Summary Annual Report 2014/15
Working in partnership
Making it happen in Walsall
Stroke Review We have been working in partnership with the seven CCGs across the Black Country, Birmingham, Solihull throughout 2014/15 to review stroke services. The aim has been to improve outcomes for people who may have had a stroke, or who may be at risk of having a stroke. The review looked at the whole range of services from prevention to hospital care and longer-term rehabilitation services. A patient advisory committee was set up, with representatives from stroke associations across the area, along with key partners and health professionals who gave feedback at every stage, as well as sharing information. Detailed analysis was carried out to find out if improvements could be made to stroke services. The next milestone for the project is to continue working with providers during 2015 to take forward the findings of the programme, and agree what is achievable. Locally, at a CCG level, plans are being developed to support prevention of stroke. Much emphasis is being placed on Atrial Fibrillation (AF) and 2015/16 should see some exciting initiatives introduced.
Looking to the future Wal sa
CCGll H
Hospital
We will work continually to transform health services locally.
Since 2014, we have been making good progress with our five-year strategic plan, which we developed with our patients, our public and our partner organisations. The plan looks at the way things are now for people in Walsall, how they should be, and how we are going to make them better. Our five-year plan focuses on the following strategic objectives: • Improving health outcomes and reducing inequalities; • Providing the right care in the right place at the right time; • Commissioning consistent, high quality and safe services across Walsall; • Securing best value for the Walsall pound and delivering public value We are planning to change the way services are organised and delivered so there is much greater emphasis on more joined up care, care closer to home and support in the community; as part of this we will make best use of digital technology and improve the take up of personal health budgets. This will help to avoid unnecessary and avoidable admissions to hospital and help us to get patients home sooner, with the right support in place. Also a number of our plans are aimed at improving life expectancy so we will be working to improve children’s services, promote take up and access to lifestyle services (prevention is always better than cure) and also the management and prevention of chronic conditions. We will work continually to transform health services locally. We will continually empower patients to take an active role in their own health, understanding effective ways of preventing illness and knowing when and how to access services, when the need arises. The objectives in our plan are not just important locally – they are also what the government wants to see happen as part of its Five Year Forward View, to improve people’s health right across the country.
NHS Walsall Clinical Commissioning Group Summary Annual Report 2014/15
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Summary Annual Report 2014/15
A full copy of our Annual Report and Annual Accounts 2014/ 15 is available to download from our website.
www.walsallccg.nhs.uk
To request a hardcopy please write to: NHS Walsall Clinical Commissioning Group Jubilee House Bloxwich Lane Walsall WS2 7JL
For more information about anything in this document or to request this report in a different format or language, please contact us on 01922 618315 or email ccgcomms@walsall.nhs.uk
Email us: Get.Involved@walsall.nhs.uk Tweet us: @WalsallCCG Visit us: www.walsallccg.nhs.uk Published by NHS Walsall Clinical Commissioning Group 2015