Horsham and Mid Sussex Clinical Commissioning Group
We are an NHS group led by local GPs & health professionals, responsible for planning and buying the majority of your local health services. Through clinical and public engagement, we work to ensure you can access the best health care and are supported to stay healthy.
Building the bigger picture What the changes to our NHS mean for local communities For the first time, health and social care services are being designed around the needs of the individual and the communities in which they live. Doctors and nurses, who know their patients best, now have the power and freedom to make decisions so their local communities get the care and services they really need. By using resources more effectively and working together with other NHS and care organisations, clinical commissioning groups will help their patients to access improved care that better caters for their requirements while addressing the needs of the most vulnerable and dependant. We are already working to improve care for frail and elderly people and those with long-term conditions, making sure they have more support so they are not admitted into hospital unless absolutely necessary. In the new NHS, patients have more involvement and choice in their care, with services designed around what they say is important and how they want to access care. Clinical commissioning groups are responsible for the care and treatment you may need in hospitals and in the community including prescribing; mental health services; and support and services for people living with learning disabilities. Importantly they are not responsible for primary care which includes GP practices, dentists and opticians â€“ these areas are now commissioned by the Kent, Surrey and Sussex area team at NHS England. www.horshamandmidsussexccg.nhs.uk 2
How we fit together Introducing Horsham and Mid Sussex Clinical Commissioning Group Our area comprises 23 member GP Practices, serving a population of 225,000 across the towns of Burgess Hill, East Grinstead, Haywards Heath and Horsham as well as the surrounding areas. We are led by a team of GPs and health care professionals committed to involving as many residents and patients as possible to develop a healthcare system with real relevance to you.
Our GP membership
Our Governing Body oversees the
Horsham Courtyard Surgery • Holbrook decisions that the CCG makes about local Surgery • Orchard Surgery • Park Surgery • Riverside Surgery • Rudgwick Medical Centre • The Village Surgery
health services, ensuring our activities meet the best standards of quality for the local population.
Mid Sussex The Brow Medical
Patient engagement is at the heart of
Centre • Cowfold & Partridge Green Surgery • Crawley Down Health Centre & West Hoathly Surgery and Turners Hill Surgery • Cuckfield Medical Practice & The Vale surgery • Dolphins Practice• Judges Close Surgery • Lindfield Medical Centre • The Meadows Surgery • Mid-Sussex Health Care & Ditchling Health Centre and Hassocks Health Centre • Moatfield Surgery • Newtons Practice • Northlands Wood Practice • Ouse Valley Practice & Gilletts Surgery • Park View Health Partnership • Ship Street Surgery • Silverdale Practice & The Avenue Surgery
everything we are doing. We firmly believe the NHS belongs to the people and your engagement is key to ensuring local care reflects local need. Patient representatives from practices meet together monthly as the Commissioning Patient Reference Group (CPRG) to discuss health services and the CCG’s work. This group is central to ensuring the health services in our area are meeting what you need.
Get involved To help us do this we are keen to hear and learn from your experiences and your ideas for how we can improve services. To find out more visit our website or telephone 01293 600300 ext 3965 www.horshamandmidsussexccg.nhs.uk 3
Putting the right pieces in the right place Our Vision Working together to deliver the best possible healthcare for the communities of Horsham and Mid Sussex
Our Mission Developing high quality services that provide care in the right place, by the right person the first time around.
Honesty and transparency
Focussed on patients
What we’re working towards in Horsham and Mid Sussex
Focussing on our ageing population and care of our carers
Improving the health of children and young people
Improving mental wellbeing and reducing alcohol abuse
Tackling inequalities and reducing mortality
System Transformation—using limited resources better to provide safe, sustainable and high quality integrated care www.horshamandmidsussexccg.nhs.uk 4
Our population Our area has a resident population of 225,040 (as at September 2012) and a GP registered population of approximately 212,000. The population is projected to increase in the Horsham and Mid Sussex local authority areas by between five and nine per cent within the next 20 years, with large increases in the older age groups (over 65s). Specifically. Overall, our area has a low level of deprivation, but there are small areas of deprivation within otherwise affluent areas. Overall smoking rates are lower in Horsham and Mid Sussex than in the rest of England and physical activity rates are higher, however alcohol misuse is a rising concern and hospital admissions for alcohol attributed conditions are continuing to rise. Practices report higher numbers of patients drinking alcohol at unsafe levels and there is particular concern about people drinking at home who might be unaware that they are drinking at levels that put their health at risk. Like other areas in the UK, Horsham and Mid Sussex has an increasing number of older people in need of high quality health and social care at a time of growing pressure on public finances; many of these are residents in care homes (in Mid Sussex over 1,200 elderly people are care home residents). Improving care for the frail elderly by redesigning services is a priority for the NHS across the whole of Sussex, as is the identification of people with dementia, as well as support for them and their carers. As people live longer risk factors for health are likely to increase and the number of people with some certain diseases will double over the next 20 years, for example by 2030 there will be 17 million people in England living with arthritis and 3 million with cancer. However, many diseases are becoming increasingly easier to treat. In Horsham and Mid Sussex 34 per cent of the GP registered population are living with one or more of the following long term conditions: Asthma; Coronary Heart Disease; Chronic Obstructive Pulmonary Disease; Diabetes; Epilepsy; Heart Failure; Hypertension; Stroke; Dementia; or Atrial Fibrillation, many of which are debilitating and life-limiting affecting mostly older people.
Our Prioriti es
Priority one: Preventing people from dying prematurely In England about 20,000 lives a year would be saved if mortality rates were reduced to the best in Europe – too many people are dying too soon from illnesses that can be prevented or treated, such as cancer, liver and lung disease. There are also persistent inequalities between communities and groups in life expectancy and healthy life expectancy. We are committed to prevention and early diagnosis through primary care within the community, tackling risk factors such as high blood pressure and high cholesterol, and improved hospital services. The CCG will: Work with Public Health to increase the coverage of NHS Health Checks Improve stroke services Reduce alcohol related harm National research has shown that the awareness and earlier detection of cancer is likely to support longer healthy life expectancy and improve survival rates. We will: Work with the NHS and the charity sector to raise understanding of signs and symptoms of cancers among GPs and the local community and share learning Continue to participate in national and local campaigns that raise the profile of cancer and increase rates of screening, Target specific groups at risk and work with local communities to ensure screening provision is culturally sensitive. 6
Preventing people from dying prematurely Ensuring access to the right services for children, people with mental health problems and those with learning disabilities, as well as treatments and drugs, will be essential in improving care and reducing premature deaths. We will: Support the development of cancer services, including radiotherapy treatment, at East Surrey Hospital Ensure patients can access drugs recommended by NICE and commission the Health Policy Support Unit to advise on appropriate treatments Manage a process for funding decisions for patients with individual needs (IFR) Improve local mental health services, including mental health day care for older people and inpatient services for those living with dementia Work to diagnose people with dementia early to ensure their wishes and needs, as well as those of their carers and families, can be heard and implemented Commission a dedicated shared care dementia ward in the local acute hospital Reduce anti-psychotic prescribing Reducing avoidable deaths and improving hospital standards is key to preventing people dying prematurely. Working alongside Public Health we will: Better assess and understand local needs Improve engagement with voluntary and community groups To ensure that people stay healthy and the risk of a premature death is reduced, NHS staff will use every contact they have with people (including others working in the NHS) to encourage them not to smoke, to drink less alcohol, to eat more healthily and to exercise more. We will: Reduce the number of smokers through targeted campaigns and support Increase support for drug and alcohol treatment and focus on alcohol prevention and intervention for young people under the age of 24 years Work to reduce obesity with weight management programmes, a physical activity strategy and healthy eating 7
Our Prioriti es
Priority two: Enhancing quality of life for people with long-term conditions Long-term conditions or chronic diseases are conditions for which there is currently no cure but can be managed with drugs and other treatments. Many are debilitating and life-limiting and those affected will mostly be older people. To achieve the best outcomes it is vital that care is coordinated . We will lead innovative solutions to delivering integrated care for our patients. We are committed to reducing inequalities by supporting people with on going health problems to live healthily and independently, with better control over the care they receive. We will: Ensure care is more convenient and centred on the person, not the condition. A holistic approach via a combination of professional and voluntary sector care will ensure patients can manage their own conditions, reducing time spent in hospital. Integrate services based on patient’s needs, including musculo-skeletal care. Enable patients to take charge of their care and have ownership of the plans to treat them, giving them the skills and confidence to manage their own health. Working with the local authority, we will: Involve patients and carers in personalised care plans, personal health budgets and self care to ensure they feel supported and can improve their quality of life Support carers to take short breaks and gain or maintain employment.
Enhancing quality of life for people with long-term conditions The number of older people who are living longer with multiple conditions is increasing. Improved care for the frail elderly, including timely diagnosis, treatment and care for people with dementia, is a priority. We will: Commission specialist dementia nurses (Admiral Nurses) Improve care and support for complex cases, including in nursing homes Introducing information systems and processes that help people to take control over the decisions they make about their health Technology can help people manage their health. By 2015 we want to significantly increase access to support people with long term conditions. We will: Empower self care by introduce telecoaching for patients to manage their own care via timely and relevant information and support Ensure a patient’s records follow them (with consent) to different health and care settings Provide online booking of GP appointments and patient access to health records Establish an updated electronic Prescription Service and repeat prescriptions By 2017, enable patients to self-monitor their health with the help of technology (using telehealth and telecare), monitored by Specialist Nurses and Community Matrons. Communicate via secure email Avoid unnecessary treatments or prescription dispensing that does not benefit patient care.
Our Prioriti es
Priority three: Helping people to recover from episodes of ill health or following injury Every year the NHS helps millions of people to recover from illness or injury. Fundamental to people regaining as much independence as they can, as quickly as possible, is effective treatment and on-going support. Partnerships are essential to ensuring recovery. We will work with others organisations which provide different types and levels of health and social care across the local area so that patients receive the right support at the right time, improving recovery and preventing unnecessary emergency admissions. We will: Share, promote and encourage best practice and joint working Gather patient feedback and numerical data and review this at the highest level to shape future care. Where change is needed the public will be fully consulted and involved. We will: Develop a Commissioning Patient Reference Group (CPRG), including representatives from all of our GP member practices, to advise us Ensure patient views are embedded in every activity and work programme, including developing ways of engaging hard to reach or disadvantaged groups Expand our public membership scheme Improve care services for people leaving hospital care such as community rehabilitation beds and therapy at home 10
Helping people to recover from episodes of ill health or following injury People with mental health problems have been shown to have worse outcomes for their physical healthcare; similarly those with physical health needs often have mental health needs that are not recognised. The gap between systems for people with mental health problems and those with physical conditions should be closed and there should be timely access to services for all. We will: ď‚ˇ Ensure people can access mental health services when they need them, regularly reviewing access ď‚ˇ Ensure problems accessing services are improved, including shorter waiting times for patients
Our Prioriti es
Priority four: Ensuring that people have a positive experience of care Ensuring that people receive high quality care, as well as high quality treatment, is a priority for the NHS and delivering the rights of patients as they are defined by the NHS Constitution is vital. We want to ensure that the delivery of care is at the highest standards We have an important role to play to ensure the delivery of your care is of the highest standards so that patients, their carers and relatives can be assured services will be held to account. We will: Work with local authorities to ensure that vulnerable people, particularly those with learning difficulties and autism are receiving appropriate and high quality care within their local communities and within their own homes where possible. Patients should be able to expect to be treated in a safe and clean environment and to be protected from avoidable harm. Continuous improvement is at the heart of all our activities, including access to service and waiting times. We will: Always ask people how they feel about their care and respond in an appropriate way to ensure that poor performance is driven out Ensure that the rights and commitments of the NHS Constitution are upheld. Continually monitor complaints and the performance of our local hospitals and services 12
Ensuring that people have a positive experience of care By giving children the best possible start in life, many future health problems can be avoided. We will: ď‚ˇ Work in partnership to make a difference to women during pregnancy and to families; including access to services that support children and young people with special educational needs and disabilities. ď‚ˇ Ensure maternity service meet high level quality and safety standards as defined by the Royal College of Obstetricians and Gynaecologists
Our Prioriti es
Priority five: Treating and caring for people in a safe environment and protecting them from avoidable harm The NHS is organising itself around a single definition of quality: care that is effective, safe and provides as positive an experience as possible Higher standards and expectations will result in safer care and improved outcomes for patients. We will: Implement a set of working guidelines for the services we commission around our single definition of quality (above). We are committed to continuously improving the quality of services, ensuring a patient’s needs are at the centre. Using national tools, we will: Set an ambition for the quality of patient services and promote active engagement across local health care, encouraged by monitoring performance, financial incentives and close joint working Set infection control targets (e.g. no more than 47 cases of infection C Difficile) To reduce the risk of harm, a culture of excellent patient safety and support is crucial. We will: Commit to care projects that address the needs of those people most at risk of suicide and serious harm to themselves or others.
Our Budget How much we have to spend and how we will make it fit health needs We have around £231.1m to spend each year on health services for local people. We are committed to using this money to improve your health and to buy safe, high quality services while working to help you stay healthy. In 2013/14 here's the big areas we are funding to keep you healthy: Hospital services - £117.6m All hospital services including ambulance, maternity and accident and emergency. Community health services – £26.9m Community hospitals and community-based care including nurses, health visitors and therapists. Medicines – £31.6m Prescriptions for medicines issued by GPs and health professionals. Mental health services – £19.1m Hospital and community based mental health services. Learning difficulties – £3.3m Services for people with learning difficulties, delivered in partnership with West Sussex County Council. Continuing and funded care – £19.5m Health care packages for people with continuing health care needs and funded nursing care for people in nursing homes. *please note that the CCG does not contract all your local health services. Specialised services, dental, public health and primary care services are funded by other bodies. www.horshamandmidsussexccg.nhs.uk 15
We are committed to the principle â€œNo decision about me, without meâ€? and we want to work with local people to shape health services.
If you live locally why not sign up to Horsham and Mid Sussex CCG Membership Scheme? You will receive regular news updates, hear about opportunities to work with us, be offered the chance to be part of surveys and consultations and can help to improve local health services. Membership is free.To join please telephone 01293 600300 and dial extension 3965 or email us at HSCCG.Contactusemail@example.com
NHS Horsham and Mid Sussex Clinical Commissioning Group (CCG), which plans and buys the majority of the area's healthcare services, has publ...