To receive a presentation from the Chief Operating Officer, Havering CCG on future strategic plans of the CCG.
Minutes:
The CCG Chief Operating Officer explained that the plans of the CCG over the next 2-5 years were driven by the Joint Strategic Needs Assessment which formed the basis for commissioning decisions. Havering had an older population, many of whom had multiple long-term conditions. Ninety per cent of patients with the most complex health problems accounted for 40% of emergency admissions.
There was poor satisfaction with services including access to primary care. There were also lifestyle problems in Havering such as alcohol, smoking and lack of physical activity. Dealing with the most complex problems would make the whole healthcare system function better.
The CCG felt that improving urgent care was not just about BHRUT but that the rest of the health economy should contribute to this. Improving the urgent care pathway was therefore a priority of the CCG over the next year. The CCG was looking to undertake a reprocurement of some of the key services within the urgent care pathway including NHS 111, GP Out of Hours and Urgent Care Centres. The aim was to encourage providers to innovate and work in a more integrated way. The aim was for services to start in 2015/16.
Use of the weekend GP opening service had increased but had still only reached 50-60% of capacity thus far. Open access to weekend GPs could be operated on a trial basis rather than having referrals solely via the NHS 111 service.
As regards integrated care, the CCG wished to expand the number of conditions covered by the integrated case management system to include dementia and end of life care. More integrated health teams would allow integrated care at a local level. A collect and settle scheme was also being developed for people discharged home from hospital.
The CCG wished to see more care delivered closer to home and to have more outpatient appointments take place locally rather than in a hospital setting. More muscular-skeletal, urology and diabetes outpatient appointments would be delivered in the community from July 2014.
In primary care, the CCG was supporting GPs coming together to share services such as stitch removal within a GP cluster. Havering and Barking & Dagenham GP practices had submitted a bid to the Prime Minister’s Challenge Fund for further investment in local primary care services. A Primary Care Improvement Director had also been appointed to the CCG.
The Committee recommended that further details of the integrated care work should be brought to a future meeting of the Committee.
The Better Care Fund submission and the CCG operating plan could be shared with the Committee. The operating plan would also be available on the CCG website. The CCG was also working with other CCGs, Councils and providers to submit a five-year strategic plan by the start of June 2014.
Members requested more details on the issues considered by the Urgent Care Board and the Chief Operating Officer responded that a summary of the Board’s decisions may be produced. It was noted that the CCG governing body held its meetings in public and that papers were available on the CCG website. The governing body met approximately 5 times a year.
A map of health services in Havering could be provided and the Chairman wished to clarify the location of services that had moved from Queen’s Hospital into community locations.
The Chief Operating Officer felt that the directory of services used by the NHS 111 telephone service was the key issue impacting on the effectiveness of the service. He felt there should be more stages of advice offered according to how serious the condition was. He wished to include NHS 111 as part of the urgent care pathway.
The CCG was working with the Red Cross on the out of hospital scheme to consider what was and wasn’t working in the existing scheme. The Chief Operating Officer would forward details of which GP practices were in each Havering cluster. Two new clinical directors had been elected by all practices from 1 April – Dr Adur and Dr Anne Baldwin.
The CCG was currently holding discussions with pharmacists, particularly on how the medicines management service could be improved. The CCG was also discussing with BHRUT how information about options for stitches removal could be given out at Queen’s Hospital.
The Chief Operating Officer confirmed that there were no new developments concerning the St George’s Hospital plans, the bid for which remained with NHS England at present.
The Committee noted the update.