Presentation to the Portsmouth
Pensioners’ Association
Tuesday 8 May 2012
Improving health services…
Portsmouth CCG:
Our ambition and our plans
Dr Tim Wilkinson
Chair of the CCG Board
Improving health services…
WHAT IS THE CCG?
What does a CCG do?
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Formally established from April 2013
GPs working in a membership model
Designing local health services
Work with:
 patients and the public
 Local authority
 Other healthcare professionals
Commissioning services including:
 Elective hospital care
 Rehabilitation care
 Urgent and emergency care
 Most community health services
 Mental health & learning disabilities
Not:
 Primary care
 Specialist services
 Public health
Key Facts about Portsmouth CCG
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215,000 registered patients
27 member practices
Delegated budget 11/12 c.£127m
Full delegated budget 12/13 c.£268m
Co-terminous with Portsmouth City Council
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Four main providers:
Portsmouth Hospitals
Solent
Care UK (ISTC and primary care)
South Central Ambulance Service
 Portsmouth & South East Hampshire system
c. 600,000 population
 Inherited strong financial and performance
track record from predecessor PCT but
system surrounding us is in difficulty
Improving health services…
HOW DO WE OPERATE?
NHS Commissioning Board
Public and
patients
Practice Members Forum
Local
Authority
Health & Well
Being Board
Stakeholders
CCG Governing Body
Public
Health
Providers
Improving health services…
WHO ARE WE?
CCG GOVERNING BODY MEMBERS
Dr Jim Hogan
Clinical Leader & AO
Dr Tim Wilkinson
Chair of Board, GP executive
Dr Elizabeth Fellows
GP executive
Tom Morton
Deputy Chair & Lay member
Dr Dapo Alalade
GP executive
Jackie Powell
Lay member
Dr John Thornton
GP executive
Innes Richens
Chief Operating Officer
Paul Cox
Practice Manager
Jo Gooch
Chief Finance Officer
Vacant
Registered Nurse
Vacant
Secondary Care Doctor
Dr Paul Edmondson-Jones
Director of Public Health
Margaret Geary
Portsmouth City Council
CCG CLINICAL LEADS
Jim Hogan
Urgent Care
Tim Wilkinson
Planned Care
Linda Collie
Children & Families, Maternity
Simon Wernick
Mental Health, Learning Disabilities
Jonathan Price
End of Life, Continuing Care
Jan Matthews
Practice Manager representative
Kevin Vernon
Long-term conditions, prescribing
Vacant
Frail Elderly, Community Services
Improving health services…
OUR PURPOSE AND OUR VALUES
What do we do? And why do we do it?: Our mission
IMPROVING YOUR HEALTH SERVICES
Enable GP surgeries
as our members to:
Work with
our
patients,
the public
& our
partners
To invest
in
improving &
better
health
services
Within
our
available
resources
GETTING THE BEST FOR THE PORTSMOUTH POUND!
Improving health services…
OUR CITY : A PORTRAIT OF PORTSMOUTH
1 in 4 children and 1 in 5 older people
live in poverty (up to 67% in places)
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City is an area of only 15 sq miles
207,000 people live within the City
100% urban
Most densely populated city in
Europe (outside London)
Strong university and naval base
presence
7.6m visitors a year generating
£373m
90 languages spoken in schools
16% of children live in an household
with no wage earner
1% of households without toilet, bath or
shower
19% of households do not have central heating
68.4% of children get 5 GCSE A*-C making
the City the second worse in the country
30% of men have no qualifications
Many children have not been to the seaside
Record for the most times a football
club has gone into administration!
40% of households do not have internet access
70% of schools have healthy school status
Life expectancy is rising particularly for
female which are now above the national
average
Improving health services…
WHAT PEOPLE TELL US
PATIENTS AND
COMMUNITIES
TELL US …
MEMBER
GP PRACTICES
TELL US …
PARTNERS AND
STAKEHOLDERS
TELL US …
Want faster access to their GP
Obstacles to referrals in some
areas
Falling satisfaction with primary
care
Advice and guidance to secondary
care needed as per paediatric and
gastro models
Highest priority must be elderly
care in particular frail elderly and
dementia
But happy with the range of
services
Better integration of primary &
community services needed
Increasing satisfaction with dentists
but want more access
Mental health: gap in service for
urgent but not crisis patients
Increasing satisfaction with
pharmacies
CCG’s PIP intranet well regarded
with improvements in hand
Do not think health & social care
are joined up
Practice Patient Participation
Groups could have greater role
Want shorter waits to hospital
Want to focus engagement on
clinical involvement in service
strategies
Lower satisfaction with hospital
services than elsewhere in the
region
More promotion of good/best
practice to members
Must maintain focus on public
health and healthy living
Integration of care across social,
primary, community & secondary
care is required
Want to be engaged through a
range of methods
Managing care pathways and
quality of care must be key
Strong commissioner/provider
relationships being sought
Improving health services…
WHAT DO WE WANT TO ACHIEVE?
WHAT WILL IT LOOK LIKE?
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Continuity of care with someone who has access to your records
Local but resilient
practices working formally together
community & social care wrapped around the practice
Integrated nursing teams
Access to specialist advice
Access to
services
Primary Care
Communications,
information &
data
• Services accessible & convenient to
those that need them
• Range of services 7 days per week for
those things that should not wait
• Specialised services provided in
community
• Range of local centres
• St Marys Health Campus as local hub
• Consistent care every day & hour
• Extended hours access
• Good physical access
Individual
responsibility &
accountability
• Greater recognition of individual
responsibilities
• High awareness of cost
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An IT system across practices
Choices clearly signposted
Pathways uncomplicated & easy to access
Referrals/forms populated directly from patient records
Results & discharge information electronic & at speed
• Choose well – right time as well as right
place
• Unplanned care requested/ accessed
only when cannot be avoided
Improving health services…
HOW WILL WE KNOW?
The CCG Corporate Wheel
We are developing a set of
outcomes measures that will
tell us whether we are
achieving what we set out to
do
Each domain in the wheel
has several measurable
segments that will be
reported routinely to the
CCG Board
Improving health services…
OUR MAIN PRIORITIES
IMPROVING INTEGRATED &
URGENT CARE
ENSURING CLINICALLY EFFECTIVE
& TIMELY ELECTIVE CARE
•Improving community provision for frail
elderly and people with chronic conditions
•Delivering effective urgent & emergency
care
•NHS Constitution: waiting times
•Trauma & Orthopaedics, ENT and Oral
Surgery
•Managing GP referrals, information,
advice and guidance
CHILDREN & FAMILIES
PRESCRIBING & MEDICINES
MANAGEMENT
•Pre-Birth to 5yrs Strategy
•Costs grow no more than 4% per annum
MENTAL HEALTH & LEARNING
DISABILITIES
•Deliver the Dementia Strategy
•Improving access to psychological
therapies
•Complete social model for integrated
learning disabilities services
STAYING HEALTHY
• Alcohol
• Obesity
• Smoking
ESTABLISHING THE CCG
•Delivering our organisational
development plan
•Achieving authorisation as a CCG
Improving health services…
OUR JOURNEY TO AUTHORISATION
Timeline for Wave one applicants
April 2012
Pre-application review by Strategic Health Authority
June to October 2012
Application and Assessment Process
June 2012
Stakeholder Survey
July 2012
Application submitted
September 2012
Site Visit by NHS Commissioning Board
• Around 45 stakeholders
• Experience of CCG to date
• Potential to deliver in the future
October 2012
Authorised
April 2013
Statutory organisation
Delivering and improving health services
Apr 12
Apr 13
OUR AMBITION
The CCG wants to be:
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Making a difference to the health of our population
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Being responsive to local circumstances and needs
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Not driven by targets set for us, but working bottom up
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Visible and engaging with our patients and public
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Perceived as competent and capable by our stakeholders
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Achieving early and full authorisation
Improving health services…
Any questions?
Improving health services…