Lewisham
Clinical Commissioning Group
Update
July 2012
Contents
Background
Vision & Plans
Structures & Ways of
Working
Authorisation
• Clinical Commissioning Groups
• Lewisham CCG
• Achieving the CCG Vision
• CCG Vision & draft Health & Wellbeing Aims
• Health & Wellbeing Priority Areas
• CCG Strategic Direction
• CCG plans & priorities 2012-13
• Governing Body
• Engagement with Practices
• Partnership Working
• Authorisation process
• Evidence Requirements
• Stakeholder Survey
An introduction to Clinical Commissioning
Groups
• Clinically-led membership organisations
• New statutory bodies (each CCG with own constitution, co-designed by
member practices)
• Key tasks include improving outcomes and holding significant
commissioning budgets
• CCGs vary in size according to management budget and scale of support
purchased from CSS/working with partners
• Accountable for commissioning – but need to buy in ‘back-office’ and
some ‘middle-office’ support
3
Introduction to Lewisham CCG
• Members are all 44 of Lewisham’s GP practices
• A Pathfinder CCG since April 2011
• 61% delegated commissioning responsibility since August 2011, 100%
from April 2012
• 7 GP executives were elected in May 2011, chair Dr Helen Tattersfield
• Wave 2 CCG for authorisation: application and evidence to be submitted 3
September, site visit from NHS CB in October, outcome advised by end
November 2012
4
Achieving the CCG Vision
The CCG leadership agreed its vision and values in June 2011
MMR Immunisation Rates
MMR at 2 from 80.5% to
89.2%
MMR at 5 from 67.4% to
72%
COPD Pathway: in place
Maternity: Action Plan
Community Nursing:
Standards Review
Better
Health
Lewisham
People
Best
Best
Value
Care
Respect for patients & carers
Local care, strong community
Value & develop staff
PPE involvement in COPD pathway development
System-wide event to develop unplanned care strategy
QIPP 2011-12 93%
achieved
GP referral rates saving
£300k at GSST & KCH
Prescribing costs savings
£1.04mn
CCG Vision &
Draft Health & Wellbeing Strategy Aims
Improve Health
Provide a wide range of support
and opportunities to help adults
and children keep fit and healthy
and reduce preventable ill health.
Improve Care
Ensure that services and support
are available to all those who
need them so that they can regain
their best health and wellbeing
and maintain their independence
for as long as possible.
Better
Health
Lewisham
People
Reduce Cost
Improve access and delivery,
streamline pathways and ensure
services provide good quality and
value for money.
Best
Best
Value
Care
Respect for patients & carers
Local care, strong community
Value & develop staff
The CCG vision and values fit with the aims of the draft health and wellbeing strategy.
Health & Wellbeing Board Priority Areas
Increase the uptake of
immunisation
Improve mental health
and wellbeing
Prevent the uptake of
smoking among children
and young people and
reduce the numbers of
people smoking
Reduce the harm caused
by alcohol misuse
Promote healthy weight
Improve sexual health
Delay and reduce the
need for long term care
and support
Reduce the number of
emergency admissions
for people with chronic
long term conditions
Increase the number of
people who survive
colorectal, breast and
lung cancer for 1 and 5
years
Discussed and agreed at Health & Wellbeing Board December 2011
CCG Strategic Direction
Priority Areas
The nine
priorities group
into four main
themes which
will be
supported by
success
measures for:
• Better health
• Better care
• Better value
1. Healthy Living
1.Increase the uptake of
immunisation
2.Prevent the uptake of
smoking among children
and young people and
reduce the numbers of
people smoking
Aims
1. Health
Provide a wide range of
support and opportunities
to help adults and children
keep fit and healthy and
reduce preventable ill
health.
3.Reduce the harm caused
by alcohol misuse
4.Promote healthy weight
2. Mental Health
5.Improve mental health
and wellbeing
6.Improve sexual health
3a. Managed Care
(LTC & Elderly)
3b. Unplanned Care
(LTC & Elderly)
4. Cancer
7.Delay and reduce the
need for long term care
and support
2. Care
Ensure that services and
support are available to all
those who need them so that
they can regain their best
health and wellbeing and
maintain their independence
for as long as possible.
8.Reduce the number of
emergency admissions for
people with chronic long
term conditions
9.Increase the number of
people who survive
colorectal, breast and lung
cancer for 1 and 5 years
3. Cost / Value
Improve access and
delivery, streamline
pathways and ensure
services provide good
quality and value for money.
8
CCG Plans & Priorities 2012-13
CCG focus on 4 long term conditions that will have a significant impact on the health
outcomes of the Lewisham population:




COPD
Diabetes
Heart Failure
Alcohol misuse
Mapped against health and wellbeing and QIPP priorities
Health and Wellbeing Board
Priorities
Smoking
COPD
Alcohol
Alcohol
Outpatients
Prescribing
P
P
P
P
P
P
P
P
P
P
P
P
P
P
Diabetes
Heart
Failure
Obesity
P
P
P
QIPP Priorities
A&E
Primary
Care
Variation
Mental
Health
P
P
P
CCG Governing Body
Each CCG must have a governing body that has overall responsibility for ensuring the organisation
delivers its objectives and duties, and will also oversee a range of other structures and subcommittees.
Voting Members
Chair (Clinical)
6 representatives of practices
2 lay members
Nurse member
Secondary care consultant
Accountable Officer
Chief Finance officer
Advisory (Non-Voting) Members
Public Health
Local Authority
Healthwatch
LMC
Engaging with Our Member Practices
Member Practices
Neighbourhood 1
Neighbourhood 2
Neighbourhood 3
Membership Forum (meets monthly)
Information sharing and advisory
Executive Committee (meets monthly)
Decision-making and delegated authority
Governing Body (meets monthly)
Overall accountability and assurance
Neighbourhood 4
Working in Partnership
Lewisham
• Health & Wellbeing Board
• Joint Commissioning C&YP
• Joint Commissioning Adult
Client Groups
• Public Health
Partnerships
South London CCGs
• Commissioning Support
Services
Lambeth &
Southwark CCGs
• Clinical Strategy
• Performance & Quality
Authorisation Process
Only the NHSCB can legally make a decision on authorisation,
although it must have regard to the assessment and views of SHAs and other parties.
The formal assessment will be based on the evidence gained from:
• 360° survey
• Desk-top Reviews
• Case Studies
• Site Visits
3 possible outcomes for each applicant CCG:
• Authorised
• Authorised with conditions
• Established but not authorised.
All CCGs will have a development plan agreed with the NHSCB which reflects the outcome.
Authorisation Evidence
The CCG must submit core documents as part of its application, including:
• Proposed CCG constitution and any other documents detailing governance arrangements
• CCG organisational structure
• Relevant minutes of multi-professional meetings, governing body and other committees
• Organisational development plan
• 360° stakeholder survey report and CCG comments
• Draft joint strategic needs assessment (JSNA)
• Draft joint health and wellbeing strategy
• Relevant health and wellbeing board minutes and reports
• 2012-13 integrated plan and draft commissioning intentions for 2013-14
• List of 2012-13 contracts agreed and signed off, via PCT clusters
• List of joint commissioning draft agreements or plans, including pooled budgets and
Section 75 agreements
• Equality and diversity strategy
• Communications and engagement strategy.
360° Stakeholder Survey
Purpose:
To assess the relationships that the CCG has with its partners and stakeholders.
Recipients:
Members of the shadow Health and Wellbeing Board, local authority, LINKs, member practices and
providers.
The survey period:
From 16th July to 10th August.
Criteria:
 Communicating a clear vision
 Involving other clinical colleagues
 Engaging with the shadow Health & Wellbeing Board
 Credible plans to deliver improvements in quality, financial balance, and QIPP and reduce
inequalities
 Strong arrangements for joint commissioning and safeguarding
What We’re Asking For
1. The Board to note the strategic direction of the CCG, in particular to endorse that it is
aligned with the needs identified in the JSNA and with the development of the draft health
and wellbeing strategic aims and priorities
2. The Board to note the CCG’s commitment to local partnership working, as members of the
Board and through existing joint commissioning arrangements for adult client groups and
for children and young people
3. For those members of the Board who have been nominated to receive the stakeholder
survey to reflect on the work of the CCG and to complete the survey accordingly.