New NHS & Challenges in
engaging commissioners and GPs
Dr Sachin Gupta
GP, Welwyn Garden City
RCGP GP Champion for Carers, East of England
Macmillan GP
The new NHS
• White Paper 2010
- Puts patient and public first
- Improve patient care
- Allow GP’s to commission care
- Involves local authority
- Improves patient choice
- Integrate health and social care
Health and Social Bill
Aims• Give patients more choice
• Give clinicians more control
• Give organizations greater freedom from
central control and political interference
• Promote competition to improve patient care
• Scrutiny by local authority through ‘Health
and Well Being Board’
Clinical Commissioning Groups
CCGs
• Composition – GPs, other health care
professionals, Finance Officer,
CEO/Accountable officer etc.
• PCTs abolished
• CCGs began work on 1st April 2013
Health & Well Being Board
• Includes Local authority, representative from
local authorities, councilors, public health
consultant, CCG GPs, health watch etc.
• Work in partnership with clinical
commissioning groups
• Take public health responsibilities
What will changes mean for the NHS
• Giving responsibility for commissioning healthcare to
GPs and their team
• Creation of independent NHS Commissioning Board to
allocate resources and oversee CCGs
• Abolition of PCTs
• Transfer of public health responsibilities to local
authorities
• Greater freedom for providers of healthcare
• Promote competition and patient choice
• Makes NHS more accountable to patient & public
Who directs funding
Input
Public Health England
DH
Jeremy Hunt,
Secretary of State
• 4 regional “hubs” (in line with CB regions),
and local units to fit with NHSCB local area
Input
National
Health
Watch
NHS Commissioning Board
4 SHA clusters (2012):
becoming 4 NHS CB regions
50 PCT clusters (2012): becoming
27 NHS CB local area teams
Commissioning services from and
contracts with…
Chief Exec, Sir David Nicholson
Monitoring
Clinical Senates (Herts in EoE senate)
Clinical Commissioning Groups (CCGs)
Herts Valleys
CCG
E&N Herts
CCG
Hertfordshire
County Council
Responsible for
Public Health
Local
Health
Watch
to evolve
from LINk
Health and
Wellbeing Board
Commissioning services from…
Specialised
services
GPs,
Dentists,
Optoms,
Pharmacists
NHS
Trusts
All to
be FTs
Monitor
CQC
Regulation
Produced by The Communications Team, NHS Hertfordshire
Independent
sector
Hertfordshire Integrated
Commissioning
Support
• Providing services for HVCCG
and ENHCCG
Challenging in engaging CCGs
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CCGs are new, finding their feet
Adapting to the ‘new NHS’
Developing local and regional priorities
Financial constrains
Lack of awareness
Lack of business cases
Challenges in engaging GPs
• Increase in workload- secondary care to primary
care shift, QoF, CQC, increase in patient demands
& expectations, low morale
• Performance management & financial constrains
• Lack of awareness
- Who are carers
- Issues faced by carers
- Benefits of supporting carers
- What can they do
Suggestions to engage CCGs & GPs
• Multi level engagement
- Individual GP Practices
- Locality level engagement
- CCG
- Health & Wellbeing Board
- Other primary health care
professionals – matrons, DNs
Pharmacists etc
- Other stake holders- public health
councilors, local authority etc.
Continued…
Arrange presentation slots in
- Practice meetings
- Locality meetings
- Practice managers meetings
- CCG meetings- most CCG have one open
meeting a month when anyone can attend
and raise issues.
- Identity enthusiasts and build relationships
- Work in partnership with other stakeholders
Highlight win win situation
Benefits of identifying carers
- Keep carers health & prevents illness
- Reduces referral to secondary care
- Reduces placement in nursing and
residential home
-If not supported then ‘two patients in
place of one’
- May reduce GP consultations and workload
Opportunity to make a difference
Continued
- Share examples of good practice and
outcomes
- Use business cases to support you (eg
Hertfordshire Business case for carer friendly
projects)
- Do not give up