Hillingdon Commissioning
Consortium
Commissioning Strategy
Summary
2012/13 – 2014/15
Contents
1. Introduction
2. Overview of JSNA highlights
3 .CCG Vision
4. CCG Aims
5. Overview of CCG Commissioning Priorities
6. Financials
7. The case for change
8. Quality, Innovation, Productivity and Prevention plans
9. National and regional priorities
10. Commissioning priorities
11. Commissioning strategy – acute
12. Commissioning strategy – community health
13. Commissioning strategy – mental health
14. Commissioning strategy – jointly commissioned services
15. Commissioning strategy – integrated and out of hospital care
16. Commissioning strategy – other
17. Patient and public engagement
18. Shadow Health and Wellbeing Board engagement
1. Introduction
This document outlines the commissioning strategy for Hillingdon Clinical
Commissioning Group for the period 2012-2015 and sets out our vision,
highlighting the initiatives we will take, with our local health economy
partners, to deliver the aims and achieve the outcomes contained herein.
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Key themes:
Quality
Partnership working
Productivity
Use of resources – money, people and estates utilisation
Patients and Public engagement
Effective and robust contracting
Key enablers e.g.: IT
2. JSNA highlights
Hillingdon Joint Strategic Needs Assessment (JSNA) highlights:
•
Hillingdon is the second largest of London’s 32 boroughs covering an area of 42 square miles (11571 hectares).
•
Hillingdon population for 2010 was estimated at 266,100 (11th largest in London). Hillingdon has significantly higher
population of young people (aged 5-19) compared with England and London. Population of older age groups (50+) is also
larger than London but smaller than England.
•
The number of live births increased by 27.3% from 3,314 in 2002 to 4,219 in 2010. This percentage increase was greater
than the %ge increases for England and London. The largest proportion of births (43.5%) were recorded in Hayes and
Harlington locality followed by Uxbridge and West Drayton (29.7%) and Ruislip and Northwood (26.8%).
•
Migration rate is 139 per 1,000 with annual movement in and out of the borough of over 35,000 and net annual migration
of over 1,100 people.
•
Hillingdon’s population increased by 8% since 2002. GLA estimates an overall 5.1% increase in Hillingdon’s population in the
next 10 years (by 2021).
•
Future increase is mainly due to a 10% rise in population under 15 years; and a 15.4% rise in the population of those 75
years and over.
•
Population of Hillingdon is uniformly distributed across the three localities – Ruislip and Northwood 86,148; Uxbridge and
West Drayton 86,139; and Hayes and Harlington 88,730) and across the 22 wards (4- 5%), except for Brunel with 6% and
Harefield 4% (GLA 2010 round population projections for 2011). Population is expected to increase in all Hillingdon wards in
the next 5 years, with highest increase projected of 9% for Botwell.
•
Hillingdon is ranked 24 out of 33 for deprivation in London (including City of London) and 157 out of 354 in England (1 being
the most deprived)
2. JSNA highlights /contd
Hillingdon Joint Strategic Needs Assessment (JSNA) highlights:
•
Hillingdon’s life expectancy for males for the 2007-2009 period was 78.6 years, which is similar to London (78.6) and England
average (78.3); and the female life expectancy for Hillingdon was 83.4 years which is significantly higher than the England
average (82.3) and similar to London average (83.1). There are inequalities in health for both men and women within the
borough. Men living in the least deprived ward of the borough have a life expectancy 6.5 years higher than men living in the
most deprived ward.
•
Hillingdon is an ethnically diverse borough with around 30% of the population from black and minority ethnic communities,
which is lower than London’s 35%. The largest ethnic community is Asian, with Indian community forming 12.2% of the total
population followed by Black at 3.4%
•
The percentage of people diagnosed with diabetes, the hospital admissions rate for alcohol-related harm, and the rate of
new cases of tuberculosis are all worse than the England average (see below ‘the Hillingdon Health profile’)
•
Over the last 10 years, the rates of deaths from all causes combined and of early deaths from cancer and from heart disease
and stroke have fallen. With the exception of the death rate from all causes combined for women, which is now lower, the
rates have remained similar to the England averages.
•
There are 15,340 children living in poverty in Hillingdon. The levels of tooth decay and physical activity among children are
worse than the England average.
•
Hillingdon has 49 GP practices (230 GPs) that serve a population of 275,656 (Feb ‘11); some of the patients come from
surrounding boroughs. Furthermore, there are 42 dental practices with 150 GDPs, 62 Pharmacies and 47 Ophthalmic
practices
3. CCG Vision
•
Hillingdon CCG has agreed the following set of principles that outline their vision:
I.
An explicit focus on health outcomes
2.
Demonstrable delivery
3.
Evidence based practice
4.
Achievement of key performance indicators
5..
Higher productivity
6.
Increased cost effectiveness
7.
Consistency, reduction of variation in performance
8.
Equity
9.
Explicit prioritisation
10.
Constructive collaboration especially between LBH, THH, CNWL and Hillingdon PCT
11.
Effective communication
4. CCG Aims
Hillingdon CCG will be running as a shadow commissioning organisation from April 2012 and aims to have full
delegated authority for all commissioning budgets. HCCG will work closely with other health economy partners
including LBH, CNWL,THH, public and voluntary sector organisations to deliver the following goals;
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Demonstrate and evidence equality and consistency in access to services and health outcomes within Hillingdon that
continues a reduction in health inequalities.
Development of primary and community based care that improves the delivery of quality care, improves access,
reduces variation in clinical practice, improves patient satisfaction and reported outcomes, and improves management
of patients with long term conditions.
Development of patient and public engagement that ensures public involvement
Achieve financial balance and a viable local health economy within existing and future resources, with particular
emphasis on robust contract monitoring across the entire contract portfolio including acute, community, primary care,
An expectation that all providers will provide timely and robust quality assured data.
Commission clinically effective care, based on an evidence base, as part of the NW Sector 5% DAS challenge
(Desirable Affordable Sustainable).
Commission care in line with health needs as identified by the JSNA and in line with the Health and Wellbeing Strategy.
Organisational development with the consortium that engenders a culture of value for money and an understanding that
all clinical decisions have financial consequences
5. Overview of Hillingdon - Diagram of commissioning priorities
Transforming
Primary Care
Transforming
Pathways of Care;
Planned Care
Transforming
Pathways of Care;
Urgent Care
GP as the co-ordinator of care; access to GP in hours; Improving early diagnosis; Targeted
and universal childrens services including early intervention; Improving cancer and
screening, Reduction in unexplained variations; Common Prescribing Formula; GP and
Practice Nurse and Practice Manager Education, consultants in the community, innovation
e.g.: near patient testing where resources follow the patient
Heart Failure; Access to consultant opinion (Choose and Ask); Improvement in
ascertainment and early diagnosis for dementia, diabetes and COPD; Service redesign for
MSK with associated pain management, COPD, CVD with associated home blood pressure
monitoring; diagnosis criteria for direct access diagnostics, ENT; telephone triage and
application of on line techniques for Physiotherapy
OOH and 111; Access to GP urgent care linked to UCC: UCC becomes referred into service:
reduction in short term admissions e.g.: alcohol related; develop clinical decision unit with
THH
Scaling up
Integrated Care
End of life care; ICP; Management of complex patients across health and social care;
dementia; carers; reducing readmissions; integrated care pathways for older patients;
enhance work with LBH and voluntary sector
Cost and Value
Of Care
Diagnostics; Community health services; Child Health Services; Sexual health Services;
Maternity services; Mental health DAS challenge; CVD DAS challenge
5. Overview of Hillingdon - Diagram of DAS
DESIRABLE
-CCG prioritised clinical
Programmes
-Clinician - led
-Robust ‘least worst’
plans to at least
maintain population health
outcomes & patient safety
“DESIRABLE
AFFORDABLE
SUSTAINABLE”
Strategy
by 2012
AFFORDABLE
Prudent ‘openbook’
assumptions re 2011/12
Outturn & 2012/13 resource
assumptions
SUSTAINABLE
Enablers
•DAS Model
•Clinical programme specific
plans to meet specific
Financial Targets produced
at DAS mtgs
•CCG use DAS model to
Prioritise between clinical
Programmes
•Senior clinician pledges to
the ‘least worst’ plans
•Contractual support in
2012 / 13 to support plans
Focussed QIPP plan
-Strategic DAS portfolios
for ONWL boroughs &
local NHS providers
Enablers
•Viable plan for each provider with some mgt. and
clinician support. Dialogue with boroughs & local
NHS providers
•Communication plan
•Integrated planning with boroughs
•Reduction in provider capacity (to help prevent
over-performance)
Enablers
•DAS Model
•Share assumptions with
Providers
•Targets by Clinical prog.
Areas and by Trust
Overview of Hillingdon
Overview of Hillingdon (APHO Hillingdon Health Profile)
Source: APHO Health profiles, 2011
6. FINANCIALS AND PROGRAMME BUDGETING
SPEND AND OUTCOME IN HILLINGDON PCT RELATIVE TO ONS CLUSTER GROUP 2009/10
Spend and Outcome relative to other PCTs in England
Lower Spend,
Better Outcome
Higher Spend,
Better Outcome
2.5
2.0
Trauma
Health Outcome Z Score
1.5
1.0
Neuro,GU
0.5
Circ
Resp
0.0
Gastro,Pois
MH
-0.5
LD
Canc
Vision
Musc,Soc
Blood
Hear,Skin
Neo
Hlth
Mat
-1.0
End
-1.5
Inf
Dent
-2.0
-2.5
-2.5
-2.0
-1.5
-1.0
-0.5
0.0
0.5
1.0
1.5
2.0
2.5
Higher Spend,
Worse Outcome
Lower Spend,
Worse Outcome
Programme Area Abbreviations
No outcome indicators readily available
Outcome indicators available
Spend per head Z Score
Infectious Diseases
Inf
Hearing
Hear
Disorders of Blood
Blood
Cancers & Tumours
Canc
Circulation
Circ
Maternity
Mat
Respiratory System
Resp
Mental Health
MH
Neonates
Neo
Endocrine, Nutritional & Metabolic
End
Dental
Dent
Neurological
Neuro
Genito Urinary System
GU
GI System
Gastro
Healthy Individuals
Hlth
Learning Disabilities
LD
Musculoskeletal
Musc
Social Care Needs
Soc
Adverse effects & poisoning
Pois
Trauma & Injuries
Trauma
6. FINANCIALS AND PROGRAMME BUDGETING
1 – Infectious Diseases – All PCTs Expenditure per 100,000 population for the selected programme
3 – Disorders of Blood – All PCTs Expenditure per 100,000 population for the selected programme
6. – FINANCIALS AND PROGRAMME BUDGETING
8 – Problems of Vision – All PCTs Expenditure per 100,000 population for the selected programme
6. FINANCIALS AND PROGRAMME BUDGETING
18 Maternity & Reproductive Health – All PCTs Expenditure per 100,000 population for the selected programme
7. The case for change – JSNA-based High Level Overview
Following the JSNA, discussions with representatives of each LBH Directorate and the PCT took place and 7
priority themes for action were identified:
1.
2.
3.
4.
5.
6.
7.
Promoting Healthier Lifestyles
Improved Co-ordination of Joint Health and Social Care Working
Safeguarding, Prevention and Protection
Community-based, Resident-focussed Services
Promoting Economic Resilience
Preserving and Protecting the Natural Environment
Reducing Disparities in Health Outcomes
Priority Themes
1.
•
•
•
•
2.
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Promoting healthier lifestyle
Develop a range of housing options that enable people to remain living affordably in their own home for as long as possible,
providing genuine choice when the need for a smaller home or increased support is required
Address the demographic pressures which include school places, ageing population, children with complex health and social care
needs etc.
Ensure all children have a healthy start in life
Continue to work in partnership to promote healthy lifestyles preventing harm especially from obesity, alcohol, drugs and smoking.
Improved co-ordination of joint working for health and social care
Share needs information, trends and commissioning priorities across agencies and sub-regionally – including adult social care,
health and children’s services – in order to develop shared, cost-effective, multi-disciplinary services that meet the needs of
Hillingdon’s residents
Co-ordinating care pathways across health and social care
Developing ‘team around the family’ approach.
(Continued over the next page)
7. The case for change – JSNA-based High Level Overview
3.
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4.
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5.
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Safeguarding, prevention and protection
Address health and social consequences of alcohol and drug abuse
Develop a cost effective prevention strategy for young people undertaking in risky behaviours
Reduce repeat victimisation from burglary, robbery, disorder and violence
Reduce repeat offending
Reduce disorder on public transport to encourage use of sustainable transport
Continue to work in partnership to protect and safeguard children, young people, vulnerable adults and older people at risk,
keeping them safe from harm
Improve the health and well-being of young people, focusing on substance misuse, sexual & mental health
Community-based Resident- focussed services
Within social care and health provision, increase the focus on prevention, reablement and recovery, reducing the need for
residential and nursing home care
Increase the provision of adult social care and health services that are based in the community, enabling people to live
independently in their own homes whenever possible.
Develop better facilities and integrated services for disabled children to enable them to access provisions closer to home.
•
Promoting economic resilience
Increasing access to employment, apprenticeships and skills training
Maintaining Hillingdon to be a centre of excellence for science and knowledge and attracting a range of high value
employers
Continuing to invest in town centres.
6.
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Preserving & Protecting our natural environment
Reduce the borough’s overall carbon footprint and use of energy
Improve transport and work to reduce traffic congestion
Maintain the quality of the borough’s parks and open spaces to encourage more residents to use them
7.
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Reducing disparities in health outcomes
Address health disadvantages for disabled people, ethnic minorities across our communities
Ensure early identification of disabled children and those that may fall below the eligibility threshold
Improve the outcomes of Looked After Children.
7. The case for change – priorities identified in JSNA review
Recurrent
Working withPriorities
local Directors of Public Health and Borough Directors, CCGs should update the current 2011/12 case for change for
Recurrent
Priorities
•
Child Health
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••
••
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(included in appendix 2) based on the Joint Strategic Needs Assessment.
Child
Older Health
People’s Health
Older
People’s
CardiovascularHealth
disease
Cardiovascular
disease
Respiratory Health
Respiratory
Health
Diabetes
Diabetes
Mental Health
Mental Health
New Priorities
New
Priorities
•
Musculo-skeletal
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••
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Musculo-skeletal
Alcohol
Alcohol
Maternity and Neonates
Maternity
End of lifeand Neonates
End
of life
Ophthalmology
Ophthalmology
Sexual health
Sexual health
7. The case for change – RECURRENT PRIORITIES
Under the above priority themes, specific actions have been agreed which impact on the priority areas.
Child Health
•
Ensuring children have a healthy start in life – by use of Healthy Start programme
•
Share information on needs, trends and commissioning priorities across health and children’s services to develop cost
effective services. Develop ‘team around family’ approach.
•
Develop a cost effective prevention strategy for young people undertaking risky behaviours. Address health and social care
consequences of alcohol and drug abuse, improve sexual and mental health.
Older People’s Health
•
More community based, resident focussed services: increase focus on prevention, self care, reablement and recovery,
reducing the need for residential and nursing home care.
•
Better co-ordination between health and social care, more involvement of the voluntary sector , and of carers.
•
Increase the provision of community based health and social care services. Better use of telecare enabling people to live in
their own homes
•
More single assessments, less complex care packages, services closer to home.
•
Wound Care – deliver more effective use of CNWL service
Cardio-Vascular Disease
•
The 5% challenge implementation (from meeting with stakeholders 26 September)
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More services in community, closer to patients
•
Emphasis on prevention, early detection , patient education and self care
•
Tackle geographic variation in prevention as well as care
7. The case for change – RECURRENT PRIORITIES
Under the above priority themes, specific actions have been agreed which impact on the priority areas.
•
•
Respiratory Health - Key Priorities:
Early identification through smoking cessation service
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Diabetes & Obesity – key actions
Move from secondary to primary care is much more effective model, which is favoured by public
CPD to ensure suitably trained workforce
Tackle local variation in care
Borough wide plans to tackle adult and childhood obesity
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Mental Health
Shifting settings of care
Improving adherence to recovery focussed care plans
Integrated working between primary and secondary care
More care planning with nominated workers, less residential care
More co-located teams, single assessments
7. The case for change – NEW PRIORITIES
Under the above priority themes, specific actions have been agreed which impact on the priority areas.
Musculo-skeletal
•
Redesign of MSK pathway as part of taking forward AQP programme across NHS NWL
•
Development of a community MSK and pain management service, with full skill mix including non medical prescribers and
encompassing triage and treatment
•
Development of self management programmes and educational materials linked to GP web sites
•
Implementation of telephone triage service and group treatment programmes
Alcohol
•
Project worker in A&E for screening and identification
•
Work with partners in the local health economy to reduce admissions to secondary care
Maternity and Neonates
• Deliver maternity matters targets including access, choice and 1 to 1 care during labour
• Ensure C section rates are reduced
• Work closely with secondary care to reduce readmissions following birth
End of Life
•
Full roll out of GSF in Primary Care to improve prognostication and identification of patients in the end of life phase of their illness
•
All identified patients to have a care plan
•
Implementation of the Coordinate my Care register and linkage with 111 to manage urgent requests
•
Development of a 24 hour Urgent rapid response service
Ophthalmology
•
Redesign of community service with sub cluster partners
•
Review DRS along with cluster partners, and improve secondary care service delivery.
Sexual health - DAS Challenge
•
Deliver targeted interventions for young people at risk e.g.: Chlamydia Screening Outreach
•
Undertaking more Level 1 Sexual Health in Primary Care
8. Quality Innovation Productivity and Prevention Plans 2012/13
What are the key projects CCGs would like to focus on (rather than the complete detail)?
Transforming Primary Care
Prescribing Formulary for NW London
Referral Standardisation/Peer Review
Improved ascertainment and early diagnosis for
dementia, COPD and diabetes
Transforming Pathways of Care/Planned Care
Developing Planned Care Pathways for MSK, COPD,
CVD, including improved ascertainment and early
diagnosis
Transforming Pathways of Care/Urgent Care
NHS 111 OOH
UCC
Scaling up Integrated Care
Rapid Response and Home Care
Integrated Care Pilot
Mental Health Integrated Care
End of Life Care, including dementia
Reduction of Readmissions
Rehabilitation services
Cost and Value of Care
Productive Community Health Services
Diagnostics – Radiology and Pathology
Procurement through AQP for MSK, diagnostics and
adult audiology
Mental health Desirable Affordable Sustainable (DAS)
Challenge
CVD DAS Challenge
9. National and regional priorities
We will share the national and regional priorities as they become known. However, we expect many of the existing priorities to
remain, such as commitments to improve Health Visiting, the readmissions pathway, to implement the National Carers and Autism
strategies, improving patient choice and information. CCG’s should factor national and regional priorities into their commissioning
strategy. Is there anything the CCG wishes to emphasise based on local circumstances?
Through discussion with LBH and health economy partners Hillingdon CCG will identify a number of priorities for implementation
locally
Engagement between general practice and Childrens’ Centres
Implementation of agreed readmissions plan
Implementation of the national autism strategy
Improved uptake of health assessments for carers
Hillingdon dementia and end of life strategy
Working with NWL CEC and NHS London on the cancer and cardiac and stroke networks,
Participation in the paediatric and maternity reviews
10. Commissioning priorities
Based on the context above (sections 5 – 10) HCCG will agree commissioning priorities in partnership with the
forthcoming organisational development support
Child Health
Older People’s Health
Cardiovascular disease
Respiratory Health
Diabetes
Mental Health
Musculo-skeletal
Alcohol
Maternity and Neonates
End of life
Ophthalmology
Sexual Health
11. Commissioning strategy – acute
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Anticoagulation – expanding services to allow for all stable patients to be cared for out of hospital care and
therefore reducing hospital waiting times
Review pathology and diagnostics contracts in line with the outer sub cluster diagnostic procurement programme
Full discharge summary within 24 hours e-mailed to correct GP. No discharge of long term patients without prior
discussion with GP. If discharging on Friday GP to be informed prior to discharge being made.
All acute admissions be reviewed within 12 hours by on –call consultant and management plan made.
Contractual arrangements with regard to DNA to be clarified to prevent gaming by acute Trusts
The requirement to keep 111 DOS up to date written into contracts
Implement clinical decision unit at locally agreed tariff with THH to emergency admissions
Reduce excess bed days by agreeing discharge pathways and criteria
Implement MSK, pain management, acupuncture pathways in community
Move more Physiotherapy to community provision
Ensure patients have care plan to enable step down from acute
Implement community ophthalmology sub cluster procurement fully
Agree local Hillingdon formulary to match primary and secondary care and equivalence of targets
Implement NWL prescribing formulary when fully agreed
Implement pathways if not delivered in 2011/12 including MSK, Gastroenterology
12. Commissioning strategy – community health
Based on the case for change and current performance, what is the CCG’s strategy for commissioning community health provision?
• To support the shift of activity from acute to community and primary care setting
• Explore opportunities provided by Finnamore Contract analysis.
• Develop service models that support current developments in urgent care provision, admission avoidance and integrated care
If known, what implications does the strategy have on what and how CCGs specifically plan to commission in 2012/13 (and to a lesser
extent 2013/15)?
• Refocus active case management to support chronic long term conditions at risk of admission
• Expansion of Rapid Response Service linked to unscheduled care and integrated care service models
• Develop pain management services in community settings, including Acupuncture
• Refocus community nursing services linked to primary care teams, including nurse prescribing
• Ensure service models for community rehabilitation services are reconfigured to support integrated health and social care for older
people service models ( STARRs model) enabling and promoting independent living
• Implement 111 and reduction in readmissions plan.
13. Commissioning strategy – mental health
Based on the case for change and current performance, what is the CCG’s strategy for commissioning mental health provision?
For all services and all ages.
•
The strategy must improve quality and value for money. This will be done jointly with the Local Authority via integrated services
including supported accomodation and independent housing.
•
Improve choice by preparing for payment by results and developing meaningful information to inform patients’ choices about
treatment provider.
•
Enable a shift in settings of care for where people receive services
•
Ensure improved integration and liaison between physical health (LTC) and mental health services e.g. unscheduled care, self
directed care.
•
To enable more cost effective commissioning of specialist services eg local eating disorders service
13. Commissioning strategy – mental health
If known, what implications does the strategy have on what and how CCGs specifically plan to commission in 2012/13 (and to a
lesser extent 2013/15)?
All ages
•
Shift settings of care by developing an enhanced model of community and primary care provision for mental health that supports
discharge and will reduce secondary care activity.
•
Develop the provision of IAPT and primary care psychologies that are NICE compliant,
•
Improving joint working with acute services including A&E liasion
•
Implement 111 linked and alternative crisis services
•
Explore opportunities provided by Finnamore Contract analysis and planning for impact of introduction of PBR care clusters
•
Specific plans for dementia, CAMHs and Substance Misuse.
14. Commissioning strategy – jointly commissioned services
Based on the case for change and current performance, what is the CCG’s strategy for commissioning jointly commissioned services?
Maximise efficiencies by increasing leverage and purchasing power across health and social care
Ensure models of care commissioned support independence and choice as well as securing best value
Develop interagency working including single point of access, integrated assessment of need and integrated care plans
Develop out of hospital and community care based models
Develop self directed support including individual budgets
Specific plans for people with Disabilities including Learning Disability, Children with Disabilities, Carers .
15. Commissioning strategy – integrated and out of hospital care
Based on the case for change and current performance, what is the CCG’s strategy for commissioning integrated and out of hospital
care , and what implications does the strategy have on what and how CCGs specifically plan to commission in 2012/13?
The integrated care strategy will deliver a whole system approach to a sustainable Integrated Health and Social Care service, which is
better value for money and produces a major shift in activity to community services. This will include adult’s age 18 years plus, older
people with mental health needs and those requiring end of life care. The key strategic aim is to commission and provide a range of
integrated services to promote recovery from illness, prevent unnecessary hospital admission, assisted discharge support and timely
discharge from hospital, maximise independent living and prevent premature admission to long term residential care.
Out of hospital care
• 111
• UCC
• OPHTHALMOLOGY
• SEXUAL HEALTH
Integrated care
Implement a comprehensive integrated care model for older people . This will include re specification /redesign of existing
community services including rapid response, active case management , community rehabilitation, falls services and intermediate care
services.
Out of hospital care
Roll out a new model for Referral Facilitation across Sub-cluster.
Cost-effective and responsive direct access diagnostics
Ensure commissioned contracts are inline with NHS London Modernisation of pathology agenda
Commission access to imaging testing which is appropriate and cost effective, with educational support and pathway management
Commission community based, cost effective, high quality audiology testing with appropriate pathway support
To commission streamlined high quality streamlined direct access clinics in line with pathway work streams with a view to reduce
revolving door patients
16. Commissioning strategy – other
• How would the CCG wish to influence the strategy for NHS CB-commissioned services, including specialised commissioning, panLondon, prison and military health services?
•
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Sexual Health:
Termination of sexual health services done on Pan-London basis
Commission schools to do more – services going into schools
Sexual relationship education already going into schools
HIV: through specialist commissioning
Cancer
Paeds surgery
Work with specialist commissioning to improve step down from Forensic
Review Eating Disorders service
How would the CCG wish to influence the primary care strategy, including dental, pharmacy and optometry services?
• Ensure HCCG is achieving Value for Money in all independent contracts
• Maintain access and comply with any new NICE guidance on treatments
• Look at redesign of Minor Oral Surgery and Criteria for Specialist Dental Services
• Interface Optometry contract with new community Ophthalmology service
• TB: plans for plan – London-wide basis – consultation at the moment
• BCG programme delivery
• Flexibility of funding to allow innovation and shift in settings of care eg A&E, MIU and UCC to primary care
17.
19.Patient
Patientand
andPublic
Publicengagement
engagement
1.
Close working relationship with Hillingdon LINKs
2.
Strong involvement from user groups (most notably Older People’s Forum, Cancer Locality Network, Adult
Mental Health User Group, Dementia Carers User Group, Hillingdon Community Voice
3.
Views of LA and links leaders canvassed
4.
Reference to all parties previously agreed priorities
5.
Continue with Practice participation Groups across Hillingdon
17. PATIENT, PUBLIC AND STAFF ENGAGEMENT
•
The following surveys have been used to inform the case for change
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
National Surveys - GP patient survey, hospital patient, outpatient, A&E and mental health services surveys
Local surveys- Urgent Care Centre attendees
Consultations on specific services – End of Life Care, Ophthalmology services
PALs and LINk feedback
Carers strategy –In depth interviews with carers
Autism strategy – programme of engagement activity with users and stakeholders
Disabilities commissioning plan
Remodelling of in-house home care into specialist reablement service surveys
TeleCare line surveys
CQC Stroke survey
PROMs
•
We need to better engage with patients, public and staff to improve the quality and efficiency of our
commissioned services
•
We have an agreed infrastructure to achieve appropriate engagement to inform the commissioning cycle.
Engagement infrastructure in Hillingdon
NWL CLUSTER
SUB-CLUSTER
BOROUGH
HOSPITALS
VOLUNTARY SECTOR
HAYES & HARLINGTON
NORTH HILLINGDON
UXBRIDGE & WEST
DRAYTON
LOCALITY SUB GROUPS
HH1
HH2
HH3
NH1
NH2
NH3
49 GP PRACTICES
UX1
UX2
UX3
LOCAL AUTHORITY
LOCALITIES
HEALTH & WELL BEING BOARD
HCCG
18. Shadow Health and Wellbeing Board engagement
How is the CCG working with local shadow Health and Wellbeing Boards in the development of the CCG’s commissioning strategy?
•
The Health and Wellbeing board has been in place since 2010 within the governance structure of the council
and partner organizations. The H&WBB aims are to improve the health and wellbeing of all Hillingdon
Communities.
•
The WBB ensures the health and social care system works together, through developing strategic leadership,
effective challenge and external engagement within the local health economy.
•
The purpose of the WBB is to hold partner agencies to account for delivering changes to the provision of
health, adult social care and housing services, within the context of the terms of reference detailed below, in
four delivery areas, these are Adult mental health, Disabilities, Long-term conditions and Housing
•
Stated partnership priorities aligned with LA and PCT are articulated in JSNA .There is a Wellbeing Strategy
with key priorities for improving health and wellbeing outcomes. The strategy focuses on 5 strategic priorities
with a work plan and performance framework with measurable improvement outcomes.
•
•
The chair of HCCG is a core member of the Hillingdon Wellbeing Board.
There are effective links between the Children and families Trust Board and the WBB. These boards are
supported by joint children's commissioning board, and a wellbeing board executive respectively. There are
named GP leads from HCCG who lead on key work streams.