Corby, My Healthcare
Tuesday 19 February 2013
Housekeeping
• Please turn mobile phones to silent/off
• No fire alarm is planned, if you do hear the
alarm, make your way to the fire exit
Aims of today
■ To keep you up to date with what’s
happening in Corby
■ To give you the opportunity to have your
say on health services
■ To build the relationship between the CCG
and our local population
NHS Corby CCG update
Dr Peter Wilczynski, Chair Designate
Authorisation
• Formal process to bring CCGs into being
• We had to demonstrate our ability to:
– commission safely
– manage the funding
– improve quality, reduce inequality and deliver
improved outcomes for our patients within the
available resources
• Similar to an Ofsted inspection in schools
• Outcome expected to be announced soon
Corby Urgent Care Centre
• Corby Minor Injuries Unit & x-ray service have
moved into the centre (all open 8am-8pm)
• Observation bays open
• Centre can assess and treat:
– Minor Injuries – such as strains, sprains, wounds, minor
burns and fractures
– Urgent medical conditions that can’t wait to see a GP –
children with high temperatures, breathing problems,
bladder and other painful infections, abdominal pain,
severe headaches, worrying worsening of a long term
condition
Corby Urgent Care Centre
Our local hospitals
• We are now responsible for negotiating
the county contract for hospital services
with Kettering General Hospital
• Hospitals are in
talks over closer
working
• Healthier Together
Get involved
• Patient Participation Groups – contact
your local GP surgery
• Corby Pulse – become a member
• ‘Like’ our Facebook page
• Follow us on Twitter @NHSCorby
• Come to our meetings
• Go to www.corbyccg.nhs.uk
Urgent Care Services
Dr Miten Ruparelia, Clinical Vice Chair
Recent local headlines
Issues
• Ageing and growing population
• KGH have experienced a sustained
increase in attendances at Accident and
Emergency
• Inappropriate attendances at A&E
• Discharge of patients into the community
• “Walking the Floors” at A&E/KGH
Our vision for Urgent Care
Self Care
Increase in self management plans including
personal health budgets
Doctor First
Appropriate appointments in primary care/
reduced A&E attendances
Urgent Care Centre
Supported by
Integrated Rapid
Response Team
(Adult and
Paediatric)
Supported by x-ray and ultrasound
services
Access to observation bays
GP Managed
Step Up Beds
Thackley Green and
Community Hospital
Acute
Admission
System Change
Enablers
- 111
- Urgent Care Dashboard
- Better patient
information
Achievements in 2012/13
• Urgent Care Centre, with 12 assessment couches, opened
• Rapid Response home visiting team established
• Two step-up beds commissioned at Corby Community
Hospital and four from Thackley Green Specialist Care
Centre enabling GPs to admit directly avoiding the need for
a hospital admission
• Near patient testing for Deep Vein Thrombosis
commissioned from General Practice, reducing the need for
an urgent hospital assessment
• Self care information for under 5s and over 50s published
• Development of urgent care pathways to ensure the patient
receives the best care at the ‘right place at the right time’
Our plans for 2013/14
• Continued focus on Urgent Care Centre
• Expanding the use of the observation couches in the
UCC to include the provision of IV antibiotics and IV Iron
• Rollout of ‘111’ in April 2013
• Assess the Doctor First pilot and if it is proven to be
successful roll out to all practices
• Assess the Advanced Nurse Practitioner into care homes
pilot and if successful roll out to all care homes in Corby
• Commission an enhanced Cardiac Rehabilitation
scheme
• Frail and Elderly care review
Table discussions
• Do you think we are doing the right things
during 2013/14?
• What should the CCG take into account
when making difficult decisions?
• What other services would you like see in
Corby?
• What services do you think need
improving/changing in Corby?
Refreshment break – 15 minutes
Mental Health Commissioning for
the People of Corby
Pat McCarthy
Who we are and what we aim to cover
• The Joint Commissioning Team commissions mental health
services for:
– NHS Corby CCG
– NHS Nene CCG
– Northamptonshire County Council
• Our Commissioning strategy - informed by 4 Strategies
– Nation Mental Health strategy, No Health without Mental
health
– Northamptonshire Joint Adult Mental Health Strategy
– National Dementia Strategy
– CAMHs Strategy
• The Financial context
• Commissioning Intentions for 2013/14
• Table top discussion to hear your views
Why Commissioning of Mental Health
Services is Important for CCGs
• At any one time 20% of women & 17% of men are
affected by depression or anxiety
• Mental Illness accounts for £77 billion of lost productivity
each year
• 20% of total disease burden is attributable to mental
illness compared to cardiovascular disease (16.2%) and
cancer (15.6%)
• Mental Illness begins early – 10% of children have
diagnosable MH condition & 50% of lifetime mental
illness is present by age of 14
• No other health condition matches mental ill health in the
combined extent of prevalence, persistence and breadth
of impact
• Demographics of people with dementia in the UK :
– In 2008 - 700,000 costing £17 billion
– In 2038 -1.4 million costing over £50 billion
– 1 in 4 people aged 80+ have dementia
• People with Serious Mental Illness are high users of
general health services:
– Lifestyle factors – smoking & obesity
– Substance misuse
– Medically unexplained symptoms
– Psychological elements of long term conditions
• Northamptonshire CCG’s spend £128m on Mental
Health services – higher than average of similar CCGs
“ A sad soul can kill you quicker than a germ”
– John Steinbeck
Mental Health Strategic Objectives
Mental Health
• Northants Adult Mental Health Strategy 2009 anticipated many themes
of national strategy “No Health Without Mental Health” published in
2011
– Focus on Well-being, resilience building & prevention (at population
level)
– Holistic approach – integrating physical & mental health care
– Strengthening primary care MH services & common MH pathway
– Supporting Recovery
Living Well with Dementia (National Strategy)
– Improve dementia pathway including care in primary care
– Improve diagnosis and early support and intervention
– Improve support for carers and carers well being
– Improve care in hospitals and care homes
– Establish memory assessment services
– Reduce use of anti-psychotic medication
Our shared principles and values
• People are part of families whose members will have
their own needs and knowledge to share, the value of
friends and being part of a community are essential to
mental health
• Personalisation
• Co-production
• Recovery
• Prevention
• Collaborative care
• Partnerships in pathway working
• Values-based and evidence-based practice
What has been achieved
• Talking therapies (IAPT) and well being services in all
localities
• Early intervention and re-ablement services to support
treatment & recovery in community
• New local forensic care pathway for mentally disordered
offenders
• Improved rehabilitation pathway reducing costs of out of area
care
• Worked with voluntary and independent providers to increase
supported living opportunities
• Implemented co-commissioning with service users
• Developed pathways, services and skills to address physical
health reviews for people with severe mental health problems
• Successful pilot of use of personal budgets in mental health
services
What has been achieved continued
• Reducing expenditure on mental health services whilst
improving quality and care pathways
• Established county-wide memory assessment services
for dementia
• Improving county dementia diagnosis rates from 43%49%
• Reduction in use of anti-psychotic medication in people
with dementia
• Partnership work with Northamptonshire County Council
in commissioning of new dementia workforce training
Financial context
• In 2012/13 Northamptonshire CCGs will spend £128m
on mental health services for all care groups
• The Mental Health programme spend includes the costs
of :
– primary care mental health and secondary care
mental health services (more than half spent with
main NHS mental health provider)
– services which are very specialist and which local
commissioners do not control
– substance misuse services
– mental Health prescribing
• Northamptonshire CCGs spend approximately £12m
more per year than average on mental health services
Commissioning Intentions
• Shift money and care for people with mild to moderate
depression and anxiety to primary care mental health
services to enable improved access, best practice and
increased capacity in local services
• Increase support to people with physical health problems
who have emotional needs such as depression and
anxiety
• Improve waiting times and referral pathway so people
access the right services first time
• Improve the care and pathway for people in mental
health crisis by increasing intensive home treatment to
enable them to remain in their homes and continue with
their lives
Commissioning Intentions
• Review services for older people with mental health
problems to improve the support and efficiency of the
pathway
• Increase capacity within the memory assessment service
• Increase diagnosis rates & improve training and
pathways in primary care for dementia
• Continue to personalise services through increase in
personal health budgets
• Continue to work with services users, carers and other
partners to identify what needs to be delivered to meet
needs within each MHPbR care pathway
Commissioning Intentions
• Improve the way we measure the effect of services on
improving peoples recovery through a working group to
develop ways to measure outcomes and experience
reported by service users.
• Continue to co-commission with service users and
carers through procurement projects
• Develop services in primary care that will support people
to manage their mental health and recovery without
admission to specialist services
• Continue to achieve efficiencies in the way we deliver
mental health services to bring our mental health spend
closer to the average
Children and Young people’s
Emotional Well Being
and
Mental Health
• Pooled budget between LA and the CCG
• Lead commissioner of county wide emotional well being
and mental health services is children’s Joint
commissioning team within the CCG
• Universal, Targeted and Specialist services
commissioned jointly
• Young Healthy Minds Partnership (formerly CAMHS
partnership) – development and implementation of
strategy
Strategy 2010-2013
• Young people and parent carers engagement
• Tackling the stigma of mental health
• Promoting emotional well being and early intervention- ie:
children’s centres - schools
• Giving particular support to vulnerable young people ie:
Looked After Children
• Proactively supporting vulnerable families
• Developing pathways to support jointly with the LA- using
the Common Assessment Framework(CAF)
• Develop skills, knowledge and competencies of the
workforce
• Improved communication and information
The therapeutic continuum
From small ‘t’ to big ‘T’
Small t
Making every day
things therapeutic,
e.g. rooms, space,
food, how you
communicate
Big T
Semi –structured
activity based
interventions,
e.g. drama, music,
sport, play, art / craft
Talking therapies,
Individual counselling,
Group therapy, family
therapy etc
Specialist therapies,
e.g. CBT
Psychoanalysis
Whole system Integrated Care Pathway
Commissioning intentions 2013-2014
• Consolidate and review progress over the last 3 years
• Review of commissioned targeted and specialist
emotional well being and mental health services
• Recommendations for commissioning beyond 2014 in
line with NCC
• Re-define relationship with schools as commissionerscontinue to build access to support services
• Focus upon the early years and early intervention for
vulnerable families
• Greater understanding of and responsiveness to locality
needs
If you would like further information on
• Public and service user involvement in commissioning
https://www.gpc.eoe.nhs.uk/page.php?page_id=316
• Mental Health Payment by Results
http://www.dh.gov.uk/health/2012/12/mental-health-pbr/
• National Mental Health Strategy No Health without Mental Health
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/Publicati
onsPolicyAndGuidance/DH_123766
• Dementia Strategy
http://www.dh.gov.uk/health/category/policy-areas/socialcare/dementia/
• Children and Young People’s Mental health Services
http://www.asknormen.co.uk
Table top discussion: With the increasing demands on
services what can we all do to manage our mental
health needs? In particular:
• What helps you to manage your own or your child’s
mental health?
• What can your community do to help you manage your
own or your child’s mental health needs?
• How can primary care mental health services (including
your GP) help you manage your own or your child’s
mental health?
• How would you like/do you think the public should be
involved in MH commissioning for Corby?
Pre-submitted Questions
Thank you for attending
Please fill in your feedback form