What will a cross boundary CCG mean for
patients?Colin Renwick, GP Townhead Surgery ,Settle.
Board Member of Airedale Wharfedale and Craven Shadow CCG
Airedale Wharfedale and Craven CCG
‘We believe that GP practices should have the flexibility withinthe legislative framework, subject to having the geographic focus describedabove, to form consortia in ways that they think will secure the best healthcareand health outcomes for their patients and locality.’
Commissioning for Patients Consultation Document 2010
Responsibilities of CCGs Elective care e.g. outpatient referrals/planned
operations. Non elective emergency care. 111 service and urgent primary care. Mental health services. Community services – nurses, podiatry, health visitors. Maternity services. Prescribing budgets. Will NOT be responsible for General Practice, Dentistry,
Opticians, Ambulance service, specialised commissioning eg forensic psychiatry – National Commissioning Board.
AN
HS
FT
Deprivation – Airedale Wharfedale
Deprivation - North Yorkshire
Health and wellbeing boards
Key Functions To assess the needs of the local population and
lead the statutory joint strategic needs assessment
To promote integration and partnership across areas, including through promoting joined up commissioning plans across the NHS, social care and public health
To support joint commissioning and pooled budgets where all parties agree it makes sense
NHS Constitution
“We put patients first in everything we do by reaching out to staff, patients, carers, families, communities and professionals outside the NHS. We put the needs of patients and communities before organisational boundaries”
Challenges 2 Health and wellbeing boards – political agenda. Unwarranted variation in quality, outcomes, activity Rising demand, limited funds and limited workforce Too many older people in the wrong part of the system
for their needs or becoming avoidably dependent or ill Avoidable admissions to hospital or long term care, and
staying too long Health services, institutions, professional values and
training not geared to the needs of the (older) people who actually use them
Crossing of Local authority boundaries –different availability of services.
In our favour
CCG is majority user of local DGH which is both innovative and realistic –ANHSFT.
Common Mental Health Trust.-BDCT. Shared providers of Community nursing services
ANHSFT. Single Ambulance Trust –YAS. Working towards integrated 111 and urgent care
provider. Significant shared public engagement work already
underway
Potential benefits of integration
• Better outcomes for service user
• More efficient use of resources: “right care, right place, right time”
• Improved access, experience and satisfaction
GPCommunity Nurses
Social services
Ambulance service.111 Directory of services
Voluntary sector
Point of contact
Telehealth
Outcome
Independent living continues
+/- support
Intermediate care
Palliative care
Long term care
Acute hospital care
Early discharge
Integrated team, single point of contact
Patient/client
Social worker
Family, friends
neighbours
Re-ablement worker
GP services
Voluntary sector
Mental health worker
Hospital based services through
telemedicine
Occupational therapist
Physiotherapist
Community nurse
Advanced nurse practitioner
How will we view success?
Reduced numbers of occupied beds. Reduced emergency bed days. Reduced delays in transfer from hospital. Increased use of home care services. Decrease in number of people in long term
residential or nursing care. Improved patient experience. Financial sustainability.
How will patients view success?
Seamless pathway of care reduced confusion in secondary care.
Same services available to all –no local postcode lottery. Improved integration between primary, secondary health
care and social care. Reduction in acute admissions. Reduction in hospital length of stay. Less need for long term care. Locally responsive, clinically led and managed CCG. A CCG that has its sight firmly set on the local health
economy.