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Patient and Public Engagement Event

Patient and Public Engagement Event. 23 March 2016 Executive Suite Dugdale Centre Thomas Hardy House 39 London Road Enfield EN2 6DS. Welcome Teri Okoro, Lay Member for Patient and Public Engagement. Housekeeping.

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Patient and Public Engagement Event

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  1. Patient and Public Engagement Event 23 March 2016 Executive Suite Dugdale Centre Thomas Hardy House 39 London Road Enfield EN2 6DS

  2. Welcome Teri Okoro, Lay Member for Patient and Public Engagement Local clinicians working with local people for a healthier future

  3. Housekeeping • No fire alarm is planned today. If you hear the alarm, please make your way outside • Please turn your mobile phones off or put them on silent • The toilets are on this floor • You have a local GP and an NHS manager on each of your tables. They are here to lead the group work sessions. We have four group work sessions. • Please help yourself to refreshments throughout the event. Local clinicians working with local people for a healthier future

  4. Listening to you • Your feedback is important to us today. We want to work closely with our stakeholders and local people to develop our plans for the future and today we are going to focus on our commissioning plans for the next year. • We would like you to get more involved in the CCG. You can: • Attend a Governing Body Meeting – dates are always advertised on our website, on Twitter (follow us @EnfieldCCG) and in the Enfield Independent • Join your GP practice’s Patient Participation Group (PPG) – ask at your practice. All 49 member practices have a PPG. We have an active PPG network and an elected PPG representative Litsa Worrall who sits on the Governing Body. • Sign up to our mailing list – contact communications@enfieldccg.nhs.uk • Volunteer to be a patient representative and help us improve services for local patients • Visit our website www.enfieldccg.nhs.uk for more information • Follow us on Twitter @EnfieldCCG • You also have some post-it notes on your tables, please use these to jot down any extra questions or comments for us and add it to the feedback wall. • We will ask you to fill in a feedback form about today’s event. Please tell us what you what think of today and tell us about topics you would like to see at future events. Local clinicians working with local people for a healthier future

  5. Today’s agenda 2:00-2:05pmWelcome - including introduction for new GB members Teri Okoro, Lay Member for Patient and Public Engagement 2:05-2:20pm Achievements since April 2015 and our plansfor 2016-2017 Dr Alpesh Patel, Clinical Vice Chair of Enfield CCG 2:20-2:40pm Introduction to the group work sessions Teri Okoro, Lay Member for Patient and Public Engagement 2:40-4:40pmFour workshops each lasting 30 minutes GP Governing Body Members and CCG commissioners lead discussions on the following key areas: Teledermatology- DrJanet High and Tara Dear Urgent Care Review- DrAlpesh Patel and Clare Kapoor Mental Health – Dr Chitra Sankaranand Keith Dean Values and Priorities – Jane Pike and Teri Okoro 4:40pmPanel questions and answers An opportunity forPatients and the public to put any questions to a panel of clinicians and managers 4:55pm Thank you and event closes Teri Okoro, Lay Member for Patient and Public Engagement Local clinicians working with local people for a healthier future

  6. Our achievements in 2015/16 and our plans for 2016/17 Dr Alpesh Patel Vice Clinical Chair Local clinicians working with local people for a healthier future

  7. Looking back on 2015-16 Main challenges we faced: • We began the financial year as a financially challenged CCGwith a brought forward deficit of £18.9m • Even after the introduction of a new funding formula, we were still 4.34% below our target allocation • Increasing diverse and growing population. Our population has increased by 14.2% in the last decade. Over the next decade, this figure is expected to steadily increase, reaching around 330,000 people by 2018, and 340,000 by 2023. Between 2015 and 2023, the population of Enfield is projected to rise by 5% and by over 10% between 2015 and 2032. • Growing demand for NHS services, especially urgent and emergency care services • Changing health needs – more older residents, more people with multiple long-term health conditions • Ensuring equitable access to services for all patients and focusing on interventions with the best clinical effectiveness • To continuously improve quality: safety, effectiveness & experience of local health services throughout the commissioning cycle • Enfield CCG placed under legal directions by NHS England Local clinicians working with local people for a healthier future

  8. How we addressed our challenges • The CCG has developed a 5-year financial recovery plan with a planned in year 2015/16 deficit of £14.4m which we are on target to achieve • We are working with strategic partners such as Enfield Council to ensure future changes and developments in local services meet the needs of our changing and growing diverse population • We are currently reviewing Urgent Care Services (workshop later today) • We continued to commissioned two additional hours per day at the Chase Farm Urgent Care centre • We commissioned extra urgent access appointments in primary care and put GPs at the front door of A&E dept. at North Middlesex Hospital • We are pleased to welcome new members to our Governing Body in 2015/16 including new elected GP members, a new Chief Officer and deputy Chief Officer and an elected Patient Participation Group representative Litsa Worrall • We are reviewing all commissioned services against: quality and outcomes, value for money and equity of access • We engaged on our commissioning intentions for 2016/17 in September 2015: the document is available on our websitehttp://www.enfieldccg.nhs.uk/Downloads/Policies/Commissioning%20Intentions%202015-16.pdf Local clinicians working with local people for a healthier future

  9. Our Transformation Programme Our Transformation Programme is key in delivering best value for NHS resources and maintaining and improving quality across patient pathways. It is organised into six overarching programmes which are: • Primary Care and Prevention • Integrated Care for Older People • Unscheduled Care • Long Term Conditions and Planned Care • Children, Young People and Maternity • Mental Health, Continuing Healthcare and Learning Difficulties • Each Programme has a clinical lead and a management lead who are responsible for delivery and a Programme Manager who actively manages the development and delivery of all the projects. • This programme will continue in 2016/17. Local clinicians working with local people for a healthier future

  10. Partnership working • London Borough of Enfield • Health and Wellbeing Board • Local providers • NHS England • Other CCGs in North Central London (Barnet, Camden, Haringey and Islington) • Voluntary sector • Patient groups Local clinicians working with local people for a healthier future

  11. Working as a North Central London partnership Barnet, Camden, Enfield, Haringey and Islington CCGs have come together to work collectively on local challenges. Our strategic intent is: “To drive improvement in the delivery of high quality, evidence-based and compassionate services, defined and measured by outcomes not process, to the population of north-central London.” We are developing a North Central London strategic plan that describes our collective commissioning intentions. Local clinicians working with local people for a healthier future

  12. Working as a North Central London partnership • A changed emphasis… • Developing a systematic approach to prevention • Earlier diagnosis of disease • Reducing inequalities in health outcomes targeting vulnerable groups • Encouraging individuals to take greater responsibility for their health • Supporting self-management of illness • Patients at the centre… • Compassionate, high quality, effective and efficient care pathways shaped by them • Care that is integrated and focussed around delivery of outcomes defined by them • Easy access to services delivered in ways and places convenient to them • Integration of care through… • Shared digital record for clinical records, data sharing, measurement and evaluation • Services to be commissioned and contracted in ways that drive partnership and integration • Financial sustainability through… • Clinically-driven focus on quality of services • Delivery of effective (evidence-based) and efficient (right first time) care Savings achieved through cutting the ‘cost of chaos • . Local clinicians working with local people for a healthier future

  13. Key areas of collaboration across North Central London Local clinicians working with local people for a healthier future

  14. Key achievementsthis year • GP out-of-hours/111 services procurement across NCL • Launch of Urgent Care Review • Improved urgent access for primary care • Additional GP capacity at North Middlesex Hospital • Improving and strengthening local services such as opthamology, OPAU. • Recruitment of neuro-navigator post • Better Care Fund • Elected PPG representative now on Governing Body • Set-up of voluntary and community stakeholder reference group • Achieved assurance of our participation duties which were rated as good by NHS England Local clinicians working with local people for a healthier future

  15. Priorities for 2016/17 Delivering national priorities NHS England Delivery the Five Year Forward View 2016/17 - 2020/ 21 https://www.england.nhs.uk/wp-content/uploads/2015/12/planning-guid-16-17-20-21.pdf • Empowering patients and local communities through a growing emphasis on strategic planning on where people live rather than organisational boundaries • Address the three national gaps, focused on: • Health and Wellbeing • Care and Quality • Funding & Efficiency Some of our local priorities • Reporting on outcomes of urgent care review • Developing integrated NHS 111 and Out of Hours services • Continuing with our financial recovery plans with a draft planned deficit of £14.9m in 2016/17 Local clinicians working with local people for a healthier future

  16. Group work Each session lasts 30 minutes Teledermatology - Led by Clinical lead: Dr Janet High, Management lead: Tara Dear This workshop will focus on the launch of a new teledermatology service for patients in Enfield. We want to explain to you how the new service works and get your feedback on leaflets we have designed for patients. Urgent Care Review- Led by Clinical lead: Dr Alpesh Patel, Management Lead: Clare Kapoor This workshop will focus on the Urgent Care review and asks for your feedback on local services. Mental Health Led by Clinical lead: Dr Chitra Sankaran, Management Lead: Keith Dean This workshop focuses on Improving Access to Psychological Therapies (IAPT) and mental health crisis. Values & Priorities: Led by Jane Pike and Teri Okoro This workshop will give you an opportunity to feedback on our corporate objectives. Local clinicians working with local people for a healthier future

  17. Teledermatology Main Issues: • Rising demand in Enfield for Dermatology consultant appointments • April 2013 to March 2014, average of 95 GP referrals per week • April 2015 to January 2016, average of 115 GP referrals per week • Referrals for ‘pigmented lesions’ need to be seen within 2 weeks of referral and as these have risen, waiting times for other routine referrals have increased to 14 weeks (as at March 2016) • Between 90-95% of Dermatology suspected cancer referrals are benign (non-cancer) • GPs need quick access to advice and support • Patients need to have confidence in GPs assessment and consultant/Teledermatology advice Local clinicians working with local people for a healthier future

  18. Teledermatology Service Proposal: • Teledermatology Service to be provided by Royal Free London • Skin lesion images taken by a trained Medical Photographer and consultant will review the images and patient history electronically • Outcome will be shared with GP within 2 weeks of referral • Service to start late Spring 2016 for single skin lesions (excluding suspected cancer) Local clinicians working with local people for a healthier future

  19. Topic questions Imagine your GP would like to refer you to the Teledermatology Service for a routine skin lesion… 1. What wouldyou think of the Teledermatology patient information leaflet provided by your GP? • The leaflet is in draft format and we would welcome suggestions and changes 2. What are the main questions you would like answered before you attended the Teledermatology appointment? • We would like to develop a Frequently Asked Questions (FAQ) guide for the service and would welcome suggested FAQs Local clinicians working with local people for a healthier future

  20. Urgent Care Review Enfield CCG is reviewing local urgent care services to make sure they are meeting the needs of our local population. We want to hear your views on how you access and use urgent care services. Local clinicians working with local people for a healthier future

  21. Urgent Care Review Main Issues: • Rising demand in Enfield for Urgent Care Services • The range of urgent care services and if there is any duplication • How patients choose when to use urgent care services and why, as well as how they navigate the system Local clinicians working with local people for a healthier future

  22. Urgent Care Review • Current Services: • 24 hour A&E Departments at Barnet Hospital (BH) & North Middlesex University Hospital (NMUH) • 24 hour NHS 111 Service • 14 hour (8am-10pm) UCC at Chase Farm Hospital (CFH) • 13 hour (9am-10pm) co-located UCC at NMUH • 12 hour (10am-10pm) co-located UCC at BH • 12 hour Walk in Centre (8am-8pm) operating at weekends and bank holidays located at Evergreen Primary Care Centre • Out of Hours GP service operating from 18.30-08.00 Monday-Friday and 24 hours at the weekend with the main base at CFH for Barnet, Enfield and Haringey • Overnight GP service at CFH site from 21.00-09.00 to provide access to primary care 24 hours at CFH Local clinicians working with local people for a healthier future

  23. Urgent Care Review Enfield Demand for Urgent and Emergency Care Services 2015/16: In 2014/15 20% (31,315) A&E patients were discharged without requiring any treatment. Local clinicians working with local people for a healthier future

  24. Urgent Care Review Demand for Services2015/16: • A&E services 100,631 attendances • UCC services 54,783 attendances • NHS 111 service 37,165 contacts • OOH service 21,127 contacts • 13,032 telephone advice • 5,186 base • 2,909 home visit • WiC service 12,750 attendances Local clinicians working with local people for a healthier future

  25. Questions 1. Which urgent care services have you used in the past year? • How many times? • Why did you choose this service? • What was your experience? • Was your issue resolved or did you need to access another service following this? Local clinicians working with local people for a healthier future

  26. Urgent Care Review Please fill in our survey and tell us more about your experience of local urgent care services: http://www.smartsurvey.co.uk/s/PH6F8/ Local clinicians working with local people for a healthier future

  27. Mental Health Main Issues: • Counselling through IAPT services – We now meeting the overall access target. The service offers both face to face and digital IAPT counselling support. • Mental Health Crisis Services- 4 hour response time target. Local clinicians working with local people for a healthier future

  28. Questions on mental health 1. IAPT Counselling a. Have you had any experience of the IAPT services in Enfield? If not, would you know what the service does and how to access it? b. Please give us your suggestions of how IAPT counselling services could develop in the future? 2. Crisis Care a. What are your experiences of the services in Enfield when there is a mental health crisis? In particular primary Care, A&E and mental health secondary care? b. Please give us your suggestions of how Crisis services could develop in the future. Local clinicians working with local people for a healthier future

  29. Enfield CCG’s • Mission • Values • Objectives Local clinicians working with local people for a healthier future

  30. We welcome your views • Mission statement • Developing our values • Strategic Objectives - how can we clearly communicate these Local clinicians working with local people for a healthier future

  31. Ask us anything! Local clinicians working with local people for a healthier future

  32. Thank you for attending today’s event. For more information www.enfieldccg.nhs.uk Follow us on Twitter @EnfieldCCG Contact: communications@enfieldccg.nhs.uk 0203 688 2814 Local clinicians working with local people for a healthier future

  33. Key dates for your diaries Governing Body meetings in public http://www.enfieldccg.nhs.uk/about-us/ccg-board-meetings.htm The next meetings are: 11 May 2016 1:30-4pm Millfield House, Silver Street, N18 1PJ 13 July 2016 1:30-4pm Venue to be confirmed Patient Participation Group (PPG) network meeting These meetings are open to PPG Chairs, members and practice staff. http://www.enfieldccg.nhs.uk/PPGnetworkmeetings.htm The next meeting is Tuesday 7 June 2016, 1.30 – 4.30pm, Executive Suite, Dugdale Centre, Thomas Hardy House, London Road, Enfield, EN2 6DS Patient and Public Engagement meetings Future Enfield CCG Patient and Public Engagement dates are: 15 June 2016 Time 2pm - 5pm Venue to be confirmed 16 November 2016 Time 2pm - 5pm Venue to be confirmed 2 March 2017 Time 2pm - 5pm Venue to be confirmed Primary Care Joint Commissioning Committee http://www.enfieldccg.nhs.uk/about-us/primary-care-joint-co-commissioning-committee.htm 17 May 2016 16:00 - 17:30 Seminar Room 2, Resource for London, 356 Holloway Road, London N7 6PA . All events are advertised on our website: www.enfieldccg.nhs.uk Twitter @EnfieldCCG and in the Enfield Independent

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