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CCG update
November 2013
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High Weald Lewes HavensA relatively healthy population, but with specific needs
• Differential life expectancy between localities• High numbers of Frail elderly• Pockets of inequality• Poor recording by GPs of smoking status• Above average young people using alcohol & drugs• Low flu vaccination rates for 65+• Above expected circulatory and respiratory diseases• Higher cancer rates in under 65s• Higher rates of depression and dementia • High numbers of road injuries and deaths • Lower % of deaths at own residence
Source: http://www.eastsussexjsna.org.uk/
A small CCG over a primarily rural area
• 164000 Population (93000 High Weald, 71000 Lewes Havens)
• 22 Member Practices• 125 GPs• No acute provider within the
CCG boundaries• 1 community provider
(integrated with acute)• 3 Community hospitals
CCG History
Pre white paper Three PBC groups exist – Havens, Lewes, and High Weald
March 2012 One CCG (High Weald Lewes Havens) formed and chair elected
July 2012 Chief officer recruited . CCG receives delegated authority as PCTC sub-committee
September 2012 Governing Body formally meets for first time and Merged ISOP published.
October 2012 Governance structure and constitution adopted by all practices
December 2012 Recruitment to governing body and management staff complete
March 2013 CCG authorised with 18 conditions and 2 directions
April 2013 High Weald Lewes Havens becomes a statutory NHS body
June 2013 Directions Lifted.
September 2013 All but two conditions remain. New Governing body member and 9 new clinical leaders appointed
IntroductionThe Financial
positionDelivery – the Green Triangle
The CCG Environment
CommissioningArchitecture
AppendicesHigh Weald Lewes Havens
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Summary of 2014/15 Commissioning Intentions• Community Services Review• Better Care Better Value• New Commissioning Models – MSK • Contract Levers
The CCG is not responsible for primary care contracting, but the plans for the future, including the Green Triangle, are interlinked with these services. The CCG has begun to develop a primary care strategy and working with the Area Team, will include a set of commissioning intentions for primary care and how they relate to the planned changes in community services.
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The Green Triangle – a manifesto for Community Services
“a fractured, confusing system made up of unclear and unwieldy referral pathways, and significant inequalities of provision across
the CCG”
“a firm commitment to radical change”
Which means…• A redesign of community services based
on patient flows• Integration of Health and Social Care to
deliver better services for patients• Development of a Primary Care Strategy
that supports 7 day access to expert clinical advice; and GPs as gatekeepers to the whole treatment and care system .• A review of mental Health Services
currently delivered in the community
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Commissioning a new MSK Service• Musculoskeletal conditions (MSK) include
disorders of muscles, joints, tendons, ligaments, and nerves.
• Current Treatments include physiotherapy, rheumatology, pain management, podiatry, and psychology
• 10,000 referrals pa in HWLH and EHS
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Why commission a new MSK Service?• Variations in referrals, diagnoses, and
treatment offered• Lack of coordination• Distance travelled by some patients for
treatment• Lack of alternatives to surgery offered
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What will be better for patients?An integrated MSK service means better clinical outcomes as follows• Promotes patient self-care• More treatment in community based settings• Quicker access to specialist advice, diagnostics,
treatment, and rehabilitation• One stop assessment and on-going care• Better coordinated follow up care• Shared Decision Making• Single point of access on discharge• Better coordination of rehabilitation
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The timelineAction Date/Status
Clinicians design service specification based on patient feedback Done
Evaluation criteria to assess providers agreed Done
Provider event Done
Invite bids for new service Done
Competitive dialogue begins February 2014
Contract awarded May 2014
Service goes live c. October 2014
