commissioning prospectus 2013/14 · NHS Calderdale Clinical Commissioning Group Prospectus 2013/14 11. COMMISSIONING INTENTION dESCRIPTION EXAMPLE MEASURES Deliver best in class urgent,

improving health, improving lives


commissioningprospectus2013/14

who we areThe aim of this prospectus is to introduce Calderdale CCG - your Clinical Commissioning Group. We hope that the information we have included helps you to understand who we are, why we exist and how we aim to deliver the best healthcare services for you.

We are responsible for buying healthcare services for the people of Calderdale. We are made up of 26 GP practices that look after the health needs of 213,000 people and we have a budget of £265 million.

CCGs are very different from their predecessors. They are made up of local GP practices which, through their constitution, establish a governing body to oversee the way in which they carry out their responsibilities. This means that local doctors - who have a good understanding about their patients - are in charge of buying and designing the health services used by local people.

our visionTo achieve the best health and wellbeing for the people of Calderdale within our available resources.

our aimOur aim is to improve the health and lives of local people by increasing life expectancy, making sure we commission and provide good quality services and by reducing health inequalities.

2 NHS Calderdale Clinical Commissioning Group Prospectus 2013/14

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our values are to;• Preserve and uphold the values set out in the NHS Constitution

• Treat each other with dignity and respect

• Encourage innovation to inspire people to do great things

• Be ambassadors for the people of Calderdale

• Work with our partners for the benefit of local people

• Value individuality and diversity and promote equity of access based on need

• Commission high quality services that are evidence based and make the most of available resources

• Encourage and enable the development of care closer to home


3NHS Calderdale Clinical Commissioning Group Prospectus 2013/14









long lifePreventing people from dying prematurely



quality of lifeEnhancing the quality of life for people with a long-term condition (including work on urgent care pathways)



independenceHelping people to recover and maintain theirindependence (including work on intermediate tier)

careEnsuring people have a positive experience of care (including those in care homes, and those accessing primary care)

protectionEnsuring a safe environment and protecting people from harm

equalityReducing inequalities in Calderdale

our logo embraces all our values




the communities we serveWe serve a population of 213,000 people in a high density geographical area stretching from Halifax and Brighouse in the east to Todmorden in the west. The population is expected to increase by 10% over the next 25 years.

our structureThe purpose of our CCG is to clinically lead the commissioning of health and care services for the residents of Calderdale. Our Governing Body includes GPs elected to represent the member practices, a registered nurse, a secondary care specialist and two lay members.


John Mallalieu Lay Member and

Deputy Chair

Julie LawerenuikDesignate Chief Finance Officer (Joint with Greater Huddersfield CCG)

Dr Matt WalshDesignate Chief Officer

Dr Alan BrookChair

Dr Nigel Taylor Dr John TaylorDr Majid AzebDr Hazel Carsley Dr Peter Davies

Dr Steven Cleasby Assistant Clinical Chair

Kate SmythLay Member and PPI and Equalities Lead

Jackie BirdRegistered Nurse

Dr Sanjay SuriSecondary Care Specialist

governing body

Paul Butcher interim Executive Director of

Public Health (Calderdale Council)

Bev MayburyDirector of Adult Social Care

(Calderdale Council)

Our Senior Management Team and senior staff are responsible for the day to day running of the CCG and we are committed to upholding the values of the NHS mandate and constitution.


our responsibilitiesOur GPs are in the driving seat, and working with their patients, this provides a great opportunity for clinical leaders to improve the quality of health care provision and achieve better outcomes for patients.

Emergencyand urgent

care inc A&EQuality of

primary care

Maternity Services

Rehabilitation

Older people’s health care

Children’s care

Learning disability and Mental health

services

Continuing care

Abortion services

Fertility services

Wheelchair services

Oxygen services

General hospital services

CLINICAL COMMISSIONING GROUP

RESPONSIBILITIES


what is important to us?Our role is to commission high quality health services for the people of Calderdale. We want to ensure that healthcare is available for anyone who needs it and help people to maintain a healthy lifestyle. We also want to address health inequalities locally and have worked in partnership with our Health and Wellbeing Board in developing our strategic priorities to focus on these inequalities. The major health issue in Calderdale are;

CALdERdALE CCG PRIORITIES 13/14 ANd BEyONd

respiratory• Smoking related deaths

• COPD related deaths

• Improving the management of conditions where care can be providing outside hospital

infant mortality• Infant mortality rate

• Maternal smoking at delivery

• Breast feeding 6-8 weeks

• Low birth weight babies

cardio vascular disease• Smoking related deaths

• Management of hypertension

• Primary care management of coronary heart disease

re-admission (<30 days)• Keeping people out of

hospital

• Joined up working

• Coordinated discharge

endocrine• Prevalence of diabetes

• Management of blood glucose

• Blood pressure

• Length of stay in hospital for diabetes patients

patient experience• GP out of hours services

• Hospital care

dementia• Diagnosis

• Care and support

care homes• Quality of care

• Utilisation of acute services


our objectives for 2013/14 are to;









Prevent people from dying prematurely improving health, im

proving lives


Enhance the quality of life for people with a long-term condition (including work on urgent care pathways)



Help people to recover and maintain theirindependence (including work on intermediate tier)

Ensure people have a positive experience of care (including those in care homes, and those accessing primary care)

Ensure a safe environment and protect people from harm

Reduce inequalities in Calderdale


what we want to achieveTo enable us to achieve our objectives we have set out our commissioning intentions. These intentions will form the way in which we commission services.

• Commissioning for quality and safety

• Outcome based commissioning – based on needs not historical demands

• Commissioning of patient-centred integrated pathways

• Shifting the balance from reliance on unplanned hospital care to planned community provision

• High quality urgent care

• “Best in class” primary care provision


The following tables outline the structure, process and outcomes we expect to achieve from our commissioning decisions.

our commissioning intentions for 2013/14 are;COMMISSIONING INTENTION

dESCRIPTION EXAMPLE MEASURES

(Not in priority order)

Reduce preventable deaths

Working across the system - focus on conditions for which there are poor local outcomes

Years of life lost amenable to health care – against national benchmarks

Reduce health inequalities

Working across the system - focus on geographical areas and improve access to healthcare and maximise every contact counts

Improved, targeted access in areas where health outcomes are the lowest in Calderdale.

Patient experience and perception (Francis Report)

Maximise opportunities to capture patient views of care and co-produce improvement

Surveys, Friends and Family Test, Francis recommendations

Address priority conditions – respiratory, CVD, endocrine, cancer, dementia

Clinical champions for specific pathways, clarity on pathways and guidelines, maximise input from integrated community teams

Improved outcomes (morbidity/mortality) against national benchmarks

Reduced reliance on unplanned hospital based care

Maximise integrated, community based planned care

Non-elective admissions, best in class primary and community care

OU

TCO

MES


COMMISSIONING INTENTION


Deliver best in class urgent, critical, specialist, community and primary care

Models which provide specialist knowledge and facilities to deliver 24/7, high quality care. Linked to relevant clinical models and networks. Improved access to core services

Clinical outcomes and access best in class against national benchmarks. Delivering against need rather than historical demand

Develop capacity and capability of workforce

Workforce skilled to work within new, flexible, integrated models, within a culture of joint accountability

Workforce planning, recruitment and retention in line with strategic direction

Deliver acute provision across two CCG geographies

High quality services provided 24/7 in both CRH and HRI – concentrating specialist knowledge and facilities – providing VFM

Clinical outcomes, access, including delivery of 18 weeks, patient experience

Integrate paediatric care

High quality paediatrics - integrating medical and surgical care (inc assessment, and maximising community based delivery)

Clinical outcomes, access, patient experience

Develop community based unscheduled care facilities

Community provision for minor injuries, linked to West Yorkshire Urgent Care model, providing appropriate diagnostic facilities

Clinical outcomes, access and patient experience. Reductions in A&E attendances

STRU

CTU

RE


COMMISSIONING INTENTION


Integrated medical and surgical assessment

Single access point for adult surgical and surgical assessment. Pathways focusing on care provided outside hospital wherever possible, and shared care

Clinical outcomes, access and patient experience.

Best in results care management

Effective, integrated care processes which deliver results which are in line with the best in the country

Improved Length of stay outpatient follow-up, patients still at home, post rehabilitation 91 after discharge, and access (18 weeks, cancer waiting times and Accident and Emergency targets)

Electronic records Shared electronic planning, single shared assessment, care co-ordination and record keeping, maximising choose and book and advice and guidance

% patients whose care is managed solely by electronic records and shared assessments

Pathways integrated across multiple providers

Integrated pathways delivering care across the care continuum – from specialist to low level support – led by a ‘host’ provider

Single accountable provider - commissioned to delivery outcomes

Promote independence and resilience through effective use of assistive technology

Maximise opportunities for integrated; tele-consultation, tele-health and tele-care in a range of settings

Levels of Independence and re-ablement, reductions in exacerbations and use of unplanned care

Preventative care and lifestyle issues

Focus on prevention and lifestyle changes – utilising every contact counts to maximise impact on both children and adults

Reduce premature death. Increase, access uptake and impact of a range of lifestyle initiatives

Significant increase in proportion of care provided at home or close to home

Shift in balance of provision away from hospital based care into integrated community models with flexible in-reach/outreach

Evidence of shift of staff and resources

PRO

CESS


longer term commissioning strategyWe have set ourselves the challenge to reduce the levels of health inequalities affecting our communities and many of these health issues can only be tackled by working together in partnership to improve the health of the people in Calderdale.

In the longer term our aim is to;

• Develop locally owned partnerships

• Build long term change through prevention and health improvement measures

• Empower patients to take responsibility for self care and self-management of health conditions

• Make primary care the best it can be; accessible and local

• Improve planned care to get the service right for different groups of people

• Ensure people get access to Emergency Care in the right place at the right time

• Integrate Hospital Care so all doctors function as part of an extended care team

• Improve training and education facilities so we have joint primary and secondary care approaches

• Motivate a strong workforce so we get the health offer right for patients

Calderdale CCG supports the development of capacity and capability in primary care and the third sector to enable them to respond to the CCG’s commissioning intentions and improve service provision for the residents of Calderdale.


‘right time, right care, right place’The NHS organisations in Calderdale and Huddersfield, together with Calderdale and Kirklees Councils have come together to carry out a complete review of health and social care across the area and develop ideas and plans that will ensure that everyone will continue not only to receive high quality services now and in the future, but that those services will be focused on patients, reducing ill health and improving outcomes for those who do fall ill or are injured.

Advances in medicine, an ageing population, changes in the types and patterns of ill health and the increasing expectations of public and patients, mean the way we deliver health and social care needs to change.

People have told us:-

• They want care closer to, and in, their homes.

• They want choice of treatment and choice of time and place.

Change is, and has always been, part of health and social care but it has often been simply a case of using more money and new resources to do more of the same. But this does not always deliver the best health outcomes for patients and is not financially sustainable. The budget for health and social care in Calderdale and Huddersfield is more than £400 million a year. While that figure is set to grow, increasing demand, inflation and the introduction of new drugs and treatments mean that costs are increasing faster. We urgently need to take a fresh look at how we deliver health and social care and make it fit for the 21st Century. It is not just about how much money we have to spend, we need to look at how we spend it.


ways of workingWe will work with providers and partners to build a shared understanding of our requirements. Our business process is outlined below;

service improvements and future opportunitiesWe will produce a procurement plan which will be continually refined as opportunities are identified. The plan will identify the programme or source, a description of the procurement intention and the proposed timeline. Further detailed information will be displayed on our website www.calderdaleccg.nhs.uk

programme /source

procurement intention

time frame

Child and Adolescent Mental Health

CAMHS Tier 2 April 2013 - September 2013

Acute Services Additional termination of pregnancy service

June 2013 - July 2013 ( to be confirmed)

Identify strategic priorities

Ask the system to respond

Use procurement strategy to commission

services

Monitor quality and

safety


how much money will we spend on healthcare?Our budget for 2013/14 is £265 million. That’s equivalent to £1,244 per person in Calderdale. The administrative budget is separate and is valued at £5.1m, approximately 2% of the overall budget. The majority of our spending is on acute care services and prescribing.

Acute Community Services Continuing Care Mental Health Prescribing

Running Costs Learning Disabilities Primary Care Enhanced

Services Other

61.7%

2.0%

0.3%

6.5%

9.4%

1.3%

4.2%

12.7%1.9%


useful links• Calderdale CCG Procurement Policy

• Patient and Public Engagement and Experience Strategy 2013 – 2016

how to get in touchNHS Calderdale Clinical Commissioning Group5th Floor, F MillDean Clough MillsHalifaxHX3 5AXTelephone: 01422 281300Email: [email protected]: www.calderdaleccg.nhs.uk

twitter.com/calderdaleccg

facebook.com/nhscalderdaleccg




http://www.calderdaleccg.nhs.uk/wp-content/uploads/2013/07/CCCG-Procurement-Policy-Final-Version.pdf

http://www.calderdaleccg.nhs.uk/wp-content/uploads/2013/03/Calderdale-CCG-PPEE-Strategy-final-version.pdf

Documents

commissioning prospectus 2013/14 · NHS Calderdale Clinical Commissioning Group Prospectus 2013/14 11. COMMISSIONING INTENTION dESCRIPTION EXAMPLE MEASURES Deliver best in class urgent,