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National Direction, Local Action
4
NHS East of England
Adapting existing Strategies
Improving Lives; Saving Lives
Looking to the Future
Our NHS, Our Future
Towards the Best Together
Darzi – direction for the8 clinical groupings
Maternity
HC
L B
usin
ess
Pla
n
Children
Planned care
Mental health
Staying healthy
LTCs
Acute Care
End of Life
Our Business Plan
Needs of population
Plans & Proposals
Programmes
Initiatives
Service changes +
Better health
Vision
Context
Strategy
Delivery
A picture of the future health for Hertsmere people
Analysis of the current status and grasp of the challenges
A description of the goals and initiatives to deliver the vision as
set out in the Business Plan
Development of implementation plans for delivering the strategy plus Performance Management
Making it Real in HertsmereMaternityMaternity
ChildrenChildren
Planned carePlanned care
Mental healthMental health
Staying healthyStaying healthy
LTCsLTCs
Acute careAcute care
End-of-lifeEnd-of-life
Midwives key to ‘Maternity Matters’ – no changes proposed
Roles for health visitors in the new Child Health Promotion Programme - improving immunisation rates
Key role for CATs in only referring the right people – diagnose to refer not refer to diagnose
Secured resources to work with 3rd sector, improve counselling, support Graduate Mental Health Workers & IAPT
Plans underway to pull together services for young adults in Borehamwood
Redesign programmes underway including care pathways for MSK (including physio review), COPD, Diabetes & Ophthalmology
Focus on referral management, consultant to consultant referral and early discharge for inpatients
Undertook short review to see whether there is a need to increase resources for hospice care
Looking Forward
We must
• Control acute spend
• Improve local access
• Ensure safety and good patient experience
Future programmes to control acute spend
Achievements
• Mental Health• CATS• Performance
Management• SPA• Innovation Fund• Website• Community Nursing• Children’s Services
• Prescribing• Patient Group• COPD• Physiotherapy redesign• In- house Phlebotomy• Increased resources for counseling• Strategic Management• Public Health
Mental Health
• Established subgroup – monthly meeting of GPs, PM, HPFT, Patient Groups, Voluntary Groups e.g Viewpoint/ Mind & Carers in Herts
• CBT/ Psychological Therapies/ IAPT - first PBC group in W Herts to deliver these services and maintain existing counseling resources
• Persuaded HPFT to respond to locality needs e.g address counseling waiting times
• Innovation Fund £47k in 3 Hubs addressing carers needs / premises shaped by local groups
• Shaping the future Mental Health Commissioning with a Hertsmere focus
CATS
• Innovative and robust approach to Performance Management including representation from PCT Finance and Contracting, Patient Group and Practices
• Developed monthly Report Card• Appointed lead - Jayne Taylor• Partnership with local acute
Trust - Barnet & Chase• GP buy-in to performance
MSKMSKDermatologyDermatologyOphthalmologyOphthalmologyUrologyUrologyRespiratory Respiratory GeriatricsGeriatricsCardiologyCardiology
SPA
• Awarded Nov 2007
• £100k project
• Working with UH UK
• Only PBC group to be awarded in UK
• Shaping services for the future
• Engagement with stakeholders
• Lessons learned
Website
www.hertsmerecommissioning.co.uk
• Portal for clinicians & public
• Information on CATS
• Public Participation “Your Say”
• Library for all documents/ minutes etc
• Link into Hertsmere council website
• Putting Hertsmere and PBC on the map
Community Nursing / Children’s Services
• Engaging with local team
• Shaping Provider Service Contract
• Enhanced resources / manpower for Community Nursing team
• Monitoring performance of contracts
• Monthly dialogue
Fast track proposals
• Direct Access Physiotherapy pathway & integration with MSK
• In house Phlebotomy
• Fair distribution of extra counseling resources
• COPD
Patient & Public Involvement
Hertsmere Patient and Public Involvement Group• Trailblazer for Herts PCT• Aim is to involve patients and members of the public in our
commissioning decision-making processes.• Initial group has met twice.• Group is in the process of agreeing a range of ‘involvement’
activities such as:– Reader panel– Leaders of disease specific patient interest groups including
linking with existing local groups to be involved in monitoring specific contracts, service redesign
– Committee membership e.g. performance management– Possible member of contributor of the accreditation process for
GPwSIs and services in which they work– Representative of the HCL PPI group on the LINk.
Public Health initiatives
• Obesity
• Smoking
• Exercise on prescription enhanced
• Local Retinal Screening service delivered by Optician
• Engagement with Council/ partnership working
Next Steps
• Efficiency … Developing specific role descriptions for each formal role within HCL - including time commitment
• Development … Establishing training and support needs of the group and individuals
• Governance … revising our robust systems based on best governance principles e.g. conflicts of interests, voting, confidentiality etc
• Review of structure … Enlarging the size of the group and establishing differing levels of involvements