1

NHS Newham CCG Annual General Meeting Tuesday 25 September 2018

2

Hello and welcomeDr Muhammad Naqvi

33

East London Health & Care Partnership and North East London Commissioning AllianceJane Milligan, Accountable Officer

3

4

East London Health and Care Partnership

ELHCP brings together 12 local NHS organisations (commissioners and providers) and

eight local councils to improve health and care services and outcomes; highlights

include:

• Digital Technology

• Workforce

• Estates

• Cancer early diagnostic centre

• Patient Involvement

5

Collaboration across NEL – what this means for Newham CCG

• NEL Collaboration

• Joint Commissioning Committee

• Outpatients

• NHS111: Rollout of new integrated urgent assessment service (NHS111)

• Commissioning strategy

• London Ambulance Service

• Winter planning

66

2017/18 Financial Overview and 2018/19 ProgressLei Wei, Interim Chief Finance Officer

6

7

We achieved good value for money for our patients in 2017/18, and successfully delivered all the key

financial duties and business requirements under the NHS Act 2006.

2017/18 Financial Overview

Key Financial Duties and Business Requirement

Target£'000

Performance

£'000Target

achived

Expenditure not to exceed income

499,263 497,553 Yes

Capital resource use does not exceed the amount specified in Directions

11 11 Yes

Revenue resource use does not exceed the amount specified in Directions

494,854 493,144 Yes

Revenue administration resource use does not exceed the amount specified in Directions

7,561 7,532 Yes

The CCG secured an unqualified opinion from our independent auditors in 2017/18 that the

financial statements. - Represented a true and fair view of state of the CCG’s affairs and.

- Have been properly prepared in accordance with accounting policies.

51%

8%

10%

9%

21%

2%

Acute Services

Community Services

Mental HealthServices

Other Non-acuteServices

Primary Care Services

Running CostAllowance

8

• Assured by NHS England, the CCG’s 2017/18 activity and finance plans aligned with our main

providers and key stakeholders, and we will continue to deliver all finance and business

requirements

2018/19 Progress

Financial Year 2018/19 £'000

Total Planned Commissioning Spending 497,056

Total Running Cost Allowance Expected 7,619

• Key areas of investment includes a Newham-based integrated health and care system, primary

care services, and collaborative initiatives to deliver financial efficiencies

• Despite the significant financial challenges Newham CCG are facing, we are currently on track in

delivering the financial plan for 2018/19.

9

AIRS Ministry Congolese Youth Choir

1010

Quality Improvement ProjectImproving discharge from hospital to community services

10

11

50% reduction in grade 2 pressure

ulcers

I felt reassured when the team

manager called me

10% reduction in follow-up DNAs

MSK Physio Service

Before this it didn’t feel

meaningful

Feedback system at

Phlebotomy

‘Are you listening?’

Falls

prevention -

EPCT

in Community Health Services

Supporting

informal carers

12

Stimulus

Newham

CCG Quality Team

Local Authority:

Information and

investigations

Barts Health Trust :

Complaints, Serious

Incidents, PALS, staff

feedback

East London Foundation

Trust: Complaints,

Serious Incidents, staff

feedback

CCG: performance,

serious incidents,

complaints, patient

feedback

Care Homes: Incidents

and staff feedback

13

Purpose

To improve the safety of and patient/staff satisfaction with

the discharge process from Newham University Hospital into

East London Foundation Trust Community Services.

QI Team• Newham CCG Quality Team

• NUH Improvement Manager

• NUH Discharge Team Manager

• NUH Ward Managers

• NUH Therapies Managers

• ELFT Associate Director for Quality and Compliance

• ELFT Deputy Director Community Services

• ELFT QI Coach, Practice Educator and Nurse Adviser EPCT

• ELFT EPCT Manager

• ELFT Therapists

• ELFT EPCT Community Staff Nurse

• ELFT Telehealth

• Service user

Scope and Aim:Who, Measures,

Data, Where and How

Change IdeasProcess

Mapping

Review data, patient and

staff feedback

15

Themes arising and actions being undertaken

Understanding of community services• Improve referral form

• Resource folder for NUH staff outlining key contacts and referral criteria for services

• Emergency admission cards for EPCT patients

• Co-designed patient information leaflet – what to expect on discharge and how to escalate

concerns

Improved patient self-care• Self administration of medication encouraged on wards

• Patient activity on wards

• Use of interpreters prior to discharge

Equipment and medication on discharge• Use of medication packs

• Equipment ordering processes – who can order what and when

• Policy outlining responsibilities

16

Outcomes so far...

• Improved communication – improving patient journey between

providers

• Joint working – incident sharing arrangement and discharge policy to

improve safety and shared learning

• Impact further reaching

1717

Quality in Primary Care Dr Naqvi, Chair Newham Clinical Commissioning Group

17

18

Quality in Primary Care

• Primary care services provide the first point of care, day or night, for the

vast majority of people who come into contact with the NHS.

• GP surgeries are a core element of primary care, but are not the only

element - it is also about coordinating access for people to a wide

range of services in the local community to help meet their health and

wellbeing needs.

• Engaging primary care practices in quality improvement (QI) activities is

essential to improving the health of the population and enhancing

patient experiences and outcomes.

19

Quality can be described in the following context

• Patient experience

• Safety

• Clinical effectiveness

20

Where we are now

• GP access is one the biggest concern for the people of

Newham.

• Newham is ranked below other north east London CCGs in

the CQC CCG ratings for Primary Care.

• Newham has 41 practices (80%) that are rated good,

however there is still a small pocket of practice that need

improvement.

21

Why is this

• Lowest number of full time GPs in the London

• Most deprived wards in the country

• Diverse and mobile population

• Population growth

• Chronic disease

22

So how can we achieve the quality outcome Newham deserves

• Extra funding given to east London

• Estates will deliver new fit for purpose buildings

• Commissioning projects

• Two GP Hubs planned offering GP and Nurse appointment evenings and

weekends

• Integrated care partnerships

• Developing the existing and up-and-coming primary care workforce

• Five year retention initiative

• Practice manager development

23

QI in practice

• Newham GP, Dr Nazmul Hussain, developed a passion for Quality

Improvement (QI) through his involvement with UCLPartners’ and Newham

CCG’s partnership programme.

• He and his team at Wordsworth Health Centre have used QI to improve

their patient appointment system, upskilling reception staff and

signposting to alternative community services.

• The team credit their health centre’s turnaround to their adoption of QI

methodology.

• This project is one of many taking place in GP surgeries around Newham

as a result of the GP development arm of the Newham Partnership

Programme.

2424

Quality Improvement at The Wordsworth Health Centre

Dr Nazmul Hussain

24

25

The Wordsworth Health Centre

26

Quality Improvement video

https://www.youtube.com/watch?v=IngpodLN67U

27

Fun Day Event

28

Fun Day Event

29

30

0

20

40

60

80

100

120

11.9

.17

13.9

.17

14.9

.17

18.9

.17

19.9

.17

20.9

.17

21.9

.17

26.9

.17

27.9

.17

28.9

.17

29.9

.17

2.1

0.1

7

3.1

0.1

7

6.1

0.1

7

9.1

0.1

7

10.1

0.1

7

11.1

0.1

7

12.1

0.1

7

13.1

0.1

7

16.1

0.1

7

17.1

0.1

7

18.1

0.1

7

19.1

0.1

7

20.1

0.1

7

23.1

0.1

7

24.1

0.1

7

25.1

0.1

7

26.1

0.1

7

27.1

0.1

7

30.1

0.1

7

2.1

1.1

7

3.1

1.1

7

6.1

1.1

7

7.1

1.1

7

8.1

1.1

7

9.1

1.1

7

10.1

1.1

7

13.1

1.1

7

14.1

1.1

7

15.1

1.1

7

16.1

1.1

7

17.1

1.1

7

20.1

1.1

7

22.1

1.1

7

Nu

mb

er o

f D

ocu

me

nts s

en

t t

o G

P’s

A COMPARISON OF THE NUMBER OF PAPER

DOCUMENTS SENT TO GP’s BEFORE and AFTER QI

Without QI

With QI

Peaks represent Monday’s

where most post comes in

Gap narrowed as

staff become more

confident

Gap widens as new

member of staff gets

trained up

Large difference to start off with

whilst staff familiarise with

process

31

Newham Primary Care Oscars 2018 winners

Practice responding to service user requests award

Recognising contribution of service users award

Practice with most Quality Improvement award

Practice Staff Leadership award

32

CMC Uptake in Newham

703

719

741

774

845 850 854 856866

885 890896

909915 920 922

933

951

968974

996

10151023

1041

10551061

10691075

700

750

800

850

900

950

1000

1050

1100

02/03/2018 02/04/2018 02/05/2018 02/06/2018 02/07/2018 02/08/2018 02/09/2018

CMC

CMC

3333

Priorities, Challenges and HighlightsSelina Douglas, Managing Director, Newham Clinical Commissioning Group

34

Achievements

• CCG rated as Good

• Outstanding for diabetes

• Green star for PPE

• No Recourse to Public Funding - tuberculosis in the homeless project

• Community Prescription joint with LBN

• 90% paperless referral ahead of 1 October deadline

• Discharge to community

• Latent tuberculosis infection (LTBI) screening and treatment programme

35

Challenge and focus for 2018/19

• Quality in Primary Care

• Newham Well-being Partnership

• Early Cancer diagnosis

• Making Every Referral Count

36

Highlights

• NHS70 birthday cards and letters from the Newham Show

• Newham’s community prescription programme 150Club

• East London Community Kidney Service

• NHS 70 Women Leader Award

3737

Q & A session

38

Closing remarksDr Muhammad Naqvi

39

THANK YOU