Your health, Your Tower HamletsA guide to your local Clinical Commissioning Group

Welcome

This guide gives you an introduction to NHS Tower Hamlets Clinical Commissioning Group (CCG). It explains what we do, and how and why we do it. It highlights the health needs of the people in Tower Hamlets, and the plans that we have to meet these needs and improve the health and wellbeing of everyone living in the borough.

Tower Hamlets is unique in London and England, with a rich historical and cultural identity. However, many people in Tower Hamlets have poorer health than people in other parts of England. We are deeply committed to improving health care in Tower Hamlets, and clinical commissioning gives us an exciting opportunity to improve this situation.

By working alongside our residents, and local health and care partners, we will commission services that help us achieve our vision of high quality, integrated health and social care services for local people.

We are working to ensure that we encourage these high standards, while reinforcing the way we monitor quality and listen to patient feedback. Your opinions are vital in helping us to develop our plans and we want to put the voices of local people at the heart of everything we do.

You will find many ways to get involved in this booklet (please see pages 12 & 13), so that your views can help to shape the healthcare services you receive. We hope you find it useful.

Dr. Sam EveringtonChair

Jane MilliganChief Officer

Dr. Sam Everington Chair

Jane Milligan Chief Officer

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About us

NHS Tower Hamlets Clinical Commissioning Group (CCG) is a clinically-led organisation, which means our plans and decisions are informed by people with a medical background such as GPs and nurses who know the local area.

Since 1 April 2013 we have been responsible for planning, buying and monitoring (a process known as ‘commissioning’) a range of local health services. This includes everything from mental health services to out of hours GP care, and from hospital services to care in the community.

We are a membership organisation formed of the 36 GP surgeries in Tower Hamlets and our work is supervised by a governing body, which includes an elected GP from each of our eight local GP networks, a practice nurse, a practice manager, lay members and the local council.

We work with a wide range of health service providers and partners in the borough and across east London to plan, buy and manage local health services. These providers include Barts Health NHS Trust and the East London Foundation Trust. We also work closely with the London Borough of Tower Hamlets (the local council) to ensure a full and integrated range of health and social care services are available to the people of Tower Hamlets.

Our Vision

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Our vision has three parts, which together show what we strive to achieve for health and health services in Tower Hamlets:

High quality health and social care services

We want our health and social care services to provide the highest quality possible for local people. We will use innovation, best practice and patient feedback to make sure that the services we commission are safe, high quality and provide a good experience for patients.

A vibrant and stable health and social care system

We will act responsibly to ensure we make the best use of the money that we have been given, to plan and pay for services in the borough, and create a stable healthcare system. We will work with our partners, as part of a wider health and social care network to ensure our plans are developed together.

Integrated services to meet individual needs

We will organise flexible services for individuals which go beyond traditional health services and meet other needs that local people have, so that everyone feels supported by services that link together seamlessly.

North, Mile End and Globe Town 1 2 3 5 6

LAP 2.Banglatown, Bethnal Green South 4 10

LAP 3.and Stepney Green 11 12 13 14

LAP 4.Wapping, Shadwell 15 16 17 18

LAP 5. 19 20212223

LAP 6.Bromley by Bow242526277*

LAP 7.East India Lansbury2829303132

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19

2122

23

24

25

2829 31

32

33

34

35

36

30

26 7b

27

20

15 16

17

1314

1112

10

56

7a

89

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1 23

Network 1. Weavers, Bethnal Green North, Mile End and Globe Town

1 Strouts Place2 Bethnal Green3 Pollard Row5 Mission6 Globe Town

Network 2. Spitalfields and Banglatown, Bethnal Green South

4 Blithehale7a XX Place*8 Health E19 Spitalfields10 Albion

Network 3. Whitechapel, St. Duncan’s and Stepney Green

11 Whitechapel Health12 City Wellbeing13 Brayford Square14 Harford Health

Network 4. St. Katharine’s and Wapping, Shadwell

15 East One16 Jubilee Street17 St. Katherine’s Dock18 Wapping

Network 5. Bow West, Bow East

19 Grove Road20 Tredegar21 Harley Grove22 St. Stephen’s23 Ruston Street

Network 6. Mile End East, Bromley by Bow

24 Merchant Street25 St. Paul’s Way26 Stroudley Walk27 St. Andrews7b Bromley by Bow*

Network 7. Limehouse, East India Lansbury

28 Limehouse29 Gough Walk30 Chrisp Street31 All Saints32 Aberfeldy

Network 8. Millwall, Blackwall and Cubitt town

33 Barkantine34 Docklands35 Island Health36 Island Medical Centre

* XX Place and Bromley by Bow are counted as one practice in two separate locations.

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How we organise our 36 GP practices into 8 networks

CCGs are responsible for commissioning most hospital, community-based and mental health services. A national body called NHS England, is responsible for commissioning GP and specialist services and the local council looks after public health services.

NHS England is responsible for the performance of CCGs and for commissioning:• GP services.

• Specialist commissioning (e.g. neurosurgery).

• Prison healthcare.

• Immunisation and screening.

• Health visiting.

London Borough of Tower Hamlets is responsible for public health commissioning:• Health promotion and prevention.

• Sexual health services and treatment (except HIV).

• Drugs and alcohol.

• NHS Health Checks.

• Health visiting (from April 2015).

NHS Tower Hamlets CCG

is responsible for commissioning:

Planned hospital care.

Maternity services.

Community services and rehabilitation.

Urgent and emergency care.

Continuing healthcare.

Cancer services.

Fertility services.

Children’s services (except health visiting).

Mental health and learning disabilities services.

Treatment of infectious diseases.

What we commission

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We have a commissioning budget of around £340 million, which is allocated as shown in this chart.

Our spending includes:

£164 million for hospital care, 83 per cent of which is spent at the Royal London Hospital (now part of Barts Health NHS Trust).

£51 million spent on community health services, 92 per cent of which is spent on Tower Hamlets Community Health Services, now provided by Barts Health NHS Trust.

£42 million spent on mental health services provided by East London Foundation Trust.

£8.4 million spent on ambulance services.

£10 million on continuing healthcare.

£30 million on prescribing.

How we spend our budget

Tower Hamlets

Comparative tuberculosis rates

60

50

40

30

20

10

0London England

164

34.6

10

30

42

51

8.4

Hospital CareCommunity ServicesMental HealthPrescribingContinuing HealthcareAmbulance ServicesOther

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The population of Tower Hamlets

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Around 254,000 people live in Tower Hamlets and the population is growing fast.

Our residents are diverse — around 90 different languages are spoken and

the Bangladeshi community make up about a third

of the local population.

People have a lower life expectancy than elsewhere in England

Some of our biggest health challenges include:

• Many people are living with a long term health condition, such as diabetes.

• People who die of cancer tend to be younger than elsewhere in the country.

• A high number of people die younger of heart disease.

• More people suffer a stroke, and survival rates are lower than elsewhere in England.

• Diseases including HIV, Tuberculosis and sexually transmitted infections are amongst the highest rates in the UK.

• There are a larger number of problem drug users compared to London overall.

• There are indications that dementia in the area is significantly under-diagnosed.

Nine percent of babies have a low birth weight

More than half of children

live in poverty

A high number of people use local A&E services when other health services could be used

Our priorities and plans

Each of our plans is clinically led and focused on our vision of high quality services, integrated around patients’ needs, and securing a stable health system.

1. Maternity

Our vision is to commission maternity services that are safe and convenient to use, with friendly staff that inspire confidence in the families using them. We want women to feel more supported during their pregnancy and for services to be more responsive and effectively use patient feedback. People will know what maternity services they should use and the quality of the overall service will be significantly improved.

Case studyAruna has recently arrived in Tower Hamlets from Bangladesh. She speaks very little English and has used a new service in Tower Hamlets called ‘Maternity Mates’, to support her during her pregnancy.

2. Children and young people

Tower Hamlets CCG is committed to improving health outcomes for local children and young people. Patients using services will have a better overall experience and care will be improved. Overall services will be of a higher standard and better quality.

“ I had a great relationship with my Maternity Mate; she helped me so much. I was really comfortable with her and was able to share my questions and concerns. We both get on well, we became friends. She was always there for me.”

Aruna, aged 24{

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3. Integrated care

We will focus on those patients that have multiple conditions and who are the most frail and vulnerable and tailor the care they receive to their needs. We are working with colleagues in social care, community health services, primary care, secondary care and mental health, to provide a more seamless and coordinated approach to providing care. This means better management of complex health conditions, easier access to services and greater continuity of care. Greater partnership working between health and social care will lead to fewer emergency attendances and admissions.

Case studyRichard lives with his partner Nic and is her full time carer. Nic has complex health needs and uses a large range of health and social care services in the borough.

4. Urgent and emergency care

All Tower Hamlets residents with an urgent care need should receive high quality care from the right person, in the right place and at the right time. Local people will be more informed about which services they should use and will use A&E only when necessary. This will shorten A&E waiting times. A clear and simple 24/7 model of care will make sure that patients are seen by the professional best able to meet their needs. This will ensure that A&E and ambulance services are able to concentrate their skills on more serious and life-threatening conditions.

“ The NHS should streamline and integrate different departments. The palaver they go through when different doctors are trying to tell each other about what’s happened to you. The police have liaison officers that help families in a crisis. It would be great if you could have a health liaison officer. They could deal with us, and then deal with all the departments in the NHS.”

Richard, a carer

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5. Long term conditions

We will support and encourage patients to have more control in managing long term conditions, as well as working with our local authority and public health colleagues in ways to stop our children and grandchildren developing these conditions as they grow older. This work will lead to improved health outcomes for people, fewer emergency admissions, better disease control and increased satisfaction with services.

6. Planned care

We want high quality, efficient and integrated planned care services that meet the needs of the local population and represent value for money. We are working with clinicians from primary, community and secondary care to redesign and develop services where we know there is scope for better patient care. Patients will have better experiences as they will be seen in the best setting in the fastest possible time. Care will be localised and integrated and services will represent good value for money.

7. Mental health

Our vision is to commission integrated mental health services that are safe and effective, with friendly staff that inspire confidence in the people and families using them, and which help people to take control of their own lives and recovery. More people with mental health problems will recover and have good physical health and more people will have a positive experience of care and support. Fewer people will suffer avoidable harm and experience stigma and discrimination.

8. Achieving excellence in general practice

We want to ensure that local primary care services are constantly improving and delivering high quality care.Although we do not contract or directly commission GP practices, we do have a duty to focus on development and quality improvement. By working closely with our members, who work in local medicine, we can share information and best practice to encourage improvements across the borough.

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9. Information and technology

IT is a powerful tool. We want to make sure that we use IT in innovative ways to help patients manage their own health, help clinicians provide effective care and to inform analysis and decision making.We recognise the role that technology can play in improving the quality of services for patients. Technology will be key to the success of a number of our projects, it will ensure that we can share information between teams and organisations, that we can help people manage their health and care and it will also enable us to keep information safe and secure.

10. Prescribing

We need to help people get the drugs they need, while ensuring medication is prescribed in the most cost effective way.Medication plays an important role in providing quality healthcare to patients and helping patients manage their care. Prescribing services use clinical expertise together with practical knowledge to ensure the safe supply and appropriate use of medicines by patients. We will work with medical professionals to continually improve the way in which they prescribe medication.

11. Last years of life

Our vision for last years of life is person-centred and takes into account where people are in their lives, irrespective of age or their diagnosis. We want to offer high quality, round-the-clock care which maximises benefits for patients, who will be seen by those most able to meet their needs. Local residents will be more educated and informed about the range of services available to them.

You can read more about all our plans in detail in our prospectus, which can be found online at: www.towerhamletsccg.nhs.uk

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The opinions of patients and the public are vital in helping to develop our priorities and plans for Tower Hamlets; we are committed to putting the voices of local people at the heart of what we do.

There are four main ways in which patients and the public can get involved in the work of NHS Tower Hamlets CCG and influence health and care services in the borough.

1. Provide feedback or make a complaint

Everyone has a right, under the NHS constitution to provide feedback, comments or to make a complaint about health services. The way in which you can do this, depends on the service that you have used.

Feedback for GP services should be given directly to the local surgery, via the practice manager or the receptionist. Feedback for hospital services are managed by the hospital trust, most often via a dedicated complaints team.

You can find out more about how to provide feedback or make a complaint about a health service in Tower Hamlets on our website, see ‘contact us’: www.towerhamletsccg.nhs.uk

Patient and public involvement: Four ways to get involved

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Get involved with the CCG

Provide feedback or make a complaint

Join your local Patient Participation Group (PPG)

Tell Healthwatch about your experiences

Four ways to get

involved

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2. Tell Healthwatch about your experiences

Healthwatch is an independent consumer body which gathers and represents the views of the public who use health and care services. By sharing your experiences and ideas with Healthwatch you can influence the way services are run.

Freephone: 0800 145 5343

Email: info@towerhamletshealthwatch.co.uk

Web: www.healthwatchtowerhamlets.co.uk

3. Get involved with the CCG

NHS Tower Hamlets CCG is committed to involving patients and the public in everything that we do. Some of the ways in which you can get involved and help shape health services in the borough are by:

• Attending public meetings

• Coming to engagement events and providing your feedback

• Telling us your experiences of services via a ‘patient story’

• Becoming a member of a service user group

• Being involved in specific pieces of research, such as surveys and focus groups.

For more information, see our website, email or phone us (details on the back cover).

4. Join your local Patient Participation Group (PPG)

A PPG is a group of patients at a GP practice who are interested in health and who want to get involved with supporting the running of their local practice. Most groups are also attended by members of the practice staff who meet regularly to discuss how to make a positive contribution to the services and facilities offered by the practice.

If you would like to get involved, please ask your GP practice receptionist if your practice has a group. You can also find out more from the National Association for Patient Participation: www.napp.org.uk

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www

Glossary

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Primary carePrimary care is the local health service that you receive from your GP, dentist, pharmacist or optometrist. It also refers to NHS walk-in services and is the most common type of health service that unwell or injured people visit.

Secondary careSecondary (or acute) care is the health service that people generally receive in hospital.

Community careMany types of care are not based in traditional health settings. Community care includes services such as home care, rehabilitation services to help with mobility and independence, treatment for substance use disorders and other types of health and social care services.

Care pathwaysThese are step-by-step processes that help patients with specific conditions or diagnoses to receive the care they need. Pathways help health care professionals to deliver consistently good care and helps patients understand how to access services.

Urgent and emergency careThese are health services for people who need urgent advice or care. Urgent care can take place in A&E for life-threatening situations, although most urgent care can be provided by a GP, pharmacy, or through self-care, using services like NHS Choices or NHS 111 (a free health care advice number available 24 hours a day, 365 days a year).

Planned carePlanned care (or elective care) is the service you receive following a referral from your GP. It is mostly provided in hospital outpatient departments but is also available in the community.

Integrated care

Long term conditionsA long term condition is an illness that cannot be cured but can be managed through medication and/or therapy. Care for long term conditions tends to focus on improving symptoms and supporting people to live a full life.

The National Voices definition of integrated care is described as ‘ person-centred, coordinated care’. For patients, this means:“ My care is planned with people who work together to

understand me and my carer(s), put me in control, co-ordinate and deliver services to achieve my best outcomes.”

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To find out more about us, please contact us using the details below:

Write to NHS Tower Hamlets Clinical Commissioning Group 2nd Floor Alderney Building Mile End Hospital Bancroft Road London E1 4DG

Telephone 020 3688 2500

Email info@towerhamletsccg.nhs.uk

Or, visit our website www.towerhamletsccg.nhs.uk

We would like to hear from you

The NHS belongs to the people It is there to improve our health and wellbeing, supporting us to keep mentally and physically well, to get better when we are ill and, when we cannot fully recover, to stay as well as we can to the end of our lives. It works at the limits of science – bringing the highest levels of human knowledge and skill to save lives and improve health. It touches our lives at times of basic human need, when care and compassion are what matter most. The NHS is founded on a common set of principles and values that bind together the communities and people it serves – patients and public – and the staff who work for it. The NHS Constitution

Design by Sparrow, a social enterprise based at the Bromley by Bow Centre. www.sparrow-studio.com© NHS Tower Hamlets Clinical Commissioning Group 2013