agenda - lpbcc.files.wordpress.com file12.10.2011 · lambeth clinical commissioning collaborative...

Adrian McLachlan, Lambeth Clinical Commissioning Collaborative Board Chair Andrew Eyres, Managing Director

Lambeth Clinical Commissioning Collaborative Board (LCCCB)

All Practice Event

Wednesday 12th October 2011 1.00 – 4.00pm

Planned outcomes of the day

Contribute to the development of clinically led commissioning in Lambeth

Increase awareness of the different clinical and non-clinical roles that contribute to successful clinical led commissioning

Develop ownership of the Strategic Plan and ensure local plans are robust

Share progress to date, good practice and learning

Agenda

1.00pm Welcome and Introductions Adrian McLachlan Chair of the LCCCB

1.10pm Overview Progress in Clinical Commissioning

– Improving Health, Improving Quality

Adrian McLachlan Chair of the LCCCB Andrew Eyres Managing Director, Lambeth, BSU

1.30pm Patient Perspectives – Diabetes

2.10pm Group Work: Delivering our Programmes – followed by coffee break

Andrew Eyres Managing Director, Lambeth, BSU

3.10pm Update on the Future Forum Ash Soni, Clinical Network Lead

3.15pm View from Practice Managers Marie Ah-Moye, Practice Manager, Tulse Hill Practice

Jenny Hoggins, Practice Manager – Stockwell Group Practice

3.30pm Question Time and Next Steps

LCCCB Panel

4.00pm Close

Copies of presentations will be available on the website

Age

nda


All Practice Event

Wednesday 12th October 2011

Group One - Urgent Care

Lambeth continues to have high levels of A&E attendance and local audits reveal that between 40-60% of people attending A&E could have their care provided safely and appropriately in primary and community settings. Please join this group to find out more about Lambeth’s Unscheduled Care Strategy and how we proactively manage high A&E attendance rates across the borough. Lambeth has been working with St Thomas’ to identify the cohorts of patients that frequently re-attend A&E and we would like to discuss the findings with you. This session will be interactive and your feedback is essential in taking our Unscheduled Care Strategy forward.

Gro

up 1

- U

rgen

t Car

e

Unplanned Care Programme The aim of the Unplanned Care Programme to is to design and implement improved unplanned care services across Lambeth that support the shift to improved health outcomes through greater planned and co-ordinated care, and reflected in lower A&E attendances and subsequent emergency admissions, fewer readmissions, enhanced quality of care and the delivery of national standards. The Unplanned Care Programme operates across two main workstreams:

Frail Elderly, (includes admission avoidance and intermediate care)

Urgent Care, (including Urgent Care Centres, Out of Hours and the Single Point of Access / 111 Initiative)

This Group will be looking at Urgent Care. Urgent Care Lambeth continues to have high levels of A&E attendance and local audits reveal that between 40-60% of people attending A&E could have their care provided safely and appropriately in primary and community settings. Please join this group to find out more about Lambeth’s Unscheduled Care Strategy including an update on Front-end A&E at Guy’s and St Thomas’, King’s and St George’s. We will also update you on the Single Point of Access / 111 Project currently underway and welcome your feedback on current plans to support the Unscheduled Care Strategy. We will also be looking at A&E attendance data by borough (Lambeth, Southwark, Lewisham) over the last three years, which highlights some improvements, so it will be interesting to find out what works well. We would also like to share data that highlight’s the high usage of A&E during core hours. This gives us the opportunity to discuss what we might do differently to address this issue. Lambeth has also been working with St Thomas’ to identify the cohorts of patients that frequently re-attend A&E and we would like to discuss the findings with you. This session will be interactive and your feedback is essential in taking our Unscheduled Care Strategy forward. Data Attached

SEL Cluster trend over 3 years – A&E Attendance by Provider

SEL Cluster Bar Chart Comparison over 3 years – A&E Attendance Qtr 1

Lambeth trend over 2 years – A&E Attendance by Provider

A&E Attendance during core hours

Gro

up 1

- U

rgen

t Car

e

0

20

00

40

00

60

00

80

00

10

00

0

12

00

0

14

00

0

Apr. '08

May '08

Jun. '08

Jul. '08

Aug. '08

Sep. '08

Oct. '08

Nov. '08

Dec. '08

Jan. '09

Feb. '09

Mar. '09

Apr. '09

May '09

Jun. '09

Jul. '09

Aug. '09

Sep. '09

Oct. '09

Nov. '09

Dec. '09

Jan. '10

Feb. '10

Mar. '10

Apr. '10

May '10

Jun. '10

Jul. '10

Aug. '10

Sep. '10

Oct. '10

Nov. '10

Dec. '10

Jan. '11

Feb. '11

Mar. '11

Apr. '11

May '11

Jun. '11

Jul. '11

Axis Title

A&

E A

tte

nd

ance

s (N

.B.

Kin

g's

did

no

t su

bm

it t

o S

US

in '0

8/9

, so

me

Gre

en

wic

h d

ata

mis

sin

g in

'09

/10

)

Bex

ley

Bro

mle

y

Gre

enw

ich

Lam

bet

h

Lew

ish

am

Sou

thw

ark

Gro

up 1

- U

rgen

t Car

e

0

50

00

10

00

0

15

00

0

20

00

0

25

00

0

30

00

0

35

00

0

40

00

0

45

00

0

50

00

0

Bex

ley

Bro

mle

y G

reen

wic

h

Lam

bet

h

Lew

ish

am

Sou

thw

ark

A&

E A

tte

nd

ance

s

(N.B

. K

ing'

s d

id n

ot

sub

mit

in 2

00

8/9

)

Ap

r. -

Ju

l. '0

8

Ap

r. -

Ju

l. '0

9

Ap

r. -

Ju

l. '1

0

Ap

r. -

Ju

l. '1

1

0

20

00

40

00

60

00

80

00

10

00

0

12

00

0

14

00

0

Ap

r.

'09

May

'0

9

Jun

. '0

9

Jul.

'09

Au

g.

'09

Se

p.

'09

O

ct.

'09

No

v.

'09

Dec

. '0

9

Jan

. '1

0

Feb

. '1

0 M

ar.

'10

A

pr.

'1

0 M

ay

'10

Ju

n.

'10

Ju

l. '1

0 A

ug.

'1

0

Sep

. '1

0

Oct

. '1

0 N

ov.

'1

0 D

ec.

'10

Ja

n.

'11

Fe

b.

'11

Mar

. '1

1

Ap

r.

'11

May

'1

1

Jun

. '1

1

Jul.

'11

A&

E A

tte

nd

ance

s -

Lam

bet

h

Lam

bet

h

Lin

ear

(Lam

bet

h)

Gro

up 1

- U

rgen

t Car

e

Provider

GP Core

Hours

(8.00am -

6.30pm)

GP Out of

Hours

(6.30pm -

8.00am)

GUY'S AND ST THOMAS' NHS FOUNDATION TRUST 64% 36%

KING'S COLLEGE HOSPITAL NHS FOUNDATION TRUST 61% 39%

ST GEORGE'S HEALTHCARE NHS TRUST 60% 40%

Total 62% 38%

0%

10%

20%

30%

40%

50%

60%

70%

GUY'S AND ST THOMAS' NHS FOUNDATION TRUST

KING'S COLLEGE HOSPITAL NHS FOUNDATION TRUST

ST GEORGE'S HEALTHCARE NHS TRUST

%

AE Providers

Percentage busy times in Lambeth AE Providers

GP Core Hours (8.00am - 6.30pm)

GP Out of Hours (6.30pm - 8.00am)

Gro

up 1

- U

rgen

t Car

e


All Practice Event


Group Two – Hypertension/

Cardiovascular Risks

Although good progress has been made, reducing premature mortality and health inequalities from cardiovascular disease remains an important priority for Lambeth. The purpose of this workshop is to review how best to reduce this excess premature mortality from cardiovascular disease by a focus on primary and secondary prevention.

Gro

up 2

- H

yper

tens

ion/

Car

diov

ascu

lar

Ris

ks

Briefing for delegates: All Practice Event 12th Oct 2011: Cardiovascular risks - Hypertension and cholesterol in Lambeth

16

Risk factors

Source: The World Health Report 2002

23

Met/unmet need

Hypertension and cholesterol (as well as smoking) are important reversible risk factors for cardiovascular disease.

Although there has been a decline in cardiovascular disease mortality in the last 10-15 years it remains an important problem with a relatively higher burden in Lambeth.

Gro

up 2

- H

yper

tens

ion/

Car

diov

ascu

lar

Ris

ks


3

Hypertension

4

Hypertension – GP diagnosed

NHS LAMBETH VS NHS ENGLAND - CLINICAL QUALITY

2009-10 QOF results published by the NHS Information Centre using QMAS data from General Practices

No. IndicatorLambeth PCT

Value 2009-10Bottom 10% Bottom 25% Top 50% Top 25% Top 10% SOURCE

Lambeth PCT

2008-09

Lambeth PCT

2007-08

1CHD6: % Patients with CHD in whom last BP reading

(measured in previous 15 months) is 150/90 or less88.3 88.3% 89.0% 89.7% 90.4% 91.0% NHS Information Centre 87.5 88.3

5

STROKE6: % patients with a history of TIA or stroke

in whom last BP (measured in last 15 months) is

150/90 or less

86.3 86.3% 87.2% 88.1% 88.8% 89.5% NHS Information Centre 85.5 86.4

7BP5: % patients with hypertension in whom last BP is

150/90 or less76.5 76.5% 77.7% 78.7% 79.7% 80.6% NHS Information Centre 75.2 75.0

11DM12: % Patients with DM in whom last BP reading is

145/85 or less78.1 78.5% 79.7% 80.7% 81.6% 82.8% NHS Information Centre 77.8 64.2

17

CKD3: & of patients on CKD register in whom the last

BP reading measured in previous 15 months is

140/85 or less



Value 2009-10Register size

Number

controlled

Number not

controlled

(incl

exceptions)

% not

controlled

% controlled

incl

exceptions

SOURCELambeth PCT

2008-09

Lambeth PCT

2007-08


(measured in previous 15 months) is 150/90 or less88.3 5138 4403 735 14.3% 85.7% NHS Information Centre 87.5 88.3

5



150/90 or less

86.3 3113 2556 557 17.9% 82.1% NHS Information Centre 85.5 86.4


150/90 or less76.5 32730 23908 8822 27.0% 73.0% NHS Information Centre 75.2 75.0


145/85 or less78.1 12474 9111 3363 27.0% 73.0% NHS Information Centre 77.8 64.2

17



140/85 or less

74.9 5595 3810 1785 31.9% 68.1% NHS Information Centre 71.0 73.9

Hypertension prevalence is increasing gradually nationally and locally. It is estimated that about 1 in 4 people are hypertensive but only about 9% are detected. Q: How do we improve early detection?

Of those people detected and treated for raised blood pressure the majority are controlled within QOF thresholds but a significant number remain poorly controlled compared to other areas – including those with other LTCs Q: How do we improve the control of those already detected (both in terms of primary and secondary prevention)?


5

Hypertension – GP variation

NHS LAMBETH GENERAL PRACTICES VARIATION - CLINICAL QUALITY

2009-10 QOF results published by the NHS Information Centre (QMAS) for Lambeth General Practices


Value 2009-10

Lambeth GP

Lowest ValueBottom 10% Bottom 25% Top 50% Top 25% Top 10%

Lambeth GP

Best Value


(measured in previous 15 months) is 150/90 or less88.3 73.3% 88.3% 89.0% 89.7% 90.4% 91.0% 100.0%

5



150/90 or less

86.3 66.8% 86.3% 87.2% 88.1% 88.8% 89.5% 100.0%


150/90 or less76.5 66.8% 76.5% 77.7% 78.7% 79.7% 80.6% 90.7%


145/85 or less78.1 66.7% 78.5% 79.7% 80.7% 81.6% 82.8% 91.9%

17



140/85 or less

74.9 53.3% 72.0% 72.8% 73.9% 75.3% 76.4% 91.8%

England PCTs' performance

10

Cholesterol

Secondary prevention

NHS LAMBETH VS NHS ENGLAND - CLINICAL QUALITY

2009-10 QOF results published by the NHS Information Centre using QMAS data from General Practices


Value 2009-10Top 10% Top 25% Top 50% Bottom 25% Bottom 10% SOURCE

Lambeth PCT

2008-09

Lambeth PCT

2007-08

2

CHD8: % Patients with CHD whose last measured

total cholesterol (measured in previous 15 months) is

5mmol/l or less.


6STROKE8: % patients with TIA or stroke whose last

measured total cholesterol is 5 or less74.3 79.6% 78.6% 77.3% 75.6% 74.2% NHS Information Centre 73.0 73.8

12

DM17: % Patients with DM whose last measured total

cholesterol (measured in previous 15 months) is

5mmol/l or less.


Total

Cholesterol

Grand

Totalmmol/l Yes No

</=2 17 7 24

2.1- 2.5 133 20 153

2.6.- 3.0 640 87 727

3.1 - 3.5 1437 229 1666

3.6 - 4.0 1834 486 2320

4.1 - 4.5 1690 743 2433

4.5 - 5.0 1241 704 1945

5.1 - 5.5 697 418 1115

5.6 - 6.0 452 239 691

6.1 - 6.5 308 127 435

6.6 - 7.0 176 63 239

>7 187 56 243

Total 8812 3179 11991

Prescribed Statin

1. A number of people don’t appear to have a

cholesterol level measured

2. A significant number of people are prescribed

a statin but remain poorly controlled.

3. A number of people who are uncontrolled are

not prescribed a statin

Source: Lambeth DataNet 2011

There is wide variation between practices within Lambeth in the control of people with raised blood pressure – some of this is likely to both avoidable and unjustifiable. Q: How do we reduce intra-practice variation in control of blood pressure?

Gro

up 2

- H

yper

tens

ion/

Car

diov

ascu

lar

Ris

ks


8

CVD risk factors

Teenagers

/Adolescent

Young school agePre-schoolPre-natal

Older people (65+)Adults (18-65)CYP (0-18)Population

Group

Wider

determinants

Primary

prevention

Secondary

prevention

End of Life

Population strategies to reduce CVD risk

Early detection, effective diagnosis

& management including lifestyle

advice to reduce CVD risk

Effective management in

people with LTCs (secondary

prevention of CVD risk)

Of those people with LTCs (CHD, Diabetes and Stroke/TIA) and a measure of cholesterol in past 15 months one in four are not controlled (QOF threshold value). Data from Lambeth DataNet suggests that poor control of risk factors tends to cluster (i.e. poor control of one CVD risk factor is also associated with poor control of other risk factors). Q: How do systematise the control of all avoidable CVD risk factors into a coherent approach in Lambeth?

The current Strategic Plan (SP) target focuses on control of blood pressure in people with CHD only (735 patients with uncontrolled blood pressure – QOF threshold - in a register size of 5138). Q: What should be the focus for Lambeth in terms of setting a target for prevention of CVD? How should this be performance managed?


All Practice Event


Group Three – Staying Healthy

The greatest contributors to premature morality in Lambeth are vascular disease and cancer which can be prevented by addressing some common risk factors (tobacco & alcohol use, inactivity and poor diet). Discussion will be focused around smoking, alcohol and current programmes.

G

roup

3 -

Sta

ying

Hea

lthy

NHS Lambeth Staying Healthy Programme

Although life expectancy continues to improve for both males and females in Lambeth, it is still lower than the England average. The greatest contributors to premature morality in Lambeth are vascular disease and cancer which can be prevented by addressing some common risk factors (tobacco & alcohol use, inactivity and poor diet). Up to 80% of heart disease, stroke, and type 2 diabetes and over a third of cancers could be prevented by eliminating shared risk factors, mainly tobacco use, unhealthy diet, physical inactivity and the harmful use of alcohol. The Staying Healthy Programme seeks to improve health outcomes and reduce health inequalities through the commissioning of systematic health promotion and prevention services. The Programme covers the following areas: Smoking Cessation and Tobacco Control, NHS Health Checks (Vascular Checks), Adult Obesity and Physical Activity, Alcohol Prevention, Mental Wellbeing, Lambeth Early Intervention and Prevention Service and Sexual Health, and Infection Prevention.

Tobacco Control: Smoking is one of the largest causes of preventable premature death. The prevalence of smoking in Lambeth is estimated as 25.2% compared to the national average of 22.2%. Between 2007 and 2009 there were an estimated 272 smoking attributable deaths compared to the England average of approximately 216 deaths.. Smoking cessation as part of wider tobacco control measures is one of NHS Lambeth’s priorities and local targets have been set in addition to the Department of Health performance targets. In 2010/11 the PCT achieved 2482 4 week quitters which exceeded the DH target of 1908 but fell short of the PCT target of 2482. This year emphasis is being made to increase the quality of the service as well as more timely submission of stop smoking data. The DH 4 week quitter target is 1935 whilst the NHS Lambeth target is 2532. NHS Health Checks: The NHS Health Check is a national programme to assess people aged 40 -74 every five years for their risk of developing heart disease, stroke, diabetes and kidney disease within the next 10 years. Patients without CVD are offered lifestyle advice and support to help prevent them from developing it. Those patients identified with a CVD related condition are placed on the appropriate disease register for management of their condition. The service is delivered by GP practices and there is an outreach service provided by GSTT community services. In 2010/2011 4,810 people (17% of the eligible population) were offered a health check. The target for 2011/2012 is for at least 20% of the eligible population to be offered the check. The focus of the work this year has been to improve reporting mechanisms and to increase practice uptake. Referrals to appropriate support through a single referral system (Lambeth Early Intervention and Prevention Service) are being promoted. . Lambeth Early Intervention and Prevention Service (LEIPS): Implementation of the new LEIP service began in July 2011. The LEIPS is an integrated health

Gro

up 3

- S

tayi

ng H

ealth

y

improvement service offering support for clients around diet, exercise, smoking cessation, alcohol, in addition to the services provided by Health Trainers. Referral to this service is through a single referral system. The service will be engaging with practices to raise awareness of the services being offered. Childhood Obesity: Addressing childhood obesity is a priority for Lambeth. Results of the National Child Measurement Programme (NCMP) 2009/10 show

that nearly 14% of young children (5‐6 years) in Lambeth schools are obese; this

is higher than the national and London average. Amongst children aged 10‐11, 1

in 4 of all Lambeth school children are obese which is substantially higher than seen nationally. The PCT aims to reduce childhood obesity prevalence from a baseline of 25.1% to 23.2% by 2015 as measured by the NCMP (year 6). Prioritised evidence based interventions are being commissioned to help tackle the issue and form part of the Lambeth multi-agency healthy Weight care pathway for children (0 – 11years). Interventions include promoting breastfeeding through the accreditation of all children centres as UNICEF Baby Friendly, Level; Level 1 healthy weight training for health and non-health practitioners; healthy weight promoting schools and the commissioning of Levels 2 and 3 children’s weight management services. Level 1 training is currently being offered to all those working with children and families. The Level 3 service will start at the end of October, whilst the Level 2 service will commence in January 2012. Information will be provided to practices once the services are up and running. Alcohol: Alcohol misuse is a risk to health locally with about 20% of the adult population estimated to be binge drinkers, similar to the national average but higher than London (14.3%). Higher risk drinkers make up 5.9% (13,358 people) locally and London has a slightly lower estimate at 5%. Increasing risk drinkers comprise 17% (38,064 people), less than London (18.8%). Those at lower risk/abstinent make up the remaining 77.1%. Admissions to hospital for alcohol related conditions have declined in the last two years to 1470.3 per 100,000 admissions in 2008/9, slightly less than London and England, prior to that Lambeth had a high and increasing rate. The mortality rate related to alcohol in Lambeth (33.6 per 100,000) remains higher than that in London (23.2) and England (25.7) in 2007/8, but has declined slightly over recent years. A range of services are being offered across different agencies in Lambeth. In the health service, 85% of General Practices are delivering screening and brief interventions (SBI), with SBI’s also part of the NHS Health checks. Specialist services have been remodelled to improve access and capacity for primary care to a specialist team of drug and alcohol workers. An alcohol specialist nurse is also in post in the acute trust (GSTT); and the Homeless Team (Three Boroughs) works with particularly vulnerable people.

Questions Alcohol

How best to support practices so that screening and brief interventions are done to a high standard to maximise effectiveness?

What specialist service support in the community do you require to improve alcohol care?

Smoking

What is needed to improve success rates and timely submission of stop smoking data?

LEIPS

What are Practices experiences so far of the Lambeth Early Intervention and Prevention Service?

Childhood Obesity

What are the ways in which practices can best be engaged to support the Lambeth Children’s Healthy Weight Care Pathway and to provide referrals to the appropriate services?

Gro

up 3

- S

tayi

ng H

ealth

y


All Practice Event


Group Four – Reducing Variation

Lambeth has started to successfully reduce variation in GP referrals and other outpatient attendances. This workshop will engage participants in identifying what has worked well, what could be done to support further improvement and what are the potential barriers enablers such as to checklist and choose and book utilisation.

Gro

up 4

- R

educ

ing

Var

iatio

n

Reducing Variation in GP referrals

National research indicates that referral rates to a particular specialty within a single area vary by as much as 10-fold between GPs (Creed et al 1990; Ashworth et al 2002). There is strong evidence that a wide variety of factors account for this variation, clinical and non-clinical (Foot et al 2010). The available research suggests that not all referrals are necessary in clinical terms and a substantial proportion of activity is discretionary and avoidable. Local specialty specific audit work indicates an 8 fold variation in GP referral rates (unstandardised).

There are also patients who need a referral but fail to receive one. For example, lack of or late referral is thought to be a key driver of poor survival rates for cancer (Department of Health 2011b).

Over the last few months, there has been significant work to support practices in reducing local variation and as such we have been road-testing a programme of visits and an information pack. Priority actions and good practice identified from these visits will be shared following the first round and review meetings will take place in early 2012. Early indicators are that this combined effort has started to have an impact. For 2011/12 we have a target saving of £1.2m relating to GP referrals (informed by benchmarks), or £510k by August. As at August £410k (80%) of this saving had been achieved. Well done to all who have contributed to this achievement! Of course, not all outpatient activity is initiated by GPs. First outpatient attendances are also initiated by General Dental Practitioners, Consultants, A&E and for a limited number specialties there are self referrals/walk-ins. There are similar efforts to reduce variation from these sources. In particular, activity levels for consultant-to-consultant referrals and follow-ups have been capped at local Trusts and payment will not be made over these agreed activity levels. Policies regarding appropriateness of consultant-to-consultant referrals are also being reviewed. Attached some benchmarked information on outpatient activity levels.

Gro

up 4

- R

educ

ing

Var

iatio

n

Group work In the group work we’d like to capture participants’ input in to: What are the savings on GP referrals to date attributable to? What has made the biggest difference? How could we have more impact? Pre-referral checklists to support referrers in making decisions to refer are available in Lambeth. Are you aware of the checklists? How could we increase utilisation? Nationally choose and book, including use of the advice and guidance function, has been successfully used to reduce variation in referrals. What are the local barriers to rolling this out for Lambeth? What value could engaging patients more in this work add? How should we do it to best effect?

Firs

t

Spec

Lam

bet

h P

CT

Lon

do

n S

HA

% v

aria

nce

Car

dio

logy

6.5

13.7

7.13

5

Clin

ical

Hae

mat

olo

gy2.

42.

2-0

.224

Der

mat

olo

gy14

.113

.9-0

.341

Dia

bet

ic M

edic

ine

3.3

3-0

.333

End

ocr

ino

logy

21.

9-0

.12

ENT

9.5

13.8

4.20

5

Gas

tro

ente

rolo

gy5.

36.

30.

947

Gen

eral

Su

rger

y5.

711

.25.

443

Ger

iatr

ic M

edic

ine

21.

7-0

.32

Gyn

aeco

logy

16.5

16.6

-0.0

65

Hep

ato

logy

0.8

0.5

-0.3

08

Neu

rolo

gy3.

95.

51.

561

Op

hth

alm

olo

gy18

.617

.9-0

.886

Pae

dia

tric

Clin

ical

Hae

mat

olo

gy2.

10.

3-1

.821

Pai

n M

anag

emen

t0.

71.

70.

993

Reh

eum

ato

logy

4.6

5.6

0.95

4

Res

pir

ato

ry M

edic

ine

2.5

3.3

0.77

5

T&O

1118

6.89

Uro

logy

7.1

80.

829

Foll

ow

-Up

Spec

Lam

bet

h P

CT

Lon

do

n S

HA

% v

aria

nce

Car

dio

logy

1.8

1.3

-0.5

18

Clin

ical

Hae

mat

olo

gy4.

67.

52.

854

Der

mat

olo

gy2.

26.

34.

078

Dia

bet

ic M

edic

ine

0

End

ocr

ino

logy

0

ENT

1.3

1.3

-0.0

13

Gas

tro

ente

rolo

gy1.

92.

00.

081

Gen

eral

Su

rger

y1.

61.

6-0

.016

Ger

iatr

ic M

edic

ine

0

Gyn

aeco

logy

1.0

1.2

0.19

Hep

ato

logy

0

No

te

The

follo

win

g sp

ecia

litie

s h

ave

bee

n e

xclu

ded

fro

m t

he

rep

ort

as d

ata

in N

HS

com

par

ato

rs is

inco

mp

lete

Dia

bet

ic M

edic

ine

End

ocr

ino

logy

Ger

iatr

ic M

edic

ine

Hep

ato

logy

Pae

dia

tric

Clin

ical

Hae

mat

olo

gy

Pai

n M

anag

emen

t0 2 4 6 8 10

12

14

16

18

20

Cardiology

Clinical Haematology

Dermatology

Diabetic Medicine

Endocrinology

ENT

Gastroenterology

General Surgery

Geriatric Medicine

Gynaecology

Hepatology

Neurology

Ophthalmology

Paediatric Clinical …

Pain Management

Reheumatology

Respiratory Medicine

T&O

Urology

Rates Per 1000

Spe

cial

ity

10/1

1 G

P N

ew

Ra

tes

Per

10

00 f

or

Lam

bet

h A

gain

st L

on

do

n P

osi

tio

n

Lam

bet

h P

CT

Lon

do

n S

HA

0

5

10

15

20

25

30

35

40

Cardiology


Dermatology

Diabetic Medicine

Endocrinology

ENT

Gastroenterology

General Surgery

Geriatric Medicine

Gynaecology

Hepatology

Neurology

Ophthalmology


Pain Management

Reheumatology


T&O

Urology

Attendance Ratio

Spec

ialit

y

10/

11 O

utp

atie

nt

Follo

w-u

p T

o F

irst

Att

en

dan

ce R

ati

o

Lam

bet

h P

CT

Lon

do

n S

HA

Gro

up 4

- C

hart

s

Var

ian

ce a

nal

ysis

fo

r Fi

rst

atte

nd

ance

s in

lam

be

th f

or

Top

sp

eci

alit

ies

Sum

mar

y:

• Fo

r Fi

rst

atte

nd

ance

s, o

vera

ll co

st h

as g

on

e u

p b

y 4

77

k b

ut

acti

vity

has

red

uce

d

• A

ctiv

ity

and

co

st h

as r

edu

ced

fo

r: (

Der

mat

olo

gy, E

NT,

Gyn

ae, N

euro

logy

an

d T

&O

)

• Th

ere

is a

dec

reas

e in

co

st b

ut

an in

crea

se in

act

ivit

y in

: (G

eria

tric

Med

an

d P

ain

Mn

gt)

• Th

ere

is a

n in

crea

se in

co

st b

ut

a d

ecre

ase

in a

ctiv

ity

in: (

Clin

ical

Hae

mat

olo

gy, G

astr

o a

nd

Gen

eral

)

* In

tro

du

ctio

n o

f G

PSI

in S

E lo

calit

y an

d b

oro

ugh

wid

e G

P e

du

cati

on

pro

gram

me

has

red

uce

d d

erm

ato

logy

ref

erra

ls.

* T&

O a

ctiv

ity

and

co

st h

ave

red

uce

d d

ue

to M

CA

TTs,

ho

wev

er t

he

09

/10

dat

a in

clu

des

so

me

ph

ysio

ther

apy

act

ivit

y fo

r K

CH

wh

ich

is n

ot

incl

ud

ed in

th

e 1

0/1

1 a

ctiv

ity.

Th

eref

ore

th

e re

du

ctio

n in

act

ivit

y 3

00

att

end

s lo

wer

th

an r

epo

rted

.

* O

pth

alm

olo

gy r

efer

rals

hav

e si

gnif

ican

tly

incr

ease

d.

• A

ctiv

ity

and

co

st h

ave

incr

ease

d f

or:

(C

ard

io, D

iab

Med

, En

do

crin

olo

gy, H

epat

olo

gy, O

ph

thal

mo

logy

,

Pae

dia

tric

Clin

ical

Hae

mat

olo

gy, R

esp

irat

ory

Med

icin

e, R

heu

mat

olo

gy a

nd

Uro

logy

)

-5000

-4000

-3000

-2000

-1000

0

1000

2000

3000

Cardiology


Dermatology

Diabetic Medicine

Endocrinology

Ent

Gastroenterology

General Surgery

Geriatric Medicine

Gynaecology

Hepatology

Neurology

Ophthalmology

Paediatric Clinical Haematology

Pain Management


Rheumatology

Trauma & Orthopaedics

Urology

Ou

tpa

tie

nt A

cti

vit

y, f

irs

t a

tte

nd

an

ce

, va

ria

nc

e 0

9/1

0 t

o 1

0/1

1

-800000

-600000

-400000

-200000

0

200000

400000

600000

Cardiology


Dermatology

Diabetic Medicine

Endocrinology

Ent

Gastroenterology

General Surgery

Geriatric Medicine

Gynaecology

Hepatology

Neurology

Ophthalmology


Pain Management


Rheumatology


Urology

Ou

tpati

en

t C

ost,

fir

st

att

en

dan

ce, vari

an

ce 0

9/1

0 -

10/1

1

Gro

up 4

- C

hart

s

Var

ian

ce a

nal

ysis

fo

r fo

llow

up

att

en

dan

ces

in la

mb

eth

fo

r To

p s

pec

ialit

ies

Sum

mar

y:

• Fo

r fo

llow

up

att

end

ance

s, o

vera

ll re

du

ctio

n in

Act

ivit

y an

d C

ost

fo

r A

ll La

mb

eth

To

p S

pec

ialt

ies

• ac

tivi

ty a

nd

co

st h

as r

edu

ced

fo

r: (

ENT,

Gas

tro

, Ger

iatr

ic m

edec

ine

and

Gyn

ae)

• th

ere

is a

dec

reas

e in

co

st b

ut

an in

crea

se in

act

ivit

y in

: (D

erm

ato

logy

, Hep

ato

logy

an

d U

rolo

gy)

• th

ere

is a

n in

crea

se in

co

st b

ut

a d

ecre

ase

in a

ctiv

ity

in: (

Pai

n M

ngt

an

d R

esp

irat

ory

Med

)

* T&

O a

ctiv

ity

follo

w u

p a

ctiv

ity

and

co

st h

ave

red

uce

d d

ue

to M

CA

TTs,

ho

we

ver

the

09

/10

dat

a in

clu

des

so

me

ph

ysio

ther

apy

ac

tivi

ty f

or

KC

H w

hic

h is

no

t in

clu

ded

in t

he

10

/11

act

ivit

y. T

her

efo

re t

he

red

uct

ion

in a

ctiv

ity

900

att

end

s lo

we

r th

an r

epo

rted

.

• ac

tivi

ty a

nd

co

st a

nd

incr

ease

d f

or:

(C

ard

io, C

linic

al H

aem

ato

logy

, Gen

eral

Su

rger

y, N

euro

logy

, Op

hth

alm

olo

gy,

Pae

dia

tric

Clin

ical

Hae

mat

olo

gy, R

heu

mat

olo

gy a

nd

T&

O )

-12

,00

0

-10

,00

0

-8,0

00

-6,0

00

-4,0

00

-2,0

00

0

2,0

00

Cardiology


Dermatology

Diabetic Medicine

Endocrinology

Ent

Gastroenterology

General Surgery

Geriatric Medicine

Gynaecology

Hepatology

Neurology

Ophthalmology


Pain Management


Rheumatology


Urology

Ou

tpati

en

t A

cti

vit

y,

follo

w u

p a

tten

dan

ce, vari

an

ce 0

9/1

0 t

o 1

0/1

1

-£1

,00

0,0

00

-£8

00

,00

0

-£6

00

,00

0

-£4

00

,00

0

-£2

00

,00

0

£0

£2

00

,00

0

£4

00

,00

0

Cardiology


Dermatology

Diabetic Medicine

Endocrinology

Ent

Gastroenterology

General Surgery

Geriatric Medicine

Gynaecology

Hepatology

Neurology

Ophthalmology


Pain Management


Rheumatology


Urology

Ou

tpati

en

t C

ost,

fo

llo

w u

p a

tten

dan

ce,

vari

an

ce 0

9/1

0 -

10/1

1


All Practice Event


Group Five – Long Term Conditions

Life expectancy in Lambeth has continued to improve over the last ten years, with mortality rate continually reducing across all causes. However, the gap in life expectancy and largest cause of death in Lambeth continue to be attributable to circulatory diseases, respiratory diseases, digestive diseases and cancer. This workshop will engage participants in identifying what areas of Long Term Conditions should future redesign work focus on, both in terms of stage of pathway and disease progression as well as specific conditions.

Gro

up 5

- L

ong

Ter

m C

ondi

tions

Long Term Conditions Life expectancy in Lambeth has continued to improve over the last ten years, with mortality rate continually reducing across all causes. However, the gap in life expectancy and largest cause of death in Lambeth continue to be attributable to circulatory diseases, respiratory diseases, digestive diseases and cancer. Lambeth has focused on Long Term Conditions as part of it’s core priorities for a number of years, specifically:

Cardiovascular disease (including coronary heart disease, stroke and hypertension)

Diabetes

COPD

Renal disease

Sickle cell anemia

Lambeth has delivered significant progress in terms of development of community heart

failure, respiratory and diabetes services. Collaboration of key stakeholders including

Acute and Primary Care Clinicians has lead to robust redesign of new care pathways

that will deliver a reduction in emergency admissions.

However, on a day to day basis there is still work to be done to help people bring blood

pressure, cholesterol and HbA1C under control, in the face of increasing prevalence of

these key risk factors.

Lambeth’s recent JSNA report highlighted the need to review emphasis and intervention in our provision of services for people with, or at risk of developing long term conditions. This workshop will engage participants in identifying what areas of Long Term Conditions should future redesign work focus on, both in terms of stage of pathway and disease progression as well as specific conditions.

Gro

up 5

- L

ong

Ter

m C

ondi

tions

Group work In the group work we’d like to capture participants’ input in to: High numbers of emergency attendances and admissions are people with one or more

long term condition. Focus to date has been on higher risk patients, should we continue

the focus on the high risk group, or should we revisit programmes of early care pathway

intervention?

What would have the biggest effect that we are not currently doing?

Based on your experience of your patient population what care pathways are not working as well as they could? What would it take to make these pathways good? What value could engaging patients more in this work add? How should we do it to best effect? How do the existing programmes, e.g. DMI, Virtual Hospital, Integrated Care Pilot, PHMCC etc. add value to this work. What can we do to ensure practices get the most out of these programmes?

Firs

t

Spec

Lam

bet

h P

CT

Lon

do

n S

HA

% v

aria

nce

Car

dio

logy

6.5

13.7

7.13

5

Clin

ical

Hae

mat

olo

gy2.

42.

2-0

.224

Der

mat

olo

gy14

.113

.9-0

.341

Dia

bet

ic M

edic

ine

3.3

3-0

.333

End

ocr

ino

logy

21.

9-0

.12

ENT

9.5

13.8

4.20

5

Gas

tro

ente

rolo

gy5.

36.

30.

947

Gen

eral

Su

rger

y5.

711

.25.

443

Ger

iatr

ic M

edic

ine

21.

7-0

.32

Gyn

aeco

logy

16.5

16.6

-0.0

65

Hep

ato

logy

0.8

0.5

-0.3

08

Neu

rolo

gy3.

95.

51.

561

Op

hth

alm

olo

gy18

.617

.9-0

.886

Pae

dia

tric

Clin

ical

Hae

mat

olo

gy2.

10.

3-1

.821

Pai

n M

anag

emen

t0.

71.

70.

993

Reh

eum

ato

logy

4.6

5.6

0.95

4

Res

pir

ato

ry M

edic

ine

2.5

3.3

0.77

5

T&O

1118

6.89

Uro

logy

7.1

80.

829

Foll

ow

-Up

Spec

Lam

bet

h P

CT

Lon

do

n S

HA

% v

aria

nce

Car

dio

logy

1.8

1.3

-0.5

18

Clin

ical

Hae

mat

olo

gy4.

67.

52.

854

Der

mat

olo

gy2.

26.

34.

078

Dia

bet

ic M

edic

ine

0

End

ocr

ino

logy

0

ENT

1.3

1.3

-0.0

13

Gas

tro

ente

rolo

gy1.

92.

00.

081

Gen

eral

Su

rger

y1.

61.

6-0

.016

Ger

iatr

ic M

edic

ine

0

Gyn

aeco

logy

1.0

1.2

0.19

Hep

ato

logy

0

No

te

The

follo

win

g sp

ecia

litie

s h

ave

bee

n e

xclu

ded

fro

m t

he

rep

ort

as d

ata

in N

HS

com

par

ato

rs is

inco

mp

lete

Dia

bet

ic M

edic

ine

End

ocr

ino

logy

Ger

iatr

ic M

edic

ine

Hep

ato

logy

Pae

dia

tric

Clin

ical

Hae

mat

olo

gy

Pai

n M

anag

emen

t0 2 4 6 8 10

12

14

16

18

20

Cardiology


Dermatology

Diabetic Medicine

Endocrinology

ENT

Gastroenterology

General Surgery

Geriatric Medicine

Gynaecology

Hepatology

Neurology

Ophthalmology


Pain Management

Reheumatology


T&O

Urology

Rates Per 1000

Spe

cial

ity

10/1

1 G

P N

ew

Ra

tes

Per

10

00 f

or

Lam

bet

h A

gain

st L

on

do

n P

osi

tio

n

Lam

bet

h P

CT

Lon

do

n S

HA

0

5

10

15

20

25

30

35

40

Cardiology


Dermatology

Diabetic Medicine

Endocrinology

ENT

Gastroenterology

General Surgery

Geriatric Medicine

Gynaecology

Hepatology

Neurology

Ophthalmology


Pain Management

Reheumatology


T&O

Urology

Attendance Ratio

Spec

ialit

y

10/

11 O

utp

atie

nt

Follo

w-u

p T

o F

irst

Att

en

dan

ce R

ati

o

Lam

bet

h P

CT

Lon

do

n S

HA

Gro

up 5

- C

hart

s

Var

ian

ce a

nal

ysis

fo

r Fi

rst

atte

nd

ance

s in

lam

be

th f

or

Top

sp

eci

alit

ies

Sum

mar

y:

• Fo

r Fi

rst

atte

nd

ance

s, o

vera

ll co

st h

as g

on

e u

p b

y 4

77

k b

ut

acti

vity

has

red

uce

d

• A

ctiv

ity

and

co

st h

as r

edu

ced

fo

r: (

Der

mat

olo

gy, E

NT,

Gyn

ae, N

euro

logy

an

d T

&O

)

• Th

ere

is a

dec

reas

e in

co

st b

ut

an in

crea

se in

act

ivit

y in

: (G

eria

tric

Med

an

d P

ain

Mn

gt)

• Th

ere

is a

n in

crea

se in

co

st b

ut

a d

ecre

ase

in a

ctiv

ity

in: (

Clin

ical

Hae

mat

olo

gy, G

astr

o a

nd

Gen

eral

)

* In

tro

du

ctio

n o

f G

PSI

in S

E lo

calit

y an

d b

oro

ugh

wid

e G

P e

du

cati

on

pro

gram

me

has

red

uce

d d

erm

ato

logy

ref

erra

ls.

* T&

O a

ctiv

ity

and

co

st h

ave

red

uce

d d

ue

to M

CA

TTs,

ho

wev

er t

he

09

/10

dat

a in

clu

des

so

me

ph

ysio

ther

apy

act

ivit

y fo

r K

CH

wh

ich

is n

ot

incl

ud

ed in

th

e 1

0/1

1 a

ctiv

ity.

Th

eref

ore

th

e re

du

ctio

n in

act

ivit

y 3

00

att

end

s lo

wer

th

an r

epo

rted

.

* O

pth

alm

olo

gy r

efer

rals

hav

e si

gnif

ican

tly

incr

ease

d.

• A

ctiv

ity

and

co

st h

ave

incr

ease

d f

or:

(C

ard

io, D

iab

Med

, En

do

crin

olo

gy, H

epat

olo

gy, O

ph

thal

mo

logy

,

Pae

dia

tric

Clin

ical

Hae

mat

olo

gy, R

esp

irat

ory

Med

icin

e, R

heu

mat

olo

gy a

nd

Uro

logy

)

-5000

-4000

-3000

-2000

-1000

0

1000

2000

3000

Cardiology


Dermatology

Diabetic Medicine

Endocrinology

Ent

Gastroenterology

General Surgery

Geriatric Medicine

Gynaecology

Hepatology

Neurology

Ophthalmology


Pain Management


Rheumatology


Urology

Ou

tpa

tie

nt A

cti

vit

y, f

irs

t a

tte

nd

an

ce

, va

ria

nc

e 0

9/1

0 t

o 1

0/1

1

-800000

-600000

-400000

-200000

0

200000

400000

600000

Cardiology


Dermatology

Diabetic Medicine

Endocrinology

Ent

Gastroenterology

General Surgery

Geriatric Medicine

Gynaecology

Hepatology

Neurology

Ophthalmology


Pain Management


Rheumatology


Urology

Ou

tpati

en

t C

ost,

fir

st

att

en

dan

ce, vari

an

ce 0

9/1

0 -

10/1

1 G

roup

5 -

Cha

rts

Var

ian

ce a

nal

ysis

fo

r fo

llow

up

att

en

dan

ces

in la

mb

eth

fo

r To

p s

pec

ialit

ies

Sum

mar

y:

• Fo

r fo

llow

up

att

end

ance

s, o

vera

ll re

du

ctio

n in

Act

ivit

y an

d C

ost

fo

r A

ll La

mb

eth

To

p S

pec

ialt

ies

• ac

tivi

ty a

nd

co

st h

as r

edu

ced

fo

r: (

ENT,

Gas

tro

, Ger

iatr

ic m

edec

ine

and

Gyn

ae)

• th

ere

is a

dec

reas

e in

co

st b

ut

an in

crea

se in

act

ivit

y in

: (D

erm

ato

logy

, Hep

ato

logy

an

d U

rolo

gy)

• th

ere

is a

n in

crea

se in

co

st b

ut

a d

ecre

ase

in a

ctiv

ity

in: (

Pai

n M

ngt

an

d R

esp

irat

ory

Med

)

* T&

O a

ctiv

ity

follo

w u

p a

ctiv

ity

and

co

st h

ave

red

uce

d d

ue

to M

CA

TTs,

ho

we

ver

the

09

/10

dat

a in

clu

des

so

me

ph

ysio

ther

apy

ac

tivi

ty f

or

KC

H w

hic

h is

no

t in

clu

ded

in t

he

10

/11

act

ivit

y. T

her

efo

re t

he

red

uct

ion

in a

ctiv

ity

900

att

end

s lo

we

r th

an r

epo

rted

.

• ac

tivi

ty a

nd

co

st a

nd

incr

ease

d f

or:

(C

ard

io, C

linic

al H

aem

ato

logy

, Gen

eral

Su

rger

y, N

euro

logy

, Op

hth

alm

olo

gy,

Pae

dia

tric

Clin

ical

Hae

mat

olo

gy, R

heu

mat

olo

gy a

nd

T&

O )

-12

,00

0

-10

,00

0

-8,0

00

-6,0

00

-4,0

00

-2,0

00

0

2,0

00

Cardiology


Dermatology

Diabetic Medicine

Endocrinology

Ent

Gastroenterology

General Surgery

Geriatric Medicine

Gynaecology

Hepatology

Neurology

Ophthalmology


Pain Management


Rheumatology


Urology

Ou

tpati

en

t A

cti

vit

y,

follo

w u

p a

tten

dan

ce, vari

an

ce 0

9/1

0 t

o 1

0/1

1

-£1

,00

0,0

00

-£8

00

,00

0

-£6

00

,00

0

-£4

00

,00

0

-£2

00

,00

0

£0

£2

00

,00

0

£4

00

,00

0

Cardiology


Dermatology

Diabetic Medicine

Endocrinology

Ent

Gastroenterology

General Surgery

Geriatric Medicine

Gynaecology

Hepatology

Neurology

Ophthalmology


Pain Management


Rheumatology


Urology

Ou

tpati

en

t C

ost,

fo

llo

w u

p a

tten

dan

ce,

vari

an

ce 0

9/1

0 -

10/1

1


All Practice Event


Group Six – Mental Health –

Integrated Primary Care

Talking Therapies

Competitive tender now for a service offering a single point of access and self referral for all talking therapies, including counselling and IAPT, in primary care in Lambeth. Consultation event on 1st November 12.30 - 3.00. The purpose of this workshop is to identify outcomes an integrated Lambeth wide talking therapy service should deliver, considering key aspects such as a single point of access, employment support activities and learning from the past.

Gro

up 6

- M

enta

l Hea

lth, T

alki

ngT

hera

pies

6th October 2011 Dear Stakeholder,

Consultation Paper: A proposed service specification for an integrated talking therapy service in Lambeth

You are invited to be involved in a consultation on an integrated primary care talking therapy service in Lambeth. Please find attached a consultation paper giving the background, purpose and time frames of this consultation. The consultation paper and timeframe was approved by the Lambeth Talking Therapy Board in September 2011. The purpose of the consultation exercise is to provide a period of community engagement in order to enable further development of the ideas and proposals for the service. Included in the attached consultation paper is a table of questions to which the Board would be grateful for your responses. There is also space to include comments on areas that you consider have not been addressed elsewhere. The questions have been attached as an optional framework for response. Please send your responses to Joiss Soumahoro at:

[email protected]

Tel: 0207 049 4381

NHS Lambeth, 1 Lower Marsh, London, SE1 7NT Alternatively, you are welcome to use your own written response format or, if you prefer to provide your comments via telephone or email, please contact Joiss. I should be most grateful if you would let me have any comments you wish to make by 11/11/2011 at the latest. The consultation document is being widely distributed, and members of the Board will be pleased to make every effort to attend any Provider/Commissioning network to discuss and debate further if requested. A workshop is also taking place on 1st November, 12.30 to 3.00 to allow for face to face discussion and input into this piece of work. To register a place at the event, contact Joiss on the contact details above. All responses will be collated and reported to the Talking Therapy Board in November. You may respond individually, as an organisation, and as part of a provider network or other stakeholder forum. The intention is to finalise the service specification and include it in an Invitation to Tender Pack which will be released on 21/11/2011. The new service will be in place from 1st August 2011.

Gro

up 6

- M

enta

l Hea

lth, T

alki

ngT

hera

pies

Please do contact me via NHS Lambeth if you require any clarification on the content of the consultation document. I do hope you can find the time to respond. Yours sincerely, Dr Mark Smith, Talking Therapy Board Chair

This is a summary of documentation out for consultation on the integrated primary care talking therapies service.

EXECUTIVE SUMMARY

1.1 As a result of the various drivers (4.1 below) influencing the future of

primary care talking therapy services in the London Borough of Lambeth, the Talking Therapy Board has reviewed current provision. The outcome of the review has concluded that the service should be developed and enhanced. It is proposed this could be realised by reconfiguring the services into one integrated service, with a single point of entry into talking therapy provision. Under the proposals, people referred into the service will be assessed and directed to the most appropriate service to meet their needs. The purpose of any talking therapy service intervention arranged and the outcomes that the service will aim to achieve will be explicit and agreed with the service user.

1.2 In future, one integrated talking therapy service will work more

collaboratively with other mental health and social care services, as well as relevant community based services, to aid people’s recovery and the maintenance of their physical and psychological health; to help them to retain and to return to employment, and to remove dependency on welfare benefits; and to aid optimum social functioning.

1.3 The consultation paper describes the approach that the Talking Therapy

Board is proposing to take in order to introduce the changes. The Board is seeking views and comments from stakeholders as widely as possible. Attached to this paper is a questionnaire, which people may wish to use to submit their comments. Alternatively the Board will be pleased to receive views in whatever format stakeholders prefer.

Gro

up 6

- M

enta

l Hea

lth, T

alki

ngT

hera

pies


All Practice Event


Group Seven – Mental Health – Lambeth Living

Well Collaborative

Developing an asset based approach to mental health through collaboration. A philosophy of easy in and easy out of services is part of the Lambeth Living Well developments. The purpose of this workshop is to further explore this aspect of easy in/easy out and the role of the newly formed Primary Care Mental Health Support Service.

Gro

up 7

- M

enta

l Hea

lth, L

ivin

g W

ell

Col

labo

rativ

e

Our future in practice

People who use services, carers, front-line staff, care coordinators,

clinicians, GPs, service commissioners and service managers

making it real & delivering change together

Wednesday 19th October at The Oval

1. Morning session: 9.30am -12.30pm Lunch social: 12.30pm -1.30pm2. Afternoon session: 1.30pm -3.30pm

Bringing people from North Lambeth together for a hands-on session to experience, connect, build and plan for the future of mental health services in Lambeth.

Hosted by the

Lambeth Living Well Collaborative

Gro

up 7

- M

enta

l Hea

lth, L

ivin

g W

ell

Col

labo

rativ

e

For the past year, the Lambeth Living Well Collaborative have been hosting events and sessions to bring people to work together in a new way. We believe that in order to make real change happen, we need to co-design our services with the people who will use them and do all we can to enable people to flourish, contribute to society and lead the life they want to lead.

Our last event was in July and brought together over 100 participants - from people who use services to GPs - for two days of rolling-up sleeves and thinking about and planning how support needs to change.

Visit lambethlivingwell.wordpress.com to read about what happend

About the sessionExperience some of the new services being developed through interactive sessions where you can give us your suggestions and feedback

Connect with people from across North Lambeth. Listen to and share your experiences, opinions and ideas through practical sessions

Build new services for the future of Lambeth with us through hands-on sessions

Plan how we will work together to deliver this radical transformation

Book a place and more informationIf you would like to book a place for this free event please reply to Natalie Sutherland

020 3049 4268 [email protected]

Who are the Lambeth Living Well Collaborative?We are a group of service users, carers, GPs, public service

commissioners and providers from the public and third sector. We are dedicated to working together to tackle the big

challenges we all face and to radically improve wellbeing by enabling people to better recover, choose and participate.

WhereWhenIndia RoomThe OvalKenningtonSE11 5SS

Choose a session:1. Morning session: 9.30am -12.30pm Lunch social: 12.30pm -1.30pm 2. Afternoon session: 1.30pm -3.30pm

Oval station 36, 185, 436


All Practice Event


Group Eight – Community

Services

Community health services for Lambeth and Southwark is now provided by Guy’s and St Thomas’ Foundation trust Community Health Services. There is a 3 year contract (with the option to extend for a further 2 years) running from 1st April 2011 to 31st March 2014. As part of the new contract negotiations all service specifications were reviewed and new CQUIN targets were set. Please join us to discuss how we can work together to review annual CQUINs and key areas of development in the Community contract for 2012/13.

Gro

up 8

- C

omm

unity

Ser

vice

s

1

Community Health Services In Lambeth Community health services for Lambeth and Southwark is now provided by Guy’s and St Thomas’ Foundation trust Community Health Services. There is a 3 year contract (with the option to extend for a further 2 years) running from 1st April 2011 to 31st March 2014. The annual contract value for the contract is over £83 million per annum providing a range of generic and specialist services across Lambeth, Southwark, Lewisham and Wandsworth. As part of the new contract negotiations all service specifications were reviewed and new CQUIN targets were set. These are:-

CQUIN Indicator

1. Pressure Ulcers: Productive community services metric

1-A. Reduction in grade 2 and 3 pressure ulcers

1-B. No grade 4 pressure ulcers

2. Falls: Productive community services metric

2-A. Update the Lambeth and Southwark falls pathway

2-B. Reduction in the number of falls resulting in fracture

3. End of Life Care 3-A. EOLC planning discussions

3-B. Gold patient register

3-C. Advanced care plans

3-D. Liverpool care pathway

4. To Encourage Effective Communication between Community and Primary Care.

4-A. Confirming electronic referral receipt

4-B Part A DN caseloads list for GP practices

4-B Part B Care plans shared with the GP practices

4-B Part C DN discharge summaries sent to GP practices

4-C. Monthly HV and GP meetings

5. Children's Immunisations 5-A.Increase the proportion of 1st DTaP/IPV/Hib immunisations

5-B.ncrease the proportion of Hib/Men C immunizations

5-C.Increase the proportion of PCV immunizations

5-D.Increase the proportion of 1st MMR immunisations

5-E. Increase the proportion of 2nd MMR immunisations

5-F. Increase the proportion of DTaP/IPV or dTaP/IPV immunisations

6. To improve the responsiveness to personal needs of patients receiving community based and community based hospital healthcare

6-A. Patient questionnaire response, Involvement in decisions

6-B. Patient questionnaire response, time for discussion

6-C. Patient questionnaire response, information provided

6-D. Patient questionnaire response, confidence in health professional

6-E. Patient questionnaire response, overall experience

Gro

up 8

- C

omm

unity

Ser

vice

s

2

Areas of work that we want to review in 2012/13 include:-

District nurses & community matrons

Health visitors

Diabetes (Southwark only)

Stop smoking (Southwark only)

Sexual health

Intermediate care

School Nurses

Early interventions (Lambeth only)

Breastfeeding (Lambeth only)

Child Immunisations

Admissions Avoidance Schemes

Use of Telemedicine

How can we work together on this?

Involvement from primary care on the contract monitoring – this can be done via the LCCCB lead Ruth Jeffrey

Reviewing the impact on 2011/12 CQUIN measures especially CQUIN measure 4 on communications

Input into service reviews and setting CQUIN target for 2012/13 Lead commissioners

Name Position Contact

Moira McGrath Director of Care Pathways [email protected]

Therese Fletcher

Assistant Director of Primary and Community Care

[email protected]

Mahroof Kazi Commissioning Manager of Primary and Community Care

[email protected]

Ruth Jeffrey LCCCB lead for community contract

[email protected].

agenda - lpbcc.files.wordpress.com file12.10.2011 · lambeth clinical commissioning collaborative...

Documents