Patient and Public Engagement Event
Wednesday 1 March 2017
9:30am-1pm
Conference Room 3, Dugdale Centre, Enfield
1
Housekeeping
• No fire alarm is planned today. If you hear the alarm,
please make your way outside
• Please turn your mobile phones off or put them on
silent
• The toilets are on this floor.
• You have a local GP and an NHS manager on each of
your tables. They are here to lead the group
discussions. We have two group work sessions today.
• Please help yourself to refreshments throughout the
morning
Local clinicians working with local people for a healthier future 3
Agenda
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9:30pm-10:00am Sign in, refreshments and networking
10:00am–10:10am Welcome
Teri Okoro, Lay Governing Body member for Patient and Public Engagement
10:10am-10:30am Enfield CCG update - our plans for 2017/18
Dr Mo Abedi, Chair
10:30am-11:30am Adherence to evidence based medicine consultation
Clinical lead- Dr Jahan Mahmoodi, Medical Director
Management lead – Mark Eaton, Director of Recovery
11:30am-12:30pm Primary Care Developments workshop
Clinical lead –Dr Mo Abedi; Chair
Management lead- Jenny Mazarelo, Head of Primary Care
12:30pm – 12:50pm Questions and Answers session with the Governing Body
12:50pm-1:00pm Thank you and event closes
Teri Okoro, Lay Governing Body member for Patient and Public Engagement
Local clinicians working with local people for a healthier future
Feedback from last
eventFollowing on from discussions at our last event:
• Your feedback on the Adherence to Evidence Based Medicine was reviewed. Today is the launch of our public consultation and we would like your feedback on our proposals in the group session. We also have copies of the consultation document and questionnaire with us today. The CCG also has two further consultation events after today :
Wednesday 22 March 2017 2pm-4pm – Community House, Edmonton Hosted by Healthwatch Enfield
Thursday 30 March 2017 2pm-4pm – Community House, Edmonton Hosted by Enfield Voluntary Action
• PAU Consultation – A final decision will be taken at our Governing Body meeting on 15 Mar 2017 1:30pm-3:30pm.
• Strategic Transformation Plan (STP) - we will provide an update on developments later in this presentation.
Recovery and
Finance Update• Enfield CCG is still in special measures.
• We are planning to close this financial year with a £7.7m deficit, with some help from the North Central London risk share agreement.
• This compares to an in-year deficit of £14.4m last year.
• 2017/18 - Plan is for a £2.1m surplus in 2017/18 – really breakeven
• 16/17 forecast out turn for QIPP has improved by £699k in month 10 (January 2017)
• 17/18 QIPP Target £24.7m Gross – 6.8% of allocation.
• We are currently designing our QIPP programme for 2017-18
A new shared management team is being appointed to work across the five CCGs
– Barnet, Camden, Enfield, Haringey and Islington:
• Helen Pettersen, Accountable Officer designate was appointed January 2017
• The interviews for the NCL Chief Finance Officer, NCL Director of Strategy and NCL
Director of Performance and Commissioning are expected to be March 2017
• The next steps are to recruit the local Chief Officers, followed by the Directors team.
• Finally, an Independent Chair will be recruited.
• Each CCG will still be the statutorily responsible organisation and have regular
Governing Body meetings, but will delegate some powers to a Joint Committee. Each
CCG will be equally represented on the Joint Committee.
North Central London (NCL)
Commissioning Management
Arrangements
About the Sustainability & Transformation Plan (STP)
STP triple aims:
1. Close gaps in Health & Wellbeing
2. Close gaps in Care and Quality
3. Close gaps in Finances
Enfield CCG / Enfield
Council
320k GP registered pop
48 GP practices
Barnet CCG / Barnet
Council
396k GP registered pop
62 GP practices
Camden CCG / Camden
Council
260k GP registered pop
35 GP practices
Haringey CCG / Haringey
Council
296k GP registered pop
45 GP practices
Islington CCG / Islington
Council
233k GP registered pop
34 GP practices
What is North Central London (NCL)?
UniversityCollegeHospital
BarnetGeneralHospital
ChaseFarmHospital
NorthMiddlesex
Hospital
RoyalFreeHospital
StAnn’sHospital
TheWhittingtonHospital
EdgwareCommunityHospital
FinchleyMemorialHospital
StMichael’s
PrimaryCare
Centre
LondonAmbulanceService
EastofEnglandAmbulanceService
Moorfields EyeHospital
GreatOrmondStreetHospital
CentralMiddlesex
Hospital
Highgate Hospital
StPancras Hospital
StanmoreHospital
Tavistock Clinic,PortmanClinic,
GloucesterHouseDayUnit
Our vision is for North Central London to be a place with the best possible health and wellbeing, where no one gets left
behind
Our vision
North Central London
Clinical Cabinet
• Chair - Clinical Lead for the NCL STP programme
• Meets every 2 weeks, reporting to the NCL Transformation Board
• Clinical representation is across health and social care in NCL at a senior level
• The purpose of the clinical cabinet is to review, advise and direct transformation across
North Central London from a clinical and patient perspective.
• The clinical cabinet works closely with the Clinical Reference Group (CRG) and provides
updates, leadership and steer to the group as well as incorporating the outputs from the
CRG in their programme of work.
The NCL case for change
Health & Wellbeing Gap
Care & Quality Gap
Financial Gap
Health and care practitioners across NCL have been working together to
understand and analyse the current issues across the system. This has
been developed into a case for change. The case for change identified the
following major gaps:
You can find the Case for Change on our website: http://www.enfieldccg.nhs.uk/Downloads/STP/NCL%20case%20for%20change.September%202016.pdf
NCL STP workstreams
• Prevention
• Achieving the best start in life
• Maternity
• Health and Care closer to home
• Urgent and Emergency Care
• Mental Health
• Cancer
• Planned Care
• Specialised Commissioning
• Commissioner savings
• Provider savings
• System-wide productivity
All the information about the plan including the summary version can be found
on our website:
http://www.enfieldccg.nhs.uk/Downloads/STP/NCL%20case%20for%20chang
e.September%202016.pdf
Workshop sessions
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10:30am-11:30am Adherence to evidence based medicine consultation
Clinical lead- Dr Jahan Mahmoodi, Medical Director
Management lead – Mark Eaton, Director of Recovery
11:30am-12:30pm Primary Care Developments workshop
Clinical lead –Dr Mo Abedi; Chair
Management lead- Jenny Mazarelo, Head of Primary Care
Local clinicians working with local people for a healthier future
Overview
• As an organisation in Special Measures we are required by NHS England
to look at everything we spend to enable us to live within our means and
ensure we can continue to fund essential services and treatments.
• As part of this on-going review we are looking at the evidence associated
with a number of procedures and treatments to see where clinical
evidence supports changing thresholds and access criteria.
• Whilst we are doing this because of our financial position the work is
clinically led and evidence based.
• Enfield CCG are also leading this work across North Central London with
our CCG Colleagues.
• Today is the start of our formal consultation period lasting until the 31st
March.
Local clinicians working with local people for a healthier future 18
Scope of Review
We are looking at four main areas:
• The thresholds and criteria associated with existing Procedures of
Limited Clinical Effectiveness where the evidence has changed.
• Additional areas that others have identified as being PoLCE that
are not currently in the North Central London policy and where we
consider it appropriate to review.
• Procedures where the clinical evidence suggests we should make
changes to thresholds to improve outcomes for patients.
• The decommissioning of homeopathic treatments at UCLH.
Local clinicians working with local people for a healthier future 19
Preparing for the
Consultation ProcessIn preparing for the consultation commencing today we have done a wide range of pre-engagement activities including:
• Discussing this with the Enfield Health & Wellbeing Board and Health Overview and Scrutiny Committee.
• Engaging with Local GPs via a range of events and with our Secondary Care Consultants via the North Central London Clinical Cabinet.
• Undertaking Pre-Engagement Work with our public.
• Working with our CCG colleagues in North Central London and with the NCL Sustainability & Transformation Plan Team.
Local clinicians working with local people for a healthier future 20
Procedure List in Full
Local clinicians working with local people for a healthier future 21
PROCEDURE PROPOSED OUTCOME
Bunions
Introduce new evidence based criteria for
treatment.
Hearing Aids
Knee Replacement Surgery
Hernia
Vasectomy
Uterovaginal Prolapse
Revision Mammoplasty
Revision of Hypertrophic Scars
Procedure List in Full
Local clinicians working with local people for a healthier future 22
PROCEDURE PROPOSED OUTCOME
Penile Procedures (Penile Implants)
Introduce new evidence based criteria for
treatment.
Cholecystectomy for Gallstones
Chalazions
Correction of Ptosis
HomeopathyDecommission
Treatment
Next Steps
• Today we are launching our consultation and are
seeking your feedback on our proposed changes.
• We are here to answer your questions and to help you
complete the consultation document or you can take the
document away and use freepost to return it or alternatively
use our online survey.
• We are holding two further public events during the month
and also discussing the evidence with Local GPs at our
Locality Meetings.
• We will also be taking our NCL CCGs through the same
process we are currently undertaking.
Local clinicians working with local people for a healthier future 23
Jenny Mazarelo, Head of Primary Care
Peter Lathlean & John Piesse, Primary
Care Development Managers
Primary Care
Transformation
Primary Care
Access Hubs
• Open from 18:30 to 20:00 Monday to Friday
• Open from 08:00 to 20:00 Saturdays,
Sundays and Bank Holidays
• Book through your registered practice or
direct on 03000 333 666
• Access hub locations:
Carlton House Surgery (Enfield Town)
Woodberry Medical Practice (Winchmore Hill)
Evergreen Primary Care Centre (Edmonton)
Medical Records
• To provide continuity of care, the hub can
access your medical records
• Patients will be asked if they consent to
their medical records being viewed by the
GP or Nurse providing their care
• A summary of the consultation will be
returned to the patient’s own practice for
adding to their medical record
Patient Online
Services
• Practices are contractually obliged to offer
patients the opportunity to book an
appointment, order a repeat prescription or
access their medical records online.
• This is a means of increasing choice and
convenience for all patients
• Ambition ~ 20% of patients with an online
account with 10% of patients using one or
more online services by 31st March 2017
iPlato – Text Reminder Messaging Service
You book an
appointment with the
GP Practice via your
preferred method
GP Practice records
your mobile number
into your patient
record
The system automatically sends
you a SMS message reminding
you of your appointment date
and time (typically 2 days before
your designated appointment).
The text includes details on how
to cancel this appointment if
required without the need to
phone the practice.
You can send a SMS
text reply – this
informs the system
to release your
appointment for
others to book
You attend your
appointment as per
usual
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Ask us
anything!
Local clinicians working with local people for a healthier future
Panel questions and answers session
Key dates for your diaries
Governing Body Meetings
All the dates for 2017 can be found on our website: 15 Mar 2017 1:30pm-3:30pm Venue: Committee Room, Holbrook House, Cockfosters Road, Barnet EN4 0DR17 May 2017 1:30pm-3:30pm Venue: Millfield House, Silver Street, Edmonton N18 1PJ
Patient and Public Engagement Meetings
For all Enfield residents and local stakeholders – details available on our website: http://www.enfieldccg.nhs.uk/patient-and-public-engagement-events.htmWednesday 21 June 2017 10am-1pm, venue to be confirmedWednesday 25 October 2017 10am-1pm, venue to be confirmedWednesday 7 March 2018 10am-1pm, venue to be confirmed
Patient Participation Group (PPG) network meetings
For Chairs and members of PPGs and staff at member practices who support patient groups only. Tuesday 7 March 2017, 6pm-9pm, Executive Suite, Dugdale CentreTuesday 6 June 2017, 1.30pm-4pm, Conference Room 2, Dugdale CentreTuesday 5 September 2017, 6pm-9pm, Executive Suite, Dugdale CentreTuesday 5 December 2017, 1.30pm-4pm, Executive Suite, Dugdale CentreDetails are on our website: http://www.enfieldccg.nhs.uk/PPGnetworkmeetings.htm
Please email [email protected] to be added to our email and be notified of news and
events.
All events are advertised on our website: www.enfieldccg.nhs.uk Twitter @EnfieldCCG and in the local press.
Local clinicians working with local people for a healthier future 33
• Your feedback is important to us today
• We want to work closely with local people to develop our plans
• Today we are going to focus on our plans for the next year
• We will ask you to fill in a feedback form (in your pack) about today’s
event. Please tell us what you what think of today and tell us about
topics you would like to see at future events.
We would like you to get more involved in the CCG:
• Join your GP practice’s Patient Participation Group (PPG). Ask your practice if you can
join. We have an active PPG network and an elected PPG representative Litsa Worrall
who sits on the Governing Body
• Volunteer to be a patient representative and help us improve services for local patients
forms are available.
• Attend a Governing Body Meeting – dates are advertised on our website, on Twitter
and in the Enfield Independent
• Follow us on Twitter @EnfieldCCG
• Sign up to our mailing list – contact [email protected]
• Visit our website www.enfieldccg.nhs.uk
Listening to you
Local clinicians working with local people for a healthier future
Thank you for attending
today’s event
For more informationwww.enfieldccg.nhs.uk
Follow us on Twitter @EnfieldCCG
Contact: [email protected]
0203 688 2814
35Local clinicians working with local people for a healthier future