patient and public engagement event - nhs enfield ccg · with pre-diabetes to prevent people...

Patient and Public Engagement Event

Wednesday 21 June 2017

10:00am-1pm

Large Hall, Cockfosters Centre for Spirituality, Church of Christ the King, 29 Bramley Road,

Oakwood N14 4HE

1

WelcomeTeri Okoro

Lay Member for Patient and Public

Engagement

Local clinicians working with local people for a healthier future

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

• Please help yourself to

refreshments throughout the event


Agenda9:30pm-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-10:20am Enfield CCG corporate update - our plans for 2017/18

Dr Mo Abedi. Chair of Enfield CCG.

10:20am-11:00am Adherence to Evidence Based Medicine Consultation

Clinical lead- Dr Jahan Mahmoodi, Medical Director

Management lead – Mark Eaton, Director of Recovery

Group work: Each topic is discussed for 40 minutes and then facilitators move

11:00am-12:20pm to the next table. Session 1 is 11:00am- 11:40am; Session 2 is 11:40am -12:20pm.

Primary Care Developments workshop

Clinical lead –Dr Mo Abedi; Chair

Management lead- Jenny Mazarelo, Head of Primary Care

Improving Adult Mental Health Service

Clinical lead- Dr Chitra Sankaran

Management lead – Peppa Aubyn

12:20pm-12:30pm Feedback- 3 key issues for both topics

Clinical/Management leads

12:30pm–12:50pm Questions and Answers session with the Governing Body

12:50pm-1:00pm Thank you and event closes


Enfield CCG corporate update - our

plans for 2017/18

Dr Mo Abedi, Chair

5

CCG Corporate update

Our achievements for 2016/17:

• Three primary care access hubs open: Mondays to Fridays 6:30pm-8:30pm; weekends and public holidays: 8.00am-8.00pm.

• Four new nurses working in our GP practices with a further 10 nurses starting their training

• Increased the number of GP practice staff trained to support victims of domestic violence. Extended this training to pharmacists, dentists and optometrists

• GP practices commissioned to identify patients:

with Atrial Fibrillation to enable more people to be treated to prevent strokes

with pre-diabetes to prevent people developing diabetes

• Integrated Urgent Care service started on 4 October 2016 providing 111 and out of hours GP service on behalf of all of the north central London CCGs (Barnet, Camden, Enfield, Haringey and Islington)


CCG update

• Commissioned Enfield Mental Health Users Group (EMU) to find out how we can improve local mental health services

• Access psychological therapies target for people with anxiety and depression of 15% was exceeded

• Our Continuing Healthcare Team supported the delivery of one of the highest levels of personal health budgets (PHBs) in London.

• Exceeded the national target for the number of people being diagnosed with dementia

• New out of hours rapid response service to enable people to stay at home if they become ill overnight and at weekends

• Achieved an improved financial position against our planned deficit

• Achieved a challenging Quality, Innovation, Productivity and Prevention (QIPP)


Finance Update

Financial position in 2016/17

Our financial plan for 2016/17 was a year-end cumulative

deficit of £41.1m.

We improved on this by being able to release a further

£3.8m into the position thus reducing the deficit to £37.2m.

What we plan to spend in 2017/18

• In 2017/18, Enfield CCG are planning a total spend of

£402.8m.


Enfield CCG’s Transformation

Programme

Enfield CCG’s Transformation Programme

Enfield CCG has a Transformation Programme that is focused on

redesigning local services to improve their quality and value for money.

We are:

• Investing in Integrated Care Services that co-ordinate care both for

patients in hospital and those in care settings such as Nursing

Homes

• Focusing on improving the way in which we manage care for

patients in the community

• Ensuring that we provide coordinated care for patients with Long

Term Conditions such as Diabetes

• Developing new community based services


Looking Forward to 2017/18

We will be commissioning:

• Services that aim to support people with mental health issues within the

primary care setting

• A crisis café for patients to have access to support to help them better manage

a crisis. This is in collaboration with London Borough of Enfield and voluntary

and community groups.

• Long term care from a new nursing home to ensure community based

provision for our patients with severe dementia

• New models of care from all our providers for a range of elective treatments

including musculoskeletal services

• A range of services from our federated GP practices including:

support to care homes

management of patients with long term conditions

management of patients urgent care needs without the need to attend hospital


Looking Forward to 2017/18

We will:

• Continue to work with our other CCGs, local providers, local authorities and

other stakeholders in north central London to deliver the Sustainability and

Transformation Plan

• Develop new services and increasing capacity within existing services to have

more care provided out of hospital

• Ensure fewer of our patients need to be treated outside of Enfield.

More information can be found in our Annual Report and Accounts on our website:

http://www.enfieldccg.nhs.uk/about-us/annual-report-and-accounts-2016-17.htm


http://www.enfieldccg.nhs.uk/about-us/sustainability-and-transformation-plan.htm

http://www.enfieldccg.nhs.uk/about-us/annual-report-and-accounts-2016-17.htm

Dr Debbie

Frost

Chair

Barnet CCG

Dr Caz Sayer

Chair

Camden CCG

Dr Mo Abedi

Chair

Enfield CCG

Dr Jo Sauvage

Chair

Islington CCG

Dr Peter

Christian

Chair

Haringey CCG

Helen Pettersen

North Central London Joint Accountable Officer

Kay

Matthews

Chief

Operating

Officer

Barnet CCG

Start Date:

1 June 2017

Sarah

Mansuralli

Local

Executive

Director*

Camden

CCG

Start Date:

1 July 2017

Noreen

Dowd

Interim Chief

Operating

Officer

Enfield CCG

Start Date:

23 May 2017

Tony

Hoolaghan

Chief

Operating

Officer

Haringey and

Islington

CCGs

Start Date:

1 June 2017

Simon

Goodwin

Chief

Finance

Officer

Start Date:

1 June

2017

Will

Huxter

Director

of

Strategy

Start

Date: 5

June

2017

Paul Sinden

Director of

Performance

and Acute

Commissioning

Start Date:

May 2017

Shared North

Central

London role

Local

CCG role

Organisational Structure for North Central London Clinical Commissioning Groups

Key:* The Camden Local Executive Director post reflects the integrated commissioning

management structure adopted by Camden CCG and Camden Council in 2016. The CCG

Local Executive Director works in partnership with the Director of Integrated Commissioning at

Camden Council. The Local Executive Director post has the same responsibilities as the Chief

Operating Officer posts in other North Central London CCGs

North London health and care organisations working in partnership

• Together we serve a population of more than 1.5 million people from the London boroughs of Barnet, Camden, Enfield, Haringey and Islington.

• As partners we have a shared vision, a collective agenda and the commitment to transform the health and care services of North London.

• Our ambition is for our communities to be happier, healthier and to live longer in good health

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North Central London

Sustainability &

Transformation Plan (STP)

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North Central London STP


Prevention

• Train staff in Making Every Contact Count and Mental Health First Aid (including

dementia awareness)

• Ensure all boroughs can learn from the Haringey devolution pilot

• Improve workplace wellbeing

• Action to reduce obesity, smoking and alcohol misuse, increase our work in falls

prevention and increase uptake of our sexual health services.

Health & care closer to home

• Offer improved access to Primary Care across the whole of North London:

Patients will be able to access consultations with GPs or other primary care

professionals in their local area between 8am and 8pm, seven days a week.

• Implement the first wave of CHINs (neighbourhood networks) in each of the

boroughs and invest in the corresponding Quality Improvement Support.

Urgent & emergency care

• Join up all community-based services to support patients to receive more care at home

and avoid admission to hospital

• Develop services in all acute hospital trusts to provide same day emergency care to

patients to support assessment, diagnosis and treatment on a same day basis with no

overnight stay (ambulatory care)

• Develop systems and pathways to treat children in the community and reduce admission

to hospital for children where possible

• Implement simplified discharge for patients.

• Begin design work to improve and standardise access to Urgent Care across North

London to avoid the need to attend an emergency department

Planned care

• Work with local clinicians and patients to redesign pathways in key areas such as

dermatology, orthopaedics, neurology, urology and ophthalmology

• Design a single point of access to assist GPs with referral advice and navigation

• Standardise access to treatment across North London to ensure equality of care provision

We will do this by reviewing procedures that are of limited clinical effectiveness and

looking at the way in which consultants make referrals between themselves

• Begin work to standardise access to diagnostic tests across North London. 15


Mental Health

• Review and, where necessary, redesign the routes into acute mental health care to ensure there is consistency of standards and access for those suffering a mental health crisis

• Develop core 24-hour mental health liaison services at UCLH and North Middlesex so that people in need do not have to stay in hospital

• Establish a specialist community perinatal mental health team to support pregnant women

• Plan the development of a local female psychiatric intensive care unit to be put in place in 2018/19

Cancer

• Improve cancer survival rates by increasing awareness of symptoms so that patients can receive a diagnosis and treatment earlier

• Agree new approaches in providing chemotherapy and radiotherapy to reduce variation in quality and support care closer to home.

• Define the outcomes that matter to patients from diagnosis to living with and beyond cancer

• Define and implement best practice cancer pathways and service delivery models

• Undertake analysis that will improve patient experience and informed decisions on therapeutic interventions during the last days of life

• Reduce wastage and improve value for money from cancer drugs spend.

16


Maternity

• Standardise the process for offering women a choice of care setting at

referral in North London.

• Ensure women have equal access to the different birth settings and

antenatal care/postnatal care settings at whichever North London

hospital they book with.

• Review and improve community maternity services that will lead to the

design of local maternity hubs.

• Work with relevant partners to design a single point from where women

can access the full range of maternity services on offer

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Leadership

• STP convenor: Helen Pettersen, AO, NCL CCGs

• Provider SRO: Sir David Sloman, Chief Executive, Royal Free

London

• Local authority SRO: Mike Cooke, Chief Executive, Camden

Council

• Co-Clinical leads: Dr Jo Sauvage, Clinical Chair Islington CCG &

Dr Richard Jennings, Medical Director Whittington Healthcare

• Finance leads: Simon Goodwin, CFO NCL CCGs and Tim

Jaggard, Finance Director UCLH

• STP Senior Programme Director: David Stout supporting Will

Huxter, Director of Strategy NCL CCGs

18


Governance

• All partners continue to work as sovereign bodies, coming together to

work in partnership

• A number of shared structures:

– Advisory Board – made up of political leaders of local authorities

and chairs of NHS organisations

– Programme Delivery Board – made up of SROs overseeing

implementation

– Health & Care Cabinet – made up of clinical and practitioner

leaders

– Finance & Activity Modelling group – made up of finance leaders

– Joint Committee of CCGs

19



Feedback and

Questions

Local clinicians working with local people for a healthier future 20

Agenda10:20am-11:00am Adherence to Evidence Based Medicine Consultation

Clinical lead- Dr Jahan Mahmoodi, Medical Director

Management lead – Mark Eaton, Director of Recovery









12:20pm-12:30pm Feedback- 3 key issues for both topics

Clinical/Management leads

12:30pm–12:50pm Questions and Answers session with the Governing Body

12:50pm-1:00pm Thank you and event closes


Adherence to Evidence

Based Medicine (AEBM)

Dr Jahan Mahmoodi, Medical Director

22

Overview

What is the consultation about?

We are exploring the evidence associated with a number of

procedures and treatments to determine whether it supports our

current referral thresholds. In the case of Homeopathic

Treatments we are seeking to stop providing NHS funded

treatment entirely.

Why are we undertaking the consultation?

We need to ensure that we are not spending money on

procedures and treatments where the benefits to patients will

be low as it means we are taking money away from essential

services.


Overview

Who is leading this work?

The work is being led by Local GPs with support from hospital

doctors and the feedback from our public, patients and other

stakeholders.

How long will the consultation continue for?

The formal consultation commenced on the 1st March 2017 and

will continue until 30th June 2017 (this has been extended due

to the election). The formal consultation was preceded by an

extensive pre-consultation with GPs and our public. After the

consultation we will review the evidence again and the

feedback before making any final decisions.


Preparing for the Consultation

The formal consultation was preceded by an extensive pre-

consultation with GPs and our public including:

• Enfield Health & Wellbeing Board and Health Scrutiny Standing

Workstream

• Engaging with Local GPs and Hospital Consultants via the North Central

London (NCL) Clinical Cabinet and direct communications with Medical

Directors and Specialists across NCL.

• Undertaking Pre-Engagement Work with our public.

• Working with our CCG colleagues in North Central London i.e. Barnet,

Camden, Haringey and Islington and with the NCL Sustainability &

Transformation Plan Team.

After the consultation we will review the evidence again and the

feedback before making any final decisions.Local clinicians working with local people for a healthier future 25

Procedure List in Full


Procedure Proposed Changes

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


Procedure Proposed Changes

Penile Procedures (Penile Implants)Introduce new evidence

based criteria for treatment.

Cholecystectomy for Gallstones

Chalazions

Correction of Ptosis

Homeopathy Decommission Treatment

Next Steps

• Consultation continues till the 30th June 2017.

• Further public events are being organised in June by the CCG.

• We continue to work seek input from our public, hospital doctors, GPs and the wider network of stakeholders.

• Once the consultation is complete we will review the evidence again and the feedback received before making any final decisions.


Workshop sessions

29










Primary Care PlenaryDevelopments in primary care



Supported by: John Piesse & Peter Lathlean – Primary Care Development

Managers

30

Primary Care

Access & ‘Walk

in’ Services

1- How do we make more efficient

use of primary care access outside

routine GP Practice Hours?

2- How can we reduce DNAs?

Primary Care Access Headlines

I. 3 Primary Care Access Hubs across Enfield

II. 756 appointments available each week

III. 79% would recommend service to a Friend or Family Member

IV. 14% ‘Did not attend’ (DNA) rate

Walk in Centre Headlines

I. 250+ appointment each weekend

II. Majority of patients seen within 30 minutes

III. Evergreen Hub the only service outlet

31Local clinicians working with local people for a healthier future

Workforce and Quality Improvement

Primary Care Clinical Workforce:

31% of Enfield GP are over 55;

45% of Enfield Practice Nurses are over 55;

There are initiatives to recruit more GPs to London

Enfield is training 10 new practices nurses

What do you think would attract clinical staff to work in Enfield?

• Primary Care Non-Clinical Workforce

Enfield practices have less non-clinical staff than other NCL CCGs;

Enfield is participating in a pilot to train non-clinical staff to support the clinical teams

What non-clinical roles do you think could help improve GP services locally?


Improving Adult Mental

Health Service



33

Outline for the discussion

• Welcome and introduction - Dr Chitra Sankaran, CCG

Mental Health Clinical Lead and Peppa Aubyn, CCG

Head of Mental Health Commissioning

• What are mental health services and an overview of

Mental Health Services in Enfield

• What local improvements have there been over the

course of the last 6 months and what are we aiming to

achieve in 2017/18

• How do we engage patients, carers and stakeholders

• Q&A


Overview of Mental Health services in Enfield

• There 330, 000 people living in Enfield and there were 55,000 people in contact with mental health services in 2016/17 (1 in 4 people will be affected by mental health issues at some point in their life)

• Mental health services are; for people who are concerned about their wellbeing and mental health and receive support from primary care all the way through to people who are in crisis and require immediate care and treatment from secondary care services

• Our main provider of secondary care services is Barnet, Enfield and Haringey Mental Health Trust and we commission other services such as Mind in Enfield, Enfield Mental Health Users (EMU) and the Enfield Carers Centre to name but a few

• More specialist services for people with learning disabilities, Older People and Autism

• Greater focus on prevention and recovery


Mental Health Improvements • Improving Access to Psychological therapies (IAPT) ‘Let’s talk’ – there

are 36,100 people living in Enfield who are predicted to have common mental health issues and this service is commissioned to support this group (achieved 50% Recovery Rate and Access Standard for 16/17). Expanding this provision over the next 3 years through the local voluntary and community sector. This provides greater choice.

• In partnership with the Trust, Enfield CCG is developing an inpatient rehabilitation service on chase farm hospital for people who require intensive treatment and rehabilitative support to learn new skills to live independently in the community –this is in line with NHSE standard to reduce ‘Out of Area Placements’

• Additional psychological services on inpatient wards to offer coping strategies and self management therapies

• Primary Care Mental Health Link Workers will be recruited to enable GP’s to offer brief interventions as part of the service offered at practice level

• Additional enablement resource for Male Psychiatric Intensive Care Unit (PICU)

• Individual Placement Service (IPS) supported employment support service – procurement starting and we are hoping to have this service in place by September 2017


How do we engage people with mental health issues and their carers

• Through development of our commissioning intentions and

strategies

• Patient and Public Events - like this one

• Through the Enfield Mental Health Partnership Board

• Through the Health and Wellbeing Board and local joint events with

Enfield Council

We want to engage more and co-produce with patients so we are

reviewing how we do this with the Enfield Mental Heath Partnership

Board


38

Ask us

anything!


Panel questions and answers session


Questions

Key dates for your diaries

Governing Body Meetings

All the dates for 2017 can be found on our website: 19 July 2017 1:30pm-3:30pm Venue: Executive Suite, Dugdale Centre, 39 London Road, EN2 6DS

20 September 2017 1:30pm-3:30pm Venue: Committee Room, Holbrook House, Cockfosters Road, Barnet EN4 0DR

22 November 2017 1:30pm-3:30pm Venue: Millfield House, Silver Street, Edmonton N18 1PJ

Enfield CCG Governing Body Annual General Meeting27 September 2017 Time to be confirmed Venue: Executive Suite, Dugdale Centre, 39 London Road, EN2 6DS

Patient and Public Engagement MeetingsFor all Enfield residents and local stakeholders – details available on our website: http://www.enfieldccg.nhs.uk/patient-and-

public-engagement-events.htm

Wednesday 25 October 2017 10am-1pm Venue: Executive Suite, Dugdale Centre, 39 London Road, EN2 6DS

Wednesday 7 March 2018 10am-1pm Venue to be confirmed

Patient Participation Group (PPG) network meetingsFor Chairs and members of PPGs and staff at member practices who support patient groups only.

Tuesday 5 September 2017 6pm-9pm Venue: Executive Suite, Dugdale Centre, 39 London Road, EN2 6DS

Tuesday 5 December 2017 1.30pm-4pm Venue: Executive Suite, Dugdale Centre , 39 London Road, EN2 6DS

Details 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.


http://www.enfieldccg.nhs.uk/patient-and-public-engagement-events.htm

http://www.enfieldccg.nhs.uk/PPGnetworkmeetings.htm

mailto:[email protected]

http://www.enfieldccg.nhs.uk/

• 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

• If you are a PPG Chair or member and would like to contact the CCG about the support

we can offer your group or to join our mailing list please email: [email protected] or

call 0203 688 2840.

• Volunteer to be a patient representative and help us improve services for local patients

• 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





Thank you for attending

today’s event

For more informationwww.enfieldccg.nhs.uk

Follow us on Twitter @EnfieldCCG

Contact: [email protected]

0203 688 2814




patient and public engagement event - nhs enfield ccg · with pre-diabetes to prevent people...

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