This booklet is a summary of two key documents produced by NHS Lincolnshire West Clinical Commissioning Group (CCG). These documents are the organisation’s Annual Review and Accounts 2013-14 and Operational Plan 2014-15 to 2015-16. The full versions of these documents are available on the website www.lincolnshirewestccg.nhs.uk

About us

NHS Lincolnshire West Clinical Commissioning Group consists of 37 GP practices covering 420 square miles across Lincoln, Gainsborough and surrounding villages and serving a registered population of 230,271.

The 37 practices all work to provide and commission (or buy) high quality health services, helping to reduce health inequalities for our population.

Clinical Commissioning Groups work with other parts of the NHS such as hospitals and community services, along with partner organisations, to deliver healthcare and improve health for local people.

Health in Lincolnshire West

There are significant health inequalities in Lincolnshire West, linked to a mix of lifestyle factors, deprivation, access and use of healthcare.

There are also significant differences in how healthy people are between different areas. For example, women in our most deprived communities die on average 17 years earlier than those in our least deprived, while men die 12 years earlier.

Our visionOur vision is that:

The people of Lincolnshire West will receive compassionate care and excellent health services that promote healthy lifestyles and prevent illness.

Our missionWe will achieve our vision by:

• Working with others to ensure high quality and co-ordinated healthcare

• Working with you to provide healthy lifestyles and reduce inequalities

• Working together to encourage the best way of doing things.

Our goals

We aim to:

• Continually improve the health of all those living within Lincolnshire West

• Reduce health inequalities and improve the quality of life for all

• Help patients access high quality, responsive healthcare of their choice

• Work together to develop healthcare designed for the needs of our patients, their families and carers

• Ensure we have effective, value for money services that improve patient experience and safety.

Our values • Be patient-centred Considering individual patient needs and the needs of the population as a whole

• Be quality-focused Securing high quality, safe and effective health services for all

• Work together Delivering through strong partnerships, comprehensive engagement and good communications

• Innovate for improvement Creating an environment for involvement, innovation and improvement

• Use resources responsibly Maximising the use of limited resources, balancing competing needs.

Our performance: Achievements

In 2013-14 a number of successful initiatives were carried out in partnership between ourselves, other local health commissioners, organisations that provide health services, social care and the voluntary sector. Some examples include:

• A new way of helping local people obtain a diagnosis of dementia, linking together primary care, hospitals and social care

• The launch of Integrated Community Response Teams, supporting older people in the community

• A new assessment and treatment service for people with a range of problems including neck and back pain

• A new way of ensuring the care of children with ear, nose and throat problems

• Helping avoid a surge of people in winter being admitted to hospital by improving the community’s approach to urgent care

• Working in partnership with the local mental health NHS Trust to implement Transforming Mental Health Services• All our member GP practices signing up to the Early Presentation of Cancer initiative to help people receive earlier diagnoses• Attendances at A&E falling by more than 2% in the first nine months of 2013-14, compared with the same period the previous year• A total of 321 fewer patients having been admitted to hospital by mid-way through 2013-14, compared to the same period the previous year• 25 GP practices signing up to the Smoke Free Homes programme• Prescribing costs falling by 4% compared with the previous year• A new way of helping treat patients with skin diseases saw referrals to outpatients reduce by three per cent• A reduction in the number of healthcare acquired infections occurring in the major local hospital• Mortality rates falling from conditions such as heart disease.

Our performance: Challenges

The local NHS works together with partners to achieve the best possible outcomes for public and patients. Sometimes though there are big issues to resolve and with a strict budget, we have to make some difficult decisions. Like anywhere else in the country, we face challenges in delivering health services and we are doing our best to tackle them. Some of these challenges include:

• United Lincolnshire Hospitals NHS Trust (ULH) is facing some significant financial pressures

• There is room for improvement on quality standards at ULH, including areas such as meeting national cancer targets and waiting times in Accident and Emergency

• The wider health and social care economy across Lincolnshire is facing a budget shortfall in future years

• There are difficulties in recruiting and retaining appropriately qualified staff in certain medical areas

• Our population is spread widely across urban and rural areas, with large variations in people’s health.

Our finances

A key financial duty of our organisation is not to spend any more money than we are allocated. This responsibility was met in 2013-14 with our annual spending coming in at £2.6 million below our budget of £267 million.

This is the resource we have and we will work with patients to make the most effective use of the money. Due to general inflation and an increasing population, our budget is due to increase a little in the next few years, but the demands on services are also growing.

Our Annual Review contains more details on our finances as well as information on how we run the organisation and manage risks.

Planning for the future

We have set out in our Operational Plan from 2014 to 2016 how we will address health inequalities and improve the health of our population. There are three themes that run through the plan: the need to improve the quality of NHS services, to deliver more integrated health and social care closer to people’s homes, and to reduce the differences in the care that people receive.

The plan highlights the following priority areas:

• Proactive care (helping you take control of your own health)

• Urgent care (when you need care straight away)

• Planned care (when you have a pre-booked appointment or operation)

• Women’s and children’s care

• Primary care (including the services you receive at your GP practice).

Proactive care: Reducing inequalities and improving life expectancy

We want to see life expectancy increase for everyone and improve faster for those from more deprived areas. Our aims include:

• Every eligible patient being offered a free NHS Health Check within the five-year cycle

• One-quarter of people with a BMI over 30 offered referrals to weight management services

• Encouraging all NHS service providers to Make Every Contact Count, helping empower patients to make healthier lifestyle choices

• Supporting GP practices on initiatives to help patients cut down on tobacco use.

Proactive care: Supporting frail older people and people with long-term conditions

We want services to be based around the needs of individual patients rather than of the organisations providing those services. Our aims include:

• Increasing the diagnosis rates for people with dementia

• Improving care for people with atrial fibrillation (a heart rhythm disorder)

• Helping more older people to remain independent at home for longer after discharge from hospital

• Seeing fewer people admitted to hospital from care homes.

Proactive care: Improving outcomes in cancer

We want to work with others to improve outcomes and reduce mortality rates from cancer. Our aims include:

• Consistently achieving all the national cancer performance targets – including when people can expect to be seen and treated

• Sustaining all our member GP practices engaged in the Early Presentation of Cancer initiative

• Prevention of disease through improved breast, cervical and bowel screening.

Proactive care: Improving mental health and learning disability care

We want to work in partnership to improve the health of those with mental health conditions, learning disabilities, and autism. Our aims include:

• Providing effective support for people with mental health problems through the Improving Access to Psychological Therapies programme

• Providing a 10% year-on-year increase in the number of people with learning disabilities receiving health checks

• Working with partners across the health community to give mental health just as much priority as physical health.

Urgent care

We want ‘joined-up’ urgent care services running around the clock. Our aims include:

• Reducing emergency admissions to hospital by three per cent each year

• Reducing unplanned admissions to hospital for the elderly

• Providing people with a number of appropriate care options according to their needs, including the NHS 111 phone service, helping people avoid admissions to hospital

• Hospitals being the place for patients who need to be in hospital – not just because there is nowhere else to go.

Planned care

We want to improve access, choice and the efficiency of services. Our aims include:

• Re-designing services so patients are able to get the right care in the right place at the right time - this may lead to a reduction in the number of outpatient appointments needed in some areas such as skin care, eye care, back care, and pain management

• More patient services being likely to be delivered in the community rather than in a hospital setting

• Working with GPs so that patients receive the right care, at the right time, which could include asking consultants for advice.

Women and children’s care

We want to improve choice and the efficiency of services. Our aims include:

• Reducing hospital emergency admissions for children and young people who have asthma, diabetes or epilepsy

• Reducing smoking rates among pregnant mothers

• Increasing the levels of midwifery-led care

• Improving child and adolescent mental health services – with a new integrated service working from April 2015.

Other plans including primary care

There are a number of other initiatives that we intend to carry out in order to achieve our aims in the Operational Plan.

We have a range of measures in place in order to improve the quality of services, we are looking at improving support for carers, and we want to continue to improve back office services such as IT, finance and human resources. We are also working with partner organisations in the county to support changes in primary care – this is expected to lead to the introduction of neighbourhood teams helping to provide a seamless health and social care service to our population.

This will be key to helping support people in the community and keeping people healthier and out of hospital.

What will we achieve?

By taking forward all these plans over the next couple of years, we aim to improve the health and wellbeing of our communities through:

• Additional years of life for people with treatable mental and physical health conditions

• Improved health-related quality of life for people with one or more long-term condition, including mental health conditions

• Reduced time spent in hospital for patients through improved integrated care in the community, outside of hospital

• More older people living independently at home following discharge from hospital

• More people having a positive experience of hospital care

• More people with mental and physical health conditions having a positive experience of care outside hospital, in general practice and in the community

• Significant progress towards eliminating avoidable deaths in hospital caused by problems in care

• A reduction in health inequalities

• Mental health being seen by the NHS and wider society as equal in importance in every way to physical health.

Have your say and get involved

It is vital that local communities have as much input as possible into improving health and healthcare services.

We use a ‘continuous listening’ approach in making sure we listen to and act on the views of patients, carers and the general public.

Our plans have benefited from many ways in hearing the ‘patient voice’. These include listening events, a Patient Experience Group, Patient Participation Groups at member GP practices, and patients’ forums.

A Quality and Patient Experience Committee, chaired by a lay member of the public, takes in all the information on patient and public involvement and helps inform and guide our decision-making.

We want to continue hearing from people across Lincolnshire West and would encourage you to get involved and have your say, helping us improve and implement our plans.

Contact details for our organisation are overleaf – get in touch today and help make a difference to the health of our area.