Chairman’s Report May 2015

This is the last day before the general election and we will shortly know the results of the polls. The NHS has remained a focus for everyone in their campaigns. We have achieved a great deal in the last few years working together, often ahead of policy and guidance. We have built on existing relationships within primary care but also managed to establish effective local networks. We are agreed as a CCG that the direction of travel has to be an increased local focus, the shared benefit of operating ‘at scale’ for resources and back up but also a continued commitment to the Right Care Right Here vision.

We were clear 10 years ago that we need more care delivered in the community for our residents and a more holistic approach, with patients at the heart of their care. The new Midland Met Hospital is an exciting opportunity now firmly in our grasp by 2018/19 and we must transform care locally to make this new hospital a reality.

Last month I was invited to speak at Public Policy Exchange, where they bring in frontline practitioners delivering services alongside people creating policy. The topic was “shaping the future of general practice services” so I was able to talk about how we are working together locally and the improvements we have made in recent years for people in Sandwell and West Birmingham. There was clearly a commitment to ensure that the involvement and commitment of GPs is not lost in emerging policies by the audience.

Regional Clinical Leadership Programme We know that to deliver the change needed in the NHS; we need empowered clinical leaders that can make a difference on the frontline. I’m really excited to be welcoming Sir Bruce Keogh to Birmingham on the 18 May, to open our regional clinical leadership programme.

We need to invest in our future leaders to help them develop the necessary skills to drive forward this agenda. GPs have told us that there is not enough tailored leadership training, developed specifically for GPs. I’m pleased we have been able to secure funding from Health Education West Midlands, to organise our own clinical leadership programme designed by primary care for primary care.

It's a unique local opportunity to support our GPs to step into future leadership roles. There's no other course like it in the world, with such expert leaders in the medical field as our guest speakers: • Sir Bruce Keogh - National Medical Director NHS England • Dr. Maureen Baker CBE DM FRCGP - Chair of Council, Royal College of General Practitioners England • Dr. Sabena Jameel - Associate Dean GP Education, Health Education West Midlands • Dr. Jane Povey - Deputy Medical Director, UK Faculty of Medical Leadership and Management.

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There will be six events taking place throughout 2015/16 with up to five places available to each of the 22 CCGs in the West Midlands. This is part of our continuing commitment to primary care development.

Quarterly Assurance Meeting Last month we had our quarterly assurance meeting with NHS England. It was a positive meeting, and initial feedback from the Area Team was good. In particular, they seemed assured by our approach to mental health and our work to tackle referral to treatment times.

There were no surprises at the meeting, and we had some positive discussions around our key priority areas. We know we need to tackle urgent care, as despite work taking place across all partners in the health and social care system we’re consistently missing the 95% target. We also need to look into instances of mixed sex accommodation breaches. In both areas NHS England seemed assured by our approach to tackling these priorities.

We have a strong track record for governance, quality and financial performance, and I think this comes across during these assurance meetings. We know there are some key priorities we need to deliver, but it’s good to know that the Area Team continue to have real confidence in our leadership team and the CCG as a whole.

Urgent and Emergency Care At the end of April all partners came together to review our urgent care action plan. This was a crucial meeting for us, as we need to collectively start delivering the 95% A&E target. NHS England is seeking regular assurance that we are fulfilling our role as system leaders.

It was a productive meeting, and partners came away with a refreshed action plan. There’s still a lot of work to do and the key priorities continue to be focused on: • Delivering the ADAPT programme, which aims to reduce delayed transfers of care. By co-locating joint health and social care teams within the trust, to work alongside consultants and our own continuing healthcare teams, we set an agreed expected date of discharge and hope to see any early warning signs that a patient might have a delayed transfer

• Committing our system resilience funding: we’re in a better place this year, as we already know our allocation for the 2015/16 system resilience funding. We’re now in the process of committing the funding, so that we can establish and communicate our plans early and progress the schemes locally. Following feedback from our providers during the urgent and emergency care listening exercise, we are planning to hold a co-design meeting at the end of June. This meeting will be a chance for all providers to come together and discuss how we deliver a sustainable urgent and emergency care service for the future.

Last month a smaller group of partners came together to plan the event in June, there were some great ideas and I think the co-design event will be a real success.

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Urgent and emergency care has been talked about for the past 10 years, but it is exciting to see everyone getting behind the programme. More information will be coming out about the co-design event soon.

Sandwell and West Birmingham Hospitals NHS Trust 2015/16 Contract Our Finance and Performance teams have negotiated a different kind of contract with Sandwell and West Birmingham Hospitals NHS Trust this year. The main difference is that the contract is now based on payment by results and not a risk share.

This year is a real milestone for us and the changes include: • The Primary Care Assessment and Treatment service at Rowley Regis Hospital is being formally embedded in the contract. For the scheme to be a true success, it needs to have the stability of a full year’s contract • Repatriation of activity or in other words “money follows the patient” • £1.2m system resilience funding • £1.1m investment in flexi beds (intermediate care).

We hope that this new arrangement will help us collectively deliver improved quality and value for money.

Primary Care Handover We also had our latest handover meeting with NHS England around primary care commissioning. Work to take on primary care commissioning is still ongoing, and we’re continuing to work with the area team to iron out any outstanding issues and agree working arrangements between the NHS England teams and the CCG. We have robust governance arrangements and I’m sure that has helped assure people in this transfer.

Although it is still early in the process, the transition seems to have gone relatively smoothly.

A key priority for us will be supporting patients at Virgin Healthcare surgery, Finch Road to register with an alternative practice as we manage the planned closure by the end of June 2015. An action plan has been developed and patients will be receiving regular communications and support to help them find an alternative practice.

New Models of Care It is still relatively early days for the New Models of Care programme – a couple of workshops have taken place with the 29 vanguards, including Vitality Partnership, to discuss next steps for the initiatives. A small national team is visiting all sites over a rolling programme over the next month before decisions are taken about how they will support and invest in the different ones, some primary care led and others more acute focused. The visit to the Vitality Vanguard bid is scheduled for the end of May where the Multi-specialty Community Provider bid team including stakeholders will be interviewed for delivery and planned approaches.

Members’ Protected Learning Time Event

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Yet again we had a fantastic turnout at our members’ protected learning time (PLT) event last month, with around 400 GPs, practice nurses and practice managers attending. It was a lovely buzzing atmosphere in the marketplace and a great way to find out what support is available from the different teams.

The PLTs are a chance for us to take time out to reflect on our work, both at a personal level and as a wider organisation. I know when I talk to GPs and practice staff they say that this is an area of real value for sharing best practice in a structured way. I don’t know of another CCG that takes primary care development to this level, so I want to thank everyone who was involved in making the afternoon a huge success.

Evaluating Winter As part of our evaluation of the winter season, our Communications Team in the Commissioning Support Unit is carrying out a short survey. We want to know your thoughts on the Choose Well Winter Campaign. Using a range of advertising and communication methods, Choose Well provides information and encouragement to help patients choose the right service when they need urgent or emergency care.

Our campaign ran from early December 2014 and ended just after Easter. We want your views on how the campaign went and what we could do to improve it. To view the survey visit our website.

Social Care Support for Practices Working with our colleagues in Sandwell Adult Social Care we have been looking at ways to integrate health and social care and start working more closely with each other. We wanted to build on the multi-disciplinary team working taking place with practices, district nurses and community teams and offer social care input to practices.

As part of our work around the Better Care Fund, we have been piloting this integrated way of working within Oldbury Health Centre and Whiteheath Medical Centre. It has been extremely successful so far and has demonstrated improved turnaround times for patients being referred into social care, an easier route for practice referral and more face to face feedback from social care.

Social care team leaders will be starting to contact practices in Sandwell to help widen this approach across other practices in the Sandwell area. This is a fantastic example of how we can integrate health and social care and I’d encourage practices to take part and connect with their social care teams.

Carer's Survey Sandwell Council has commissioned Sandwell Carers Alliance to consult with local carers to understand their local needs and outcomes. This is especially important as the Care Act 2014 has recently come into effect, and this means that for the first time, carers have the same legal rights as those they care for. As GPs we see the impact on carers every day in our work, so it’s really important that we get behind the consultation and help promote this to the carers we see.

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This consultation will engage carers of all ages, who live in Sandwell or who care for people living in Sandwell.

The results of the consultation will feed into the development of a Joint Carers Strategy 2015-18, and inform the commissioning and development of health and wellbeing services for carers in the future. For more information or to take part in the surveys see our website.

Stakeholder Bulletin Our latest stakeholder bulletin (spring 2015) has been released. It’s worth a read as it highlights our key work priorities and achievements over the last few months. It also looks ahead to some of our challenges and opportunities in 2015/16. I’d especially like to mention the work of our Medicines Quality team, which has been showcased in the report. The team has been doing some great work, alongside practices, to reduce prescribing costs and improve the quality of medicines prescribing for patients. Our bulletin is available on our website.

Safeguarding Launch a Health Passport Our Safeguarding Team has launched a Health Passport for young people leaving care. Young people were actively involved in developing the passport, which gives an easy guide to local health services.

This is a great piece of work, and will support some of our most vulnerable young people to access the right health care at the right time.

Finally…I am really pleased to highlight another success story for our safeguarding team. Our Designated Nurse for Looked after Children, Jane O’Reilly, and the team have been doing fantastic work to ensure some of our most vulnerable children receive the right health care for their needs.

We have a duty to ensure that all children in care (Looked after Children) have an initial health assessment completed by a Consultant Paediatrician, within 20 days of entering care. This is then followed up by regular health assessments.

Since April 2014 the looked after children team has done an enormous amount of work in Sandwell, to improve co-working and communication with Sandwell Council. This has involved improving processes; to communicate changes of status and new entries into the care system. This will ensure all children get the regular health assessments they need and clear healthcare plans to help them achieve their potential.

We have a national standard to ensure 85% of health assessments are completed. The team has not only achieved the target (set by the Department for Education) but surpassed this and achieved 93%, the best figure that Sandwell has seen in over 10 years.

Well done to Jane and her team.

Dr Nick Harding MB ChB BSc FRCGP MFMLM DRCOG DOccMed PGDIP (Cardiology) Chair of Sandwell and West Birmingham Clinical Commissioning Group

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