NHS Leeds West CCGStakeholder Meeting27th June 2013

WELCOME

Leeds CCGs

We work

together to commission

our local providers

The Leeds Health and Wellbeing Strategy

Our member practices and patients have told us:

• We need to better manage long term conditions• We need to help people to stop smoking and to lose weight• We need primary care to change to be able to do this• We need to have less patients going to hospital• People want to be treated with dignity and respect• We need to have better services for people with mental

health problems• We need to have better outcomes for people with cancer• People wanted us to include children in our plans• People want their views to be taken into account

OLDER PEOPLE ADULTSCHILDREN AND FAMILIES

Improve cancer

services

Reduce the gap in life

expectancy in west Leeds

Long term conditions management

Sexual health

Improve mental health

support / services

Choice and access for elective

care services

Increase choice

and control at End of Life

Improve urgent

care services

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CLeeds West CCG Priority Health Goals

USE OF RESOURCESTo use commissioning resources

effectively

QUALITY AND SAFETYTo transform care and drive continuous improvement in

quality and safety

ORGANISATIONAL DEVELOPMENTMembers can meet their obligations as clinical commissioners at practice level and to have the

best developed workforce we possibly can

PRIORITY HEALTH GOALSTo tackle the biggest health

challenges in west Leeds, reducing health inequalities

Our Strategic Objectives

Working together locally to achieve the best health and care in all our communities

Our Vision

Our PurposeTo work for members to improve the health of our populations through effective commissioning, collaboration and primary care development

Organisational Development Plan

Plan on a Page

Priority Health Goals - Member Practice Actions

Improve cancer

services

Reduce the gap in life

expectancy in west Leeds

Long term conditions

management

Sexual health

Improve mental health

support / services

Choice and access for elective

care services

Increase choice and control at End of Life

Improve urgent care

services

Prio

rity

Heal

th

Goal

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LWCCG Clinical Commissioning Scheme Local QP Indicators (QOF) DES Schemes(examples)

• Diabetes treatment (23 practices)• Increase referrals to alcohol services (5

practices)• Respiratory disease management (3

practices)• Increase early diagnosis of cancer (3

practices)• Prevention of CVD (2 practices)• Increase referral to weight management

services (1 practice)

• Stroke review 6 months post discharge• Preconceptual advice for diabetes• Prophylactic prescribing for COPD• Self management programmes• Every Contact Counts training• Increase bowel cancer screening• Peer reviews for: - Outpatient referral data - Emergency admissions - A&E attendances• Develop action plan for frequent attenders

at A&E

• Alcohol related risk reduction scheme• Risk profiling and care management scheme

(risk stratification)• Timely diagnosis for people with dementia• Remote care monitoring prep scheme• Learning disabilities health check scheme• Shingles• Rotavirus• Patient participation• Extended hours• Childhood immunisations• HPV• Improving patient online access• Flu and Pnemococcal

Healthy Lifestyles

What do we know?This is a priority for us because we know that we have the widest life expectancy gap in Leeds and we want to continue encouraging and promoting healthy lifestyles. Alcohol misuse is a key area of concern; and we know that we have a high number of emergency admissions to hospital for alcohol related liver disease.

• Reduce emergency admissions for alcoholic liver disease• Develop new and innovative ways of reducing smoking rates with a particular focus

on parents that smoke• Put plans in place to tackle childhood obesity• Continue to support and deliver health checks and refer those who need to adopt

healthier lifestyles into services that can help• Improve the support for people who regularly visit A&E as a result of alcohol or

substance misuse

What are we going to do?

Sexual Health

What do we know?

Large Student Population

Meets the health and wellbeing strategy’s priority to support people to choose healthy lifestyles.

• Improve access to, and uptake of, a range of sexual health services in partnership with the local authority who has the main responsibility for commissioning these services.

• In particular, focus on improving the sexual health in those populations that have high STI (sexually transmitted infection) and unplanned conception rates.

• Work with primary care to improve the uptake of these services.

What are we going to do?

Managing Long Term Conditions

What do we know?Improving care and managing long term conditions is a shared priority for all organisations across the city that provide health and social care. It is particularly important for us as we have a high number of patients with long term conditions who are admitted to hospital as an emergency when they could have been helped at home. Our GP practices, and information from the JSNA have highlighted diabetes as a major cause for concern.

• Continue to roll out a process called ‘risk stratification’ in our GP practices. • Make it easier for people to get primary care health services in normal working hours and out

of hours.• Improve the way and how quickly we identify people at risk of developing long term conditions.• Increase and improve how diabetes is managed in primary care.• Improve how we help people to manage their long term conditions themselves.• Put processes in place to identify people earlier with respiratory illness • Improve how we manage and prescribe medicines.

What are we going to do?

Improve cancer services

What do we know?We have a higher than average number of people aged under 75 who die from cancer, in particular breast, bowel and lung cancer. Members of the public have told us that this is one of the health issues that is important to them, and reducing premature death is also one of the health and wellbeing strategy’s priorities

• Work closely with national screening programmes to plan services and make sure that there are enough.

• Improve the numbers of people taking up bowel screening, particularly in harder to reach groups.

• Build on the successful lung cancer screening campaign and develop further marketing campaigns to support bowel and ovarian cancer screening.

• Involve patients to improve the numbers of people taking up screening, and use their experience to understand how effective our commissioning processes for cancer services are.

What are we going to do?

Improve mental health servicesWhat do we know?

High suicide rate in our area, in Leeds 12 and 13 (Armley, Wortley and Bramley). Members of the public have told us that improving people’s mental health and wellbeing is important to them.Priority for Leeds Health and Wellbeing Board. There is also a growing need to support an ageing population with dementia.

• Commission more mental health support services. • Enable our member practices to work closely with the community and voluntary sector

to offer holistic care to patients.• Improve access to IAPT( Improving Access to Psychological Therapy) services in our area. • Improve the diagnosis of patients with suspected dementia more quickly and refer them

for treatment.• Contribute to reducing the suicide rate in our area by increasing access to primary care

and support more people in high risk groups by referring them to a range of services that can help.

What are we going to do?

Improve Choice and Access for Elective Care Services

What do we know?

Providers and monitored on 18 week referral to treatment times.National drivers have created the Choose and Book system and this is likely to develop into an e-referral service in the near future.Use of Choose and Book in LWCCG practices is high.

• Working with our providers to ensure compliance with nationally mandated targets• Working through the MOT and QP peer review around referrals to understand and

educate more around more appropriate referrals• Working on pathway redesign and developing local pathways on the Map of Medicine

What are we going to do?

Improve urgent care services

What do we know?

Urgent care services are a priority because of the pressure on A&E departments, access to primary care and feedback from our member practices who are telling us that demand on their services is increasing.Patients have told us that the system is confusing so we are committed to making improvements.

• Reduce unnecessary A&E attendances and people being admitted to hospital unnecessarily by offering local alternatives and better information.

• Reduce unnecessary hospital visits for people with long term conditions by improving support at home and closer to home

What are we going to do?

Improve care for people at the end of life

What do we know?

This is important to both our member practices and members of the public in terms of dignity and respect. It is also an important priority for Leeds and we will work closely with our partners to ensure that we put plans in place to improve this locally.

• Support more people to die in the place where they choose at the end of their lives, including support for their families and carers.

What are we going to do?