Slough CCG AGM Welcome

1. Slough CCG AGM Welcome ‘Working Together for a Healthy Slough’

2. Agenda • Welcome- Alan Webb, Chief Officer • Presentation of Annual Report - Dr. Jim O’Donnell, Clinical Chair • Questions • Presentation of Annual Accounts – Nigel Foster, Chief Finance Officer • Questions • Ends (followed by Bhangra performance – main lobby)

3. Slough CCG AGM ‘Working Together for a Healthy Slough’ Annual Report Presentation Dr. Jim O’Donnell, Clinical Chair Slough Clinical Commissioning Group

4. Our first year… Our journey began with one simple question “I can’t get an appointment with my GP – how can you help me?”

5. Slough’s landscape… • Diverse community where English is often not the first language • An area of high need with significant deprivation & health inequality • A quarter of children living in poverty • Growing & ageing population (up 17.1% since 2001) • Berkshire receives some of the lowest levels of health funding per head in the nation • Slough CCG has achieved improved health outcomes throughout the year in challenging circumstances and within budget

6. The Patient Voice… We are committed to ensuring that the voice of the patient community is reflected in the design of the health services we deliver and commission

7. Some successes over the past year…

8. Prime Ministers Challenge Fund…

9. Prime Ministers Challenge Fund (PMCF)… • 30April 2013: Slough CCG Board meeting in Public – that question • (Used prescribing savings to increase the number of GP appointments • – 5,000 extra over the Summer/Autumn • Used Winter Pressures funding to add to this further – 6,000 more) • 18October: PM announcement of £50m funding for improving access • December: Slough practices committed to application – led by our patients & public • January: Used the ELC process to co-design our bid for funding

10. Prime Ministers Challenge Fund (PMCF)… • Application submitted 14February 2014 – 48,000 appointments, 11 additional projects • Patient-led: What would “good” or “great” general practice look like? • Notified of our success 14April 2014 - £2.95m awarded • Practices & Patient Representative Group Forum mobilised • Feverish activity, late evening meetings, concrete plans • 1July: phased start of extended hours • 2nd week in August: fully implemented across Slough

11. Prime Ministers Challenge Fund (PMCF)… • All patients registered at a Slough practice • GP appointments to 8pm, Monday to Friday and • Saturday & Sunday from 9am to 5pm • Delivered from four Cluster practices – Crosby House, Bharani MC, Farnham Road and Langley HC • Very popular, well subscribed, mainly routine bookable appts., walk-ins also • Sustainability: part-time GPs increasing their commitments • Weekend and evening appointments look set to increase as a proportion of the general practice total – the times suit many people

12. Prime Ministers Challenge Fund (PMCF)… • Additional projects: • Phone texting: For cancelled appts; Public Health messages; and reminders • Dedicated mobile number for urgent contact (vulnerable patients) • Development of Patient Reference Group • Info programme: Comprehensive health information to be made available around self-care and keeping well & healthy • Introduction of self-help groups: At practice level • Exercise programme: Advice on how to access exercise groups in a social way • Patient access programme: Improvements to how GPs manage patient consultations, e.g. telephone consultations • Group consultations • Practice experience led design: Creating a positive patient experience, designed with and for patients • Changing consultations: Using simple words / plain English • Schools programme ‘Pester power’ around use of NHS services • Slough OD work – helping practices develop through this process

13. Diabetes… • Slough has above national average rates of diabetes – there are approx. 9,000 patients in Slough with the condition • Type 2 diabetes is six times more prevalent in people of South Asian origin • It is predicted that by 2030 up to 14% of the population will have diabetes

14. How did we tackle the issue? • Mentorship Programme established to help ‘upskill’ the 16 practices across Slough • Dedicated nurse-led clinics to help guide and train primary care practitioners • A key diabetes contact in each surgery for patients to get specialist advice • Support from PPGs to provide support and encourage self-management • This resulted in: • A target of a 5% uplift in the number of controlled diabetes population being met and exceed by all but one practice • A 7.2% increase in BP control • A 3.56% increase in total cholesterol control • Slough CCG is now ranked No. 2 out of 211 in England in delivering the • eight care processes in diabetes – a significant achievement

15. A&E pressures (Wexham Park)…

16. Winter campaign…

17. The result? A 0.6% increase in A&E attendance from Slough patients v. a population increase of 2% in a setting in which use of A&E nationally is increasing much faster

18. Quality Concerns at HWPH & Prescribing Advisor Team initiatives • Federated Quality Committee – three CCGs • Concerns re: Maternity, Stroke & A&E parameters and performance, & others • Raised through the quality mechanism to CQRG level • CQC unannounced inspection of HWPH, reports, Assurance Process • Currently seeing significantly improving performance in some areas • Slough CCG provided additional GP appointments over the winter period – made possible through savings via the expertise of our prescribing team, re-invested in GP appointments, whilst delivering improvement in the quality of our prescribing

19. New services and improving the patient experience… • Maternity – by implementing an experience-led commissioning approach and listening to patients we have allowed this to influence our commissioning strategy and achieved improvements in the quality of care and patient satisfaction • Better Care Fund - strong partnership working with our partners e.g. Slough Borough Council and HWB on the agreement of the Better Care Fund. • Physiotherapy – by de-commissioning and re-commissioning a new provider we have a much enhanced, faster and more comprehensive service in place • Community Gynaecology Clinic – this has enabled faster access to treatment and an improvement in patient choice and convenience.

20. Going forward… • Continuation of PMCF, roll-out of eleven related projects • Frimley Park acquisition of Heatherwood & Wexham Park: support the agreement, monitoring of quality • The frail older patient: home treatment teams, whole system change • Asthma Care: high admission rates, national outlier, two child deaths, poor levels of understanding of asthma management, and compliance with inhaler treatments and personalised asthma management plans. Supernovas. • Cancer care: the 2-week-wait referral system, End-of-Life care • Stroke Care: unsatisfactory aspects – performance needs to improve • Technology Enabled Care Services (TECS): Quality Working Group of NHSE

21. By working together we have demonstrated we can continuously improve the health of Slough THANK YOU for taking this journey with us & we look forward to another challenging and successful year…

22. Questions?