Clinical Commissioning in the Farnham area A presentation to Farnham Town Council

1. Clinical Commissioning in the Farnham area A presentation to Farnham Town Council Thursday March 15, 2012 Dr. Jane Dempster Farnham Dene Medical Practice Chair Farnham CCG

2. Health & Social Care Bill The NHS White Paper, ‘Equity and excellence: Liberating the NHS’, set out the Government's long-term vision for the future of the NHS The vision builds on the core values and principles of the NHS - a comprehensive service, available to all, free at the point of use, based on need, not ability to pay

3. It sets out to: • Put patients at the heart of everything the NHS does • Focus on continuously improving those things that really matter to patients - the outcome of their healthcare • Empower and liberate clinicians to innovate, with the freedom to focus on improving healthcare services

4. From April 2013: • Primary Care Trusts and Strategic Health Authorities will be abolished • Clinical Commissioning Groups (CCGs), consisting of GPs and other clinicians, will be responsible for designing and commissioning health services for their local population • CCGs will be overseen by a new National Commissioning Board which will also be responsible for commissioning specialist services like transplants and health services in prisons

5. What are Clinical Commissioning Groups? • Groups of GPs and other key healthcare professionals who will be responsible for around 80% of the healthcare budget in their area and will plan and pay for services for the local population • Clinical Commissioning Groups will commission local healthcare, but GP services within an area will be commissioned by the National Commissioning Board • Clinical Commissioning Groups (CCGs) (formerly known as GP Consortia) will buy services from the hospitals, ambulance service and community services providers

6. All GPs will be a member of the CCG in their area • Each CCG will have a governing body • Governing bodies will include GPs, nurses, hospital doctors, other healthcare professionals and patient/lay representatives • The CCGs will also be responsible for engaging with local people to ensure that the services they are paying for meet local patient needs

7. What is Commissioning? • Over the past decade the role of commissioning, as a key driver of quality, efficiency and outcomes for patients, has become increasingly important to the health system in England • Commissioning is the process of planning, agreeing and monitoring services. However, this simple definition conceals great complexity.

8. Securing services is much more complicated than securing goods and the diversity and intricacy of the services delivered by the NHS are unparalleled. • Commissioning is not one action, but many; ranging from the health needs assessment for a population, through the clinically based design of patient pathways, to service specification and contract negotiation or procurement and finally to theongoing assessment of the quality of service.

9. Local Clinical Commissioning Groups • Proposed CCGs have taken part in initial risk assessments of proposed configurations • Farnham sits within the NHS Surrey Primary Care Trust area • There was a proposal for a Farnham CCG • The proposal was not viable - population size – 46,000, five GP practices • Department of Health suggests that population size needs to be at least 100,000

10. Population sizes for local possible CCGs • Farnham 46,000 • Guildford and Waverley 220,000 • Surrey Heath 90,000 • North East Hampshire 170,000

11. Commissioning for Farnham residents • Farnham GP practices have decided to form a partnership CCG with North East Hampshire CCG • North East Hampshire CCG has 19 GP practices and a population of around 170,000 • Together the two areas will be able to exert greater influence on Frimley Park Hospital – the acute hospital used by most patients from both areas • This partnership will have no impact on referral patterns or patient choice

12. Farnham Community Hospital and Centre for Health • Provides a wide range of services aimed at improving the health and well-being of the local population • PPI funded project so is owned by a private investment company • Lease belongs to Government – Thirty year lease • Site offers three GP practices • Outpatients appointments (Frimley Park Hospital and Surrey and Borders)

13. The Centre also provides :- • Diagnostic services, including X-ray and blood testing • Full range of Specialist outpatient clinics • Intermediate care day assessment and treatment older people • Specialist physiotherapy outpatient clinics • Podiatry • 63 inpatient beds for Intermediate care and Rehabilitation, including Stroke Rehabilitation (all single room with en-suite facilities) • 21 inpatient continuing care beds for Psychiatry of Old Age (all single room with en-suite facilities)

14. Community mental health outpatient services • Children’s services - Outpatient and assessment facilities • Child and Family Consultation Services • Specialist care Dentistry • Day services for people with eating disorders • Renal dialysis satellite unit • Community nursing base ( District Nurses) • Health Visitors including Child health Clinics • Adult and Community Services locality office • Retail Pharmacy

15. Future Plans for Farnham Hospital: Run by Surrey Community Services No intention to remove any services. SCS in process of probable transfer to Assura (now Virgin Health). They hope to expand the services offered and to make full use of all facilities.

16. Can I take your questions?