CCG Locality meeting slide pack Future locality meetings Wellbeing Service reminder

1. CCG Locality meeting slide pack • Future locality meetings • Wellbeing Service reminder • Dementia Audits • Flu vaccinations • Practice Information Support Pack – for information • PMS Review • Primary Care Strategy • Suffolk Federation Over 75 schemes • AOB

2. Future locality meetings • To enhance each meeting with a ‘local’ focus, non-CCG GPs are invited to jointly chair each meeting which takes place every other month • If you are interested, please either speak to the CCG Chair, leave your details on the evaluation form in your pack or email emily.rawlinson@ipswichandeastsuffolkccg.nhs.uk

3. Suffolk Wellbeing ServiceA Reminder

4. Suffolk Wellbeing ServiceA Reminder

5. Dementia AuditsThe issue 5

6. The Opportunity 6

7. Dementia Diagnosis Rate

8. No of people undiagnosed

9. Influenza Season 2014/15 The issue • Ipswich and East Suffolk CCG spent £2.4 million on hospital admissions for influenza and pneumonia in 2013/14. • This equated to 853 emergency admissions to Ipswich Hospital Trust (IHT). • The majority of the 853 people admitted were diagnosed with pneumonia. • The average LOS of people with influenza and pneumonia in IHT was 9.3 days. • This equates to 22 beds year round for people with influenza and pneumonia in 2013/14 (that’s almost a ward). • In 2013/14 there were 73.6% of 65+, 48.3% of under 65 at risk and 48% of pregnant women vaccinated for influenza. • No figures for pneumonia vaccination available.

10. What are the CCG doing to support increasing the uptake: • Flu and Pneumonia vaccinations are included as part of the quality audit for the care home contract. • Practices encouraged as part of their specific work for over 75s to ensure patients have had their flu and pneumonia vaccinations in particular for the most vulnerable 2% of patients and housebound patients. • Flu Clinic times/dates being collated. These will be advertised in the local press and on CCG website. • Implement Flu Kills campaign (see appendix 1). • Flu and Pneumonia leaflets sourced (including foreign language). Could we highlight that there is a myth buster for all on the flu protect website along with some other useful information. http://flu-protect.co.uk/downloadable-materials/ • Advertising free flu vaccination for primary carers. • The Area Team are commissioning a flu vaccination service from pharmacies. The service is only available to the ‘at risk’ patients between 18 and 65 (not the over 65s). Pharmacies will look to recruit patients that have not made arrangements for their vaccination through Primary Care. • Information provided via Locality Meetings to promote use of pneumonia vaccination opportunistically (see appendix 2). • Messages to be sent to Suffolk Family Carers, Parish magazines and CCG website.

11. What are some practices doing to ensure their best possible take up? Fressingfield Advertise in practice and on website from August and in all September and October editions of parish magazines plus handing out leaflets ● They do not write out individually to all patients to invite but will write out to non-responders in October ● Walk in clinics during the week early morning and early evening for 2 weeks ● Very good at opportunistically grabbing people when they come in for something else Alderton Surgery Invite all eligible patients under 65 by letter or text ● Well publicised via posters, website, prescriptions ● 1 full open day at each site for drop in appointments (2 nurses) ● Regular clinics with bookable appointments ● Housebound and care home patients all systematically done by practice and SCH Re invite non responders ● Prompt within SystmOne for anyone eligible so can be opportunistically done ● A marker added against all patients eligible to help with reminding patients attending Haven Health Heavily publicised walk in clinics which are advertised well in advance year after year via posters, website and on prescriptions ● Meeting with all staff at start of season so everyone knows all processes and how to answer patient queries ● Write out late in to season to those who haven’t attended yet ● All nursing and residential home patients systematically done ● Very efficient in arranging housebound patients to be done with SCH ● Exception code refusals ● EMIS Web has slick clinical protocol for recording GP practices are encouraged to put messages on TV screens within their own practice, on prescriptions and website. Other useful information can be found at: http://flu-protect.co.uk/flu-campaign-support/

12. Children to be offered flu vaccinations at school A pioneering pilot programme to offer children flu vaccinations at school is to be rolled out. For the first children in years 7 and 8 are being offered the vaccination as part of a county-wide pilot scheme. As part of the programme each child will be offered the vaccine as a simple nasal spray which is painless and a quick alternative to an injection.

13. Appendix 1 – Flu Kills Campaign

14. Appendix 2 – Pneumonia Vaccination Cross matching reports of upcoming appointments vs. patients still needing a flu jab From the Green book Chapter 25: Pneumococcal (December 2013) https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/263318/Green-Book-Chapter-25-v5_2.pdf Dosage and schedule Adults over 65 years and at-risk groups aged two years or over: A single dose of 0.5ml of PPV23. Administration Vaccines are routinely given into the upper arm in children and adults or the anterolateral thigh in infants under one year of age. This is to reduce the risk of localised reactions, which are more common when vaccines are given subcutaneously (Mark et al., 1999; Diggle and Deeks, 2000; Zuckerman, 2000). However, for individuals with a bleeding disorder, vaccines should be given by deep subcutaneous injection to reduce the risk of bleeding. Pneumococcal vaccines can be given at the same time as other vaccines such as DTaP/IPV/Hib, MMR, MenC, Hib/MenC and influenza. The vaccines should be given at separate sites, preferably in different limbs. If given in the same limb, they should be given at least 2.5cm apart (American Academy of Pediatrics, 2003) (see chapter 11). The site at which each vaccine was given should be noted in the individual’s records. Reinforcing immunisation PPV23 Antibody levels are likely to decline rapidly in individuals with no spleen, splenic dysfunction or chronic renal disease (Giebink et al., 1981; Rytel et al., 1986) and therefore re-immunisation with PPV23 is recommended every five years in these groups. Revaccination is well tolerated (Jackson et al., 1999). Testing of antibody levels prior to vaccination is not required. Although there is evidence of a decline in protection with time (Shapiro et al., 1991), there are no studies showing additional protection from boosting individuals with other indications, including age, and therefore routine revaccination is not currently recommended. Individuals who have previously received a 12- or 14-valent PPV should be immunised with PPV23 to gain protection from the additional serotypes. to encourage staff to vaccinate opportunistically.

15. Appendix 3 Flu Vaccination rates for Over and Under 65s per Practice

17. ALL AGES BY TFC SPECIALTY Contains: ENT ACTIVITY CARDIOLOGY ACTIVITY UROLOGY ACTIVITY OPHTHALMOLOGY ACTIVITY GASTROENTEROLOGY ACTIVITY RESPIRATORY ACTIVITY GYNAECOLOGY ACTIVITY

18. ENT Activity

19. Cardiology Activity

20. Urology Activity

21. Ophthalmology Activity

22. Gastroenterology Activity

23. Respiratory Medicine Activity

24. Gynaecology Activity

25. PMS Review

26. Suffolk PMS Review Update • Meetings taken place between the Area Team, LMC and two Suffolk CCGs looking at: principles of the review; value of the development framework; and updates to the development framework • Meeting with local MPs • Meeting between the two CCGs and LMC GPs to discuss the development framework 26

27. PMS Review – Development Framework Refresh • Core requirements section removed • Targets/language updated e.g. PCT to Area Team • Development indicators updated in new sections • Access • Public Health (Vacc & Imms, screening etc) • Prescribing • Use of NHS resources • Collaboration • Other (moved from core section e.g. community liaison, winter and disaster planning) 27

28. PMS ReviewNext Steps • Letter from Area Team describing the offer under Option 3 scheduled to be sent on 10th September. • CCGs, LMC and Area Team meeting to review the refreshed Development Framework being scheduled. • NHS England Executive meeting on 11th September to discuss PMS Reviews across the country. This may result in area and local agreements being subject to regional and national moderation. • Subject to outcome of above meeting, local objective remains for practices to have all necessary information on Option 2 and 3 to make choices by 10th October. 28

29. Primary Care StrategyUpdate

30. Purpose and Process Purpose: • To develop an ambitious and achievable framework for primary care commissioning and delivery for the next ten years. Process: • A group of local GPs and others have reviewed national and local approaches as well as qualitative and quantitative information on issues and opportunities for primary care in Suffolk. The output has been reviewed and refined by an external stakeholder group • Notes sent out via Inbox to all - some feedback ...more welcome. • Next steps: opportunity for individual practice feedback by email, in next practice link visits and at a dedicated group debate at the November training and education event.

31. Interim aims identified • Consistent high quality care • Leadership and co-ordination of integrated healthcare for local communities. • Delivery of all forms of care other than those which must be provided in an alternative care setting (acute, MH, community) for safety or other reasons. • Organisational forms capable of delivering excellence at practice level, 'locality' level and CCG or Suffolk wide level, (as appropriate to service)

32. Action Plans being developed relating to; • Recruitment and retention • Commissioning service models • Sustainable organisational forms • Infrastructure and implementation support including IT, estates, shared services, pathway implementation

33. If you have any comments, questions or points you wish to make after the locality meeting please forward them by e-mail; Louise.hardwick@ipswichandeastsuffolkccg.nhs.uk or David.brown2@ipswichandeastsuffolkccg.nhs.uk or Mark.shenton@nhs.net

34. Any other business • Is there anything else you would like to discuss? • Do you have any ideas about future agenda items for your locality? • If so, please raise now or add a comment to the evaluation form in your pack