commissioning newspaper issue 3

Dr Charles Alessi,

Chair of the National

Association of Primary CareDr Peter Swinyard,

Chair of the Family Doctor

AssociationDr Michael Dixon,

Chair of the NHS AllianceProfessor Steve Field,

Chair of the NHS Future

Forum

www.commissioningshow.co.uk Issue 3

1000’s of commissioners, 4 healthcare leaders, 1 big debate

Four healthcare leaders to debate the challenges facing CCGs

Four national healthcare leaders will give their opinion on the immediate implementation challenges facing clinical commissioning groups (CCGs) and how these problems can be overcome.

The debate promises to be stimulating with the speakers including Dr Charles Alessi, Chair of the National Association of Primary Care, Dr Peter Swinyard, chair of the Family Doctor Association, Dr Michael Dixon, chair of the NHS Alliance and Professor Steve Field, chair of the NHS Future Forum. The session will be chaired by Beverley Bryant, managing director of Capita Health.

The leaders symposium will begin at 18.30 on the 27th June, preceded by a drinks reception. If you would like to attend please contact our delegate team on 02476 719 686.

continues on page 9

4 in 10 doctors need more knowledgeThe biggest challenge as CCGs work towards authorisation will be to get practices and individual GPs to feel involved, believes Dr Peter Swinyard, Swindon GP and chair of the Family Doctor Association (FDA).

‘If I knew the answer to that I would be one up on Barbara Hakin (managing director of commissioning development at the Department of Health) who said that it will be very difficult to get people to feel it’s ‘their’ CCG rather than ‘the’ CCG,’ he says.

The all-consuming nature of the day job and the disillusionment of senior doctors resulting from government reforms of the NHS pension, means that a lot more work still needs to be done to persuade doctors that the new system is going to work.

A FDA survey of its members earlier this year revealed that only four in ten doctors felt they had sufficient knowledge about commissioning and 27% wanted more information to help them participate.

continues on page 12

SEE PAGE 3 SEE PAGE 12 SEE PAGE 20SEE PAGES 6 & 7

Latest programme inside

Alastair McLellan to chair CCG debate

A familiar face on Long Term Conditions

Make a new CONNECTion

STILL TIME TO BOOK Call 02476 719 686 or visit www.commissioningshow.co.uk/book

The quality and patient safety agenda whilst managing finances is set to be a key theme of a leaders symposia sponsored by Capita which closes the first day of the conference.

Media partners:

Event sponsors:

In association with:

“The opportunity to share the experience of others facing the same challenges, for me is the most compelling reason to attend.”Dr Charles Alessi

STOP PRESS.........Stephen Dorrell MP to speak at CCG debate

Complete the Roadmap Competition at the Commissioning Show for your chance to win a car!

See our website for more details.

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Commissioning is organised by:

Unit 17, Exhibition House, Addison Bridge Place, London W14 8XP www.commissioningshow.co.uk Tel: 0207 348 5250

Ralph Collett, Show director [email protected]

James Hall, Sales manager [email protected]

Dan Harding, Event executive [email protected]

Alice Andrews, Delegate manager [email protected]

Sophie Holt, Marketing and PR manager [email protected]

Julia Danmeri, Head of operations [email protected]

Vanda Vokes, Conference and speaker manager [email protected]

Rebecca Royal, Event administrator [email protected]

Jo Farrimond, Accounts [email protected]

Andy Center, Chief Executive [email protected]

Michael Westcott, Business Development Director [email protected]

Phil Nelson, Commercial Director [email protected]

Jonathan Wood, Director of Finance [email protected]

Phil Soar, Chairman

Lansley and Hakin to deliver keynotesSecretary of state for health, Andrew Lansley and Dame Barbara Hakin, national director of commissioning development, will be delivering the closing keynotes on day one and two of Commissioning 2012.

Both sessions are expected to deliver the latest insights into national policy and direction, combined with a vision for the NHS going forwards. A Q&A session will follow giving delegates the opportunity to put their questions to the speakers. So no matter what your position on the politics of healthcare, these sessions promise forthright views and some lively debate.

Chaired by Dr Charles Alessi, Chair of the NAPC, the keynotes will be held in the 600 seater CCGs of the Future theatre, with coverage streamed live to other theatres to cater for overflow. Andrew Lansley will be taking to the stage at 17.00 on Wednesday 27th June with Dame Hakin on Thursday 28th at 15.35

NHS INFORMATION REVOLUTION?The long awaited information strategy is due to be published in the next few weeks with a promise by the Government that it will bring about an ‘information revolution’.

Delegates at the Commissioning Show will be able to find out first hand whether this information revolution really will be delivered.

Ailsa Claire, Transition Director Patients and Intelligence for the NHS Commissioning Board Authority, which will be implementing the strategy, will be giving a talk explaining the far-reaching implications of the strategy.

Ms Claire says they have been doing a lot of work attempting to understand how data might assist the NHS to do things differently, including changing its relationship with the public.

‘The directorate that we’re trying to set up is about enabling people to make the best decisions they possibly can, whether they are a commissioner, a patient or anyone else in the system. We have been working to gain an insight into how patients want to engage and relate to care services and how the care services can support them to make their own decisions,’ she explains.

The Commissioning for Intelligence Programme, which Ms Claire has been leading, has been conducting research into different channels of communication and how informatics can support the business model of clinical commissioning groups (CCGs).

‘We have been looking at what data standards and quality we need to put in to the strategy to enable information to flow through the system. We are working to help CCGs to directly relate to the health of the population they are working with. The information strategy will focus on enabling people to make the best decisions and it will place IT as an enabler.’

Ms Claire says her talk will be directly aimed at clinical

commissioners and it will explain what the impact of the information strategy is likely to be.

To inform the new strategy, her department has been examining how CCGs get intelligence and information. She says CCG leaders they have talked to have told them that they want a very different flow of information and processes from the ones previously provided by primary care trusts (PCTs).

‘The real problem has been that the primary source of information for PCTs was contract information and what the CCGs want is patient based information which exists but is difficult to get at, so that is what we have got to try and get for them.

‘Some of the information will be facilitated by the new role of the Information Centre which will be a given a specific new responsibility for data linkage for health and social care. It will therefore become a safe haven where patient data will be made unidentifiable and available for CCGs.

‘Data will improve. In the past it has been very separate for the NHS and the business model has often had to adapt to informatics instead of the other way around. We now have an opportunity to turn that around and make the provision of data and information a support mechanism for the NHS and not for it to become something imposed on the NHS,’ she promises.

fdbhealth.co.uk

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‘Productivity through Technology’ stream 27th June at 2.15pm.Come and listen to FDB’s Product and Marketing Director, Mark Treleaven on why the time and technology is right for a sea change in Primary Care medicines management.

MEDICINES OPTIMISATION AT STAND AA51

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“We are working to help CCGs to directly relate to the health of the population they are working with”Ailsa Claire

Andrew Lansley Dame Babara HakinDr Charles Alessi

SEE THE LATEST SHOW NEWS ATwww.commissioningshow.co.uk

www.commissioningshow.co.uk 3

Visit us at stand B41 to � nd out which patients could bene� t from Xarelto®

© Bayer Healthcare BHP

Xarelto®15 and 20mg � lm-coated tablets (rivaroxaban) Prescribing Information (Refer to full Summary of Product Characteristics (SmPC) before prescribing) Presentation: 15mg tablet: Red, round, biconvex � lm-coated tablets containing 15mg rivaroxaban. 20mg tablet: Brown-red, round, biconvex � lm-coated tablets containing 20mg rivaroxaban. Indication(s): Prevention of stroke & systemic embolism in adult patients with non-valvular atrial � brillation with one or more risk factors such as congestive heart failure, hypertension, age ≥75, diabetes mellitus, prior stroke or transient ischaemic attack. Posology & method of administration: Dosage – 20mg orally od with food. Continue therapy long term provided bene� t of prevention of stroke & systemic embolism outweighs risk of bleeding. Refer to SmPC for information on converting to/from Vitamin K antagonists (VKA) or parenteral anticoagulants. Renal impairment: mild (creatinine clearance 50–80ml/min) – no dose adjustment necessary; moderate (creatinine clearance 30–49ml/min) – reduce dose to 15mg od; severe (creatinine clearance 15–29ml/min) – limited data indicates rivaroxaban plasma concentrations are signi� cantly increased, reduce dose to 15mg od & use with caution. Patients with creatinine clearance <15ml/min – use not recommended. Hepatic impairment: Do not use in patients with hepatic disease associated with coagulopathy & clinically relevant bleeding risk (including cirrhotic patients with Child Pugh B & C patients). Elderly, body weight & gender: No dose adjustment. Paediatrics: Not recommended below 18 years of age. Contra-indications: Hypersensitivity to active substance or any excipient; clinically signi� cant active bleeding; hepatic disease associated with coagulopathy & clinically relevant bleeding risk (including cirrhotic patients with Child Pugh B & C); pregnancy & breast feeding. Warnings & precautions: Clinical surveillance in line with anticoagulant practice is recommended throughout the treatment period. In studies mucosal bleedings & anaemia were seen more frequently during long term rivaroxaban treatment compared with VKA treatment – haemoglobin/haematocrit testing may be of value to detect occult bleeding. Following sub-groups of patients are at increased risk of bleeding & should be carefully monitored after treatment initiation. Use with caution – in patients with severe renal impairment (creatinine clearance 15–29ml/min) or in patients with renal impairment concomitantly receiving other

medicines that are potent inhibitors of CYP3A4 (PK models show increased rivaroxaban concentrations in these patients); in patients treated concomitantly with medicines affecting haemostasis; in patients with an increased bleeding risk such as congenital or acquired bleeding disorders, uncontrolled severe arterial hypertension, active ulcerative gastrointestinal disease (consider appropriate prophylactic treatment for at risk patients), recent gastrointestinal ulcerations, vascular retinopathy, recent intracranial or intracerebral haemorrhage, intraspinal or intracerebral vascular abnormalities, recent brain / spinal / ophthalmological surgery, bronchiectasis or history of pulmonary bleeding. Use is not recommended in patients: with creatinine clearance <15ml/min; receiving concomitant systemic treatment with azole-antimycotics or HIV protease inhibitors; with prosthetic heart valves; for treatment of acute pulmonary embolism. If invasive procedures or surgical intervention are required, stop Xarelto use at least 24 hours beforehand. Restart use as soon as possible provided adequate haemostasis has been established. See SmPC for full details. Xarelto contains lactose. Interactions: Concomitant use with strong inhibitors of both CYP3A4 & P-gp (e.g. ketoconazole, itraconazole, voriconazole, posaconazole, ritonavir) is not recommended as increased rivaroxaban plasma concentrations to a clinically relevant degree are observed (may increase risk of bleeding). Avoid co-administration with dronedarone. Use with caution in patients concomitantly receiving other anticoagulants (e.g. enoxaparin), NSAIDs (including acetylsalicylic acid) or platelet aggregation inhibitors due to the increased bleeding risk. Strong CYP3A4 inducers (e.g. rifampicin, phenytoin, carbamazepine, phenobarbital, St. John’s Wort) should be used concomitantly with caution as they may reduce rivaroxaban plasma concentrations. Pregnancy & breast feeding: Contra-indicated. Effects on ability to drive and use machines: Adverse reactions like syncope & dizziness are common. Patients experiencing these effects should not drive or use machines. Undesirable effects: Common anaemia, dizziness, headache, syncope, eye haemorrhage, tachycardia, hypotension, haematoma, epistaxis, GI tract haemorrhage, GI & abdominal pains, dyspepsia, nausea, constipation, diarrhoea, vomiting, pruritus, rash, ecchymosis, pain in extremity, urogenital tract haemorrhage, fever, peripheral oedema, decreased general strength & energy,

increase in transaminases, post-procedural haemorrhage, contusion. Uncommon thrombocythemia, allergic reaction, allergic dermatitis, cerebral & intracranial haemorrhage, haemoptysis, dry mouth, abnormal hepatic function, urticaria, cutaneous & subcutaneous haemorrhage, haemarthrosis, renal impairment; feeling unwell, localised oedema, increased: bilirubin, blood alkaline phosphatase, LDH, lipase, amylase, GGT; wound secretion. Rare jaundice, muscle haemorrhage, increased conjugated bilirubin. Frequency not known pseudoaneurysm formation following percutaneous intervention, compartment syndrome secondary to a bleeding, renal failure/acute renal failure secondary to a bleeding suf� cient to cause hypoperfusion. Occult or overt bleeding from any tissue or organ which may result in post-haemorrhagic anaemia and complications with variable severity (including fatal outcome). Prescribers should consult SmPC in relation to full side effect information. Overdose: Rare cases of overdose up to 600mg have been reported without bleeding complications or other adverse reactions. Due to limited absorption a ceiling effect is expected at supratherapeutic doses of 50mg rivaroxaban or above. No speci� c antidote is available. Use of activated charcoal to reduce absorption may be considered. For management of bleeding complication associated with rivaroxaban please refer to the SmPC. Legal Category: POM. Package Quantities and Basic NHS Costs: 15mg – 28 tablets: £58.80, 42 tablets: £88.20, 100 tablets: £210.00; 20mg – 28 tablets: £58.80, 100 tablets £210.00. MA Number(s): EU/1/08/472/011-21. Further information available from: Bayer plc, Bayer House, Strawberry Hill, Newbury, Berkshire RG14 1JA, U.K. Telephone: 01635 563000. Date of preparation: November 2011.Xarelto® is a trademark of the Bayer Group.

Simple, proven, predictable anticoagulation

Prevention of stroke and systemic embolism in eligible patients with non-valvular atrial � brillation

UK.PH.GM.XAR.2012.205 May 2012

Xarelto®

NOW AVAILABLE FOR

Adverse events should be reported. Reporting forms and information can be found at

www.mhra.gov.uk/yellowcard. Adverse events should also be reported to Bayer plc.

Tel.: 01635 563500, Fax.: 01635 563703, Email: [email protected]

coagulation

complicateda stop to

ant -l

help put

One tablet, once daily Xarelto®: simple stroke prevention in atrial � brillation vs warfarin

BAY01J11011_new_Xarelto _CPJ_A4_0503.indd 1 09/05/2012 11:52

Federated Sharing in the “Liberated NHS”

In the “Liberated NHS”, the need for federated sharing of information is growing. Information needs to flow across CCGs, member practices, Health and Wellbeing Boards, LMCs and hospital Trusts. It must be instantly disseminated and usable, avoiding irrelevance and confusion over versions and accuracy.

Traditional solutions are already failing to meet the challenge. Emails with long distribution lists get lost, ignored or deleted when mailboxes are full. Websites can drown the materials relevant to you, or they join a long list of external places to visit for important information.

GPTeamNet offers an information m a n a g e m e n t solution for CCGs that instils confidence in information. Our federated approach operates, without duplication, across the CCG and its practices, localities, provider groups and related bodies. Every team has their own GPTeamNet portal providing a robust, secure platform for collaboration. Many CCGs are already reaping the benefits GPTeamNet offers.

GPTeamNet provides specific modules for day to day operations. Rather than asking colleagues to visit a CCG site and search for information, offering limited incentive to do so, it delivers benefits to practices as part of their daily activity. CCGs can centrally manage referral guidance for the practices to drive consistency, saving time and money. Users can track who has read and acknowledged information, and use collation and submission features for statutory frameworks.

To see GPTeamNet in action and to learn how we can support you, visit us at Stand AA61 at The Commissioning Show 2012 or email [email protected].

Connect with delegates at CommissioningThe Commissioning Connect platform is live for Commissioning Show delegates.* Unique to the healthcare event sector, Connect allows delegates to set their own agenda for the show, ensuring they get to talk about what matters most to them.

From fast paced team updates to lively debates, delegates can set a topic, reserve an area in the networking space and search for attendees to invite. It will also bring social networking to the show, allowing delegates to share their discussion groups through Twitter, Facebook and LinkedIn - even inviting their networks and colleagues to join the debate!

Find out more at www.commissioningshow.co.uk*Connect is for our NHS and public sector delegates, expert partners, associations and media partners.

In partnership with

@CommShowFOLLOW US ON TWITTER


Aimed predominantly at CCG and PCT cluster board members and finance directors they will provide an insight into how demographic data can be used for strategic planning and targeting wellness campaigns.

Experian, an information services company, has a track record of success gained from three decades of experience in managing and interpreting consumer and business data.

In one successful project Experian used customer insight to help Great Yarmouth and Waveney PCT to increase consumption

of fruit and vegetables in a deprived population at greatest risk of heart attacks, strokes or diabetes.

Using a data-led strategy the PCT was able to introduce a mobile food shop which gave people access to wholesale price produce, information about food preparation and directed them to lifestyle improvement programmes in their area.

Using data from the Mosaic Public Sector lifestyle segmentation, National Hospital data and the Health Survey for England, the PCT was able to

identify the people who would most benefit from the initiative, the best times for the service to run and the best route for the truck to take.

During the first five months the project achieved a 26% increase in people consuming the recommended five a day and 137 customers were referred to other health services such as breast feeding, stopping smoking and the Health Trainer service.

The insight Experian has provided to NHS Barking and Dagenham has helped with a range of campaigns across the London borough including improving access to services.

With help from Experian the PCT was able to identify where groups most likely to have teenage pregnancies spent their free

time. The resulting poster campaign was hugely successful in increasing awareness of services available for pregnant teens and a pregnancy information website experienced a 38% increase in traffic.

Another highly targeted campaign reduced inappropriate attendances at A&E departments by identifying problem groups and the GP catchment areas where they lived.

Experian’s Health Needs Assessment Service can help CCGs to identify local health needs using the most comprehensive, accurate and consistent view of the UK population’s health risks.

Greenwich PCT commissioned Experian to review their existing service provision and future needs in order to improve services for those with the greatest health risks and to increase pharmacy network efficiency.

A Health Needs Assessment for planned housing developments identified where current services were sufficient for the new population and where gaps may occur, informing future planning of health services in the area.

‘The Experian team had the right level of technical expertise and innovation that resulted in work that was more thorough than other providers - a 10/10 in terms of recommending them to others,’ was the verdict of David Long, joint community pharmacy lead at NHS Greenwich.

One to one surgeries will offer insight from industry experts

For premier healthcare – refer to uswww.hcahospitals.com HCA is the private hospital group of choice for the successful

treatment of serious and complex medical conditions. Our six world-class hospitals, three private patient centres in partnership with top NHS teaching hospitals and ten outpatient medical centres achieve some of the highest patient outcomes and lowest infection rates in the UK.

Our internationally recognised Centres of Excellence provide the latest in cardiac care, neurology (brain and spine injuries), women’s health, paediatrics, IVF and fertility, and we are the UK’s largest private provider of cancer care.

Using the latest technology, drugs and therapies, we ensure our patients always have access to the best possible treatment and leading specialists and doctors from NHS teaching hospitals. We have direct access to the latest clinical trials, and more intensive care beds than any other private hospital group in the UK, achieving consistently high patient survival rates.

We treat patients from London, the UK and all over the world and promise privacy, respect, comfort, cleanliness and the highest standards of treatment.

Visit us at stand AA67 to find out how we can care for your patients.

Thinking about business intelligence?Think about SystmOne.

In the new world of GP commissioning there’s a temptation to spend thousands on new software for business intelligence and risk stratification. But if you choose to deploy SystmOne, there’s simply no need.

Along with our extensive clinical reporting functionality, which comes as standard when you deploy SystmOne, we can also offer you regular data extracts and analysis tools. That means everything you need to assess efficiency and quality is included in the same clinical system you use every day.

Whether you want to report on Trust-supplied SUS data or analyse coded data to isolate problematic conditions, SystmOne can help. Want data monthly? Or perhaps just once or twice a year? The very best thing about SystmOne is that it’s completely configurable. Whatever your requirements are, and however large (or small) your patient population is, we have the right tools on hand.

Moving to SystmOne is the easiest way to get all the right tools and share the right information, across your entire Clinical Commissioning Group.

To find out more, visit us on stand E21.

Expert surgeries sponsored by Experian where delegates can book one-to-one sessions with an expert partner will run throughout the day on both days of the Commissioning Show.

“The Experian team had the right level of technical expertise and innovation that resulted in work that was more thorough than other providers”David Long


The outward signs of heart failure include breathlessness, fatigue and ankle swelling. Alongside this, patients have evidence that the heart is not functioning efficiently. It is a serious condition, patients are frequently admitted to hospital with episodes of breathlessness and only half of patients survive five years from their initial diagnosis. However if it is identified early then it is also a treatable condition and both the symptoms and survival can be improved. The three most important interventions are cardiac rehabilitation, treatment with beta-blockers and treatment with either ACE inhibitors or Angiotensin Receptor Blockers.

The biggest problem with LVD is that it is not detected. The definitive test for LVD is an echocardiogram. This is painless, non-invasive and can be carried out in a primary care setting, but it is not cheap (£86 per echo plus management and clinical assessment costs). Because LVD is more common in people who have had heart disease, in recent years it has become normal practice for hospitals to ensure that every patient discharged from hospital after a MI has an echocardiogram. But this still leaves a problem. Patients who had their MI in the past may not have had an echocardiogram. Indeed there is a substantial backlog of MI survivors who could benefit from review.

The Sandwell pilot project started from this point. In collaboration with the University of Birmingham an algorithm was developed to identify the patients most likely to have LVD. Local Cardiology support to review findings was enlisted. The algorithm prioritises older male patients who have survived an MI.

The process was then piloted in a volunteer general practice. Every patient over 45 was assigned a risk score using this algorithm and those with the highest risk were invited for echocardiography and a cardiac assessment in the practice. The results were a great success.

Of 19 patients invited, 16 attended for the echocardiogram and check up. Those who attended were all male with an average age of 78.5 years. They had a history of MI on average 11 years before. As a result of the assessment we referred 5 for management of heart failure. 7 patients needed adjustments to their treatment.

Patient views were elicited through a combination of questionnaire and an informal discussion with the CHD nurse at the review. The main findings were that the invitation did not cause alarm or worry, the patients thought that it was good that the GP practice was trying to identify things that could help them live a longer healthier life. The next most striking comment from the patient feedback was that the patients thought that a specialist should review how they were doing at some unspecified but periodic interval. This didn’t reflect dissatisfaction with the GP but more the notion that something like a heart attack should be monitored and managed by a cardiologists or specialist nurses who only dealt with heart attacks.

Of the three that did not attend one had been admitted to hospital and the other two had recently been seen as part of a routine CHD review at the surgery. Of the patients who had been identified as having moderate or severe LVD there was a general feeling of reassurance that a management plan was in place. One patient who had a section of lung removed due to cancer had assumed that his breathlessness was entirely due to this and as such had not informed the GP of his increasing breathlessness. He had been leading an ever more restricted

existence. Treatment changes helped improve quality of life quite noticeably.

The cost savings from this work are via prevented emergency admissions, which are often the way in which people with previously undiagnosed heart failure are detected. Better medical management in the community is an improvement both for patients’ quality and length of life.

For more information come along to our workshop: LVSD case finding improves patient quality and length of life and saves hospital admissions - Thursday 28th June 2012, at 14:20.

© Bayer Healthcare BHP

Xarelto®15 and 20mg � lm-coated tablets (rivaroxaban) Prescribing Information (Refer to full Summary of Product Characteristics (SmPC) before prescribing) Presentation: 15mg tablet: Red, round, biconvex � lm-coated tablets containing 15mg rivaroxaban. 20mg tablet: Brown-red, round, biconvex � lm-coated tablets containing 20mg rivaroxaban. Indication(s): Treatment of deep vein thrombosis (DVT) & prevention of recurrent DVT & pulmonary embolism (PE) following an acute DVT in adults. Posology & method of administration: Dosage – 15mg bd for 3 weeks followed by 20mg od for continued treatment & prevention of recurrent DVT & PE; take with food. Refer to SmPC for information on duration of therapy & converting to/from Vitamin K antagonists (VKA) or parenteral anticoagulants. Renal impairment: Mild (creatinine clearance 50–80ml/min) – no dose adjustment necessary; moderate (creatinine clearance 30–49ml/min) – 15mg bd for 3 weeks, reduce maintenance dose to 15mg od; severe (creatinine clearance 15–29ml/min) – limited data indicates rivaroxaban plasma concentrations are signi� cantly increased, 15mg bd for 3 weeks, reduce maintenance dose to 15mg od & use with caution. Patients with creatinine clearance <15ml/min – use not recommended. Hepatic impairment: Do not use in patients with hepatic disease associated with coagulopathy & clinically relevant bleeding risk including cirrhotic patients with Child Pugh B & C patients. Elderly, body weight & gender: No dose adjustment. Paediatrics: Not recommended below 18 years of age. Contra-indications: Hypersensitivity to active substance or any excipient; clinically signi� cant active bleeding; hepatic disease associated with coagulopathy & clinically relevant bleeding risk (including cirrhotic patients with Child Pugh B & C); pregnancy & breast feeding. Warnings & precautions: Clinical surveillance in line with anticoagulant practice is recommended throughout the treatment period. In studies mucosal bleedings & anaemia were seen more frequently during long term rivaroxaban treatment compared with VKA treatment – haemoglobin/haematocrit testing may be of value to detect occult bleeding. Following sub-groups of patients are at increased risk of bleeding & should be carefully monitored after treatment initiation. Use with caution – in patients with severe renal impairment (creatinine clearance 15–29ml/min) or in patients with renal impairment concomitantly receiving other medicines that are potent inhibitors of CYP3A4

(PK models show increased rivaroxaban concentrations in these patients); in patients treated concomitantly with medicines affecting haemostasis; in patients with an increased bleeding risk such as congenital or acquired bleeding disorders, uncontrolled severe arterial hypertension, active ulcerative gastrointestinal disease (consider appropriate prophylactic treatment for at risk patients), recent gastrointestinal ulcerations, vascular retinopathy, recent intracranial or intracerebral haemorrhage, intraspinal or intracerebral vascular abnormalities, recent brain / spinal / ophthalmological surgery, bronchiectasis or history of pulmonary bleeding. Use is not recommended in patients: with creatinine clearance <15ml/min; receiving concomitant systemic treatment with azole-antimycotics or HIV protease inhibitors; with prosthetic heart valves; for treatment of acute pulmonary embolism. If invasive procedures or surgical intervention are required, stop Xarelto use at least 24 hours beforehand. Restart use as soon as possible provided adequate haemostasis has been established. See SmPC for full details. Xarelto contains lactose. Interactions: Concomitant use with strong inhibitors of both CYP3A4 & P-gp (e.g. ketoconazole, itraconazole, voriconazole, posaconazole, ritonavir) is not recommended as increased rivaroxaban plasma concentrations to a clinically relevant degree are observed (may increase risk of bleeding). Avoid co-administration with dronedarone. Use with caution in patients concomitantly receiving other anticoagulants (e.g. enoxaparin), NSAIDs (including acetylsalicylic acid) or platelet aggregation inhibitors due to the increased bleeding risk. Strong CYP3A4 inducers (e.g. rifampicin, phenytoin, carbamazepine, phenobarbital, St. John’s Wort) should be used concomitantly with caution as they may reduce rivaroxaban plasma concentrations. Pregnancy & breast feeding: Contra-indicated. Effects on ability to drive and use machines: Adverse reactions like syncope & dizziness are common. Patients experiencing these effects should not drive or use machines. Undesirable effects: Very common urogenital tract haemorrhage (in women <55 years in DVT-T trials). Common anaemia, dizziness, headache, syncope, eye haemorrhage, tachycardia, hypotension, haematoma, epistaxis, GI tract haemorrhage, GI & abdominal pains, dyspepsia, nausea, constipation, diarrhoea, vomiting, pruritus, rash, ecchymosis, pain in extremity, urogenital tract haemorrhage, fever, peripheral oedema, decreased general

strength & energy, increase in transaminases, post-procedural haemorrhage, contusion. Uncommon thrombocythemia, allergic reaction, allergic dermatitis, cerebral & intracranial haemorrhage, haemoptysis, dry mouth, abnormal hepatic function, urticaria, cutaneous & subcutaneous haemorrhage, haemarthrosis, renal impairment; feeling unwell, localised oedema, increased: bilirubin, blood alkaline phosphatase, LDH, lipase, amylase, GGT; wound secretion. Rare jaundice, muscle haemorrhage, increased conjugated bilirubin. Frequency not known pseudoaneurysm formation following percutaneous intervention, compartment syndrome secondary to a bleeding, renal failure/acute renal failure secondary to a bleeding suf� cient to cause hypoperfusion. Occult or overt bleeding from any tissue or organ which may result in post-haemorrhagic anaemia and complications with variable severity (including fatal outcome). Prescribers should consult SmPC in relation to full side effect information. Overdose: Rare cases of overdose up to 600mg have been reported without bleeding complications or other adverse reactions. Due to limited absorption a ceiling effect is expected at supratherapeutic doses of 50mg rivaroxaban or above. No speci� c antidote is available. Use of activated charcoal to reduce absorption may be considered. For management of bleeding complication associated with rivaroxaban please refer to the SmPC. Legal Category: POM. Package Quantities and Basic NHS Costs: 15mg – 28 tablets: £58.80, 42 tablets: £88.20, 100 tablets: £210.00; 20mg – 28 tablets: £58.80, 100 tablets £210.00. MA Number(s): EU/1/08/472/011-21. Further information available from: Bayer plc, Bayer House, Strawberry Hill, Newbury, Berkshire RG14 1JA, U.K. Telephone: 01635 563000. Date of preparation: November 2011.Xarelto® is a trademark of the Bayer Group.

Simple, proven, predictable anticoagulation

UK.PH.GM.XAR.2012.204 May 2012

Treatment of deep vein thrombosis (DVT) and prevention of recurrent DVT and pulmonary embolism (PE) following an acute DVT in adults

Xarelto®

NOW AVAILABLE FOR

coagulation

complicateda stop to

ant -l

help put

Visit us at stand B41 to � nd out more about cost saving opportunities in DVT treatment

Xarelto®: the � rst oral single-drug approach for DVT treatment

Adverse events should be reported. Reporting forms and information can be

found at www.mhra.gov.uk/yellowcard. Adverse events should also be reported to Bayer plc.

Tel.: 01635 563500, Fax.: 01635 563703, Email: [email protected]

BAY01J11011_DVT_CLINIC_PHAM_Ad_297x210_0305.indd 1 09/05/2012 11:36

Sandwell PCT is pioneering active case-finding for undiagnosed heart failure.

Sandwell PCT is pioneering active case-finding for undiagnosed heart failure.

Following a successful pilot project it is planned to use MSDi Clinical Manager software to identify patients who are likely to have heart failure or Left Ventricular Dysfunction (LVD), which is a common precursor of heart failure. The identified patients are invited for echocardiography and assessment in their own GP practice. Those who need it are referred for specialist management of heart failure or to their GPs if they need other changes to their medication.

Finding hidden heart failure Accommodation at the Commissioning Show 2012

Are you looking for accommodation in London for your stay at the Commissioning Show?

Did you know you can get preferential rates on a range of hotels through our accommodation partner Event Express? There are also great value options for NAPC members.

Visit the Commissioning Show website... www.commissioningshow.co.uk/accommodation to find out more.

“The patients thought that is was a good thing that the GP practice was trying to identify things that could help them live a longer and healthier life”

6 www.commissioningshow.co.uk

The definitive event for clinical commissioning is back this June– There is still time to book for one of the UK’s largest healthcare events.Registration is now open for one of the UK’s largest GP events. With the changes well underway that will bring about a primary care-led health service, you can join over 3000 GPs and primary care professionals leading the way in delivering better patient service. Take a look at the latest programme for our conference sessions and speakers. But the Commissioning Show is about much more than listening to the key issues debated by some of healthcare’s most influential figures. It’s really about the commissioners themselves and the experience they can offer each other, all the successes and cautionary tales from those on the road to authorisation - however far along.

Commissioning gives you the perfect platform to put your burning questions to policy makers, experts, local authorities and most importantly your healthcare peers. So what do you need to know to deliver the best service for your patients in 2012 and beyond?

*Content provided by our event sponsors, visit www.commissioningshow.co.uk for more details

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Managing Long Term Conditions Integrated Care Productivity Through Technology CCGs of the Future HWB: Productive relationships

Chair’s welcome Chair’s welcome Chair’s welcome Chair’s welcome Chair’s welcome

Patient and professional perspectives on living with LTCs

If “culture eats strategy for breakfast”, how do we change it?

Moving towards authorisation: Cumbria in 2013

Meeting the intelligence needs of CCGs The anatomy, physiology and embryology of health and wellbeing boardsQuality, Productivity and Prevention

in cardio-metabolic disease through an Innovative clinical change management programme*

Battle plans and care pathways*

Preparing for CQC

Supporting commissioning intelligence* Building blocks of integrated care* National guidelines: translating them into local practice*

Networking Networking NetworkingNetworking Networking

Improving patient care and service efficiencies through partnership working

Here’s one I made earlier: Case studies on integrated care Developing multi-disciplinary workingSystems to support the next

generation of commissioningAnother ‘talking shop’? A case study on

the rise of the decision-making HWB

Lunch Lunch LunchLunch Lunch

QIPP showcase: LTC management that works

Continuity of GP care, the bedrock of integration How can GPs avoid conflicts of interestPredictive modelling to reduce

risk and admissions

What will success look like? Measuring performance on health

and wellbeing in CornwallSponsored session* Realising the financial benefits of

commissioning DVT and Heart Failure Services in Primary Care*Medicines Optimisation* Health Protection Services for the

next decade: from HPA to PHE*Models for Stable Angina* How working with pharmacy can improve

quality and support integration in LTCsNetworking

Setting up the optimum commissioning support

Networking

Networking NetworkingAlive and clicking: Social

media and the NHSHow to overcome tribal loyalties? Panel discussion on cooperative HWB working

Sponsored session* The big wins for integration Networking

Measuring meaningful improvement in LTC: how will we do it? Integration in practice Mental Health care management

enabled by technology Identifying opportunities for CCG efficienciesThe co-production model – a shared population approach to health and

wellbeing reflecting all interests and assets

Plenary session: Secretary of state for health

Leaders symposia and reception - Sponsored by - Capita

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Integrated high quality care: NHS Future Forum’s vision for making it happenOutside the box: innovative approaches

to improving outcomes in LTCs

5 high impact changes that achieve integration

Exploiting technology to drive efficiency

How can HWBs transform services and outcomes?

Insurance risk and service risk: what do you need to know?

Networking

Optimising current anticoagulation therapy in atrial Fibrillation - The role of TTR*

The lessons learned in improving outcomes for patients with Asthma* Protect your income whilst

improving patient accessNetworking

Quality initiatives that improve care, save lives and reduce expenditure Sponsored session*NetworkingNetworking Networking

Networking NetworkingHow can commissioners improve experience of care?

Mental Health Services: How do we commission together?

Developing multi-disciplinary working within commissioning

Telehealth to challenge the status quo - the need for evidence

The Future of Public Health – a new landscape

LunchLunch Lunch

Lunch LunchSystem leadership and integrated commissioning, experiences

from the front line

Seeking outside help with commissioning: outsourcing options

Who can add value to commissioning for LTCs

Mobile solutions. Communication at the point of care

Birmingham: improving outcomes in a complex environment

CCG Leaders: The big debateDon’t Buy IT* LGC: Joint working debate

Walk in my shoes: how co-designing strategy and service drives innovation and

integrated care in stroke prevention*Sandwell LVSD Pilot*

Networking Networking

Networking Networking Networking

Plenary session: Dame Barbara Hakin National Director of Commissioning Development

Farbe/colour:PANTONE 288 CV

Farbe/colour:PANTONE 288 CV

7www.commissioningshow.co.uk

You can view full programme details online at www.commissioningshow.co.uk but here are just some of the highlights...MOVING TOWARDS AUTHORISATIONA CCG pioneer shares its experiences of moving towards authorisation in 2013, offering practical tips to those facing the same challenges. Dr Hugh Reeve, chair of Cumbria Clinical Commission Group and GP Partner, Nutwood Surgery, Grange-over-Sands.

5 HIGH IMPACT CHANGES THAT ACHIEVE INTEGRATION: LEARNING FROM INTERNATIONAL BEST PRACTICEThe Nuffield Institute published a seminal report on integrated care, which analysed how four successful health economies have made integration happen. This session provides insights and lessons for CCGs wanting to achieve the same. Dr Rebecca Rosen, Senior Fellow, Nuffield Trust

PATIENT, CARER AND PROFESSIONAL PERSPECTIVES ON LIVING WITH LONG TERM CONDITIONSThis session explores the perspectives of professionals and contrasts them with the perspective of a person and carer with experience of living with a long term condition that is reaching epidemic proportions - dementia. Dr Amit Bhargarva, GP Principal, Southgate Medical Group and Fiona Philips, Ambassador, Alzheimer’s Society

MEASURING MEANINGFUL IMPROVEMENT IN LTC: HOW WILL WE DO IT?An overview of COF indicators and their role in CCG accountability.Dr Gillian Leng, Deputy Chief Executive, NICE

ANOTHER ‘TALKING SHOP’? A CASE STUDY ON THE RISE OF THE DECISION-MAKING HEALTH AND WELLBEING BOARDSWigan has used an approach in developing its Health and Wellbeing Board that has majored on new commissioning leadership relationships. GPs and Councillors have been building the foundations of a common purpose and vision for health and wellbeing. As CCGs come into being the intention is that the Health and Wellbeing Board is placed to be able to put strategic commissioning for change and improvement directly into action. Integrating wellbeing, social care and clinical pathways is at the centre of the work. Stuart Cowley, Director: Personalisation & Partnerships, Wigan Council

New for 2012, the facilitated learning area will allow you to join a facilitated workshop where you can work with colleagues and other groups on real life scenarios. Lead by a professional facilitator, each session will have a set task to complete as a group, with the objective of leaving with practical solutions that can be implemented in your locality.

An innovative delegate booking platform opens up new opportunities for networking, both in the run up to the show and beyond. Delegates will be able to create a bespoke conference programme for themselves, combining their selections from the formal sessions with facilitated networking and face to face meetings with peers.

Commissioning 2012 will be covering the hottest topics of the day, though we may not know what they all are yet! Our round table programme will allow delegates, partners and experts to table hot topics and watch the debate unfold. These lively, less structured discussions are an ideal way to gain insight into current practice and opinion.

New for 2012, the facilitated networking area will allow delegates to build their own programme of meetings around the main conference programme. Identify experts and peers with practical experience in your key areas. You can even create your own sessions around the topics that matter most to you and invite like-minded colleagues to join you.

WHAT’S NEW FOR 2012?Listen, learn, debate: The social network

Commissioning’s hottest debates: Get face to face with your commissioning heroes:

A programme featuring the who’s-who of Commissioning:Andrew Lansley, Secretary of State for HealthDr Charles Alessi, Chair of the NAPCDr Michael Dixon, NHS AllianceDame Barbara Hakin, National Director of Commissioning DevelopmentDr Nick Hicks, Director of Public Health, Milton Keynes NHSGoran Henriks, Chief executive of learning & innovation, Jonkoping County CouncilAilsa Claire OBE, Transition Director Patients and Intelligence, NHS Commissioning BoardDr Hugh Reeve, Chair of Cumbria Clinical Commissioning GroupPeter Brambleby, Joint Director of Public Health, NHS Croydon & Croydon CouncilDr Sam Barrell, Chair of Baywide Clinical Commissioning GroupStuart Cowley, Director: Personalisation & Partnerships, Wigan CouncilKim Carey, Corporate Director for Adult Care & SupportProfessor Martin Cowie, Professor of Cardiology, Imperial College London (Royal Brompton Hospital)Hugh Janes, Fareham and Gosport CCG ManagerDavid Colin-Tomé, DCT ConsultingEdna Robinson, Chair of The Big Life Group, Managing Director of the Clinical Commissioning Community ProgrammePhil Da Silva, QIPP Right Care ProgrammePaul Hodgkin, Chief Executive, Patient OpinionDr Matt Fay, General Practitioner, Westcliffe Medical Centre, ShipleyDr Gillian Leng, Deputy Chief Executive, NICEDr Rosie Benneyworth, GP, Somerset Clinical Commissioning GroupJeremy Nettle, Chair, Intellect Health and Social Care CouncilAndy Brogan, Wellbeing Practice Lead, Vanguard Consulting

Dr Alison Hill, Managing director NHS Solutions for Public Health and Director SEPHOSir Muir GrayHazel Stutely OBE, Exeter UniversityProfessor Chris Drinkwater CBE, Independent Chair, Newcastle Bridges CCGMandy Wearne, Director of service experience, North West Health RegionSue Harris, Worcester County CouncilRay Johannsen Chapman, SLAMStephen Johnson, Head of Long Term Conditions, DHLindsey Davies, President of the FPHDon Redding, Director of policy, National VoicesStephen Foster, Chair Health Care Professionals Commissioning NetworkDr Howard Freeman, GP, Assistant Medical Director at NHS LondonDr Mike Warburton, Director, CapitaJill Foster, Practice manager, Beacon Primary CareMrs Geraldine Taggart Jeewa & Dr Simon Abrams, Joint Honorary Secretaries of the Family Doctor AssociationDr Kam Singh, GP, Thurmaston PracticeCynthia Bower, Chief Executive, Care Quality CommissionAlan Lotinga, Director of Health and Wellbeing at Birmingham CouncilProfessor Steve Field, NHS Future ForumDr James Kingsland, National Clinical Commissioning Network LeadStephen Dorrell, MPMike Farrar, Chief Executive NHS ConfederationNiall Dickson, Chief Executive, General Medical CouncilPlus many more…

Final speaker programme is subject to confirmation Stuart Cowley

Fiona Philips

Dr Hugh Reeve

Dr Rebecca Rosen

Gillian Leng

Andrew LansleyMichael Sobanja

Sir Muir Gray Dame Barbara HakinDr Nick Hicks

Dr Johnny Marshall


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Patient and professional perspectives on living with LTCs

If “culture eats strategy for breakfast”, how do we change it?

Moving towards authorisation: Cumbria in 2013

Meeting the intelligence needs of CCGs The anatomy, physiology and embryology of health and wellbeing boardsQuality, Productivity and Prevention

in cardio-metabolic disease through an Innovative clinical change management programme*

Battle plans and care pathways*

Preparing for CQC

Supporting commissioning intelligence* Building blocks of integrated care* National guidelines: translating them into local practice*

Networking Networking NetworkingNetworking Networking

Improving patient care and service efficiencies through partnership working

Here’s one I made earlier: Case studies on integrated care Developing multi-disciplinary workingSystems to support the next

generation of commissioningAnother ‘talking shop’? A case study on

the rise of the decision-making HWB

Lunch Lunch LunchLunch Lunch

QIPP showcase: LTC management that works

Continuity of GP care, the bedrock of integration How can GPs avoid conflicts of interestPredictive modelling to reduce

risk and admissions

What will success look like? Measuring performance on health

and wellbeing in CornwallSponsored session* Realising the financial benefits of

commissioning DVT and Heart Failure Services in Primary Care*Medicines Optimisation* Health Protection Services for the

next decade: from HPA to PHE*Models for Stable Angina* How working with pharmacy can improve

quality and support integration in LTCsNetworking

Setting up the optimum commissioning support

Networking

Networking NetworkingAlive and clicking: Social

media and the NHSHow to overcome tribal loyalties? Panel discussion on cooperative HWB working

Sponsored session* The big wins for integration Networking

Measuring meaningful improvement in LTC: how will we do it? Integration in practice Mental Health care management

enabled by technology Identifying opportunities for CCG efficienciesThe co-production model – a shared population approach to health and

wellbeing reflecting all interests and assets

Plenary session: Secretary of state for health

Leaders symposia and reception - Sponsored by - Capita

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2 2

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Integrated high quality care: NHS Future Forum’s vision for making it happenOutside the box: innovative approaches

to improving outcomes in LTCs

5 high impact changes that achieve integration

Exploiting technology to drive efficiency

How can HWBs transform services and outcomes?

Insurance risk and service risk: what do you need to know?

Networking

Optimising current anticoagulation therapy in atrial Fibrillation - The role of TTR*

The lessons learned in improving outcomes for patients with Asthma* Protect your income whilst

improving patient accessNetworking

Quality initiatives that improve care, save lives and reduce expenditure Sponsored session*NetworkingNetworking Networking

Networking NetworkingHow can commissioners improve experience of care?

Mental Health Services: How do we commission together?

Developing multi-disciplinary working within commissioning

Telehealth to challenge the status quo - the need for evidence

The Future of Public Health – a new landscape

LunchLunch Lunch

Lunch LunchSystem leadership and integrated commissioning, experiences

from the front line

Seeking outside help with commissioning: outsourcing options

Who can add value to commissioning for LTCs

Mobile solutions. Communication at the point of care

Birmingham: improving outcomes in a complex environment

CCG Leaders: The big debateDon’t Buy IT* LGC: Joint working debate

Walk in my shoes: how co-designing strategy and service drives innovation and

integrated care in stroke prevention*Sandwell LVSD Pilot*

Networking Networking

Networking Networking Networking

Plenary session: Dame Barbara Hakin National Director of Commissioning Development

Bureaucracy gone madThe last 20 years, pressure on general practice has increased exponentially with the introduction of the GMS/PMS contract; QOF; Information Governance; Nice Guidelines; and new levels of Health & Safety and Employment legislation.

From 2012, we can look forward to commissioning; Revalidation and CQC Registration

(Care Quality Commission), the major difference this time being that not only will all this be compulsory, but it will be actively policed. With the CQC, failures risk your licence to trade.

CQC changes nothing and yet changes everything. Contrary to popular belief, it does not introduce new regulation, but merely rehashes and re-labels old ones. The real change will be in the way your practice will operate at every level from the ground up. Add commissioning to this mix and gone are the days when the entire system could have got away with revolving around just one or two managers. The annual ritual of getting

all the compliance and clinical performance targets filled out just in time for the March deadline will be redundant as the organisation will have to prove performance and evidence at every level, 365 days a year.

If anyone said this is a great opportunity, you would be tempted to lock them up, once you stop laughing. In fact there is a kernel of truth in this.

One opportunity lies in the willingness of primary care to rise up to the challenge of a culture change and this means reforms at every level. Freeing up the most valuable members of the management team to concentrate on business development; enhancing services; and increasing practice capacity is a must. Delegating some responsibilities down the line happens to be exactly what new regulations demand.

Whereas clinical record keeping has come leaps and bounds with new technology, general quality assurance still remains in the doldrums, a constant paper chase entirely dependent on one or two managers. New technologies offer automation of all these quality processes, with new levels of efficiencies and intelligence, with the potential to revolutionise your resource management.

Taking this to the next levelA major strength of primary care in England comes from practices being very local, community-based. At the same time, primary care will have to cope with increasing demand while funding is getting tighter. Practices also need to up their game in consistency of care quality and patient experience while clinical care is getting ever more complex.

Can practices cope with this or is this the end of general practice as we know it?General Practice CAN survive and, for the sake of healthcare, has to! By forming GP Provider Organisations, practices can gain access to “industrial strength” management capabilities, processes and governance while still maintaining their independence.

Such GPPOs can bring much better care process control into primary care, which ensures greater consistency in quality and patient experience while also freeing up GP time to focus on patients with needs that go beyond a standard protocol.

Beyond improving practice productivity, this approach also allows GPs to protect and strengthen their role as “Prime Provider” along an integrated care pathway. This does also allow practices as a group to take on additional services that individual practices alone would not be able to provide.

Management support, tools, systems and processes can be brought to GPPOs by a central partner at higher quality and lower cost than individual GPPOs as a central partner can benefit from scale efficiencies.

This article co-written by: Bharat Patel – CEO of X-Genics ([email protected]) and Dr Oliver Bernath CEO of Integrated Health Partners ([email protected]). More information on www.xgenics.com & www.ihpclinics.com

8 www.commissioningshow.co.uk

2012 - Strategies for a game change Bharat Patel

Dr Oliver Bernath

‘‘Don’t Buy IT”InMedical Seminar at Commissioning.

In this seminar we will be assessing the changing world of information and data and the economics that surround

healthcare technologies.

We will discuss how technology is delivered now and how it will be delivered in the future. We will look at an alternative model for funding - mitigating the risks and costs of implementation for CCG’s.

We will explore the concept and the reality of creating new and exciting partnerships where risks and rewards are shared. We will investigate how the need for time consuming large capital expenditure projects can be removed and replaced with real time managed services where results are rewarded with payment. Clinicians are paid by results - so should your IT and Information providers!

Combining data and information generates knowledge. When used this will lead to better management of the medicine and economics that surround the patient. This new environment will unlock the latent clinical knowledge within the CCG community allowing it to focus on the patient.

With so many different sources of data how can you find the information you are looking for in a timescale that makes a difference. We will look at the opportunities and threats of multi-source and multi system data and – by using the right tools – the knowledge that can be extracted.

We call this a TotalCare™ Platform.Fundamentally we will explore ways to ensure that clinicians can focus on being clinicians, providing them with the right information for them to plan medicine and develop new pathways now and make informed decisions that positively impact on the health economy of the future.

InMedical and CMA Group are on stand D42

IMPORTANT CHANGE: Prostap DCS is replacing Prostap, which will be discontinuedby the end of October 2011, so it is necessary for prescriptions to reflect this change of name.

To find out more visit: www.ProstateCancerUpdate.co.uk or contact Takeda UK Medical Information on 01628 537900

NOW AVAILABLE:PROSTAP DCS

All the benefits of Prostap with the added

simplicity of a Dual Chamber Syringe

(DCS)

come as standardProstap DCS is indicated for all stages of prostate cancer1,2 andprovides a package of care for your patients. Not only isProstap DCS simple to use,3 it is also cost-competitive4 andmost importantly, Prostap DCS delivers well-documented,long-term efficacy in all stages of prostate cancer5-7 and issupported by survival evidence, in combination with flutamide,in high-risk localised and locally advanced prostate cancer8,9

With Prostap DCS’s package of care, Great Expectationscome as standard.

PRESCRIBING INFORMATIONPROSTAP* SR DCS/ PROSTAP* 3 DCSLeuprorelin Acetate Depot Injection 3.75mg/11.25mgPresentation: Powder and solvent for prolonged-release suspension forinjection in pre-filled Dual Chamber Syringe (DCS). Prostap SR DCSPowder: contains 3.75mg of leuprorelin acetate, equivalent to 3.57mgbase. Prostap 3 DCS Powder: contains 11.25mg of leuprorelin acetate,equivalent to 10.72mg base. Indications: Prostap SR DCS/Prostap 3 DCS:as an adjuvant treatment to radical prostatectomy in patients with locallyadvanced prostate cancer at high risk of disease progression; as anadjuvant treatment to radiotherapy in patients with high-risk localised orlocally advanced prostate cancer; locally advanced prostate cancer, as analternative to surgical castration; metastatic prostate cancer; managementof endometriosis including pain relief and reduction of endometrioticlesions. Prostap SR DCS is also indicated for endometrial preparation priorto intrauterine surgery; preoperative management of uterine fibroids toreduce their size and associated bleeding. Dosage and Administration:Prostate Cancer: Prostap SR DCS: 3.75mg administered every month asa single subcutaneous or intramuscular injection. Prostap 3 DCS: 11.25mgevery 3 months as a single subcutaneous injection. Do not discontinuewhen remission or improvement occurs. Response to therapy should bemonitored clinically. If response appears to be sub-optimal, it should beconfirmed that serum testosterone is at castrate level. Endometriosis:Prostap SR DCS: 3.75mg administered as a single subcutaneous orintramuscular injection every month. Prostap 3 DCS: 11.25mg as a singleintramuscular injection every 3 months. Treatment should be for a periodof 6 months only and initiated during the first 5 days of the menstrual cycle.If appropriate, hormone replacement therapy (HRT - an oestrogen andprogestogen) should be co-administered with Prostap DCS to reducebone mineral density loss and vasomotor symptoms. EndometrialPreparation Prior to Intrauterine Surgery: Prostap SR DCS: 3.75mg as asingle subcutaneous or intramuscular injection 5-6 weeks prior to surgery.Therapy should be initiated during days 3 to 5 of the menstrual cycle.Preoperative Management of Uterine Fibroids: Prostap SR DCS: 3.75mgas a single subcutaneous or intramuscular injection every month, usuallyfor 3-4 months but for a maximum of six months. Elderly: as for adults.Children (under 18 years): Not Recommended - safety and efficacy in

children have not been established. For chronic administration, theinjection site should be varied periodically. Contraindications:hypersensitivity to the active substance, any of the excipients or tosynthetic GnRH or GnRH-derivatives. Women: lactation, pregnancy,undiagnosed abnormal vaginal bleeding. Precautions and Warnings:General: development or aggravation of diabetes may occur; thereforediabetic patients may require more frequent monitoring of blood glucose.Hepatic dysfunction and jaundice with elevated liver enzyme levels havebeen reported; therefore close observation should be made andappropriate measures taken if necessary. The ability to drive may beimpaired due to visual disturbances and dizziness. Men: a transient rise inlevels of testosterone may occur initially. This may be associated withtumour flare, sometimes manifesting as systemic or neurologicalsymptoms. These symptoms usually subside on continuation of therapy.An anti-androgen may be administered to reduce the risk of flare (seeSmPC, section 4.4). Patients at risk of ureteric obstruction or spinal cordcompression should be closely supervised in the first few weeks oftreatment. These patients should be considered for prophylactic treatmentwith anti-androgens. Should urological/neurological complications occur,these should be treated appropriately. Women: whilst ovulation is usuallyinhibited during therapy, contraception is not ensured. Patients shouldtherefore use non-hormonal methods of contraception. During the earlyphase of therapy, sex steroids temporarily rise, possibly leading to an increase in symptoms, which dissipate with continued therapy.Menstruation should stop with effective doses of Prostap DCS; thereforethe patient should notify her physician if regular menstruation persists. Theinduced hypo-oestrogenic state may result in a small loss in bone mineraldensity over the course of treatment, some of which may not be reversible.However, during one six-month treatment period, this bone loss shouldnot be important. In patients with major risk factors for decreased bonemineral content, Prostap DCS may pose an additional risk. Before treatingthese patients for fibroids, their bone density should be measured, andwhere results are below the normal range, Prostap DCS therapy should notbe started. In women receiving GnRH analogues for the treatment ofendometriosis, the addition of HRT (an oestrogen and progestogen) hasbeen shown to reduce bone mineral density loss and vasomotorsymptoms. Prostap DCS may cause an increase in uterine cervical

resistance. This may result in some difficulty in dilating the cervix forintrauterine surgical procedures. Diagnosis of fibroids must be confirmedprior to treatment, by laparoscopy, ultrasonography or other investigativetechnique. In women with submucous fibroids there have been reports ofsevere bleeding following administration of Prostap DCS, as aconsequence of acute submucous fibroid degeneration. Patients shouldbe warned of the possibility of abnormal bleeding or pain, in case earliersurgical intervention is required. Side Effects: Refer to section 4.8 of theSmPC in relation to other side effects - very rare cases of pituitaryapoplexy have been reported following initial administration in patientswith pituitary adenoma. General: adverse events which have beenreported infrequently include peripheral oedema, pulmonary embolism,hypertension, palpitations, fatigue, muscle weakness, diarrhoea, nausea,vomiting, anorexia, fever/chills, headache (occasionally severe), hotflushes, arthralgia, myalgia, dizziness, insomnia, depression, paraesthesia,visual disturbances, weight changes, hepatic dysfunction, jaundice, andincreases in liver function test values (usually transient). Reactions at theinjection site have been reported rarely. Changes in blood lipids andalteration of glucose tolerance have been reported which may affectdiabetic control. Thrombocytopenia and leucopenia have been reportedrarely. Hypersensitivity reactions including rash, pruritus, urticaria, andrarely, wheezing or interstitial pneumonitis have also been reported. Bonemass reduction may occur. Anaphylactic reactions are rare. Spinal fractures,paralysis, hypotension and worsening of depression have been reported.Men: if tumour flare occurs, symptoms and signs due to disease may beexacerbated e.g. bone pain, urinary obstruction, weakness of the lowerextremities and paraesthesia. These symptoms subside on continuation oftherapy. Impotence and decreased libido will be expected with ProstapDCS therapy. Hot flushes and sometimes sweating are often associatedwith administration with Prostap DCS. Orchiatrophy and gynaecomastiahave been reported occasionally. Women: side-effects reported are mainlythose related to hypo-oestrogenism e.g. hot flushes, mood swings,including depression (occasionally severe) and vaginal dryness. Breasttenderness or a change in breast size, and hair loss, may occur occasionally.A small loss in bone density may also occur, some of which may not bereversible (see Precautions and Warnings). Vaginal haemorrhage may occurdue to acute degeneration of submucous fibroids. Legal Category: POM.

Package Quantities: Prostap SR DCS: one dual chamber pre-filled syringecontaining 3.75mg leuprorelin acetate powder in the front chamber and1ml of sterile solvent in the rear chamber. One 25 gauge needle, onesyringe plunger and one injection site swab are included in a singleinjection pack. Prostap 3 DCS: one dual chamber pre-filled syringecontaining 11.25mg leuprorelin acetate powder in the front chamber and1ml of sterile solvent in the rear chamber. One 23 gauge needle, onesyringe plunger and one injection site swab are included in a singleinjection pack. Basic NHS Cost: Prostap SR DCS £75.24; Prostap 3 DCS£225.72. Marketing Authorisation Numbers: Prostap SR DCS: 16189/0012;Prostap 3 DCS: 16189/0013. For full prescribing information and details of other side effects, see Summary of Product Characteristics. Full prescribing information is available on request from: Takeda UKLimited, Takeda House, Mercury Park, Wycombe Lane, Wooburn Green,High Wycombe, Bucks, HP10 0HH, UK. Telephone: 01628 537900; Fax: 01628 526617. Date of Prescribing Information: September 2011.*Registered Trademark of Takeda. PS110937.

References:1. Prostap SR DCS. Summary of Product Characteristics.2. Prostap 3 DCS. Summary of Product Characteristics.3. Takeda UK Ltd. Data on file. DF110503.4. MIMS. September 2011.5. Jocham D. Urol Int 1998; 60: 18–24.6. Kienle E & Lübben G. Urol Int 1996; 56: 23–30.7. Bischoff W et al. J Int Med Res 1990; 18(Suppl. 1): 103–113.8. D’Amico AV et al. JAMA 2004; 292: 821–827.9. D'Amico AV et al. JAMA 2008; 299: 289–295.

PS110939i Date of preparation: September 2011

Adverse events should be reported. Reporting forms and information can be found

at www.yellowcard.gov.uk. Adverse events should also be reported

to Takeda UK Ltd on 01628 537900.

PRS372 Brendon Ad Hoc Ad 297x210 AW 29/09/2011 10:07 Page 1

9www.commissioningshow.co.uk

As part of the Managing long term conditions stream, this session will highlight the burden of stable angina within the UK population. It aims to increase delegate’s understanding of how optimal medical therapy, in line with NICE guidelines, can help

deliver best care across the patient pathway.

NICE Guidance on Stable Angina was published in July 2011 and emphasises the importance of optimal medical therapy for the first-line management of patients with stable angina. Williams will highlight the potential opportunities to optimise the management of these patients in a primary care setting to improve the overall patient care pathway.

Helen worked as a specialist cardiac pharmacist at King’s College Hospital for 15 years before taking up her current

role as Consultant Pharmacist for CV Disease working across the South London Sector for a number of PCTs, acute trusts and the South London Cardiac and Stroke Network. She is involved in a wide range of activities including d e v e l o p i n g pharmac is t - led clinics in primary care to manage hypertension and vascular risk, supporting community heart failure services and contributing to the NHS Health Checks roll-out.

Specialist cardiac pharmacist helps count the cost of chest pain.Consultant pharmacist for cardiovascular disease, Helen Williams, will be taking to the stage for the Menarini-sponsored session on stable angina.

Helen Williams

continued from page 1

Whilst current attention is inevitably focused on the need to achieve authorisation, the underlying challenge facing CCGs remains the need to sustain patient safety and quality whilst realising £20bn of efficiency improvements. In addition many CCGs across the country will inherit health economies that are either already financially challenged or unsustainable over the long term in their current configurations.

To address this challenge, Capita believes that CCGs will need to embrace and implement innovative forms of commissioning. This is where Capita’s experience and commissioning capabilities can help CCGs to make change happen.

Capita is currently helping commissioners in Leeds to achieve real returns by using an ambitious new predictive modelling tool and clinical commissioning portal to identify patients with long term conditions who are most at risk. Working with three CCGs and NHS Leeds the predictive modelling tool is enabling multi-disciplinary teams to focus clinical resources on those with the greatest need and proactively intervene early to reduce unnecessary emergency admissions. The Capita Portal has been so successful it is now also being deployed across North Yorkshire.

Andrew Lawrence, Capita’s managing director for commissioning, says: ‘ P o s t - a u t h o r i s a t i o n is when the task of implementing innovative forms of commissioning begins in earnest. The need to embrace new ways of working will be vitally important to bring long term stability to many health economies.

‘It needs to start with applying commissioning techniques which

are grounded on practice populations and help better coordination across health and care services. CCGs will also demand information tools increasingly driven by real-time data, enabling clinicians to anticipate patients’ needs for healthcare services before, rather than after, they are incurred.

‘Better information coupled with the increasing use of outcome-based contract levers and incentives, means CCGs have a real opportunity to influence priorities and drive improved provider performance.

‘This is when the work of authorised CCGs really begins.’

SEE THE FULL PICTURE WITH VISION 360

Vision 360 provides:•Shared patient records between authorised clinicians and

healthcare workers to encourage fast and accurate clinical decisions away from the patient’s registered practice

•Remote access for GPs and business continuity for practices

•Cross-practice reporting on referrals, commissioning and other business aspects of healthcare provision for PCTs, GP consortia and local health boards

•Central task management between care providers within a local community

•Interoperability with other clinical systems

Vision 360 complements existing systems so there is no need to ‘rip and replace’. It has its own central data repository and patient data is streamed into Vision 360 from Vision and EMIS systems as a background task throughout the day. GP practices can continue to use their existing systems - avoiding the cost and disruption of system migrations.

For more information please contact [email protected]

Vision 360 is a complete IT solution that builds local healthcare communities around centrally stored, shared patient records.

Andrew Lawrence

Patients presenting to their GP with symptoms suggestive of heart failure or DVT are usually referred to hospital for specialist assessment and for

a scan. Typically this can cost primary care in the region of £500 per patient and often more if admitted as an emergency referral.

However, ample evidence based on the commissioning of DVT and heart failure diagnostic services proves that about 50% of these patients do not have a DVT or heart failure therefore do not need to be referred and a simple blood test in the GP surgery when used with clinical examination can rule out these patients. This decreases unnecessary referrals and saves primary care significant sums of money.

The session on June 27th at 2.30pm hears from a CCG manager who has successfully implemented such diagnostic services in primary care and a consultant cardiologist who recently chaired a consensus panel on this subject. They will welcome any questions on the why and how to commission heart failure and DVT diagnostic services and what level of savings can realistically be achieved with real life examples.

With the introduction of new oral anticoagulants there is increasing debate over the place in therapy for aspirin and warfarin in managing atrial fibrillation. In a recently published consensus from the Royal College of Physicians Edinburgh, aspirin should no longer be routinely recommended, whilst warfarin should be standard first choice paying close attention to achieving optimal control.

To see how the management of this long term condition can be implemented in practice join the symposium titled ‘Optimising current anticoagulation therapy in atrial fibrillation – the role of TTR’, on the 28th June at 10.00am

What mood are you in?IE is a multi-award winning digital marketing agency specialising in the health sector.

IE helps clients strengthen and deepen their online presence through sector-leading, interactive web sites and web apps that engage with audiences, communicate expertise and deliver measurable value.

IE will be showcasing their recent work with 2gether NHS Foundation Trust on Moodometer – a responsive web app version of the Trust’s already successful iPhone app. Moodometer is an interactive mood diary which helps users monitor, understand and manage their emotional wellbeing as well as smoothing the pathway to tele-health and face to face clinical support.

Other notable projects include brand repositioning work for Central Surrey Health, award winning websites for Solihull NHS Care Trust and West Midlands QI, hospital intranets and CCG websites.

So if you’re looking for Open Source content managed websites, web and mobile apps or branding and design – IE is a perfect partner.

www.iedesign.co.uk/health

The Sound Doctor is a website. It’s an audio-visual self-management tool for people with long-term conditions. The aims are to reduce the number of avoidable hospital admissions, to reduce the number of GP consultations and to improve patient experience.

The Sound Doctor is working to the QIPP agenda on long term conditions.

Each condition covered on the website (currently diabetes and COPD) consists of about sixty short films giving information on key areas of healthcare that will help patients manage their condition more effectively.

The films are all 3-5 minutes in length and are organised so as to provide a structured learning programme. The site is fully interactive and designed with the help of a leading health psychologist specifically to encourage behavioural change.

The editorial director is Dominic Arkwright, a BBC presenter with twenty years’ distinguished time served on the Today programme, Newsnight and other national programmes.

SEE THE LATEST SHOW NEWS ATwww.commissioningshow.co.uk


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RedCross

MDDUS

B80 B81

C81 C82 E81D82 E82 E83D83 F81

G72

G64

G62

G52

D74D72

D70E73

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C72

C74 D73

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H11 H13 H14G11F11C11 C12B11 B12

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Map ofMedicine

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STAIRSTO

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Plan not to scale and subject to change.Correct at the time of print

Commissioning 2012 National Hall - Floorplan

Gallery

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RedCross

MDDUS

B80 B81

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THEATRE 4

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THEATRE 1


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STAIRSTO

THEATRES1, 3, 4


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PCC CLN

DAFNE

Novartis

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106

K31

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Sponsored by:

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NetworkingZone

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I45

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RedCross

MDDUS

B80 B81

C81 C82 E81D82 E82 E83D83 F81

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G64

G62

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D74D72

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Plan not to scale and subject to change.Correct at the time of print

Source new services and meet expert partners in one of the UK’s largest exhibitions of healthcare suppliers. Interested in exhibiting? Only a handful of stands left, call 0207 348 5254 now!

Gallery


Always think about continuity of care

CCGs: The Big Debatecontinued from page 1

Another challenge for the new NHS, working within a financial straitjacket, will be managing patient expectations. A point that Dr Swinyard says he has stressed repeatedly at meetings in Whitehall is that the Department of Health must work with commissioners to help patients understand that while they can’t have everything they want they will be able to have everything they need.

Looking to the future, Dr Swinyard is an optimist: ‘I personally happen to believe that clinical commissioning is the best option we’ve ever had and it is the best chance that has been handed to us of influencing what happens.

‘GPs are really quite good at adapting to an environment- we are quite Darwinian in our ways and old lags like me have seen all sorts of systems come and go and yet the basic continuity of the doctor-patient relationship survives. If you ask a patient what they value it is always that they know who their doctor is and that they have a single named person they can go to for healthcare advice.’

Amidst all the upheaval of the reforms Dr Swinyard is adamant that continuity of care and the individual ethos of each practice should be preserved.

‘My message to delegates coming to the Commissioning Show is to think about continuity of care and always think of the patient first whatever service you are commissioning,’ says Dr Swinyard.

Continuity of GP care, the bedrock of integration, is the subject of the session on Wednesday June 27 which will be addressed by joint honorary secretaries of the FDA - Mrs Geraldine Taggart Jeewa a senior practice manager from Southport and Dr Simon Abrams, a Liverpool GP.

HSJ editor, Alastair McLellan will be ensuring all the tough questions get answered in a balloon debate on the future of CCGs. The session promises some lively debate with Commissioning Show delegates adding their views to those of some of the most vocal figures in healthcare. It’s a must attend for anyone interested in hearing the latest strategies from some of the bodies making the healthcare reforms happen.

The hot topics:• Is ‘assumed liberty’ for CCGs a good idea – should it (and will it) be more of case of ‘earned autonomy’

• Will CCG decisions drive the efficiency agenda or vice versa?

• Providers have always held the upper hand over commissioners. Will the future by any different?

• What are ethical dimensions of clinical commissioning?

• How will CCGs manage risk – indeed, do they even understand the risks they face?

• Are CCGs likely to take lay representation more seriously than past commissioners?

The PanellistsStephen Dorrell, Chair, House of Commons health committeeThe man that HSJ called everybody’s fantasy health secretary,

it was Mr Dorrell’s incisive critique of Andrew Lansley’s health reforms that - along with professional and Lib Dem unrest - led to the “pausing” of the Health Bill.

Mike Farrar, Chief executive, NHS ConfederationOne of only four people to have appeared in the top half of the HSJ100 for its entire, six-year history. A former SHA chief executive and influential commentator on NHS reforms.

Sir Robert Naylor, Chief executive, University College London Hospitals Foundation TrustAcademic health science centres and the trusts that form their base are more influential than ever. None has a higher profile than UCL Partners and its bedrock trust University College London Hospitals.

Niall Dickson, Chief executive, General Medical CouncilThe figure behind the revalidation requirements being imposed by the General Medical Council. In addition, Mr Dickson has extracted assurances from government on language testing for doctors.

Dr Jennifer Dixon, Director, Nuffield TrustAs the DH slims down its research and policy capability, the more organisations such as the Nuffield Trust increase their influence.

Jeremy Taylor, Chief executive, National Voices National Voices is the leading coalition of health and social care charities. Its influence was recognised in Mr Taylor’s appointment as co-chair of the Future Forum’s information workstream.

Dr Peter Swinyard

Tailored financial advice for GPs and their practices

Wesleyan Medical Sickness provides bespoke financial planning to suit the personal and business needs of GPs.

Through dealing exclusively with the GP profession, our Financial Consultants have an in-depth knowledge of the issues affecting you today.

Wesleyan Medical Sickness is a trading name of Wesleyan Financial Services Ltd, which is authorised and regulated by the Financial Services Authority. Wesleyan Financial Services Limited is wholly owned by Wesleyan Assurance Society. The Financial Services Authority does not regulate Inheritance Tax Planning. Registered No. 1651212. Head Office: Colmore Circus, Birmingham, B4 6AR. Telephone calls may be recorded for monitoring and training purposes.

GP-AD-30-06/12

Alternatively, to book an appointment with your Financial Consultant:

0800 294 9173

[email protected]

Please quote reference 45367

We can advise on:

•NHS Pension Scheme

•Retirement & estate planning

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•Mortgages

Come and visit us at stand C72 to test your pension knowledge and win a prize.Terms and conditions available on the stand.

45724 Commissioning Show A4 Ad GP-AD-30 06/12.indd 1 15/05/2012 15:45

Stephen Dorrell

Mike Farrar

Sir Robert Naylor

Niall Dickson

Dr Jennifer Dixon

Jeremy Taylor


UnitedHealth UK: Building partnerships for commissioning support In its guidance to the NHS about delivering service excellence, the NHS Commissioning Board makes clear that the new commissioning system needs to be “better and more efficient than anything that has gone before” and that it can “only be achieved by doing things differently”.

Commissioning Support Services that are customer focused and can help improve outcomes for local populations will be critical in realising this vision for the NHS.

In our conference session, The Building Blocks of Integrated Care: Commissioning Support Partnerships to Enhance Collaboration we will look at how working in partnership to provide commissioning support can not only deliver effective and efficient commissioning, but drive improvements in patient care and integration of services across providers.

As Clinical Commissioning Groups consider how best to exercise their right to choose the commissioning support that will help them meet the needs of their patients and NHS Commissioning Support Services develop their services and are subject to assurance – developing and building effective partnerships will play an important role.

With so many factors still to be determined, the establishment of meaningful relationships with external partners might not seem like a top priority. However, independent research undertaken by the King’s Fund concluded that used appropriately, external support can play a role in raising the standard of commissioning in the NHS, and in doing so help the system to achieve the improvements in quality and productivity needed over the coming years.

The combination of the experience and knowledge of NHS commissioners with the capabilities, insights and capabilities of external partners provides great potential in ensuring innovative, customer focused and responsive commissioning support services can deliver improvements for NHS patients.

Drawing on our experience of partnering with the NHS for over 10 years, our session will share some of the key lessons learned in building effective partnerships and discuss practical examples about how:

•Using the right data to drive decision-making can improve quality and reduce cost

•Defining the health needs of local populations can lead to innovation as well as better budget management

•Making contracts with providers can be an opportunity to enhance care coordination and redesign clinical pathways and improving outcomes

AstraZeneca evolves to meet healthcare challenges PSUK is the largest supplier of pharmaceutical and consumable

products to GP practices in the UK. Our extensive product portfolio covers pharmaceuticals, consumables, disposable instruments and medical equipment at the most competitive net pricing available. We are continually expanding our product range and are delighted to quote for refurbishments and new builds.

Additionally, to enhance the purchasing experience PSUK offers innovative management solutions to over 7000 GP practices. We work closely with GP Consortia to streamline purchasing and facilitate relationships with suppliers to ensure a win/win outcome for the NHS and the practice. Our management services encompass medicine optimisation and contract negotiation and implementation. Furthermore, we hold over 40 study days that are CPD accredited to increase profitability, efficiency, patient care and staff contentment

For further information on PSUK please contact Heidi Barrett on 01904 732274/07501 683574 or visit www.psuk.co.uk

Hello,

I’m Lisa Anson, President of AstraZeneca UK Marketing Company

At AstraZeneca we discover, develop, manufacture and market innovative prescription medicines for seven important

areas of healthcare, which include some of the world’s most serious illnesses: cancer, cardiovascular, gastrointestinal,

infection, neuroscience, respiratory and inflammation.

Our commitment to patient care however, goes beyond our innovative medicines. As a partner in healthcare, we wish

to support the delivery of a world class National Health Service for patients.

The NHS has not been immune to our national deficit and growing debt, and aims to release up to 20 billion pounds of

efficiency savings by 2014. We understand the challenges the NHS faces to realize those efficiency savings, especially as

increasing prevalence amongst patients with Long Term Conditions, provides a service delivery and economic challenge

for the NHS.

In this increasingly challenging and changing UK healthcare environment, we recognise that to be more patient and

customer centric we must continue to evolve. We are adapting and better aligning ourselves to support the NHS to meet

policy, productivity and efficiency aspirations.

By pooling skills and resource with the NHS, we are helping to improve the lives of patients and are supporting

organisations to deliver productivity and efficiency improvements, without compromising on quality or outcomes for

patients. We have engendered this closer partnership with the NHS facilitated primarily through Joint Working as a

credible and valid approach to help the NHS achieve its goals as set out by the ABPI and Department of Health, as well

as other forms of collaboration.

The Department of Health guidelines on Joint Working confirm the Government’s wish to see a closer and more

mature working relationship between the NHS and the pharmaceutical industry. In fact, the NHS has set out clear

recommendations for NHS Managers to consider closer Joint Working with their suppliers to achieve their objectives

within the new NHS.

Joint Working is intended to support the achievement of NHS goals by helping to ensure that patients, as the primary

beneficiaries, receive better, more consistent care, and experience a positive difference in their health.

One example of a successful Joint Working project AstraZeneca has undertaken was with ESyDoc pathfinder consortium.

We listened to their needs and agreed to pool skills, expertise and resources for the joint development of a patient

focused COPD pathway in line with national guidelines. Together, along with other stakeholders such as Surrey and

Sussex Healthcare NHS Trust, Surrey Community Health, South East Coast Ambulance Trust and Breathe Easy we

achieved some positive results. Results for this project highlighted that there were 210 emergency COPD admissions in

2009 versus 225 in 2010.1 However there was a 21% reduction in COPD hospital bed days and an average length of

stay fell from 6.8 days to 5.0 days.1 In addition, 463 out of 487 COPD patients reported that they were ”very satisfied” with

the care that they had received, and 433 out of 487 COPD patients said they were ”totally aware” of what the next steps

were in their self management plan.1

The benefits to AstraZeneca of Joint Working may include improvements in our corporate reputation, as well as that of

the Pharmaceutical Industry in general. In addition, Joint Working projects can also be of benefit through more and/or

better use of medicines, including those of AstraZeneca’s through supporting their appropriate use in clinical practice.

Importantly, we believe that Joint Working, through demonstrating our continued commitment to working in partnership

with the NHS on a shared agenda for patient benefit, helps to provide a platform which supports sustainable relationships

with the NHS both now and in the future.

Lisa Anson, President of AstraZeneca UK Marketing Company

References: 1. AstraZeneca Data on File 2011. (DOF\099\Apr2011)

Date of preparation: May 2012

1846903

Lisa Anson



Ingrid Saffi n, Partner at Mundays LLP, talks about:

HIDDEN BENEFITS OF THE HEALTH AND SOCIAL CARE ACT 2012The passing of the Health and Social Care Act 2012 is welcome news to forward thinking leaders and members of Clinical Commissioning Groups. There is a good deal of detail yet to come from the Government but at last CCGs and the GP practices that are part of them can get on with organising themselves with confi dence and taking up the challenge of being at the forefront of the new look NHS.

Much has been made of the undeniable challenges that face CCGs but help and guidance is available from legal advisors like Mundays LLP, with whose help CCGs can:

• set up their constitutions• put in place safeguards and processes to facilitate

good governance• deal with confl icts of interest• identify and deal with any liability issues where

CCGs have commenced to operate without forming a separate the legal entity

• once clear details have emerged as to what the Government has in mind in terms of their legal identity going forward, unwind and transfer liability where CCGs have formed a separate legal entity through which to operate in the meantime

• advise on and deal with property issues arising from the transfer of PCT property to NHS Property Services Limited

So far, so predictable, but what about the hidden bene� ts that working together with an eye on value for money can bring? Not many column inches have been dedicated to these opportunities but as CCGs develop and become more sophisticated, Ingrid Sa� n of Mundays LLP believes that CCGs and their members will recognise the bene� ts of working e� ectively as buying groups for goods and services that are consumed by their member GP practices but fall outside the scope of CCGs’ primary role. � is could encompass anything from stationery and o� ce furniture to legal services such as conveyancing, partnership matters, employment advice and wills.

Mundays LLP is ready to partner CCGs and GPs to bring these benefi ts now, with packages of cost eff ective legal services for members of CCGs that roll out the services to their members and their members employees. Mundays LLP will be at the Commissioning Show on stand D73 so why not take a few minutes to stop by and talk to them.

LEGAL EXPERTISE FOR HEALTHCARE THAT GETS STRAIGHT TO THE POINTAt Mundays our clients want us to be on their side as a legal partner – more than just a provider of legal advice. � is means we understand not just their needs today, but their needs in the future.

At Mundays we have a nationally recognised team of approachable and enthusiastic lawyers. We understand healthcare businesses and o� er practical advice and commercial solutions to a wide variety of clients.

Whatever your business, we will be talking your language.

[email protected]/healthcare

Contact Ingrid: ingrid.saffi [email protected] 590 535

To fi nd out more about Mundays LLP legal advice please visit www.mundays.co.uk


BlueLibris is a leader in personal health monitoring and safety technologies and the acquisition adds a novel, mobile telecare platform to Numera’s existing telehealth products, social engagement solutions, and professional services portfolio. The combined telecare and telehealth offering enhances Numera’s existing business partners’ offering with the goal of improving outcomes through its Transitions in Care, Independent Ageing, and Long-Term Condition management programmes.

The BlueLibris device also features a unique, automated fall detection algorithms for Personal Emergency Response Services (PERS).

The acquisition means the devices will now be equipped with Numera’s telehealth gateway technology, allowing the end user

to upload biometric measurements from a variety of health devices through the mobile personal health gateway. Users will also receive personalised reminders to take medications, upload measurements, and health coaching specific to their health condition.

“The market for telecare and telehealth is expected to grow to over £3 Billion by 2017,” said Tim Smokoff, CEO of Numera. “Often, a person will need telehealth-related services for general wellness or long-term condition management, and later have a need for the personal safety and immediate response offered by a telecare platform. This acquisition makes it possible for Numera’s customers to have both, as they need them, on the same scalable platform.”

“As we continue development of the BlueLibris products, we will extend the capabilities of the device with additional, innovative sensing capabilities to enrich activity monitoring and feedback for behaviour change and lasting engagement for those living with chronic and long-term health conditions,” said Bill Reid, Head of Product Development at Numera.

Numera plans to market the product through new and existing distribution and business partners by Q4, 2012.

Numera will be demonstrating the product at The Commissioning Show in London.

This vision is underpinned by our guiding ideal - Passionate about really making healthcare work. This tells you nothing about what we really do.

Whether you are a commissioner, a clinical leader or working in the upper

echelons of management, you will understand that knowing what to do is a far cry from making it happen. Medicology makes it happen. We make it happen faster. We make it happen with less resistance. We make it happen at far less cost and we make it happen with far, far less drama. As true experts in behavioural change (or perhaps more accurately; removing behavioural blocks to change), we can catalyse the achievement of your reform at a speed you never thought possible.

www.medicology.co.uk/commissioning

The NHS is currently expected to make unprecedented efficiency savings while improving quality of care and health outcomes – and the new commissioning consortia are the bodies tasked with overseeing the process.

Doing that job requires robust, wide-ranging, up-to-date, in-depth information. And that is what Dr Foster can provide, helping you to:•Assure the quality of your providers •Control costs and ensure value for money •Identify patients most at risk of multiple admissions to hospital •Profile your population on the basis of current and future need

Dr Foster Intelligence provides web-based solutions to healthcare organisations to help them measure, understand and improve the quality and cost-effectiveness of their services. Our unique access to Secondary Uses Service (SUS) data and the ability to link this to local datasets, combined with our long-term proven experience and understanding of the NHS and the vital role of analytics, enables us to provide a unique and valuable insight to NHS organisations. This can support and underpin all areas of performance, measurement and improvement. We currently manage datasets for our own informatics products, with over 825 million records in our data warehouse.

Every month, we undertake a data staging process where we collate, cleanse and standardise millions of new SUS returns before adding them to our live data warehouse, where they become instantly accessible in our online business intelligence tools. We are now making this data staging and processing capability available to CSOs as a fully managed service.

Ingrid Saffi n, Partner at Mundays LLP, talks about:

HIDDEN BENEFITS OF THE HEALTH AND SOCIAL CARE ACT 2012The passing of the Health and Social Care Act 2012 is welcome news to forward thinking leaders and members of Clinical Commissioning Groups. There is a good deal of detail yet to come from the Government but at last CCGs and the GP practices that are part of them can get on with organising themselves with confi dence and taking up the challenge of being at the forefront of the new look NHS.

Much has been made of the undeniable challenges that face CCGs but help and guidance is available from legal advisors like Mundays LLP, with whose help CCGs can:

• set up their constitutions• put in place safeguards and processes to facilitate

good governance• deal with confl icts of interest• identify and deal with any liability issues where

CCGs have commenced to operate without forming a separate the legal entity

• once clear details have emerged as to what the Government has in mind in terms of their legal identity going forward, unwind and transfer liability where CCGs have formed a separate legal entity through which to operate in the meantime

• advise on and deal with property issues arising from the transfer of PCT property to NHS Property Services Limited

So far, so predictable, but what about the hidden bene� ts that working together with an eye on value for money can bring? Not many column inches have been dedicated to these opportunities but as CCGs develop and become more sophisticated, Ingrid Sa� n of Mundays LLP believes that CCGs and their members will recognise the bene� ts of working e� ectively as buying groups for goods and services that are consumed by their member GP practices but fall outside the scope of CCGs’ primary role. � is could encompass anything from stationery and o� ce furniture to legal services such as conveyancing, partnership matters, employment advice and wills.

Mundays LLP is ready to partner CCGs and GPs to bring these benefi ts now, with packages of cost eff ective legal services for members of CCGs that roll out the services to their members and their members employees. Mundays LLP will be at the Commissioning Show on stand D73 so why not take a few minutes to stop by and talk to them.

LEGAL EXPERTISE FOR HEALTHCARE THAT GETS STRAIGHT TO THE POINTAt Mundays our clients want us to be on their side as a legal partner – more than just a provider of legal advice. � is means we understand not just their needs today, but their needs in the future.

At Mundays we have a nationally recognised team of approachable and enthusiastic lawyers. We understand healthcare businesses and o� er practical advice and commercial solutions to a wide variety of clients.

Whatever your business, we will be talking your language.

[email protected]/healthcare

Contact Ingrid: ingrid.saffi [email protected] 590 535

To fi nd out more about Mundays LLP legal advice please visit www.mundays.co.uk

NUMERA ADDS SOLUTIONS TO ITS PRODUCT RANGE

Passionate about People, Performance & Health

Measure, understand and improve

Numera has now added a combined telecare and telehealth solution to its product range following the acquisition of BlueLibris LLC – the company behind a small, wearable device that allows two-way, hands-free voice communication through a cellular network as well as GPS location tracking.

Medicology’s vision is to be an inspirational catalyst to healthcare improvement in the face of unprecedented economic, demographic and disease challenges.

“By combining the capabilities of BlueLibris with our existing family of PC, Smartphone, and home hub gateways and the Numera Social engagement platform, families, friends, and caregivers are equipped to participate in and deliver sustained engagement, which is critical for lasting behaviour change.” Bill Reid

Do you know how much your practice spends on blood glucose test strips? Surprised? Then come and visit us at stand I32 at the Commissioning Show where we will show you how to reduce the cost of blood glucose testing without compromising on quality and accuracy.

GlucoRx is a leading global manufacturer of blood glucose machines and the GlucoRx Nexus blood glucose meter and test strips have now been successfully adopted as the meter and strip of choice by a number of PCT and hospitals nationally.

The GlucoRx Nexus test strips are up to 36% cheaper than the market leaders such as One Touch, Freestyle, Aviva and Contour strips. We offer a range of support to practices in helping you to make patient switches easy and painless so allowing GP’s to reduce their spend on test strip both quickly and effectively.

Come and discuss how we can help you.

The meter of Choice

Elmvia Australia would like to welcome you to the 2012 GP Commissioning show. We have travelled from

Brisbane this week to support the event.

At Elmvia we have over 6 years’ experience of working closely with UK and Irish Doctors, dentists and Nurses looking to find a new job Down under.

We are based in Queensland and have a national network of clients all over Australia.

As migrants ourselves we have a great deal of personal experience in moving from the UK and our service will allow you to have a stress free and seamless move. We will support all your registration and Visa application paperwork from the start of the process and be there with open arms to welcome you when you arrive.

With us this week in London we have a most valuable client interested in meeting you to discuss their current needs. If you have time come along and see us when you can.

Air Products Healthcare provides a scalable, fully-managed telehealth

service without the need for capital expenditure. We have extensive experience of providing in-home services to patients with long-term-conditions. Since 2006 we have successfully provided this support to over 200,000 patients.

Air Products is a leading homecare service provider who manages all the non-clinical aspects of telehealth leaving the clinician to focus on managing the patient’s health and wellbeing. We offer Risk Stratification, nurse led monitoring, a 24/7 support care-centre and a team of dedicated homecare service engineers to support patients in their homes.

There is no capital outlay; you only pay for what you need. You have easy, immediate access to patient history and vital signs; and receive qualified clinical alerts for early identification of an acute event. And, with access to the most appropriate technologies, you can secure the service and equipment that best suits your needs.

To find out more call 0845 602 0776 or visit www.airproducts.co.uk/telehealth

Immediate access to patient history

Meet employers from “Down Under”


How can MATCH help my business? The MATCH Affiliate Scheme will provide you with access to experts who will support your staff, helping

them transform your company's competitive performance by embedding flagship techniques, derived

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Our research. Your business.The perfect MATCH

The Multidisciplinary Assessment of

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(MATCH) is a well-established research

collaboration between four leading

UK universities (Birmingham, Brunel,

Nottingham & Ulster) and is funded

since 2003 by the Engineering and

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and partner contributions.

For further information please contact Elizabeth Deadman [email protected] 01895 266050 or check the MATCH website: www.match.ac.uk/sme.php

®

MATCH helps improve decision-making for technology

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greater confidence that the value to patients and others

will be consistently defined and readily recognised.

To this end, MATCH delivers: standardised methods for

establishing clinical value; new approaches to capturing

user needs for early design and in-use upgrades; best of

breed research into production and decision-making

processes; and a forum for engaging regulators and

finding better ways forward for all concerned.

What MATCH doesAssesses value …

…by developing methods and models to assess the value of

products at each stage of development, from identification of

need through to mature offerings in the market.

Optimises product development and manufacture…

…by researching processes for improving information and

decision-making, leading to more effective development and

production processes, better clinical integration and improved

provision for users.

Engages end users…

…by employing empirically based valuations of health and

related benefits to inform value models and develop methods for

engaging with users at the conception and design stages.

Focuses on Industry…

…by maintaining a strong industrial perspective, and using real

industrial problems to drive and ground its research activities.

About MATCH

FOLLOW US ON TWITTER @CommShow


“At the forefront of the manufacturing and worldwide distribution of cost effective and innovative diabetes products, Ypsomed Ltd is a total solution provider for the management of diabetes care.

The company’s current product portfolio consists of Blood Glucose Meters, Lancets, Pen Needles, and Tubeless Insulin Pumps.

Ypsomed Ltd are currently helping Clinical Commissioning Groups, PCTs and Consortia save as much as £400,000 per annum on prescribing blood glucose test strips, pen needles and lancets, based on an average size PCT.

Voted as a test winner in an independent study the mylife Pura blood glucose meter is used confidently by people with diabetes worldwide. It is precise, accurate and out performs the most established strips available.

Our mylife OmniPod insulin pump is one of the first tubeless pumps on the market, and is proving revolutionary for all its users.”

Leading trade association partners with Commissioning

BCS, the chartered institute for IT, have partnered with the Commissioning Show in support of the Productivity Through Technology stream.

The aim of the institute is to foster links between experts from industry, academia and business to promote new thinking, education and knowledge sharing, making them a perfect fit for the Commissioning Show

“Primary care has more challenges now than ever, with the expectation that CCGs will deliver high quality services and cost savings. When we asked GPs what were their top priorities for 2012, over a quarter believed the innovative use of technology would be one of the most effective solutions to improving productivity and patient care.” Advises James Hall, stream manager.

Inspired by this swell of interest, this stream looks at different uses and solutions that technology can offer primary care and social services.

The stream offers case studies and expert advice, with a particular focus on mobile and tele-health solutions.

Legal category: POM

Further information is available from: Boehringer Ingelheim Limited, Ellesfield Avenue, Bracknell, Berkshire. RG12 8YS

For an educational pack, go to www.pradaxa.co.uk/SPAFeducationalpack or call the Pradaxa® information line on 0845 601 7880

Date of preparation: March 2012 Job code: UK/DBG-121156

Please refer to the SPC before prescribing this product, particularly in relation to side-effects, precautions and contra-indications.

PREVENTIONSTROKE

The first new oral anticoagulant for stroke prevention in atrial fibrillation in 50 years

Pradaxa® For prevention of stroke and systemic embolism in adult patients with nonvalvular atrial fibrillation with one or more of the following risk factors:

• Previousstroke,transientischaemicattackor systemic embolism (SEE)

• Leftventricularejectionfraction<40%

• Symptomaticheartfailure,≥ New York Heart Association (NYHA) Class 2

• Age≥75 years

• Age≥65 years associated with one of the following: diabetesmellitus,coronaryarterydiseaseorhypertension

Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard.

Adverse events should also be reported to Boehringer s Drug Safety on 0800 328 1627 (freephone).

19438 BIP SPAF Brain commioning A5 Ad.indd 1 12/03/2012 15:14

Meet the Chairs Collectively our faculty of stream chairs represent over 300 years of healthcare and management experience. They will be on hand throughout the show to ensure the debate flows and the important questions get answered.

CLINICAL COMMISSIONING GROUPS OF THE FUTURE Dr Charles Alessi, Chair, NAPC

INTEGRATED CARE Dr Johnny Marshall, Joint Chair, NAPC NHS Alliance Coalition Michael Sobanja, Policy Director, NHS Alliance

PRODUCTIVITY THROUGH TECHNOLOGY Andrew Hartshorn, Vice Chair, Intellect Health and Social Care Council Jeremy Nettle, Chair, Intellect Health and social Care Committee

HEALTH AND WELLBEING BOARDS Dr Nick Hicks, Director of Public Health, Milton Keynes Ed Harding, Partner, HK Consulting

MANAGING LONG TERM CONDITIONS Dr Michael Dixon, Chair, NHS Alliance Sir Muir Gray

KEYNOTE CHAIR Dr Charles Alessi, Chair, NAPC

LEADERS SYMPOSIUM CHAIR Beverly Bryant, MD, Capita

Dr Nick Hicks

Ed Harding

Dr Johnny Marshall

Dr Michael Dixon

Michael Sobanja

Sir Muir Gray

Andrew Hartshorn

Dr Charles Alessi

Jeremy Nettle

Beverly Bryant


Instrapac IUCD Procedure Pack

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Forceps1 x Simms Uterine Sound1 x Cusco Medium1 x Currie Uterine Scissor

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43 x 38cm1 x Gallipot 60ml1 x Polypropylene Tray

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Professor Steve Field, chairman of the NHS Future Forum and chairman of the National Health Inclusion Board, who is a keynote speaker in the CCGs of the Future stream, says: ‘Now there is political certainty that it’s going to happen, the health service is changing almost daily.’

He says he can’t predict yet what he will be

talking about at the Commissioning Show because he says the atmosphere between now and June will have changed.

‘What I can guarantee though is that what I will be saying will be bang up to date, very relevant.

‘People are in the middle of forming and storming CCGs and the issues they are going to be dealing with in eight or twelve weeks time are going to be very different to those they are grappling with now. CCGs have been working with draft guidance but they haven’t yet seen a lot of the detail about how their groups should be structured. All of these policy papers on these issues can now be released and talked about.

‘Everybody involved in commissioning should come to this conference because they will be able to find out the most up to date information and be able to network with colleagues and this will really help them develop their local commissioning.

‘People will come because they will want to hear about commissioning, where the politics is going and there will be loads of things they will want to talk about.

Delegates who attend this speaker stream will also be able to gain inspiration from Dr Hugh Reeve, Chair of Cumbria CCG and GP Partner, Nutwood Surgery, Grange-over-Sands.

Cumbria is recognised as being at the forefront of many of the current NHS changes. This pioneering CCG has been created from six locality commissioning groups and is seeking to devolve responsibility as much as possible to local level while gaining the advantages of being part of a large group.

This CCG is well on the way towards gaining authorisation in 2013, and in this talk delegates will hear some of

the key lessons already learned and be offered practical tips on making progress.

The learning points will include: being clear about where you are heading; how to keep members on board CCGs; the importance of focusing on clinical quality and not just balancing the books and building partnerships with specialists, the third sector and patients.

Instrapac IUCD Procedure Pack

£10.06 per pack 1 x Rampley Spongeholder

9.8”1 x Teales Vulsellum

Forceps1 x Simms Uterine Sound1 x Cusco Medium1 x Currie Uterine Scissor

5 x Cotton Wool Balls1 x Dressing Towels

43 x 38cm1 x Gallipot 60ml1 x Polypropylene Tray

with 2 integral pots1 x Sterile Field


8895732 (x1)

Non-Sterile Vinyl Gloves -Powder-FreeAvailable in Small, Medium & Large



7326028 Small (x100)

7326036 Medium (x100)

7326044 Large (x100)

Combur 10 Test Strips

£23.99 per pack of 100

Pipcode Size / Pack Size

2697274 Combur 10 (100)

Instrapac TOE Forceps

£0.89 per item


8893133 (x1)

Instrapac Iris Stitch Scissor 11.5cm

£0.93 per item


8893240 11.5cm (x1)

R

Instraspec Clear Vaginal Speculum with Locking Device



8899494 Small (x25)

8899502 Medium (x25)

8899510 Medium/Long (x25)

8899528 Large (x25)

CCGs of the FutureProgress towards implementing the health service reforms is so rapid, now that the legislation has received Royal Assent that CCGs are having to run very hard to keep up with all the changes.

Professor Steve Field

“People will come because they will want to hear about commissioning, where the politics is going and there will be loads of things they will want to talk about”Professor Steve Field

Pro-Cure - New year brings new wave of commercial support

Air your views on Health and Wellbeing as part of national survey

Leading public sector title Local Government Chronicle will be presenting the initial findings of their survey into the progress of Health and Wellbeing Boards at a special

session at the Commissioning Show.

Delegates will have the chance to discuss the results and share their views on the outcomes, ready for the upcoming focus report in the title. This will be one of the first studies of its kind to draw on the views of both local authority and health service figures to get a snap shot of how joint working is progressing.

Director of the Health and Wellbeing stream and session facilitator, Mike Broad comments: “Whilst there has been excellent pioneering work in some areas, many others are still in the early stages of building their relationships with local authorities. This session will offer a candid insight into respondents priorities and concerns and hopefully generate some lively debate as to possible solutions. I would urge anyone involved in HWB development to come along and air their views.”

Employment law helpline for practicesA SPECIALIST employment law helpline operated by MDDUS will help practices cope with the increasing demands of commissioning.

The service is available to practice managers within MDDUS group schemes or members who have employment

responsibilities.

An experienced team of in-house advisers is on hand to provide specialist employment law and HR advice for those experiencing difficulties with employment matters.

The advice service operates mainly during core hours but is available 24/7 for urgent enquiries. And as the service is unlimited, members can speak with the team regularly for follow-up on developing situations.

MDDUS employment law adviser Liz Symon said: “This service is already proving very popular with our members who are looking for advice and support that complies with the latest employment law legislation.

“Contractual issues have been a real hot topic for our members when contacting MDDUS for advice and we also receive a number of calls on policy issues such as maternity and sick pay. We expect these issues will be brought to the fore as more practices become involved in commissioning in line with the planned NHS reforms. This will likely mean an increased demand for the expert service we provide at MDDUS.”

In addition to the helpline, MDDUS is also offering to practice schemes - where all employing GP/GDP partners are members of the Union - the option of a Legal Support, Representation and Indemnity package (LRI) which will be available for a small additional fee per head of employer. The LRI package provides access to assistance in matters that go beyond simple advice and guidance.


Our specialist team is leading the procurement for a national children’s epilepsy surgery service, ‘111’ single-point-of-access initiatives, healthcare and dentistry in prisons and payment by results procurements for drug and alcohol support services.

PRO-CURE works with Primary Care Trusts (PCTs) and Clinical Commissioning Groups (CCGs) to meet their objectives and support the delivery of high quality healthcare and better outcomes for patients.

Experienced NHS procurement professionals, our team can guide commissioners step-by-step through the most effective competitive procurement or any qualified provider (AQP) process, supporting the shaping of service specifications and maximising value for money.

We also offer commercial advice, project and performance management.

For more information, contact: Caroline Thomsett, Assistant Director of Corporate Services, Telephone: 0118 916 7945 Email: [email protected]

NHS PRO-CURE has kicked off 2012/13 with a series of high-profile projects supporting commissioners.


HWBs are the centrepiece of the machinery that will see local authorities taking responsibility for improving the health of their local populations.

The HWB will be the strategic forum that sets the priorities for their clinical commissioning groups (CCGs) and will bring together representatives from primary care, public health, social care plus elected representatives and patient groups.

This stream of the conference will focus on successful early joint working between local authorities, HWBs and healthcare organisations.

Dr Nicholas Hicks, Director of Public Health, Milton Keynes NHS, who is chairing the stream on June 27, says people coming to the Commissioning Show who are involved with HWBs will be at the stage of wondering what they are supposed to be doing with their new organisations.

‘Some will have the answer and will want to tell everybody else, others will be thinking – how are we going to make this work and - what can we do, what can’t we do?’

‘HWB Boards will bring people together with a sense of purpose. They will create a real opportunity for people to work together to achieve things they haven’t before. The challenge will be making sure that the aspirations and ambitions that will be discussed really do translate into practical change that affects the live of individuals, families and communities.

‘CCGs and Councils will have a duty to pay due regard to Joint Health and Wellbeing Strategies. How this plays out in practice will be a key test of the effectiveness of HWB Boards. Will the HWB strategies have the power to change council policies?

‘For example, if a council policy had previously promoted

the night time economy with a liberal stance on licensing applications and approval of a larger casino and the health and wellbeing strategy subsequently prioritised mental health and reducing alcohol related harm, would the influence of the HWB strategy be sufficient to change council decisions? How would that play out? What do HWBs need to do to become powerful? I hope these are the sorts of questions the meeting might address.’

Dr Hicks says he would like to see everyone involved with HWBs coming to listen to the talks in this stream - elected members, council officers, local authority chief executives, people involved with CCGs and Health Watch, who represent the public.

‘By June, people involved in HWBs will be looking for inspiration from examples of good practice that are already up and running and will be wanting to make sure they really do understand the rules and regulations and the powers they have. They will want to know what they really can do that they couldn’t do before,’ he says.

Case studies in this stream include early HWB implementers Wigan, Birmingham and Cornwall. In Wigan integrating wellbeing, social care and clinical pathways is at the centre of their work. In Birmingham the HWB is getting to grips with meeting the needs of a young diverse population and some challenging health inequalities. One of the challenges for the new HWB in Cornwall has been identifying which outcomes will be priorities and what success looks like.

Keynote speakers include John Wilderspin, National Director, Health and Wellbeing Board Implementation at the Department of Health, who will explore how CCGs can use HWBs to develop a strong partnership with local government and Dr Alison Hill, Managing Director NHS Solutions for Public Health, who will outline some of the building blocks that HWBs should be putting in place to achieve better health outcomes.

Dr Nicholas Hicks

The HWBs are coming...Each top tier and unitary authority should now have set up their own health and wellbeing board (HWB) which will be operating in shadow form and preparing to take on their statutory functions by April 2013.

“They will create a real opportunity for people to work together to achieve things they haven’t before”Dr Nicholas Hicks

Fiona Phillips calls for joined up care pathways for Alzheimer’s patients

This is the view of broadcaster and TV presenter Fiona Phillips who will be giving a talk on her experience of caring for both her parents over a period of 14 years while they battled the disease.

Fiona reckons her mother, while still only in her fifties, had had the disease for six years before she realised – something she still feels guilty about today. ‘She never told me because she had forgotten she had been to the GP and hadn’t taken the information in. I wished I could have been around for her

more. She was really frightened and was crying all the time – she knew something was catastrophically wrong with her,’ she says.

The journey of Fiona’s parents’ through the medical and social care services were both different and both lacking in many areas.

Her father ended up living in squalor after her mother died and received very little help from social services. Hospital staff had little understanding of his problems - when he was admitted to hospital with pneumonia staff asked him long lists of questions, which he couldn’t answer.

When the GP came to see him at home to treat his leg there was a great deal of concern about his leg but not his dementia. ‘People with Alzheimer’s just slip between health and social care and both services are often inadequate,’ says Fiona.

Her plea to clinical commissioners is: ‘Just consider what it means to have a devastating diagnosis like Alzheimer’s. It is a cruel disease that can make families fall apart under the burden of caring.’

She will tell CCGs that they should be commissioning integrated pathways of care. The pathway should start with early diagnosis and informing next of kin so that they know early on what is happening. Patients and carers should be given clear, written information about the disease, about what help and support is available, and how they can access it. Every patient should be entitled to good quality care in their own home.

‘What happens at the moment is that you are literally left to get on with it and, as happened to me, you just try find out things along the way, often by making terrible mistakes,’ says Fiona.

Alzheimer’s Disease is a much misunderstood condition starting from the moment the patient first walks into their GP’s surgery.

i-healthbooker set to transform CCG communication

A web application which creates a unique online community for clinical commissioning groups (CCGs), their clinicians and the service providers they work with, will be showcased at the Commissioning Show.

i-healthbooker is the brainchild of West Yorkshire GP Dr Chris Jones, managing director and owner of IQUS, the company which developed Rota Master the software application which automates complex duty rotas for unscheduled healthcare providers.

The Facebook-style system is built around a flexible, locally managed service directory which enables networks of users to create and share the content they need to survive in the new NHS.

Through i-healthbooker commissioners can build their own service directory which enables them to communicate directly with their clinicians, guide referral decisions through user-defined pathways and keep service information up to date. The system enables them to create groups for task or topic orientated collaboration and communication, build a library of CCG-specific content and monitor referrals in real time. They can also link and share information with other CCGs.

Clinicians can use the system to build a personal profile, write a blog, communicate with colleagues in their own CCG as well as those around the country and enjoy real time clinical networking. The system gives them access to CCG-specific pathways to guide their referrals, a knowledge base set up and managed by local colleagues and up-to-date information regarding service providers.

Service providers can maintain their own record within i-healthbooker to ensure CCGs and referrers always have up to date information and patients can book appointments online and rate services.

Dr Jones, who is CCG commissioning lead for his practice in Ossett, says the idea for i-healthbooker came as he realised there was a need for the hundreds of people involved in each CCG community to be able to communicate with each other in real time and have ready access to the deluge of information that is being created by the new commissioning process.

‘My aim has been to produce an integrated system so that everything that commissioners and clinicians need is available in one online place. i-healthbooker is a framework that will be developed over time to become richer and deeper in functionality as it adapts to the needs of its users,’ he says.

Visit the Commissioning Show exhibition to meet the IQUS team who will be on hand to demonstrate how i-healthbooker works. For further information, contact [email protected]


commissioning newspaper issue 3

Documents

family doctor association

nhs pension

leaders symposia

leaders symposium

dr charles alessistop

nhs future forum

ccg debatecomplete

ccgs work