west hampshire clinical commissioning group...clinical director: mental health, clinical cabinet of...
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West Hampshire Clinical Commissioning Group Key facts The West Hampshire Clinical Commissioning Group (CCG) has:
54 constituent member GP practices A delegated budget of £467million for 2011/12 covering acute hospitals, community
services and prescribing services A population of 536,073 local residents An area of 2,242.4 square kms (865.8 square miles) Services provided by eight providers:
o University Hospital Southampton NHS Foundation Trust o The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust o Winchester and Eastleigh Healthcare NHS Trust o Basingstoke and North Hampshire NHS Foundation Trust o Salisbury NHS Foundation Trust o Southern Health NHS Foundation Trust o Solent NHS Trust o South Central Ambulance Service NHS Trust
Relationships with five councils: o Hampshire County Council o New Forest District Council o Winchester City Council o Eastleigh Borough Council o Test Valley Borough Council
Leads The CCG governing body has five members:
Dr Sarah Schofield (Chair) – Children and Families and Unscheduled Care lead Dr Nigel Sylvester (Vice Chair) – Health and Wellbeing, Prescribing, and
Winchester/Basingstoke Acquisition lead Dr Tim Thurston – Primary Care and Community lead Dr Simon Goodison – Long-term Conditions lead Dr Jim Rose – Mental Health lead
Clinical Directors Dr Simon Hunter - Planned Care Dr Katrina Webster - Mental Health, clinical cabinet of the West Hampshire Clinical
Commissioning Group
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Dr James Read - Medicines Management Dr Adrian Higgins - Unscheduled Care Dr Lesley Ayling - Children and Families Dr Nick Arney - Long term conditions The West Hampshire CCG Committee also has the following members: Heather Hauschild - Executive Director Mike Fulford - Finance Lead Dr Ruth Milton - Director of Public Health Behrooz Vaezi – West Hampshire Adult Services, Hampshire County Council Margaret Wheatcroft – Non Executive Director Martin Cox – Hampshire LINk Meetings The CCG has the following regular meetings:
Clinical Cabinet meetings once a month Clinical Executive meetings twice a month West CCG Committee (sub group of the SHIP Board) once a month
Point of contact details
Jackie Zabiela – 023 8062 7445 or [email protected]
The Clinical Leadership Structure
TBC
Clinical Director
for Planned Care
Local Authority PartnersLMC
West Hampshire CCG Transition Programme
West New Forest Grouping Mid‐West Grouping
(EN & TVS; ESP; T & W)
WINCAR & Andover Grouping
Clinical Cabinet – Clinical Directors and Interim Board
Interim CCG Board
Sponsor and Drive Projects
Sponsor and Drive Projects
Management Team Support
Other Local CCG Partners as agreed
Clinical Director for Long Term
Conditions
Clinical Director for Mental Health
Clinical Director
for Prescribing
Clinical Director for Community Services
Clinical Director
for Children and
Families
Clinical Director
for Primary Care
Clinical Director for Unscheduled
Care
Biographies
Chair – Dr Sarah Schofield Unscheduled Care, Children and Families
Sarah Schofield trained at Leicester University before she returned to her home territory in Southampton to complete her GP training. She did her GP registrar year at North Baddesley Surgery before becoming a partner in 1989, having completed her hospital training at both Royal Hampshire County Hospital and Southampton General Hospital. Alongside working as a GP, Sarah:
worked in A&E for over 10 years was Chairman of the local Primary Care Group (PCG) was lead for both the Orthopaedic and Emergency Care Network has been National GP Lead for the Department of Health
Musculoskeletal Framework and Clinical Audit Group was the Assistant Medical Director at Southampton General Hospital
for eight years has been the representative for her local GP practices for practice
based commissioning. This experience provides Sarah with the back-drop required to take the West Clinical Commissioning Group forward to ensure the best services are provided for the local population.
Vice-chair - Dr Nigel C Sylvester Prescribing, Health and Wellbeing, Basingstoke and Winchester Hospitals merger
Nigel has been a GP in Winchester for 30 years and has been involved with commissioning for the majority of that time. His main interest lies in forming close and creative relationships between Primary and Secondary care in order to make the most of limited NHS resources. He is married to Sue who is a senior NHS manager and has two children, one a teacher and one at Durham University. He has recently moved to Emsworth to be near his boat. He also cycles and runs in order to stop his arteries furring up.
Dr Tim Thurston
Primary Care, Community
Tim is a Partner at New Milton Health Centre. He qualified from Guy's in 1982 and has been actively involved in commissioning since the mid 1990s at the inception of locality groups. His wife is also a GP and they have three children, two of which are aspiring medics, one is in teacher training. He has a special interest in developing the role that general practice and community services can play in providing excellent NHS care.
Dr Simon Goodison Long Term Conditions, Patient and Public Involvement
After qualifying in 1980 from Middlesex Hospital Medical School and training in General Medicine, Radiotherapy and Paediatrics, Simon spent 18 months working in West Africa in The Gambia and then returned to the UK to complete his training as a GP. He joined Blackthorn Health Centre, Hamble, in 1991 and is a GP trainer. He has been involved in commissioning for the last 15 years initially as Mental health Lead for the Eastleigh and Test Valley South PCT and then as a Locality Practice Based Commissioning (PBC) lead for Eastleigh Southern Parishes. In his spare time he is involved in amateur dramatics, playing tennis and rowing on the river.
Dr James Rose Mental Health
Jim Rose is a rural GP near Andover. He qualified in 1986 and after working ten years in a large urban practice, he moved to St Mary Bourne in 2003. In addition to clinical and teaching commitments, he has worked extensively at the management/clinician interface. In his spare time, he sails with his family and rides a mountain bike.
Heather Hauschild
Executive Director West Hampshire
Heather has over 20 years experience in the health service and a wealth of experience in the development of a wide range of clinical services. Heather trained as a nurse in Southampton and post qualification and the completion of a degree; she obtained a place on the NHS management training programme in the West Midlands. She has worked for the former Wessex Regional Health Authority, Birmingham Heartlands Hospital and Poole Hospital, where she was Director of Operations for five years. She lives in Hampshire with her family.
Mike Fulford
Finance Director
Mike has worked in the local health service for over 18 years and has a wealth of experience across both acute provision and the commissioning of health services. Mike studied for his accountancy qualifications in Southampton before joining Southampton University Hospitals Trust and has also worked at Winchester & Eastleigh Healthcare Trust, Eastleigh & Test Valley South & New Forest PCTs and Hampshire Primary Care Trust, where he has been Deputy Director of Finance for 5 years.
In his spare time he enjoys sport and music and lives with his family in Hampshire.
Clinical Directors
Dr Nick Arney
Clinical Director: Long term conditions Nick Arney qualified in 1987 from the Middlesex Hospital and University College Hospital London Medical School. After working for 18 months in the NHS he joined the Royal Air Force where he worked for the next seven years until leaving in 1995. Since 1995 he has been a GP in Totton, has had a keen interest in training GPs and has been involved in practice based commissioning on and off for the last five years. He has been the practice leader for IT during this time and has overseen the development of many new systems to improve patient care. He is married with two children and is an enthusiastic cyclist as well as having a passion for Italy having lived there for a year.
Dr Lesley Ayling
Clinical Director: Children and Families Lesley works as a locum GP in Hampshire. She trained in Cambridge and Oxford, graduating in 1983 followed by hospital jobs in Brighton, Leeds, York and Sheffield and developed an interest in paediatrics. She was a salaried GP in Sheffield before moving south in 2000. She also works as a GP appraiser and teaches medical students at Southampton University. She has particular interests in working within and across teams to improve the quality of care for patients. In her spare time she enjoys sailing, making music and spending time with her family who live in Hampshire.
Dr Adrian Higgins
Clinical Director: Unscheduled Care Adrian Higgins trained at Manchester University before taking up a partnership in Southampton in 1992 after completing GP training. He did his GP registrar year in North Manchester before becoming a partner having previously completed hospital training in East Lancashire. Alongside working as a GP, Adrian:
Has worked as a GP with Specialist Interest (GPSI) in Elderly Care
was Chairman of the Southampton Professional Executive Committee
was Medical Director for NHS Southampton has led unscheduled care work with GP Front-end Emergency
Department pilots and Walk in centre rationalisation in Southampton
has worked collaboratively with Providers and Commissioners across South West Hampshire
is currently the Clinical Lead for the 111 service development across the SHIP area.
This experience provides Adrian with the back-drop required to take the West Clinical Commissioning Group forward to ensure the best services are provided for the local population.
Dr James Read
Clinical Director: Medicines Management James Read qualified from Guys' Hospital in 1993 and undertook GP training in Norfolk. He has been a GP partner in Sutton Scotney since 2000. During this time he has been involved in various musculoskeletal and rheumatology assistant posts and is a GP trainer. James has been the medicines management lead for Winchester Practice Based Commissioning group for two years and looks forward to the challenge of extending this role across West Hampshire.
He is married to a local GP and spends spare time keeping up with an energetic 6 year old son, trying to keep fit and booking the next skiing holiday!
Dr Katrina Webster
Clinical Director: Mental Health, clinical cabinet of the West Hampshire Clinical Commissioning Group Katrina graduated from Manchester University in 2002 prior to working in Lancashire, Yorkshire and Western Australia. She then moved to Hampshire to complete GP training in Winchester which included a six month placement working with a local community mental health team. Since completing her GP training she has worked as a locum GP at various practices within west Hampshire and also completed two international placements in Cambodia, as part of the NHS South Central’s Improving Global Health through Leadership Development scheme. This involved working to train local healthcare workers and improve community health services in a deprived rural area of western Cambodia. As a locum GP she hopes to bring a unique insight into the variations within the west Hampshire population and looks forward to working with local GPs and secondary care colleagues to make GP commissioning a success for our population and healthcare providers.
Dr Simon Hunter
Clinical Director Planned Care, West Hampshire CCG After GP training Simon worked in the Solomon Islands for two years where he developed an interest in population based medicine. Since then Simon has been a GP in Southampton for 23 years, held lead roles in successive NHS reforms and obtained a Masters degree in Evidence Based Health Care. He is currently Associate Medical Director for SHIP cluster and Clinical Director Planned Care for West Hampshire CCG.
Alton
Bordon
Fordingbridge
Ringwood
Milford-on-Sea
Lymington
Lyndhurst
Hythe
Romsey
Waterlooville
Winchester
Basingstoke
Whitchurch
Tadley
OdihamFleet
Farnborough
Alton
Bordon
Petersfield
Sutton Scotney
Andover
Stockbridge
New Alresford
Eastleigh
Tatchbury
Fareham
GosportPortsmouth
City
SouthamptonCity
Havant
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West Hampshire The West Hampshire Clinical Commissioning Group (CCG) has:
•54constituentmemberGPpractices
•Adelegatedbudgetof£467millionfor2011/12coveringacutehospitals,communityservicesandprescribingservices
•Apopulationof536,073localresidents
•Anareaof2,242.4squarekms(865.8squaremiles)
•Fiveelectedboardmembers:
DrSarahSchofield(Chair)
Dr Nigel Sylvester (Vice-chair)
Dr Tim Thurston
DrSimonGoodison
Dr Jim Rose
TheCCGiscurrentlyrecruitingeightadditionalclinicalboardmemberstoforma‘clinicalcabinet’alongsidethelocalityleads.
Priorities
WehavestartedtodiscusstheprioritiesforWestHampshireincludingthelistbelow.Weareaskingforyourfeedbackonwhatelseshouldbeincludedandwhichshouldbethetopfiveprioritiesforthenextyear.
• Improvingcommunityservicescontracts
•Reducingvariationacrosspractices
•Engagementincommissioningdecisions
•Ensuringqualityofcareinourhospitals
• Integratedservicesforunscheduledcare
•FocusonCOPD,heartfailureanddiabetesinLTCs
•FocusonICATSanddermatologyforplannedcare
•FocusonPRAMS/LARCScontractsforprimarycare
Clinical focus and added value focusonoutcomes,involvingconstituentpracticesandcolleaguesinsecondarycare,communityandmentalhealth,publichealthandsocialcare
Engagement ensureinclusionofpatients,public,communitiesofinterest,healthandwellbeingboardsandlocalauthorities,incommissioningdecisions
Clear and credible plan todeliverthelocalQIPPchallenge
Collaborative arrangements robustarrangementsforworkingwithotherCCGstocommissionservicesoverawidergeography
Capacity and capability tocarryoutbothcorporateandcommissioningresponsibilities
Great leaders that can make a real difference
drivingtransformationalchange
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Authorisation processAuthorisationistheprocessCCGsmustcompletebeforetheycanbecomeastatutoryorganisationwhichwillallowthemtoemploystaff,procureservicesandenterintocontracts.
Thesixareasofauthorisationinclude:
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Primary care SharedVisionPracticesandtheCCGsharethecommongoalofdeliveringbetterhealthforthepatientsofHampshire.
Howdoweensurethatweareworkingtothesameagenda?
Effectiveness HowdoweensurethatGPsskillsandenergyarefocusedondeliveringbetterhealthoutcomes?
Howdoweutiliseselfhelpandotherresourcestomanagedemandswhicharenotalwaysbasedonneed?
Commissioning
Howdoweensurethatpracticeshavethetoolstobeeffectivecommissioners,particularlyinrelationtoprescribing,referralsandenhancedservices?
Health needs
Howdowebuildthespecifichealthneedsofourlocalitiesintoourhealthcareprovision?
Sustainability Howdoweensurethatpracticesarerewardedforsupportingthe commissioning responsibility by releasingtheirGPsforCCGroles?
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Community • focusingonservicesdeliveredbycommunityproviders(excludingMentalHealth
Services)toensuredeliveryoftheagreedquality,innovation,productivityandpreventioninitiatives
•deliverrobustcontractsforcommunityservicesandmechanismstoensuresubsequentsustainabilityofthosecontractedservices
•ensuringeffectiveandproductive:
communityconsultantsandspecialistnursesvirtualwardsrehabilitationservicescommunitypodiatry,physiotherapy,
speechtherapy,occupational therapy,dieticiansamongstothers
• serviceswhichmaximiseindependenceandpreventhospitaladmission.
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Long-term conditions • represent70%activityandcostofthehealthcaresystem
•accountfor76%ofunscheduledadmissions
•accountfor55%ofGPconsultations
Challenges include:
• riseinnumbersofpeoplewithlong-termconditions(LTCs)
•currentwayofmanagingpatientswithLTCsisnotsustainable
•needchangeinbehaviourandsystemstodeliverefficientandeffectivecaretopatients living with an LTC
Areas shown to be effective in improving quality of care for patients with LTCs include:
• riskprofiling
• integratedcaremanagementwithintegratedteamsatlocalitylevel
• systematicempowermentofpatientstoselfmanage/selfcare
•bettertargetedservicestoimproveoutcomes,mortalityratesandphysicalfunction
What will this deliver?:
•improvedhealthstatus&mentalwell-being
•helptopreventunnecessaryadmissionsto hospital
•enablepatientstoremainintheirhomesandcommunities
•improvesfeelingofcontrolintheircondition
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Patient and Public Involvement “Nodecisionaboutme,withoutme”isattheheartoftheGovernment’sreformstotheNHS,toshiftdecision-makingascloseaspossibletopatients.
Effectivecommunicationandengagementisaboutgettingtherightmessagestotherightaudiences,throughthemostappropriatechannels,atthemostappropriatetime.Itisatwowayprocess–informing,sharing,listeningandrespondingisessential.
Whyisengagementsoimportant?
•Betterdecisionmaking,improvedservicesandbetter outcomes
•Greatercommunitysupport,trustandconfidence
•Deliversdifficultchangesuccessfully,with less conflict
•Helpsyoutoidentifyareasofwasteandinefficiency
•Helpstomanagedemandforservicese.g.inappropriateuseofemergencyservices
•Helpstacklehealthinequalitiesandsupportbehaviourchange
•ThenewpatientparticipationDES
CCGswholistentopeopleandcommunicatethisprocesswillincreaseunderstandingandconfidenceinusinglocalservices.
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Prescribing •playaleadingroleinthedeliveryoftheMedicineManagementStrategy
•workcloselywiththeMedicineManagementDirectorfortheSHIPCluster,theMedicineManagementLeadsofthelocalitiesandMedicineManagementPharmacists
•developrelationshipswithHospitalPharmacistsandtheLPC’s
•agreepoliciesthatwillenabletheCCGtoworkwithinitsagreeddrugbudgetandensurethatlocalitiesworkwithintheirindividualnotionaldrugbudgets
•workwithDistrictPrescribingCommitteestoensure thatpoliciesareinplacetoadoptnewdrugsornewindicationsforexistingdrugs
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Health and Wellbeing •workwiththelocalauthoritytoimprovethestrategiccoordinationof
commissioningacrosstheNHS,socialcare,publichealthandchildren’sservices
• improvehealthlocallybyforgingnewrelationshipsbetweenorganisations
•ensureproperengagementwithlocalpeople
• tacklekeyissuessuchashealthinequalitiestoensureconsistentandcomprehensivehealthandwellbeingacrossthecounty
Winchester and Basingstoke Merger •workingwithBasingstokeandNorthHampshireNHS
FoundationTrust(BNHFT)andWinchesterandEastleighHealthcareNHSTrust(WEHCT)intheprocessofmergingintoaformalpartnership
•ensurethisprocessiscompletedinthebestinterestsofallourpatients
•ensurefoundationtruststatusisachieved across both trusts
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Mental Health • improvequalityandoutcomesofmentalhealthservices,enhancecommunity
mentalhealthpromotionandpreventmentalhealthillnessthroughearlyintervention
•assisttheCCGBoardinthedevelopmentofaMentalHealthStrategy
•workwithotherorganisationstoensureacoordinatedapproachtoMentalHealthcommissioning,including:
general practices
communitycareproviders
acute trusts
social services
voluntary sector
•workwithlocalityleadstogetpracticeviews on mental health service provision andtosupportpracticesindeliveringtheircomponentsofthementalhealthstrategy
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Planned Care Theprioritiesfordevelopmentthisyearinclude:
Map of Medicine
Continuingtodeveloplocalcaremapsandtheuseofthetooltodesignlocalhealthcareservices,supportclinically-ledserviceimprovementandtodeliverhighqualitycareinthefaceofeconomicchallenges.
Advice and Guidance
DevelopingtheuseofAdviceandGuidance(A&G)toallowonecliniciantoseekadvicefromanotherontreatmentplans,ongoingmanagementofapatient,clarificationoftestresultsortheappropriatenessofareferral.
Teledermatology
Theuseoftelemedicinetoexchangemedicalinformationconcerningskinconditionsfordiagnoses,consultationandtreatmentadviceaswellascontinuouseducation.
Patient Reported Outcome Measures (PROMS) – decision aids for patients
PROMSmeasurequalityfromthepatientperspective to calculate the health gain aftersurgicaltreatment.Howcanweuse this as a tool to ensure patients makeinformeddecisionsaboutmedicaltestsortreatments?
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Unscheduled Care •Outofhoursprimarycareserviceand111service
• reducingnon-electiveadmissionsandlengthofstayinhospital
• improvingaccesstoearlysupporteddischargeandongoingrehabilitation forstrokepatients
• supportinghospitalstoreducere-admissionswithin30days
•workwithEmergencyDepartmentstoachievefourhourtarget andco-locateprimarycareservicewhereappropriate
• improveuseandoutcomesforintermediate carebeds
•driveupqualityandexperienceof unscheduledcareservices.
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Children and Families •provideseniorclinicalleadershipandadviceforworkrelatingtochildren
andfamilies
•ensureprocessesmeettheresponsibilitytosafeguardandpromotethewelfareofchildrenandyoungpeople
•developworkingrelationshipswithcliniciansinoutsideorganisationsinvolvedinchildrenandfamilies
• leadingthedevelopmentofaservicespecificationfortheGovernmentrecruitmentof100+healthvisitorsforWestHampshire