Locality Meeting 15 May 2014 Co-commissioning Prescribing Urgent care and Health & Independence

1. Locality Meeting 15 May 2014 Co-commissioning Prescribing Urgent care and Health & Independence Update on RAIDR CCG feedback EPaCCs  reminder

2. Co-commissioning • Simon Stevens (NHS Chief Exec) has announced an option for CCGs to co-commission primary care services • Expressions of interest are required by 20th June 2014 (from interested CCGs) • Largely relates to GP services • Scope • work with patients, Health and Wellbeing Board • Designing local contracts, egPMS • Discretionary payments eg premises • Managing resources • Contractual performance • Procurement for new services • Key points • Geography? Single CCG or joint with neighbouring CCGs? • Benefits? • Improved integration of health & care services and out of hospital care, mental health, community services etc • Improved service quality • Enhanced patient and public involvement in developing services • Reducing inequalities

3. Co-commissioning - continued • Any submission would require the CCG to identify the areas that it would wish to cover • Spectrum of co-commissioning • An Ipswich and East Suffolk bid or with West Suffolk ? • Greater involvement in decisions made by Area Team • Joint commissioning with Area Teams • Delegated commissioning arrangements – CCG undertakes tasks on behalf of Area Team • Expressions of interest would need to indicate the form and proposed timescales of the co-commissioning, extent of co-location of Area Team Staff and in particular how the CCG would deal with potential conflicts of interest. • More detail is being worked up by the NHS Commissioning Assembly

4. Co-commissioning – What next? • Some proactive approaches from practices expressing interest that those involved in the delivery of primary care should be shaping primary care services. • Before the CCG goes any further with thinking about this we want to ask you what you think. We will send Senior Partners a letter this week, requesting your practice’s view on: • Option 1 - Supportive of a submitting a proposal to pursue these additional opportunities • Option 2 – Do not support the option and wish to retain the status quo • We will also be asking other partner organisations what they think, including the LMC.

5. Prescribing Budget update • Current YTD position (up to and including Feb 14) £1.4m overspent (3%) Budget 14-15 • Based on forecast outturn 2013-14 • Same methodology as last year i.e. weighted ASTRO PUs taking into account deprivation • Public Health drug spend will be top sliced as per last year • Net uplift of 0.2% (1.9%* uplift - £1m QIPP saving) Changes this year • Spend on DN supply chain dressings will be top sliced • Spend on drugs commissioned by NHSE will be top sliced • Nationally allocation of ASTRO PUs has changed. Less weighting for patients aged ≥65 yrs. *regionally recommended uplift

6. QIPP priorities

7. Urgent CareKey messages from GPs at December Education Event Urgent care services need to be where the patients are / go to currently Integrated urgent service at the front door of A&E, including primary care, with senior leadership Increase patient awareness and understanding of self-care options Discharge planning on arrival Up-skill staff Ensure access to other urgent services including diagnostics

8. To boldly go… Vision of the Urgent Care System Diagram provided by Dr Imran Qureshi

9. Proposed Overall Urgent Care System Model for Suffolk

12. Update on RAIDR The RAIDR (Reporting Analysis & Intelligence Delivering Results) system is being offered to practices as of now. The first wave of practices have been contacted and are already starting to receive training on the system. It is anticipated that all practices will be able to receive the training and use the tool by the end of June. RAIDR will be able to support the NHS England Admissions Avoidance DES, Over 75s work, MDTs.

13. CCG Feedback raised at April education event To raise a query, you can email iesccg.gp-contract-queries@nhs.netThe mailbox is monitored twice daily, issues are then logged and a response should be available within 20 working days.

15. Hospital Ambulance Liaison Officer (C) • Collaborative working • Supported 7 day working • 65% fewer delays reported • Positive patient outcomes in handover and response times • Reduction of financial consequences Community Escalation Beds and Discharge Planning Nurses (AA/C/ESD) • Supported 7 day working • Positive patient outcomes, being treated in the right place • Collaborative working • Reduced patient length of stay in hospital • Used by 218 patients • Average length of stay 9 days Primary Care Contract COPD (AA) • Positive patient outcomes • Reduced respiratory admissions • 2,253 patient contacts by Primary Care • 1,407 prescriptions issued • 24% reduction in COPD admission than last year (Jan- March) • 4% reduction in overall respiratory admissions than last year (Jan- March) Top 5 Patient Flow Winter Schemes 2013-14 Evaluation Based Weekend Diagnostic, Therapies and Pharmacy (AA/C/ESD) • 4% increase in weekend dispensing • Supported 7 day working • Positive patient outcomes • Collaborative working • 12% of patient seen by therapies were discharged the same day • 58% of patients seen by therapies were discharged at the weekend Additional Consultant hours in ED, EAU and Capel Ward (AA/C/ESD) • Positive patient outcomes • Supported 7 day working • Reduced waiting times for patients • Improved patient flow • Senior clinical decision making • 20% additional weekend discharges on Capel Ward than before consultant • 95% year end ED performance met (AA) Admission Avoidance | (C) Capacity | (ESD) Early Supported Discharge

16. EPaCCS Reminder • EPaCCS (Electronic Palliative Care Coordination System) went live on the 6th May • Practices need to create EPaCCS records for patients on End of Life registers. • Supportive documents to help practices do this is available on the Ipswich & East CCG Palliative Care web pages • An FAQ has been included within the delegate packs • EPaCCS is a national requirement