The New CommissioningLandscapeChris DrinkwaterNewcastle West CCG Partnership Forum
Newcastle West CCG• Part of Newcastle/Gateshead CCG Alliance –shared accountable officer and financeofficer.• 127,000 population with 17 practices.• CCG Board with 2 lay members – PPI andGovernance.• Represented on Wellbeing for Life Board x2• Practice Forum with two members from eachpractice.
CCG Public & Patient Involvement• Partnership Forum – Board lay members, 2local councillors, GP chair & vice-chair,accountable officer, voluntary sector reps,patient reps, housing association, HealthWatch.• Community Forum• Patients Forum
The Number Plate1856 1784 33Newcastle West CCG Challenge
Cost Pressures• Children & Parents• Mental Health• Long Term Conditions including cancer• Older People• Behavioural issues – drugs, alcohol, obesity,sexual health
Re-balancing the bio-medical & the social:Looking in both directionsHospital CCGsIndividuals&CommunitiesDTCsPolyclinicsWellbeingServicesMedical model (QoF/health checks) Social modelEvidenceIndividual responsibility & behaviour changePatient centredness£££Unsustainable DemandPhysical Capital SocialDTC – Diagnostic & Treatment Centre
Newcastle NDC Baseline MentalHealth Survey (2004)Men aged 45-55• Living alone – 49%• Economically inactive – 58%• GHQ above threshold - 63%• Associated high levels of smoking,alcohol consumption and obesity.
Social Prescribing• Supportive socialnetwork• Increased self-esteem• More physicallyactive• Better nutrition• Decreasedalcohol/smoking• Better diabeticcontrol
Key activities• Physical Activity• Healthy eating/cooking• Arts/health• Befriending• Welfare rights/benefits• Volunteering opportunitieswww.diabetes.nhs.uk/year_of_care.Social Prescribing for Long Term Conditions
NESTA “People Powered Health”Co-production for long term conditions• Recognising people as assets• Building on peoples capabilities• Promoting mutuality and reciprocity• Developing peer support networks• Breaking down barriers betweenprofessionals and users• Facilitating rather than deliveringwww.nesta.org.uk/areas_of_work/public_services_lab/people_powered_health.
Commissioning for Long Term Conditions : The learning£££Traditional Biomedical care•Complex / specialist/ inpatients•QOF / Surveillance / medicationSupporting self managementIn the health service1:1 consultation•Care planning•Joint decision makingStructured patient educationSupporting self managementIn community•Living with long term condition•life style issues•Community support / social capital•Public health / well beingYear ofCareAdded valueCo-productionFrom Year of Care Programme at www.diabetes.nhs.uk/year_of_care
Community Health ChampionsWorking with communities to tacklehealth inequalitieswww.hwn.org.uk
Key Learning so far!• Engaging with GPs is like communitydevelopment – start with their concerns and notwith demands or a magic widget.• Lead providing/Alliance contracting is not easy.Think small local supply chains.• Target inequalities/vulnerability.• Make links with NHS and social care providersand explore common interests.• Think about metrics for quality improvement,social value and cost savings.