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ELR CCG AGM 2015 main session
- 1. Welcome to our Annual General Meeting 2015 Sub-title #elragm2015
- 2. #elragm2015 What we plan to cover this evening Looking back Overview of the Year Meeting our aims Financial Performance Our values and staff Looking forward New faces, new roles Our focus for coming year How you can get involved
- 3. #elragm2015 Through our engagement, you told us you wanted…. •Care delivered closer to home •Closer working with social care •More work on prevention •Better quality and more efficient services
- 5. #elragm2015 About our patch - 340,000 people of whom…. (England Average 23.1%) (England Average 23.7%) 5% increase on current population
- 6. #elragm2015 Gender and longevity England Average 79.1 years England Average 83.1 years ELR 50.6% female - England average 50.2%
- 7. #elragm2015 The three major causes of mortality
- 8. #elragm2015 Aim 1: Transform services and enhance quality of life for people with long-term conditions COPD Mental Health IAPT
- 9. #elragm2015 Aim 2: Improve the quality of care
- 10. #elragm2015 Aim 3: Reduce inequalities in access to healthcare
- 11. #elragm2015 Aim 4: Improve integration of local services Non-integrated health care Integrated wraparound GP and community services GPs
- 12. #elragm2015 Aim 5: Listening to our patients and public Launched today!
- 13. #elragm2015 New faces, new roles •Karen English appointed as Managing Director •Dr Richard Palin newly appointed chair •Donna Enoux promoted to Chief Financial Officer •Carmel O’Brien – Deputy Managing Director
- 14. #elragm2015 Aim 6: Living within our means Manage within Budget Manage within Cash Limit Manage within Capital Limits Manage within Running Costs Target
- 15. #elragm2015 Managing within Budgets Budget - £335,185,000 Actual - £335,182,989 NHS England had set a target for the CCG to achieve a surplus of £3,308,000. The CCG over-achieved its target by delivering a surplus of £3,310,011.
- 16. #elragm2015 Our staff must be equipped to deliver our strategies
- 18. #elragm2015 Finding out more and getting involved For details of our accounts, our work and how you can get involved: Copies of the Annual Report and the Annual Report Executive Summary are available here Visit: www.eastleicestershireandrutlandccg.nhs.uk Call us on 0116 295 5105 Email: listening@eastleicestershireandrutlandccg.nhs.u k
- 19. #elragm2015 Questions to the Panel
Editor's Notes
- Graham will open the AGM following a short video welcome from Simon Stevens On behalf of East Leicestershire and Rutland CCG, I’ m delighted to welcome so many of you here and delighted to have received that message of support from the NHS Chief Executive, Simon Stevens. As Simon said, we think that in East Leicestershire and Rutland we are doing lots of innovative things and developing exactly the new kinds of services and approach that the NHS will need for the future. At this AGM, we’d like to share some of the details of what we’re doing and give you the chance to ask us questions about them.
- Graham continues “Here’s what we plan to cover this evening. We want to look back, celebrate what we’ve achieved and discuss how we’ve sought to meet our aims. We will inform you about our Financial Performance. And we’ll update you about how we’ve looked after and supported our staff. We also want to look forward We’ll be updating you on some new faces and new roles in our organisation We’ll explain our main areas of focus for the coming year. And we’ll be informing you of both existing AND some exciting NEW ways in which you can get involved with us.”
- Graham continues From our engagement work you have told us that you want: Care closer to home includes access to services in patients’ own homes and other alternatives to hospital admissions because you tell us that you only want to stay in hospital if it is absolutely necessary; Closer working with social care means improving care pathways to make referrals less confusing and more straightforward; More work on prevention means reducing diseases through screening, advice and health checks; and Better quality and more efficient services is exactly what it says We’d like to explain how we’re working to deliver precisely that.
- Graham continues and hands over to Andy Ker at the end of this slide “Guiding everything that we do is this mission - which I know will be familiar to many of you. Underneath this mission we have a six key aims. My colleagues are going to explain in detail each of these aims and what we’re doing to deliver them. “I’d now like to invite our Clinical Vice Chair, Andy Ker, to begin by explaining the overall demographic and healthcare context in which we operate.” “Andy……
- Andy “Thanks Graham. The population of East Leicestershire and Rutland currently stands at 324,000 of whom: 26% are 60 years and over – this is higher than the England average 24% are 20 years and under – this is in line with the England average Over the next ten years there will be an additional 19,000 people (5% on current population) in East Leicestershire and Rutland who will be aged 60 years and over This means we will be supporting more people with long term conditions and this is a critical part of our planning right now
- Andy continues… The average life expectancy within East Leicestershire and Rutland is 80.5 years for men, and 83.9 years for women, both of which are higher than the national average. 50.6% of our population is female which is similar to the England average of 50.2% In NHS East Leicestershire and Rutland, only a small proportion of people live in deprived areas. Nevertheless, there are significant pockets of disadvantagein areas on the edges of Leicester City and within the market towns. We have to ensure this deprivation is not overlooked.
- Andy continues… Accounting for more than two-thirds of all deaths, the major killers in East Leicestershire and Rutland are: Cancer (29%) – All England data 29% Cardiovascular disease (27%) – All England data (28%) Respiratory disease (13%) – All England data (15%) Cancer We are taking the national campaigns and developing locally tailored versions to make them tightly relevant to our local population. In the past year, we aligned with national campaigns on “Blood in the Pee”; Urological Conditions; and “Indigestion for more than 3 weeks” UHL are getting an increased number of cancer referrals from GPs in our area, which is proof that our local doctors are screening earlier and picking up earlier patients who need treatment. The challenge is now how to deal with the increased demand for services as a result of this increased number of referrals. There is also a challenge our GPs have to face, due to NICE lowering the risk threshold that is used to underpin recommendations for cancer screening from a positive predictive value of 5% to 3%. This will also increase the numbers of people referred for screening. Cardiovascular We have delivered training for GPs in heart conditions, failure and atrial fibrillation which causes irregular heart rate and a higher risk of stroke All practices are involved – GPs now better understand medical requirements and can much better manage the risks for their patients We are now seeing more patients taking Meds to avoid blood clots and therefore reducing stroke risk which is great news Respiratory We have made sure we are picking up people with respiratory disease earlier who would not previously have been picked up, for example people around 40 who smoke and who have persistent coughs. We’re arranging for them to have screening earlier, then if necessary put on immunisers or vaccination which stops them developing more serious conditions and can push back by years the age at which they develop severe cardiovascular problems. Ref GP SIP paper – in April 14 227 hand held spirometry by March 15 - 1680
- Andy continues… COPD Third leading cause of death in England after circulatory disease and cancer – on average one person dies every 23 minutes from COPD in England We have improved services for patients presenting with severe COPD. Patients are now labelled as having Mild, Moderate, Severe or Very Severe condition. Those with Severe or Very Severe will now have care plans and steroid programmes, but will also be referred onto a pulmonary rehab programme, as part of the GP Service Incentive Payments scheme. As a result, more of our patients are able to stay at home rather than having to be referred into hospital. This, of course, does raise different emotional challenges of learning to live at home with a long-term condition. CCG has developed a programme linked to secondary and community care to manage COPD and asthma: Increasing accurate diagnosis Spirometric competency assessment – rolling programme Inhaler technique training – primary care professionals Services developed to meet the needs of an ageing population Develop care of dementia in general medical practice Working closely with community and secondary care Alzheimer’s Society delivery of Hospital Liaison Dementia Support Service in UHL 2014-15 Mental health We have a drive this year on dementia, recognising there is still a hesitancy amongst the public to engage around dementia. One of our local surgeries, the Uppingham Surgery only 2 weeks ago held an open Dementia Day. We have put in place Shared Care Agreements with our Provider Partners, so that patients who are diagnosed with Alzheimers are being given medication and repatriated back to their GP so they can receive follow up care closer to home. This isn’t just good for the individual patients, but also frees up space in the system so that more patients can be seen. We had a problem with out of county beds mental health last year – no local capacity and sometimes up to 100 out of area We re-designed the acute mental health pathway. It is a great example of commissioners and providers working together for best of patients so the patient is at centre to get a better service Strengthening the crisis pathway for patients with mental health needs, particularly for those with urgent needs, but who are not in crisis, so they are now seen within five days; Working with our colleagues in Leicestershire Partnership NHS Trust (LPT) to reduce out-of-area places from 37 down to single figures so patients and their families and friends do not have to travel so far Leicester, Leicestershire and Rutland Crisis Care Concordat The Crisis House which was opened on 28 February 2015 and offers six places in a 24 hour, 7 day a week therapeutic environment as a short-term alternative to home treatment with the aim of reducing the likelihood of an admission to hospital. Service users are offered a range of support from skills development and support with self-confidence to practical problem solving and recovery-focused therapeutic support. A telephone support line aimed at people experiencing a mental health crisis also went live in February. We hope this makes it easier for service users to access support and guidance when they find themselves in immediate difficulties. The service can also arrange access to face-to-face support for those patients who need immediate access to extra support and care. The dedicated housing support service for the Bradgate Unit is provided in partnership with Blaby District Council and offers support to quickly processing housing applications, help with deposits and rent and sourcing furniture. The pilot service commissioned in October 2014 from the InMind Healthcare Group provides a service is for users leaving the acute inpatient unit. It aims to ease bed pressures at the Bradgate unit, by offering support to service users making the transition from acute care back in to the community. The service is provided within a hospital setting, and patients are under the care of the medical and nursing staff at InMind. The planned length of stay for individuals is 14 to 28 days. The triage car is staffed by a police officer and a mental health nurse and they attend or give telephone support to front line officers dealing with incidents where a member of the public appears to be in a mental health crisis as these can often result in an in-patient referral. The additional expertise is designed to ascertain the most appropriate way of dealing with the individual. As a result, the number of people detained in a place of safety for up to 72 hours under Section 136 of the Mental Health Act has fallen. IAPT Expansion of Increasing Access to Psychological Treatment services – ‘talking therapies’ - with more patients requesting such care, resulting in improved uptake of the service. Our recovery rates are around 7 per cent above the national target (DN Joe to get figures from Jim Bosworth). That tells us two things – (i) the service is good and (ii) GPs are referring the right people. That is partly because GPs are working through the self-referral process with their patients, giving them advice and being signposted to the availability of the service.
- Andy continues and hands over to Carmel at the end of this slide (Carmel to amend) In line with the Berwick Report – A “Promise to act a Commitment to Learn – Improving the Safety of Patients in England” published in 2013, we continue to monitor quality of care within our local providers – UHL, LPT , EMAS. We do this in a number of ways; through routine contractual arrangements, through triangulation of various data – feedback from GPs, patient feedback, Healthwatch colleagues and by undertaking unannounced quality visits across hospitals both UHL & LPT and community services. Monitoring of safe staffing arrangements within our providers and supporting recruitment and retention strategies across the wider workforce within LLR along with Universities DMU and Leicester Medical School. Some areas of focus this year: In the last year we've worked closely with UHL to improve the quality of discharge letters to GPs this is important as it ensures that following a hospital stay the GP is clear about changes of drugs and / or follow up arrangements once home. Through our routine monitoring arrangements and feedback from our GP membership we identified concerns regarding the community nursing service offer to patients across ELR which meant higher number of pressure ulcers and some gaps in being able to respond to patients in a crisis. Our close work with LPT has seen a positive response and improving service across ELR which we are keeping under close scrutiny. Its important that we act in the role of a critical friend to our local providers, we recognise the challenges they face, its important for patients that we work together to transform services locally. Some ways in which our GP membership have been improving quality of care this year are for those people who have AF (Andy to expand in lay mans terms). Our GPs have undergone specialist training and through applying the CHADS2 score a clinical prediction rule for estimating the risk of stroke in patients with non-rheumatic atrial fibrillation (AF), a common and serious heart arrhythmia associated with thromboembolic stroke. It is used to determine whether or not treatment is required with anticoagulation therapy or antiplatelet therapy. This means that by identifying early and treating the numbers of people who go on to have a stroke (which is severely debilitating and has a life long impact) will be reduced. Care planning case study Care planning has been a key focus across the whole of LLR. We have worked with our CCG, Out of Hours, UHL and EMAS colleagues to develop both our End of Life Care Plan and our Personalised Care plan templates that can be recognised across our whole local health economy. The care plans captures key information relating to the patient’s health and wishes which better informs professionals involved in the patients care. The End of life Care plan known as deciding right includes information to inform health care professionals as to what to do in the event of an emergency to help prevent admissions in secondary care, our personalised care plan also includes information relation to an emergency. Through our work with care planning all of our GP practices have had training and have an end of Life Lead GP and we have seen an increase in patients with a quality care plan now with over 90% of our patients in care homes having a plan. This has resulted in patients especially those at the end of their lives being able to choose where they wish to die and because of the plan this has led to ten times more people dying in their place of choice, normally at home or in a hospice. I’d now like to invite our Chief Nurse and Quality Officer, Carmel O’Brien, to talk about how we are working to reduce inequalities in access to healthcare. Carmel….”
- Carmel “Thanks Andy… How does the CCG promote Equality, Inclusion and Human Rights? We take our responsibility to promote equality, inclusion and human rights across within our commission plans seriously. We expect our staff and membership to treat everyone they come into contact with fairly and not discriminate because of their age, disability, gender, gender reassignment, sexual orientation , religion or belief, pregnancy or whether they are married or in a civil partnership. we use the national Equality Delivery System as a framework to help us do this and have published our progress through our governing body meetings Some of the ways we do this are by: undertaking equalities analysis of our commissioning plans involving patients and users in our engagement work and being determined to ensure we understand the population we serve . So what does this mean for our patients? Urgent care Last year we came and talked to you over a number of months about how we could improve urgent care services You told us that you would like to have more options for urgent care in your local area as A & E/ED in Leicester means considerable travel for many of you and in April this year the new services started. These are delivered at Melton Mowbray, Oakham, Market Harborough, Oadby and in the first 5 months over 1000 people each week and demand continues to grow, this is also very good news for the urgent care system because it means that people who don’t need to go to A & E/ED are being treated in the right place which means that the A & E teams are mostly seeing people with life threatening conditions. This is particularly important as we head towards the colder weather and winter pressures so you will see a campaign later in this year which will help people to go to the right place first time. During the consultation exercise we had feedback from people across all categories of the nine protected characteristics outlined earlier Another specific example in relation to people with a Learning disability who are in an inpatient setting. Over the last year we have undertaken Care and treatment reviews for our patients with complex learning disability some of whom have been in an inpatients hospital secure setting for some considerable time and often outside of Leicestershire and Rutland. This has supported greater understanding of the types of services that will need to be developed to support local people to live in the community near to their families and also ensure that the current placement and provider is ensuring safe and effective care for this vulnerable group of individuals.
- Carmel continues… Carmel continues… We continue to work closely with our local authority partners both in Leicestershire County and Rutland to develop integrated services across ELR as part of our Better Care Fund Integrated Crisis response service It works by allocating patients what we call a ‘virtual bed’. A nurse will come to the patient’s home and stay with the patient all through the night to monitor them, just as they would on a real hospital ward. The monitoring nurse can call upon a roaming team of more experienced senior nurses to attend the patient’s home at any point and provide additional support and care where necessary. The Overnight home-based nursing support service was introduced in 2014 to prevent hospital admissions and allow patients to remain in their own homes, either following an unexpected injury or illness, or by providing end of life care for those who do not wish to be admitted to hospital. Alongside this Leicestershire LA crisis response provides an urgent response prevent admissions, this can be by providing personal care needs, help with meal preparation supporting the community nursing services and prevention an admission to hospital In Rutland we have implemented the Community Agents services where they are already working with the communities to identify vulnerable people, supporting for example those with low level mental health problems or the socially isolated Id like to share some examples of how these services have supported people over the last year. An 80 year old lady considered in last days of life, who had expressed home was her preferred place of death but the family were overwhelmed and requesting admission due to lack of support. CHS were able to provide Hospice at Home care support and symptom management in the day and overnight ICRS virtual bed health care assistant so that family could leave and rest. The lady died four days later, peacefully at home. (Referred by GP) Falls case study - Gentleman known to have Parkinson’s disease referred after a fall at home, and the paramedics attended, he had sustained no injury but was deemed at risk of a further fall, with no immediate informal network for support. He was assessed and allocated to be visited at specific times to support safe transfer and aide his confidence by the roaming team. Onward referral was made to CHS Day ICS and his own GP. He had his medication adjusted and received therapy services and remains at home. Loughborough Older Person’s Unit The Loughborough Older Persons’ Unit at Loughborough Community Hospital is a place for older people who need to be seen and assessed quickly, but do not need to go to A&E. It offers a same day, or appointment based service, and you can be referred by your GP, the ambulance service or a district nurse. The most common reasons a person might be referred to the unit are if they are suffering from a chest infection, have been experiencing unexplained falls, have a urinary tract infections and or have been suffering from heart problems. The unit can test for and organise support for all these conditions, avoiding the need for the patient to go to accident and emergency where their condition will often worsen or having to stay in hospital overnight while tests are carried out.
- Carmel continues and hands back to Graham at the end of this slide…. Carmel continues and hands back to Graham at the end of this slide…. We have continued our programme of taking our listening booth out across ELRCCG we've been too Sure start centres, Learning disability groups and markets stalls listening to diverse groups experiences of care. The listening booths supported achieving 690 individual questionnaire with 190 participants attending one of the 8 public meetings as part of our Urgent Care Centre consultation. Overall we had 1300 views from members of the public and 200 via a petition which led to the final decision regarding centres and opening hrs (in hours through GP services, OOH weekdays 5-9 pm (Oakham, MH & Melton) and BH & W/E 9-7 for Oadby 8-9 mon- fri BH & W/E 8-8. We continues to bring Patient Stories to our Governing Body we've heard stories about how challenging it is for patients and families to manage coordination of services for children with complex health needs; a number of stories feature issues with coordination of care across county boarders for people who have been diagnosed with Cancer by screening programmes or via referral from GP. This only increases the need to ensure a responsive service from our acute providers in Leicester, Nottingham, Peterborough and Coventry Our Patient & Public Engagement group has continued over the last year sharing our plans and receiving feedback about how we can improve services and develop our plans. We have revised our digital strategy – we've launched our new CCG website today, we've revamped our CCG membership schemes (myCCG) for members of the public and you can join by creating an account to keep upto date with latest and most relevant to you, We've expanded our social media channels via twitter – which allows us to get messages out re campaigns such as Choose well campaign – that is self management, use of community pharmacy, visit GP or UCC and only go to A&E only when necessary. Facebook, Youtube – you'll have seen our GB and staff films through today, including launching toady ELRCCG TV – this is a subscribed podcast via itunes or your tablet which will download to your device. Currently you have the set of videos you’ve seen today but we will be including a short video intro to our community service model. A film about how CCGS work and how you can get involved, this will include working with partners such at Healthwatch on content and material decide by them but delivered through ELRCCG TV Toady we've also launched our prototype mobile app “health access in your hands” this will give you details and direction of exactly which services are available to you any time of the day – GP, Pharmacy, dentists UCC Hopefully you will know that we launched our ‘Summer of listening’ early this year which concludes today this focused on engagement as part of BCT planned care workstream. Engagement with our member GP practice on federation and new models of care and asking you for your views about how we communicate and engage and how we could improve. Hopefully if you attended our workshop this afternoon we have some good response to this New for this year – Commissioning for Good Patient experience – we've been selected as one of 10 NHS organisations Macmillan Cancer Support/NHS England pilot Id like to hand you back to Graham
- Graham introduces our new roles and hands over to Donna at the end of this slide…. As many of you will know, I’m stepping down as Chair this year. It’s been a hugely enjoyable time and I’ll be sorry to go. But what makes it easier is knowing that the team picking up the baton is stronger than ever. In particular, I’m delighted that Richard Palin has agreed to become our new Chair from this September. We are all also delighted this year when Karen English was appointed to succeed Dave Briggs as our Managing Director. Karen will be supported by Carmel O’Brien as her Deputy. And to complete the round of new appointments, Im really pleased that Donna Enoux has been promoted to Chief Financial Officer. And on that note, I’d like to invite Donna to tell you about our financial performance this year. Donna…..
- Donna “Thanks Graham… As you can see we hit all our financial statutory duties set for us as a CCG. We managed within our Budget, our Cash and Capital Limits, and not only did we manage within our Running Cost target, but we actually underspent against this and used money we could have spent on CCG management costs to invest in additional healthcare services. The auditors gave us an unqualified audit opinion on our Annual Accounts and more importantly stated that we were achieving Value for Money when commissioning healthcare services for the local population of East Leicestershire and Rutland CCG.
- Donna hands over to Karen at the end of this slide… So, although we actually overachieved against the target set by NHS England of a £3.3m surplus, it doesn’t mean we’ve been afraid to invest in new services or treatments when they were justified…… A really good example of this is in relation to the prescribing of Daily Oral Anticoagulants (DOACs), more commonly known as blood thinning drugs given to patients at risk of stroke. Currently, our GPs are reviewing those patients who fit the criteria for DOACs as opposed to their current medication, Warfarin. Unlike Warfarin, patients using DOACs don’t require regular blood tests at the GP surgery, therefore improving their quality of life, and also DOACs don’t interact with lots of other drugs that people may be taking which improves patient outcomes. And by reducing the prevalence of stroke, resources can be freed up to treat other conditions. Whilst we have ensured that the CCG financial targets are met, we recognise the financial pressure that our local providers are under and where appropriate have ensured we have supported investment into our local Trusts, over and above the level of healthcare commissioned at the beginning of the year. In 14/15 we invested an additional £2.2m with the University Hospitals of Leicester to enable them to address the long waiting lists they had in relation to the 18 week Referral to Treatment target. As a direct consequence of this investment with UHL, no patients are now waiting more then 18 weeks to receive their treatment after being referred by their GP unless there is a particular cilinical reason. And now I’m now delighted to ask our new Managing Director, Karen English, to explain what we’ve been doing within the CCG to support our staff….
- Karen hands over to Richard Palin at the end of this slide We recognise our staff are our most important resource (reference the staff videos that have been running throughout the afternoon) We aim to involve them in the decisions that effect them: Staff development days – December and July December’s event invited each team to identify their priorities for 2015 and the support they would need from colleagues outside their own team Valuable exercise that both focused the teams and illustrated the interdependencies between the teams Vision and values refresh Launched at the away day in July; developed through the Freedom to Speak up staff group; presented to the Freedom to Speak Up Steering Group Five values have been developed by the staff: Excellence – we strive to be the best we can be Integrity – We act in the way we would want to be treated, we model best behaviour and are aware of our personal impact on others Ownership – We do what we say and take personal responsibility Heart – Patients at the heart of everything we do One Team – We are at our best when we work together These are work in progress and are part of the… Our finance team were shortlisted for the HMFA team of the year in 14/15 Best Places to Work Proud to be one of the best places to work in the NHS The award is derived from the results of the Annual NHS Staff Survey. The survey collects the experiences and opinions of NHS staff on a range of matters such as job satisfaction, wellbeing and raising concerns. So the award is based on what our staff say about the CCG as an employer We’d now like to look to the future, and I’m delighted to ask our new Chair, Richard Palin, to set out some of our main areas of focus for the coming year. Richard….
- Richard “Many thanks Karen… “It’s a huge privilege to have been asked to become our Chair for the coming year. And here are three areas on which we will be particularly focussing this year. Firstly, beginning today we are engaging on a potential Community Services model. We really want to hear everyone’s views on this and today we have published on our new website our document setting out our ideas and inviting everyone’s comments. This aims to make a difference to how care is commissioned and provided based on local need and a ‘Home First ‘ approach. We have already engaged with a range of local stakeholders as part and parcel of developing this potential model. This will now be the subject of further detailed clinically-led engagement with stakeholders, patients and their families. Our engagement process to date has enabled us to understand current issues and the breadth of potential for bringing together community and primary care services. It is our aim to set out potential ways in which each locality can have the right level and range of services to serve the needs of local patients. Primary Care is placed at the core of our model development with a proposal for discussion centred on wraparound community services to achieve greater integration of health and social care professionals. We have identified a number of areas that need to be addressed through the proposed model to ensure a solid foundation for community services. These areas are not exhaustive and include: Changing the current model of community services commissioning to give the CCG and its GPs more accountability to influence how services are delivered; Creation of joint GP/Provider posts to enhance accountability; Delivery of a rehabilitation and re-ablement model that moves services from a hospital to a home environment; Improving access to community services that are currently considered sub-optimal including physiotherapy; Expanding the times when care is available both at home and in health facilities; Establishing clinical support networks and services in acute and primary care to identify, enable and manage both complex care, frail elderly and sub-acute care locally; Making the most of the land and estate available to deliver local services avoiding unnecessary travel to acute hospitals; Minimising service barriers through simplified specifications and joint commissioning of primary, social and community services; and Changing the model of community services commissioning to focus on outcomes rather than inputs. Our proposed model is likely to require significant organisational change both within each locality and by community service providers requiring leadership, time, skill and resources to ensure change is achievable. The next stage will be to agree support for further engagement with our wider stakeholders and public to further strengthen and develop our proposed model. We do not believe that most aspects of this proposed model should require formal public consultation over and above robust and widespread engagement, however where there are such aspects, we are aware and concur that this consultation should be taken forward as part of the wider LLR-wide Better Care Together consultation, rather than as a separate exercise. We know that this is also the view of the Better Care Together programme. That brings me onto the Better Care Together programme overall. We are delighted to be playing a leading role in the BCT programme. Our activity to date has been on leading its work on Planned Care. Going forward from this Autumn, we will be leading its work streams on Learning Disabilities and Mental Health. The formal consultation on Better Care Together is due to commence on 30th November and we look forward too continuing to support its development and progress. Of course, Better Care Together is intimately linked with and aligns with our overall plans to transform our services. As a working GP, I’m particularly pleased with the work we’re pioneering to develop GP Federations and Networks - and I was particularly pleased to see our work recognised by the NHS Chief Executive, Simon Stevens, in his video message at the start of our AGM. (Tim will provide briefing on GP Federations, Networks etc) St Luke’s Sometimes things don’t go quite as smoothly as we would like and one area in particular that has proven to be particularly challenging has been on securing a start date for the development of a new hospital at St Luke’s. We fully accept that St Luke’s has been a difficult issue for many years and has been a significant challenge for our CCG over the last two years We understand the frustrations of the local community but we want to reassure people that we have been driving this project as hard as we can It is important to explain the background of cha(nge in the NHS and the step changes in treatment that have taken place over recent years. This means that people can be treated closer to home or even in their own homes which we know is incredibly important. This in turn means that the hospitals we commission must be reviewed and if necessary re-purposed to provide a different kind of service to reflect changing patient need and this is a complex task which inevitably takes time and we must work with the national requirements of us which have also proven to be complex and national legal changes have had to be made to some of the processes to accommodate our needs We have a responsibility to you as a patient and a tax payer and we are determined that when St Luke’s is completed it will not only be fit for purpose today but it will be able to flex to meet the needs of tomorrow We really do understand that people find it difficult to understand why it is taking such a long time. That’s why I’m delighted to be able to tell you that following a meeting last Thursday between NHS Property Services the Morgan Sindall, I can report that positive progress was made. We anticipate that a formal instruction to proceed will be issued to the contractor by the end of this week. Based on this, Morgan Sindall will shortly issue a start date for work to begin.
- Richard continues… As Carmel explained earlier, as a CCG we’re always looking for new ways to keep everyone involved in what we’re doing and improve the way we’re listening and engaging. So I would really urge you to try out the new social and digital channels we are introducing. In particular, I would really urge you to go onto our brand new website, launched today, and create your free new myCCG account. I’d also invite you to try out our new Podcast Channel - ELRCCG TV - also launched today and available via Podbean or by subscribing via iTunes. These are highly innovative new communications and engagement services of which we’re really proud. Of course, there are all of the more traditional ways of getting and keeping in touch with us. Hopefully, you will have been able to pick up a copy of our Annual Report or its Executive Summary when you arrived at the AGM. If not, you can download a copy for free via our website.
- Richard continues… I hope that’s been of some interest to you. I’d now like to open up the discussion to the floor and invite Questions to our Panel.