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CCG Locality meeting slide pack Future locality meetings Wellbeing Service reminder Dementia Audits Flu vaccinations Practice Information Support Pack – for information PMS Review Primary Care Strategy Suffolk Federation Over 75 schemes AOB. Future locality meetings. - PowerPoint PPT Presentation
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CCG Locality meeting slide pack
•Future locality meetings •Wellbeing Service reminder •Dementia Audits•Flu vaccinations•Practice Information Support Pack – for information•PMS Review•Primary Care Strategy•Suffolk Federation Over 75 schemes•AOB
Future locality meetings
• To enhance each meeting with a ‘local’ focus, non-CCG GPs are invited to jointly chair each meeting which takes place every other month
• If you are interested, please either speak to the CCG Chair, leave your details on the evaluation form in your pack or email [email protected]
Suffolk Wellbeing ServiceA Reminder
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Suffolk Wellbeing ServiceA Reminder
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Dementia AuditsThe issue
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The Opportunity
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Organisation Name Practice List Size
Patients in Care
QOF Dementia Register
Adjusted Forecast No with
Dementia
Dementia Gap
(Num)
Dementia Gap (%)
Dementia Diagnosis Rate (%)
14 BURLINGTON ROAD 16,888 224 206 283 77 27.3 72.7NORWICH ROAD IPSWICH 9,822 27 93 130 37 28.7 71.3WICKHAM MARKET 9,472 97 111 163 52 31.8 68.2HAVEN HEALTH 6,820 42 49 74 25 34.0 66.0DERBY ROAD IPSWICH 16,247 146 148 225 77 34.2 65.8HADLEIGH HEALTH CENTRE 14,712 100 158 248 90 36.2 63.8SAXMUNDHAM 8,896 76 101 162 61 37.7 62.3LEISTON 6,643 99 93 150 57 38.0 62.0IXWORTH SURGERY 9,116 72 87 143 56 39.1 60.9HOLBROOK 7,865 110 99 163 64 39.2 60.8CHESTERFIELD DRIVE 14,513 121 107 176 69 39.2 60.8IVRY STREET MEDICAL PRACTICE 11,026 113 97 165 68 41.4 58.6BARRACK LANE MEDICAL CENTRE 15,755 48 78 134 56 41.6 58.4ORCHARD MEDICAL PRACTICE 13,365 37 59 106 47 44.5 55.5RAVENSWOOD MEDICAL PRACTICE 15,066 46 91 165 74 44.7 55.3STOWHEALTH 17,759 156 148 279 131 46.9 53.1COMBS FORD SURGERY 9,944 176 100 189 89 47.1 52.9FRAMLINGHAM 9,255 95 91 172 81 47.2 52.8AVERAGE - - - 0 0 0.0 51.8THE BIRCHES MEDICAL CENTRE 8,097 30 57 113 56 49.6 50.4WALTON SURGERY 4,195 44 37 75 38 50.5 49.5HAWTHORN DRIVE IPSWICH 7,735 55 47 96 49 51.1 48.9EYE 5,836 48 49 104 55 52.7 47.3CONSTABLE COUNTRY MEDICAL 10,986 - 64 137 73 53.2 46.8CENTRAL SURGERY 14,564 151 144 315 171 54.3 45.72 DEBEN ROAD IPSWICH 7,829 9 40 89 49 54.9 45.1WOODBRIDGE RD IPSWICH 11,844 60 66 149 83 55.8 44.2LATTICE BARN 13,339 63 78 177 99 55.9 44.1MARTLESHAM HEATH 5,892 15 32 73 41 56.2 43.8HOWARD HOUSE FELIXSTOWE 7,036 128 84 200 116 58.1 41.9ALDERTON 3,879 14 26 63 37 58.7 41.3LITTLE ST JOHN ST WOODBRIDGE 6,365 68 60 145 85 58.7 41.3DEBENHAM 8,526 23 41 105 64 61.0 39.0THE GIPPING VALLEY PRACTICE 1,658 2 7 18 11 61.0 39.0ORCHARD STREET MEDICAL CENTRE 5,108 9 16 46 30 65.6 34.4 MENDLESHAM 7,050 15 27 80 53 66.2 33.8ALDEBURGH 3,960 64 45 135 90 66.6 33.4THE COUNTRY PRACTICE 12,657 154 71 224 153 68.4 31.6FRESSINGFIELD MEDICAL CENTRE 4,975 13 21 72 51 70.7 29.3BILDESTON 6,727 29 30 103 73 70.9 29.1FELIXSTOWE ROAD MEDICAL PRACTICE 10,765 39 40 138 98 71.0 29.0FRAMFIELD HOUSE 11,808 112 63 231 168 72.7 27.3
Dementia Diagnosis Rate
7
No of people undiagnosed
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Influenza Season 2014/15
The issue •Ipswich and East Suffolk CCG spent £2.4 million on hospital admissions for influenza and pneumonia in 2013/14.•This equated to 853 emergency admissions to Ipswich Hospital Trust (IHT).•The majority of the 853 people admitted were diagnosed with pneumonia. •The average LOS of people with influenza and pneumonia in IHT was 9.3 days.•This equates to 22 beds year round for people with influenza and pneumonia in 2013/14 (that’s almost a ward).•In 2013/14 there were 73.6% of 65+, 48.3% of under 65 at risk and 48% of pregnant women vaccinated for influenza.•No figures for pneumonia vaccination available.
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What are the CCG doing to support increasing the uptake:•Flu and Pneumonia vaccinations are included as part of the quality audit for the care home contract.•Practices encouraged as part of their specific work for over 75s to ensure patients have had their flu and pneumonia vaccinations in particular for the most vulnerable 2% of patients and housebound patients.•Flu Clinic times/dates being collated. These will be advertised in the local press and on CCG website.•Implement Flu Kills campaign (see appendix 1). •Flu and Pneumonia leaflets sourced (including foreign language). Could we highlight that there is a myth buster for all on the flu protect website along with some other useful information. http://flu-protect.co.uk/downloadable-materials/•Advertising free flu vaccination for primary carers. •The Area Team are commissioning a flu vaccination service from pharmacies. The service is only available to the ‘at risk’ patients between 18 and 65 (not the over 65s). Pharmacies will look to recruit patients that have not made arrangements for their vaccination through Primary Care. •Information provided via Locality Meetings to promote use of pneumonia vaccination opportunistically (see appendix 2). •Messages to be sent to Suffolk Family Carers, Parish magazines and CCG website.
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What are some practices doing to ensure their best possible take up?Fressingfield Advertise in practice and on website from August and in all September and October editions of parish magazines plus handing out leaflets ● They do not write out individually to all patients to invite but will write out to non-responders in October ● Walk in clinics during the week early morning and early evening for 2 weeks ● Very good at opportunistically grabbing people when they come in for something else Alderton SurgeryInvite all eligible patients under 65 by letter or text ● Well publicised via posters, website, prescriptions ● 1 full open day at each site for drop in appointments (2 nurses) ● Regular clinics with bookable appointments ● Housebound and care home patients all systematically done by practice and SCH Re invite non responders ● Prompt within SystmOne for anyone eligible so can be opportunistically done ● A marker added against all patients eligible to help with reminding patients attending
Haven HealthHeavily publicised walk in clinics which are advertised well in advance year after year via posters, website and on prescriptions ● Meeting with all staff at start of season so everyone knows all processes and how to answer patient queries ● Write out late in to season to those who haven’t attended yet ● All nursing and residential home patients systematically done ● Very efficient in arranging housebound patients to be done with SCH ● Exception code refusals ● EMIS Web has slick clinical protocol for recording GP practices are encouraged to put messages on TV screens within their own practice, on prescriptions and website.
Other useful information can be found at: http://flu-protect.co.uk/flu-campaign-support/
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Children to be offered flu vaccinations at schoolA pioneering pilot programme to offer children flu vaccinations at school is to be rolled out. For the first children in years 7 and 8 are being offered the vaccination as part of a county-wide pilot scheme. As part of the programme each child will be offered the vaccine as a simple nasal spray which is painless and a quick alternative to an injection.
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Appendix 1 – Flu Kills Campaign
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Appendix 2 – Pneumonia Vaccination
Cross matching reports of upcoming appointments vs. patients still needing a flu jab From the Green book Chapter 25: Pneumococcal (December 2013)https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/263318/Green-Book-Chapter-25-v5_2.pdf Dosage and scheduleAdults over 65 years and at-risk groups aged two years or over: A single dose of 0.5ml of PPV23. Administration Vaccines are routinely given into the upper arm in children and adults or the anterolateral thigh in infants under one year of age. This is to reduce the risk of localised reactions, which are more common when vaccines are given subcutaneously (Mark et al., 1999; Diggle and Deeks, 2000; Zuckerman, 2000). However, for individuals with a bleeding disorder, vaccines should be given by deep subcutaneous injection to reduce the risk of bleeding. Pneumococcal vaccines can be given at the same time as other vaccines such as DTaP/IPV/Hib, MMR, MenC, Hib/MenC and influenza. The vaccines should be given at separate sites, preferably in different limbs. If given in the same limb, they should be given at least 2.5cm apart (American Academy of Pediatrics, 2003) (see chapter 11). The site at which each vaccine was given should be noted in the individual’s records.
Reinforcing immunisationPPV23 Antibody levels are likely to decline rapidly in individuals with no spleen, splenic dysfunction or chronic renal disease (Giebink et al., 1981; Rytel et al., 1986) and therefore re-immunisation with PPV23 is recommended every five years in these groups. Revaccination is well tolerated (Jackson et al., 1999). Testing of antibody levels prior to vaccination is not required. Although there is evidence of a decline in protection with time (Shapiro et al., 1991), there are no studies showing additional protection from boosting individuals with other indications, including age, and therefore routine revaccination is not currently recommended. Individuals who have previously received a 12- or 14-valent PPV should be immunised with PPV23 to gain protection from the additional serotypes.to encourage staff to vaccinate opportunistically.
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Appendix 3Flu Vaccination rates for Over and Under 65s per Practice
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ALL AGES BY TFC SPECIALTY
Contains:ENT ACTIVITY
CARDIOLOGY ACTIVITYUROLOGY ACTIVITY
OPHTHALMOLOGY ACTIVITYGASTROENTEROLOGY ACTIVITY
RESPIRATORY ACTIVITYGYNAECOLOGY ACTIVITY
ENT Activity
Aldeburgh
Wickham Market
Bildeston
Holbrook
Framlingham
Leiston
Howard House
Walton
Hadleigh
Stow Health
Derby Rd
Saxmundham
Mendlesham
Eye
Barham & Claydn
Haven Health
Barrack Ln
Orchard Med
Fressingfield
Lattice Barn
Norwich Rd
Ivry Street
Alderton
Solway & Whale
Debenham
Grove
Burlington Rd
Framfield
Hawthorn Dr
Woodbridge Rd
Little St Johns St
Felixstowe Rd
Deben Rd
Combs Ford
Martlesham
Constable Country
Birches
Needham
Chesterfield Dr
Ixworth
Ravenswood
0 1 2 3 4 5 6 7
All Ages - ENT First Attends Outpatient GP Referrals only per 1,000 weighted list - All IESCCG Practices 2014/15 Vs. 2013/14 YTD (April-June)
2013/14 Equivalent Activity YTD 2014/15 Activity YTD
CCG Average 2013/14 CCG Average 2014/15
Cardiology Activity
Eye
Ivry Street
Solway & Whale
Framlingham
Wickham Market
Barham & Claydn
Haven Health
Barrack Ln
Walton
Chesterfield Dr
Mendlesham
Stow Health
Burlington Rd
Orchard Med
Martlesham
Needham
Leiston
Debenham
Felixstowe Rd
Derby Rd
Lattice Barn
Bildeston
Ixworth
Birches
Alderton
Framfield
Howard House
Aldeburgh
Holbrook
Hawthorn Dr
Grove
Little St Johns St
Ravenswood
Combs Ford
Norwich Rd
Woodbridge Rd
Saxmundham
Hadleigh
Deben Rd
Fressingfield
Constable Country
0 1 2 3 4 5 6 7
All Ages - Cardiology First Attends Outpatient GP Referrals only per 1,000 weighted list - All IESCCG Practices 2014/15 Vs. 2013/14 YTD (April-June)
2013/14 Equivalent Activity YTD 2014/15 Activity YTD
CCG Average 2013/14 CCG Average 2014/15
Urology Activity
Aldeburgh
Bildeston
Eye
Walton
Haven Health
Leiston
Howard House
Fressingfield
Solway & Whale
Orchard Med
Mendlesham
Derby Rd
Framlingham
Saxmundham
Framfield
Wickham Market
Debenham
Chesterfield Dr
Little St Johns St
Woodbridge Rd
Ivry Street
Needham
Barrack Ln
Barham & Claydn
Holbrook
Burlington Rd
Felixstowe Rd
Alderton
Stow Health
Ixworth
Ravenswood
Lattice Barn
Norwich Rd
Constable Country
Combs Ford
Grove
Martlesham
Deben Rd
Hadleigh
Hawthorn Dr
Birches
0 1 2 3 4 5 6 7 8 9
All Ages - Urology First Attends Outpatient GP Referrals only per 1,000 weighted list - All IESCCG Practices 2014/15 Vs. 2013/14 YTD (April-June)
2013/14 Equivalent Activity YTD 2014/15 Activity YTD
CCG Average 2013/14 CCG Average 2014/15
Ophthalmology Activity
Little St Johns St
Walton
Saxmundham
Stow Health
Bildeston
Grove
Framlingham
Howard House
Orchard Med
Ixworth
Aldeburgh
Mendlesham
Combs Ford
Derby Rd
Woodbridge Rd
Framfield
Solway & Whale
Wickham Market
Ivry Street
Barrack Ln
Hadleigh
Felixstowe Rd
Deben Rd
Debenham
Eye
Leiston
Ravenswood
Holbrook
Constable Country
Norwich Rd
Needham
Burlington Rd
Hawthorn Dr
Martlesham
Lattice Barn
Fressingfield
Haven Health
Birches
Alderton
Chesterfield Dr
Barham & Claydn
0 0.5 1 1.5 2 2.5 3 3.5 4
All Ages - Ophthalmology First Attends Outpatient GP Referrals only per 1,000 weighted list - All IESCCG Practices 2014/15 Vs. 2013/14 YTD (April-
June)
2013/14 Equivalent Activity YTD 2014/15 Activity YTD
CCG Average 2013/14 CCG Average 2014/15
Gastroenterology Activity
Howard House
Solway & Whale
Combs Ford
Fressingfield
Eye
Lattice Barn
Stow Health
Ivry Street
Orchard Med
Aldeburgh
Barrack Ln
Hadleigh
Norwich Rd
Leiston
Chesterfield Dr
Wickham Market
Holbrook
Bildeston
Haven Health
Saxmundham
Derby Rd
Framfield
Woodbridge Rd
Debenham
Felixstowe Rd
Little St Johns St
Deben Rd
Walton
Framlingham
Mendlesham
Hawthorn Dr
Needham
Ixworth
Burlington Rd
Birches
Ravenswood
Constable Country
Grove
Martlesham
Barham & Claydn
Alderton
0 1 2 3 4 5 6
All Ages - Gastroenterology First Attends Outpatient GP Referrals only per 1,000 weighted list - All IESCCG Practices 2014/15 Vs. 2013/14 YTD (April-
June)
2013/14 Equivalent Activity YTD 2014/15 Activity YTD
CCG Average 2013/14 CCG Average 2014/15
Respiratory Medicine Activity
Eye
Walton
Birches
Stow Health
Alderton
Fressingfield
Grove
Barham & Claydn
Solway & Whale
Lattice Barn
Combs Ford
Burlington Rd
Howard House
Saxmundham
Deben Rd
Barrack Ln
Derby Rd
Orchard Med
Wickham Market
Leiston
Debenham
Ivry Street
Chesterfield Dr
Mendlesham
Framlingham
Needham
Norwich Rd
Framfield
Holbrook
Haven Health
Hadleigh
Aldeburgh
Hawthorn Dr
Ravenswood
Martlesham
Ixworth
Constable Country
Woodbridge Rd
Bildeston
Felixstowe Rd
Little St Johns St
0 0.5 1 1.5 2 2.5 3 3.5
All Ages - Respiratory Medicine First Attends Outpatient GP Referrals only per 1,000 weighted list - All IESCCG Practices 2014/15 Vs. 2013/14 YTD
(April-June)
2013/14 Equivalent Activity YTD 2014/15 Activity YTD
CCG Average 2013/14 CCG Average 2014/15
Gynaecology Activity
Aldeburgh
Eye
Fressingfield
Mendlesham
Wickham Market
Framlingham
Ixworth
Holbrook
Alderton
Howard House
Bildeston
Hadleigh
Saxmundham
Walton
Ivry Street
Constable Country
Combs Ford
Little St Johns St
Stow Health
Framfield
Debenham
Deben Rd
Lattice Barn
Grove
Martlesham
Solway & Whale
Felixstowe Rd
Derby Rd
Ravenswood
Norwich Rd
Leiston
Needham
Woodbridge Rd
Barham & Claydn
Haven Health
Orchard Med
Burlington Rd
Birches
Chesterfield Dr
Hawthorn Dr
Barrack Ln
0 1 2 3 4 5 6 7 8
All Ages - Gynaecology First Attends Outpatient GP Referrals only per 1,000 weighted list - All IESCCG Practices 2014/15 Vs. 2013/14 YTD (April-June)
2013/14 Equivalent Activity YTD 2014/15 Activity YTD
CCG Average 2013/14 CCG Average 2014/15
PMS Review
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Suffolk PMS Review Update
• Meetings taken place between the Area Team, LMC and two Suffolk CCGs looking at: principles of the review; value of the development framework; and updates to the development framework
• Meeting with local MPs• Meeting between the two CCGs and LMC
GPs to discuss the development framework
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PMS Review – Development Framework Refresh• Core requirements section removed• Targets/language updated e.g. PCT to Area
Team• Development indicators updated in new
sections • Access• Public Health (Vacc & Imms, screening etc)• Prescribing• Use of NHS resources• Collaboration• Other (moved from core section e.g. community liaison, winter
and disaster planning)
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PMS ReviewNext Steps
• Letter from Area Team describing the offer under Option 3 scheduled to be sent on 10th September.
• CCGs, LMC and Area Team meeting to review the refreshed Development Framework being scheduled.
• NHS England Executive meeting on 11th September to discuss PMS Reviews across the country. This may result in area and local agreements being subject to regional and national moderation.
• Subject to outcome of above meeting, local objective remains for practices to have all necessary information on Option 2 and 3 to make choices by 10th October.
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Primary Care StrategyUpdate
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Purpose and ProcessPurpose:•To develop an ambitious and achievable framework for primary care commissioning and delivery for the next ten years. Process: •A group of local GPs and others have reviewed national and local approaches as well as qualitative and quantitative information on issues and opportunities for primary care in Suffolk. The output has been reviewed and refined by an external stakeholder group •Notes sent out via Inbox to all - some feedback ...more welcome. •Next steps: opportunity for individual practice feedback by email, in next practice link visits and at a dedicated group debate at the November training and education event.
Interim aims identified
• Consistent high quality care• Leadership and co-ordination of integrated
healthcare for local communities. • Delivery of all forms of care other than those
which must be provided in an alternative care setting (acute, MH, community) for safety or other reasons.
• Organisational forms capable of delivering excellence at practice level, 'locality' level and CCG or Suffolk wide level, (as appropriate to service)
Action Plans being developed relating to;
• Recruitment and retention
• Commissioning service models
• Sustainable organisational forms
• Infrastructure and implementation support including IT, estates, shared services, pathway implementation
If you have any comments, questions or points you wish to make after the locality meeting please forward them by e-mail;
Any other business
• Is there anything else you would like to discuss?
• Do you have any ideas about future agenda items for your locality?
• If so, please raise now or add a comment to the evaluation form in your pack
