The role of patients in

shaping the NHS

NHS Southwark Clinical

Commissioning Group

17 February 2015

Session Outline

1. National NHS – Background to the NHS

– National reorganisation

– Key organisations in new national structure

2. NHS Southwark Clinical Commissioning Group (CCG) – Southwark Context

– What NHS Southwark CCG is responsible for and what it is not

– What is commissioning

– How is the CCG structured

3. Voice of the Patient in Southwark – Requirements to involve patients and the public

– The role of patient members and patient representatives

– How NHS Southwark CCG engages with local people

Section 1:

National NHS

National context

• Every day the NHS saves lives and helps people stay

well, but 66 years ago, many people faced choosing

between poverty if they fell seriously ill or not having

care.

NHS formed in 1948, when:

• The population was 47 million

• Food rationing was still in place

• A quarter of homes had no electricity

• Life expectancy for men was 66 years

National context

Today and every day the NHS saves lives and helps people stay well and live well for longer: • The NHS treats 1 million people every 36 hours

• 88% of patients in the UK described the quality of care they received as ‘excellent’ or ‘very good’ (Call to action 2013)

• The NHS is funded through taxation,

producing a fixed amount of money for

the country’s health services

The NHS Constitution

• Published by Department of

Health in 2011

• First document in NHS

history to explicitly set out;

1) What patients, the

public and staff can

expect from the NHS

2) What the NHS can

expect from them in

return

National context

National context

• There are a number of future challenges:

– Ageing and growing population

• In 2013 the UK population was 64.1 million

• In 2013 the UK male life expectancy was 78.9 years

– Increase number of people with long-term conditions

– Lifestyle factors e.g. smoking, weight, drinking too

much alcohol / drugs

• The result of this means

– Increasing need for services

– Rising cost of services

National context

If the NHS doesn’t do things differently there will be a

difference between the amount of money needed and the

amount available - nationally this is expected to be £20

billion by 2015.

• The NHS has been through significant changes recently following the ‘Health and Social Care Act 2012’ which came into effect on 1 April 2013

• Primary Care Trusts and Strategic Health Authorities were abolished

• Clinical Commissioning Groups (CCGs),

NHS England and Public Health England were established

• Clinicians (primarily GPs) were identified

as leaders of CCGs

• Health and well-being boards were established – Clinical Commissioning Groups have representation, along with

Local Authority, Police, Community Action Southwark and Healthwatch

– Responsible for Health and Well-being strategy and Joint Strategic Needs Assessment (JSNA)

• Local Authorities (e.g. Southwark Council) took on responsibility for most Public Health functions together with Public Health England

National context

National context

• Work in groups to identify what the missing organisations

are and where they fit in the diagram

• The organisations / departments that you need to locate

in the structure are:

– Department of Health

– GPs

– Health and well-being board

– Healthwatch Southwark

– Hospital services

– NHS England

– Pharmacists

Task 1:

Task 1:

Task 2:

• Working in groups

• Match the role described with

the name of the right organisation.

Exists to inspect hospitals, care

homes, dental and GP

surgeries, as well as all other

care services in England to

ensure they provide people with

safe, effective, compassionate

and high quality care.

Care Quality

Commission

National organisation responsible

for improving health for people in

England. It oversees the work of

CCGs as well as directly commission

some services

NHS England

Local statutory organisation with

new duties for ‘Public Health’ –

improving the publics health – with

specific focus on smoking and

bowel cancer in Southwark

Southwark Council

The local patient and public body

established from April 2013, which

acts as a point of contact for

individuals, community groups and

voluntary sector organisations when

dealing with health and social care and

has a representative seat on the

Health and Wellbeing board, CCG

Governing Body and various sub

committees

Healthwatch

Southwark

One of 211 local organisations

in England who are responsible

for planning and buying health

services for the population of

their local area.

Clinical Commissioning

Group

National organisation

responsible for strategic

leadership of both the

health and the social

care systems Department of

Health

Section 2:

NHS Southwark CCG

Southwark context

By 2031 the

population will have grown by 26% to 369,000

We estimate that 42,000 in Southwark

have a common mental illness

which is 20% higher than England

13,000 adults diagnosed with diabetes and this will rise to

22,000 by 2025

28.5% of year 6

children are obese

Heart disease, lung disease

and cancer are top 3 causes of

death

Gap in life expectancy is widening along

the 78 bus route

Task 3:

What is commissioning?

Commissioning: the planning and organising,

procurement, monitoring and performance management

of health and health care services for a local community

or specific population.

What services does the CCG

Commission?

• Hospitals e.g. King’s College Hospital

• Mental Health e.g. South London and the Maudsley, dementia memory clinics

• Urgent care and additional GP services

• Community services e.g. foot health, district nursing

• Learning disability services

How we are organised

19

Member Practices (In two localities: North Southwark and South Southwark)

COUNCIL OF MEMBERS

CCG GOVERNING BODY

Integrated

Governance &

Performance

Committee

Commissioning

Strategy Committee

Dulwich

Programme

Board

Remuneration

Committee

Audit

Committee

Engagement and

Patient Experience

Committee

Primary Care

Programme Board

Prevention

Programme Board

Integration

Programme Board

Engagement

Programme Board

Mental Health and

Parity of Esteem

Programme Board

Southwark Medicines

Optimisation

Committee

Southwark

Safeguarding

Executive

Quality & Safety

Programme Board

Information

Governance Steering

Group

Southwark

Health and Wellbeing Board

Conflict of Interest

Panel

Our Healthier

South East

London

Programme

Patient and

Public Advisory

Group (PPAG)

Stakeholder

Reference

Group (SRG)

South

Southwark

Locality Group

North

Southwark

Locality Group

South

Southwark

Locality PPG

North

Southwark

Locality PPG

Practice PPGs

£206m

£68.2m

£27.5m

£31.6m

£1.8m

£8.4m £4m

£15.2m £7.2m

Acute hospital services

Mental health and learning disability services

Community services

Primary care prescribing

Re-ablement fund with Southwark Local Authority

Continuing care and funded nursing care

Property and other costs

In year reserves and risk-management fund

CCG running costs (corporate overheads)

The CCG Budget 2013/14

Total = £357m 20

Section 3:

Voice of the Patient

Voice of the Patient

• Good practice to review, design and

develop services in partnership with

patients

• Actively engaging patients to understand

what works for you

• Legal duty for NHS commissioners to

involve patients and public

• Clinical, lay and director leadership on engagement

• Staff to specifically support patient (and

member) engagement across the CCG

Voice of the Patient

• Dulwich and surrounding areas consultation

• Primary and Community Care strategy development

• Urgent care centre review and development of extended primary access

• Mental health service stakeholder engagement

• Big health check day for people with learning disabilities

• Southwark and Lambeth Integrated Care (SLIC)

• Our healthier south east London

• Healthier weight services

Voice of the Patient

• More services in community settings including at GP practices and

pharmacies

• Services need to be accessible both in terms of when and where

and be better joined up

• Patients need information to help them manage their own conditions

(self management)

• It is complicated for patients to know where they should go for

emergency and urgent services and we need to be much clearer in

our communication

• Better communication between GPs and hospitals, including better

and more timely discharge systems

• Better support for people in crisis out of hours other than A&E

• More focus on physical health in mental health in order to improve

healthy life expectancy

Engagement Structures in NHS Southwark CCG

Governing Body

Engagement and Patient Experience Committee

Locality PPGs

Practice PPGs

Voice of the Patient

Voice of the Patient

• Practice Patient Participation Groups – Each of 44 Southwark practices to have a Patient

Participation Group

– To discuss and address issues affecting people using the

surgery

– To discuss how services are changing e.g. primary care access

– To report to and from Locality PPG’s (North & South)

• Patient Surveys – Annual GP surveys – practice surveys

– Hospital surveys • How R we doing

• Cancer, maternity services

• Engagement meetings - Service reviews / redesigns

• Outreach to seldom heard voices

Voice of the Patient

• Patient Advice and Liaison Service (PALS) – Provided directly by hospitals

• Guy’s and St Thomas’

• King’s College Hospital

• South London and Maudsley

– Offers confidential advice, support and information on health-related matters. They provide a point of contact for patients, their families and their carers

– Help with health-related questions and resolving issues within 2 working days without being a formal complaint

– Provide information about complaints procedure, and how to get independent help

• NHS England – Customer care line

0300 311 22 33

• Complaints – All providers of NHS services have their own complaints policy

– A more formal process than using PALS

– Should be able to complain in writing, by email or face-to-face

– Your rights to complain are set out in the NHS Constitution

Task 4:

• Work in groups on your tables

• Read each of the case studies that you have been given as if it was an issue that had been raised at a Practice PPG

• Identify which of the following places would be most appropriate for the information to be taken to help address the issue – CCG

• Locality PPG

– NHS England • Customer care line

– Complaints service

– Patient Advice and Liaison Service

– Service provider directly

– Any others…

Future events

• Want to make your

groups and meetings

as productive as

possible?

• Join us for this

interesting and

dynamic workshop

• Book your place

today

Thank you for your participation

Please complete and return your evaluation form and equalities form before leaving

Contact details:

Rosemary Watts

Laura Brannon

souccg.southwark-ccg@nhs.net

020 7525 7888