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
020 7525 7888