This month’s Board meeting was packed full of plans - truly ambitious plans to make improvements to health and health services in Wandsworth. We heard about the visionary plans for a new urgent care model, a new framework for prevention, as well as our local take on the South West London Sustainability and Transformation Plan (STP).
CCG colleagues have been working closely with partner organisation, patients and the public to develop our plans. At our meeting there were a number of discussions about how we will continue to engage with individuals and communities to help us refine and deliver the changes that are needed. Indeed the presentation of a petition by Wandsworth Keep Our NHS Public is an indicator of the level of concern about the state of the NHS and the importance of keeping an open dialogue about what we are doing and why. Our aim remains to do the best we can with the resources we have to ensure the best health outcomes for local people.
We must achieve all of this in the context of a worsening financial position across south west London. Our plans are also a key part of addressing and improving this position.
Our Deputy Director of Commissioning and Planning, Rebecca Wellburn, gave an overview of our vision for urgent and emergency care. This sets out how national recommendations from the Five Year Forward View and regional priorities from the South West London STP will be addressed and delivered locally. Our vision puts primary care firmly at its heart; we want to ensure that GP surgeries are the first point of contact for patients who need urgent care. We want to reduce the range of alternative options so that it’s easier for patients to understand the system and use it correctly. We also need patients to be more confident about managing their own care.
The new model will include things like extra bookable GP and nurse appointments from 8am to 8pm, seven days a week. We are also aiming to offer urgent GP appointments for patients who need them, within a four hour slot. These initiatives will be complemented by easier access to urgent care services through 111, an urgent care centre and continuing our work to avoid unplanned emergency hospital admissions for frail and elderly people.
The Board discussed some of the many challenges we will need to overcome to make this model work and Rebecca committed to bringing back the implementation plan and progress report in about six months’ time.
Sandra Iskander, our former Director of Corporate Affairs, Performance and Quality, has recently moved to an exciting new role at NHS England but kindly came back to present a report focusing on performance and looking at new requirements for 2017/18. As lead commissioner for St George’s NHS Foundation Trust, the CCG’s own performance is rated on how well the trust does in a number of areas. By the end of the year, we expect to have achieved a number of NHS Constitution and Operational Plan targets including diagnostics 6-week wait and ambulance response times. Performance against the standard for four hour waits in A&E will not meet the overall 95% required but St George’s has coped well so far this winter and we’re looking at an average of 92% people being seen in four hours by the end of the year.
It was also great to hear that in NHS England’s assessment of how well we have delivered our patient and public participation statutory duties, we were assessed as “good” for both collective and individual duties to involve.
Rebecca was in the spotlight again to describe our local plans to evolve the five year STP. There is much to do to develop the initiatives that we have designed but we also heard about what has been happening over the past year. Things like: the Wandsworth Multi-Specialty Community Provider (MCP) that has been commissioned to bring together primary and community services around the needs of frail and elderly patients; all GPs having access to rapid consultant advice using new technology; social workers in community health teams; and more patients with urgent conditions treated at St George’s but without needing to be admitted. These and other projects show what can be done and are a solid foundation for our plans over the next two years.
Next up was a presentation on our Prevention Framework. This has been developed with partner organisations and led jointly by the CCG and Wandsworth Council. Anna Riley from Wandsworth’s Public Health team, told us how this framework supports the STP and requires all health, local authority, voluntary and private sectors to work together. We agreed that prevention needs to be built in to all our care pathways and even into the environment, so that it is easier for example to make a healthier choice to walk or cycle, or choose healthy food.
Again, this was inspiring in its ambition and we look forward to receiving the implementation plan in the spring.
Last and definitely not least, the finance report confirmed that we are on target to achieve a balanced financial position and the planned 0.5% surplus at the end of March. However, we are below target on the savings we need to make and there are significant financial pressures in the system that will make it difficult to maintain our balanced position.
If you’d like to know more, you can read the Board papers on the CCG website or view the livestream on our YouTube channel.