Chat from the Chair – June 2017

Despite the warm sunshine giving us a taste of summer holidays to come, there was no let-up in this month’s Board meeting.  We looked at a process to harmonise policies on effective commissioning across south west London, received updates on working arrangements of the Merton and Wandsworth Local Delivery Unit (LDU), reviewed models of assurance, heard about progress in planned care work plans and finished with a look to the first meeting of the Merton and Wandsworth Local Transformation Board.   

We also highlighted how important it is for us to regularly hear of the work of the Healthy London Partnership (HLP) as their initiatives support CCG activities, for example, in paediatrics.  With this in mind, we have committed to including an update from the HLP in our Board meetings on a regular basis.

We are entering a period of transformative change in our health and care systems and locally we want to ensure that our models of care are based on good evidence of effectiveness where that is available. At the heart of it we are keeping focused on the care of patients, with changes driven and informed by clinicians and patients. Changes we make must bring about sustainability in the long term and we need a strategic system view of our finances to support delivery.

The meeting was interrupted by the sounding of an unplanned fire alarm, so apologies to those of you who were watching the live broadcast.  With news of the catastrophic incident at Grenfell Tower unfolding overnight, we were reminded of how important it is to treat alarms seriously and to act quickly.  Fortunately, in this case, it was a false alarm.   

Policies on Effective Commissioning Initiatives are not new and over the coming months we will be consolidating and harmonising existing policies from across the South West London Alliance of CCGs.  These polices ensure that clinicians have guidance readily available for a wide range of procedures for example where there is evidence of limited clinical effectiveness. It was agreed that the harmonisation process would take the form of CCG membership of various task groups and via committees in common, and it was also generally acknowledged that work of this nature is a huge undertaking that requires careful consideration, planning and widespread public engagement where necessary.  As a Board, we recognised that there is a balance to be found between consistency across south west London and what is most appropriate to be set at local level i.e. by the CCG, for instance when clinical evidence may be unclear.  There is still much to be worked through in this important area.

Turning to the future working arrangements of the Merton and Wandsworth Local Delivery Unit (LDU), we heard from James Blythe, Managing Director, who has asked all directorates to review their structures to optimise the possibility for joint staffing allocations across the LDU.  We also heard that a review is being undertaken to look at utilising CCG premises as effectively as possible.  We were assured that suitable staff communications would be set up, including a staff forum, and that a base within Wandsworth would be maintained. 

It was also good to hear that in recognition of the strength and diversity of local patient and public involvement (PPI) groups that there would continue to be designated local PPI support within the CCG. 

A point to clarify here is that each CCG remains its own statutory body, and that the LDU provides a way for teams to work together across two CCGs in order to bring about efficiencies and improvements particularly with our mutual providers. 

A review of our board assurance framework helped us to understand the current substantial risks that the CCG is managing. We saw that when it came to St George’s trust that the risk position is a reflection of an organisation undertaking huge change and that risk reports capture a moment in time on a longer journey.

The mood was then greatly lifted by hearing of progress made in planned care work-streams – and by planned care, I am referring to outpatients and elective services.  This is all about improving the patient journey, i.e. their experience and clinical care.  For example, being seen quicker and in better settings.  Current work plans include Ear, Nose and Throat services and diabetes.    

Our planned care programme is critical for the long term and this together with our urgent care programme are work-streams we will keep regular sight of at Board meetings. 

In our management reports, we heard confirmation that there is no change for the next 12 months to the CAMHS Neurodevelopment Assessment Service at SWL St George’s and of how input from the National Autistic Society has been invited for any future developments to improve the service. 

We also confirmed that our Annual Report and Annual Accounts had been successfully signed off, and that reports to the Board on performance and finance would be re-designed for clearer and more consistent formatting. 

Management Reports are not usually the most exciting part of the meeting, but this month proved the exception with the announcement of the first meeting of the Merton and Wandsworth Local Transformation Board (LTB) to take place this week.  The LTB is the next level below the South West London Sustainability and Transformation Plan (STP), and has been created with the purpose of integrating health and social care through bringing the conversation to trusts and the wider system, and looking at clinical and financial sustainability.  I will be chairing the LTB and look forward to the progress that can be gained from these invaluable discussions. 

Overall, it is heartening to see that the principles of better quality care and better cost effective care are apparent across all of these impressive work streams.  There is much still to do, but I am greatly encouraged by the level of interaction and enthusiasm that exists to take these initiatives forward.

If you’d like to know more, you can read the Board papers on the CCG website