Annual General Meeting September 19 2018 Opening remarks

Annual General Meeting September 19, 2018

Opening remarks Dr Wirin Bhatiani – CCG Chair

The CCG Objectives Objective 1 Improve health outcomes. Objective 2 To improve the quality of care and patient experience of care. Objective 3 Deliver best value for money.

Patient and Public Involvement We strive to put the patient’s voice at the heart of everything we do. • We have continued to build on the successes of previous years by strengthening our innovative approach to public engagement • On August 3, 2017, and October, 24, 2017, the CCG held road show events where we spoke to 400 people about their views on the flu immunisation, new roles within GP practices and about ways in which people were trying to be healthier • We have given 23 presentations to community groups, had stalls at 17 events, conducted 25 one-on-one interviews with members of the public, attended 20 public meetings, held 13 focus groups, attended 15 community and voluntary sector meetings, held six ETAG meetings and held two roadshows

Patient and Public Involvement - Outcomes Here are some examples of the outcomes of patients engagement. • The launch of the Maternity Voices Partnership in June 2017 and a further five sessions have happened since with mums/mums-to-be and dads/dads-to-be via activities or breastfeeding sessions taking place in Bolton’s Children’s Centres • A closer understanding of the Trans community in Bolton. Through a very specific piece of engagement we were able to interact with eight Trans patients, offering valuable feedback, advice and suggestions • Engagement with healthcare professionals, children, young people and their families was used to inform a new service specification for Child and Adolescent Mental Health Services (CAMHS)

GP Membership Engagement We have also been engaging in a dialogue with our membership regarding improvements to services through: - • • Neighbourhood meetings. Practice visits. CCG events. Clinical leads meetings.

Challenges and Achievements Neighbourhoods Future Focused Finance Bolton Care Record Mental Health Community Working Partnership Working

Neighbourhoods As part of the Bolton Locality plan there have been various innovations which are designed to improve the health and wellbeing of people in Bolton has configured the borough into nine ‘Neighbourhoods’, which are based on populations of 30, 000 to 50, 000 people. Neighbourhoods working can support closer local working relationships between health and social care and with voluntary and community groups. The aim is to provide support to the patients registered with the GP Practices in that Neighbourhood as locally as possible.

Future Focused Finance In 2018 NHS Bolton Clinical Commissioning Group (Bolton CCG) became the first CCG in the country to attain the highest level of NHS finance accreditation. It provides external confirmation that the Bolton CCG Finance Team provides a superior service enabling the wider organisation to deliver the best care services possible. One contributing factor to this achievement is the close working relationship which is enjoyed at Bolton CCG between clinical and finance staff, working together to provide services rather than being separate entities.

The Bolton Care Record 90 per cent and Bolton residents are now covered by the BCR and, since September 2017, there has been a 36. 25 per cent uptake in the usage of the BCR across GP practices, the Bolton NHS Foundation. Trust, the out-of-hours service and Greater Manchester Mental Health. The patient experience has been improved as they no longer are required to explain their conditions numerous times to people operating across different organisatons. All professionals with legitimate access are now able to see information from a number of organisations. This results in improved visibility of Information, improved patient experience, improved patient care and also releases time for staff to undertake their health and care duties.

The Bolton Care Record – Case Study The Bolton Care Record is an important addition to the health and social care economy in Bolton: A patient arrived at A&E who was hypotensive, hypothermic, ketotic, acidotic and had many pressure sores. He was unable to give any information apart from his name, from which his NHS number was retrieved from PAS. Dr Simon Irving logged onto the Bolton Care Record and found what medication the patient was currently on, his full medical history, allergy status and baseline BP. It was discovered that the patient had suffered from Hepatitis C, was a Type 2 Diabetic and suffered from Hypothyroidism. The information which the Bolton Care Record offered was incredibly valuable to the treatment of the patient and ensured that his treatment was appropriately tailored to his specific needs in a much faster timeframe than would otherwise have been available to medical staff at A&E.

Mental Health and Wellbeing There have been several mental health specific transformation fund schemes introduced to prevent people waiting too long in A&E with mental health issues: • Since April 2017, a team of Approved Mental Health Practitioners are now in place seven days a week which has taken pressure off the Emergency Duty Team, RAID and A&E. • Mental health specific A&E diversion commenced in December 2017, consisting of a qualified mental health practitioner in A&E who reviews anyone presenting with mental health issues and diverts them to more appropriate services. • The Sanctuary relocated in June 2017 from the community to the Royal Bolton site which has improved numbers attending and supported closer working with Greater Manchester Mental Health Trust staff.

Community Working There are over 1, 500 voluntary groups and 49, 000 volunteers in Bolton. The Voluntary, Community and Social Enterprise (VCSE) sector is responsible for contributing a huge amount to the health and wellbeing of the people of Bolton. They provide support, help, information and guidance and provide a vital link between public services and the people they serve. The introduction of programmes such as the Community Asset Navigators (CANs) has been proven to help people who are feeling disconnected from their community and just need additional support to make their lives more fulfilling. The estimated economic contribution by volunteers in Bolton stands at over £ 100 million per year and this can been seen in programmes supporting health and wellbeing, community development, education, training and research and sport and leisure activities.

Partnership Working As part of the Locality Plan, it is imperative that all of the organisations in Bolton that provide health and care services work closer together to provide the best possible service for the public. By working together, we will avoid duplication and fill any gaps, make effective use of skills and resources, and improve the integration of services for the borough to benefit residents. Joining up services and taking down barriers between teams and key workers will make the whole process much simpler – ensuing that people do not always have to attend hospital to receive the best possible care. The Locality Plan is designed to tackle some of the main health and care issues in Bolton, such as: • • • Poor life expectancy Heart disease Social isolation Child obesity Alcohol related harm

Key Initiatives: Moving forward Su Long – Chief Officer

Neighbourhood Working

Developing the Integrated Care Partnership (ICP) Project Group working on this: Jackie Bene, CEO Bolton FT Dr Stephen Liversedge, CCG Board & Clinical Director of Primary Care Dr Dharmesh Mistry, CCG Board & Neighbourhood Lead GP Dr Sharif Uddin, LMC Chair Dr George Ogden, GP Federation Chair Lynda Helsby, AD Primary Care, CCG Rachel Tanner, DASS, Bolton Council Lyndsey Darley, AD Community Services, Bolton FT

Joined up working & The Bolton £ Health and Wellbeing Board Bolton Strategic Partnership Board Co Chairs: Dr Wirin Bhatiani & Cllr Linda Thomas 3 CCG GP Board Members, 3 Councillors, 4 other CCG Board members, 4 Council Officers, 3 Bolton FT Board members, 3 Gtr Manchester Mental Health FT representatives Bolton Programme Management resource Bolton Integrated Care Partnership Bolton Strategic Commissioning Function

Workforce Challenges • • GPs Practice Nursing Middle grade doctors Consultant workforce in specific specialties (A&E, dermatology) Nurses of all levels, particularly in acute and nursing homes Social Workers Home Support Workers

Table discussions