Changes in the NHS and Nottingham City CCG

Changes in the NHS and Nottingham City CCG Dawn Smith Chief Operating Officer & Ian Trimble Executive GP NHS Nottingham City CCG Working together for a healthier Nottingham

Changes in the NHS and Nottingham City CCG • Background – Why all this change? • NHS Nottingham City CCG • CCG structure • Authorisation • What does this mean for you? Working together for a healthier Nottingham

The NHS was facing a complex mix of pressures • • Demographics – ageing population Expectations – increasing Technology – rapidly accelerating Costs and growth – unsustainable • But also ideology of choice and competition (building on changes introduced by previous Labour government) Working together for a healthier Nottingham

The Coalition government’s response - Equity & Excellence: Liberating the NHS Government’s long term vision for NHS • Put patients at the heart of everything the NHS does • Focus on the continuous improvement of the things that patients (clinical outcomes) • Empower clinicians to innovate and improve healthcare services (greater role for clinicians in setting direction for delivery of services) • Less top down control from government Working together for a healthier Nottingham

The Health and Social Care Bill, 2011 Provision covers 5 themes; • Strengthening commissioning of NHS services (clinically led commissioning) • Increasing democratic accountability and public voice (limiting political micromanagement, increasing LA oversight) • Liberating provision of NHS services • Strengthening Public Health Services • Reforming health and care arm’s length bodies (decrease NHS admin. by a third to increase resources going to frontline services) Working together for a healthier Nottingham

How does this look in Nottingham City? • Formation of shadow CCG mandated by practices. • Retaining clusters with their history of practice co-operation. • Nottingham City and Nottinghamshire County PCT (Cluster) still exists and remains the statutory authority until April 2013. • CCG staff are formally employed by PCT until April 2013. • Responsibility for commissioning of healthcare services has been delegated by the PCT to the CCG. • New CCG executive board consisting of 9 Nottingham City GPs and some senior staff from the PCT Working together for a healthier Nottingham

Terms of Engagement Timeline Working together for a healthier Nottingham

What’s the difference between the CCG and the PCT? PCT CCG • Primary care contracts • Manages commissioning budgets • Dental and optometrist contracts • Community Pharmacy • Will work with PCT cluster on primary care performance • Links with LA & Public Health Working together for a healthier Nottingham

CCG proposed Vision: • Our purpose is to work together with compassion and caring to improve health and reduce health inequalities through the provision of high quality and value-for-money services that are patientcentered. This will be achieved by: Our proposed Values: • • • Taking an active and inclusive approach to involving patients, carers and the public in all aspects of our work. Understanding and responding to the needs of our diverse population. Continually improving the quality of services through collaborative and innovative clinical commissioning. Enabling, supporting and encouraging development of the local workforce to deliver health improvements. Securing cost effective and integrated services within available resources. Working together for a healthier Nottingham

Structure Working together for a healthier Nottingham

NHS NOTTINGHAM CITY CLINICAL COMMISSIONING GROUP Chief Operating Officer Dawn Smith Director of Cluster Development & Performance Maria Principe Director of Finance & IT Terry Allen Director of Contracting, Quality & Delivery Teresa Cope Working together for a healthier Nottingham Company Secretary Lucy Branson

We have come a long way already - Really effective GP Executive - High quality management support in depth - Comprehensive organisational structure at £ 25/head - Stable Financial basis - And of course practices and clusters really working well and supporting our commissioning work Working together for a healthier Nottingham

And also - Understand on track to deliver QIPP - with a particular focus on the Quality part of QIPP - Good handle on 'day job' of commissioning - Building links with other CCG's and clinicians - Sound governance of our organisation This is all illustrated by Sir David Nicholson’s visit and by our short-listing for CCG of the year Working together for a healthier Nottingham

So what are the next steps? The key task will be to demonstrate our competencies in order to be authorised that is fully approved to commission by ourselves in 2013 We also need to keep doing the 'day job' over the next 12 months and beyond Develop a longer term vision and plan Working together for a healthier Nottingham

Authorisation • Submission of evidence to demonstrate capability across six domains • Assessment of track record • Discussion with CCG • Annual assessment • Board validates evidence - 360 degree review Working together for a healthier Nottingham

Timeline • Risk assessment of configuration Oct – Dec 2011 • July - Oct 2012 NHS Commissioning Board established • Consideration of applications from Oct 2012 • Establishment of CCGs from Oct 2012 Working together for a healthier Nottingham

What does this mean for practices? +ve -ve • CCG lead by clinicians – controlling the agenda Practices more accountable for use of NHS resources and financial pressures / risks of QIPP • Opportunity to get involved in designing services • Performance management over broader area • More collaborative working and support for practices • Need to up-skill in terms of corporate governance • Clinical representation at contract negotiations • Market management challenges • Expansion of primary care role • Dealing with time, cost and capacity constraints to make this shift Working together for a healthier Nottingham

How can PMs and the primary care administrative team become involved? What can you contribute? • Key role in supporting practice clinicians in managing practice budget – inc e. Healthscope. • Cluster boards – support and feeding back to the Executive on ideas and issues. • Supporting the voice of patients. Working together for a healthier Nottingham

• What does the group think about our proposed Vision and Values? Does it capture how we should be working? • What support would PMs and the primary care administrative team like the CCG to give? Working together for a healthier Nottingham

Any Questions ? Working together for a healthier Nottingham