Becoming an NHS statutory Body

Dr Sam Hullah, Chief Clinical Officer

Well the 1^st of April came and went and North Hampshire CCG came into being as a statutory NHS body.  The first working day was Tuesday the 2^nd and the team assembled for our first ever briefing.  As Accountable Officer it was my job to rally the troops. Organisational culture is very topical in the NHS right now and so I felt it was important to set the tone for how I wanted our CCG to work.

There is no substitute for hard work and this has characterised the organisation over the last year.  We are on a mission to improve the health and wellbeing of our patient population and hard work will be needed if we are to be successful.  We will also need self belief, and in addition, to quote a NHS buzzword, resilience.  Setbacks and disappointments are inevitable but we shall remain positive and look to turn disappointments into opportunities.

A good team spirit has built up over the last twelve months; we need to build on that and maintain high levels of trust and mutual support.  And finally we need to keep our CCG as a great place to work.  We have done many interviews over the last few months and it is pleasantly surprising how many candidates have commented on how the style of our CCG is one of the things that attracted them to the job.

So hard work, self belief, resilience and team spirit will be the characteristics of our CCG.

In that spirit we set about our first week, helped at long last by the addition of some new team members.  And it was very much business as usual but with the added excitement of knowing that now we were “doing it for real”.

Nobody at our CCG is under any illusions about the magnitude of task we face in bringing about whole system reform with the intentions of not only improving patient care but achieving that within the financial resources available to us.  Our locality has been plagued for decades with an unfair allocation of NHS money, so at the same time as we work on many clinical pathways it is my firm intention to challenge, at the highest levels, the funding formula which sees our patients get almost the lowest per head funding of any CCG in the country.

On a brighter note we are very much looking forward to moving to our new premises in Chineham Business Park, on June 13th 2013.  We have been made very welcome at Old Basing Surgery and have got used to boxing and coxing for space but we really have outgrown the space and need to move on, despite the sentimental attachment we have built up over the last 18 months.

There is much to do but I now have three days a week in which I can lead our CCG forward.  I am, and shall always be, enormously grateful to my partners at Crown Heights for allowing me to take up this once-in-a-few lifetime opportunity; the first weeks is over but the challenge has just begun!

Public’s turn to talk about the new NHS shake-up

Dr Hugh Freeman

On a glorious summer night we held the second of our summer Road Shows and we worried that the soaring temperatures would keep people away.  Thankfully we were wrong and the turnout at our Chawton Park Surgery in Alton was very good.

The theme of the evening was to share more details about what a Clinical Commissioning Group is and what it does.  We shared details about our commissioning priorities and our vision for the future.  We also showed a short film about us, available to watch on our website and as part of it had been filmed in Alton it went down very well with those who came along.

Taking questions after the presentations was fascinating because the questions were so different to those raised at the first road show at Shakespeare House Health Centre in Popley.  It demonstrated to us that there are a lot of questions out there and we need to provide the answers.

Some of the questions centred on the relationship between North Hampshire Clinical Commissioning Group and our local hospitals.  My colleague, Dr Sam Hullah, explained that we are working with the hospitals so that they see themselves as part of the pathway to better health care and not just as a place for surgical procedures.  This is a big change of attitude.  Sam also explained that, at the moment, we are working with Hampshire Hospitals Foundation Trust to change how the Emergency Department works and how it looks.   At the moment patients have a confusing choice of the Out of Hours Service, the walk-in Hampshire Health Centre and the Emergency Department.  We want to take all of these elements into one less confusing unit.

Another interesting question was about the voluntary sector and how we will work with them.  Communications Manager, Anne Phillips, explained that she has already been involved in a series of voluntary sector meetings and has more planned.  It’s an area where we really feel we can work together in a very positive way.

Anne also had a question for the audience.  She asked those gathered if they really wanted to be involved in health care.  The answer was a resounding yes, they do want to know what the Clinical Commissioning Group is up to and they want to use their voice and their experiences.

Two pharmacists from Boots the Chemist came along to the Road Show.  They asked what they could do to support us – North Hampshire Clinical Commissioning Group – and expressed their concern about medicine waste.  Sam supplied some shocking figures for North Hampshire – between £500k and £1m is wasted in this area alone on medicines that don’t get used.  Such a waste…and possibly the subject of another blog!

Do you want to understand the new NHS reforms?

The first of our four Road Shows kicked off this week at our Shakespeare House Health Centre in Popley. As it was the first we were feeling a little nervous about how it would go. It was a great success I am relieved to say.

 We started the evening with my colleague Dr Sam Hullah recalling the many battles to bring about Clinical Commissioning Groups like North Hampshire. It’s been a long struggle to get to the stage where we are now a shadow Clinical Commissioning Group.  Sam reminded everyone that the Health and Social Care Bill which is now an Act holds the record for more changes to a parliamentary bill than any other in the history of legislation. And we showed a short film introducing US  and explaining our vision and health care priorities.

North Hampshire CCG Road Show

 The film was a success with one person very kindly saying it was so interesting it should be shown on BBC South Today!  It is now available to view on YouTube and you can link directly from our website. 

 My presentation about the nitty gritty of commissioning health care provoked almost an hour of questions. The questions were robust, intelligent and challenging from ‘how do you prioritise’ what health care to commission to ‘how do you take responsibility for patient experience and delivery of service beyond primary care’.

We prioritise what health care to buy for North Hampshire by knowing what the needs of the local population are. We are helped with this task by fantastic public health research. We use a tool called the Joint Strategic Needs Assessment and this helps us identify what our local population needs. So what I’m saying is that we prioritise based on local knowledge and needs.

And yes we do take responsibility for patient experience and delivery of service. The question was based around hospital care. So I explained at the Road Show that we as a CCG buy hospital services and so it’s important to know that the patient outcomes were good and we got value for money. We have systems in place to make sure we know what happens to patients and that a good service is delivered, but we will be looking to improve the way we gather first hand experience from patients.

 I think one of the most fascinating comments last night was about ‘feedback’ and how some see feedback as just a way of complaining when really it should be the good as well as the bad. Feedback from patients is crucial. We need to know what works and what doesn’t so that together we can bring about change.

 All in all it was a good and positive start to the Road Shows. Looking forward to the next one tonight at  Chawton Park Surgery in Alton.  Do come along. And there are two more next week so plenty of opportunities to learn about local health care and what it means to you.

What are the health issues facing North Hampshire?

Dr Hugh Freeman, Chair, North Hampshire Clinical Commissioning Group

We – North Hampshire Clinical Commissioning Group– are now three months into our life as a shadow body under the guidance of Hampshire Primary Care Trust. By April 2013 we will have full statutory powers and budgetary responsibilities.

 A lot of hard work to bring about these changes has already taken place and more is underway. If you would like to learn more about the new NHS and what we as a Clinical Commissioning Group are doing then do come along to one of our Road Shows in the next couple of weeks. 

Find out how you can play a part in shaping a healthy future for the people of North Hampshire. We will be holding four road shows at four different venues and the aim is to have a 60 Minute agenda where we share and exchange local health care information.  It’s your chance to make your voice heard and we would love to hear your questions and concerns.

One question we are anticipating is about how we decide what care to commission – that is buy – from health and social care providers.

 To help us make our decisions we use a tool called the Joint Strategic Needs Assessment which provides us with information on key health issues. It helps identify the health challenges in our area so that we can make the right decisions.

 The health challenges facing North Hampshire are –

 Lifestyle– lifestyle issues such as obesity and binge drinking have a significant impact on the use of NHS resources. Basingstoke & Deane district has similar numbers of obese people and binge drinkers as the national average. Cardiovascular disease is the main cause of death locally and nationally.

Diabetes in North Hampshire is similar to the national average.

Chronic Obstructive Pulmonary Disease (COPD) deaths are lower than the national average .

Infectious disease– there is a low incidence of Tuberculosis (TB) relative to the national average

 Cancer– there is a similar proportion of people living with and dying from cancer as compared to the national average. But North Hampshire has more smokers and this is likely to have an adverse effect on cancer statistics in the future Children and young adults– levels of obesity are relatively higher in Basingstoke & Deane in both Year R and Year 6.  Worryingly high is the fact that 17.3% of Year 6 children are classified as obese.

 Older people– dementia figures are similar to the national average. But estimates suggest the numbers will double over the next 20 years.

 Mental health – the area has a higher than expected number of people experiencing depression, but cases of mental illness are lower than the national average.

Our vision at North Hampshire Clinical Commissioning Group for health care is firmly rooted in this local knowledge. We understand the needs of our population and are determined to meet these needs by commissioning services that focus upon preventative care and staying healthy; and where patients need healthcare that the right care is delivered at the right time in the right place. It is essential to delivering our vision that we ensure everyone for whom we are responsible gets the best quality and value health care possible within the resources available and that access is equitable and targeted to need.

Join us to hear more about all of this at one of these four venues this summer:

24th July– Shakespeare House Seminar Room, Shakespeare House Health Centre, Shakespeare Road, Popley, Basingstoke, RG24 9DT 26th July– Chawton Park Surgery, Chawton Park Road, Alton, GU34 1RJ

31st July– Hackwood Partnership, Essex House, Essex Road, Basingstoke, RG21 8SU

 1st August– Tadley Community Centre, Newchurch Road, Tadley, RG26 4HN

Odiham Cottage Hospital – What A Year!

What a difference a year makes is a phrase I have heard and used many times.

But reading the Summer Newsletter for Odiham Cottage Hospital over the weekend made me think about how true this phrase can sometimes be.  The hospital is a busy and vibrant place with a broad range of clinics and day centres on offer.  Last year it was a very different story.

Dr Hugh Freeman, Chair, North Hampshire Clinical Commissioning Group

In July 2011 – after one hundred years of public service – Odiham Cottage Hospital closed its doors and many of us feared it would be for the last time.

But never underestimate the power of a local community when it joins together and uses its voice!  Within days and weeks a huge community wide campaign began to grow.

 We – North Hampshire Clinical Commissioning Group – responded to this community campaign.  Hampshire County Council and NHS Southern Health Foundation Trust did the same and earlier this year the hospital re-opened with a new look and range of services.

This summer will be very different for the hospital Trustees, League of Friends and the many local users and supporters.

An integrated care team is now based at the hospital.   This team of Community Matron and community nurses with other healthcare workers and a dedicated social worker are now offering clinics and a day centre for the elderly.

A partnership with St Michael’s Hospice now means complementary therapy clinics for terminally ill patients are also available.

It’s a success story that makes up for the grim weather!

NHS time and money more precious than ever…

Dr Hugh Freeman, Chair, North Hampshire Clinical Commissioning Group

With NHS budgets having to go further and everyone wanting more for their money – it’s more important than ever that nothing gets wasted.

And there is an area where patients could really help. Every appointment costs money, every call to an Out of Hours service costs money.  I would say to patients think before you do either of these and ask ‘is this really necessary?’
Patients are incredibly important and the amount of time you get with them is precious and has to be used wisely. So when you get someone sitting in front of you who says

‘I’m better now but I thought it was sensible to come and see you anyway’. No surprise if the GP feels a bit frustrated.

That’s an appointment that could have been used by someone who really needed it and both time and money have been wasted.

What about the patient who called an out of hours GP to say ‘My turkey is still frozen is it ok to cook it?

And another Out of Hours call at Midnight to say ‘I need to see a Doctor my daughter has head lice.’  Each of these calls has to be logged and there is a cost for making them.

Each time an appointment is taken by someone who really doesn’t need one there is another patient who does need the slot and has to wait for another day. Each time a patient makes an unnecessary call to an Out of Hours service there could be another urgent case trying to get through. So it’s not just money that is being wasted.

A patient once made an appointment to say ‘I’ve lost my medication and need another prescription’. Again a waste of time and money as the receptionist could have handled this.

And ”Do you think I should make an appointment to see the nurse for my regular check-up? was another waste of GP time and money. The nurse could have been contacted instead.

One of the GP magazines ran a competition a few years ago trying to find the most ridiculous reason for calling a GP out at night.  The winner….A GP who had been called by a distressed elderly lady demanding immediate help to find her  tortoise missing in the garden.

So in this brave new world of patients having a bigger voice in their own health care and in local health care decisions I would say use it to spread the word about money wasted on inappropriate use of GP time.  North Hampshire Clinical Commissioning Group wants to end waste like this but to do so needs patients to help and support.

 When every penny counts and every minute is important do you agree we could all use the time and money in better ways?