Agenda item

Although Hillingdon CCG had received official confirmation of its assurance rating for 2016-17 and had been rated as ‘Good’, it aspired to be ‘Outstanding’.  To achieve an 'Outstanding' rating, improvements would be needed around delivery against the 4 hour A&E standard, use of personal health budgets and ongoing post-diagnosis dementia support.  These areas had all been included in the 2017/18 plans. 

It was noted that the procurement for urgent and emergency care would take place next year to better integrate the emergency services (e.g., being able to book GP appointments and live access to clinicians through the 111 service).  It was hoped that this would alleviate some of the challenges currently faced within the existing system.

Hillingdon’s Accountable Care Partnership (ACP) had moved to the testing phase following an assurance process which was approved by the CCG in May 2017.  There was currently a shared budget and investigations were underway on capitation.  It was thought that the calculation for capitation would: be more sensitive to patient types; reduce unnecessary admissions; and provide patients with more independence.

Four Care Connection Teams had been fully recruited and were linked to multi-disciplinary teams.  They aimed to encourage self help and self awareness to ultimately reduce admissions.  The CCG had been working with the voluntary sector and Hillingdon4All to extend the service to those with long term conditions such as diabetes and had also been developing an outcomes framework. 

The CCG’s financial position continued to be challenging, particularly in relation to planned and emergency care at Hillingdon Hospital and continuing care budgets.  Within North West London (NWL), every CCG and provider had a financial target.  CCGs used QIPP to achieve these targets.  Although the 2016/2017 target had been tough, it was thought that the 2017/2018 target of £14.4m would be an even bigger challenge. 

Over the last 2-3 months, the 8 NWL CCGs had been working together to identify improvements.  Although the CCGs were not merging and would remain separate entities, they were looking to merge certain functions to gain economies of scale and reduce time spent in meetings.  As the CCG governance seemed to be confusing to some, this simplification was welcomed but concern was expressed at the possibility that local decision making would be lost. 

The Board was advised that Sarah Crowther had been appointed as the CCG Governing Body’s new lay member for public and patient involvement and engagement. 

With regard to Choosing Wisely, the Board was advised that there had been two separate processes underway at the same time:

1. theNWL review had been taking place over the last three months and looked to encourage patients to buy over the counter remedies for a range of minor conditions.  This had overlapped with the national NHS campaign; and
2. stopping pharmacies from automatically reordering repeat prescriptions without ascertaining whether all of the medication on the prescription was needed.  This poor practice had resulted in a 7% wastage of drugs.  Patients were being encouraged to register online with their GPs so that they could control their repeat prescriptions as well as view their own medical records.  This would help patients to take ownership of their own health whilst still providing them with some support.

It was noted that GPs would not be enquiring about patients’ means but would be asking all patients if they could buy their medication over the counter instead of getting a prescription for the same thing (where appropriate).  Patients would not be forced to pay for medication over the counter.

RESOLVED:  That the Health and Wellbeing Board noted the update.