Agenda item

Andrew Bland, CCG Chief Operating Officer and Dr Jonty Heaversedge CCG  chair, will present an introduction to the Clinical Commissioning Group. A paper is attached.

Andrew Bland, CCG Chief Operating Officer, will present the South East London (SEL) five year commissioning strategy. A presentation is attached.

5.1  The CCC chair, Dr Jonty Heaversedge, and Chief Officer, Andrew Bland, of Southwark Clinical Commissioning Group (CCG) presented on the work of CCG and the South East London (SEL) Commissioning Strategy.

5.2  The committee  conducted a question and answer session with the CCG representatives covering the following queries and concerns: 

• Can the CCG explain why the 5 priority pathways for the SEL strategy were chosen (planned care, urgent & emergency care, maternity, children & young people, cancer)? These were picked as significant to Southwark and because CCGs were better able to make a difference over the SEL system wide area - the solutions which are needed are to be found beyond the borough level. 

• Are there going to be more services joined up across different boroughs? There are already services joined up – but this strategy is looking at what can be done better. There will be consideration of whether a service can be better delivered at a local level or at a wider SEL level.  Dr Jonty Heaversedge said the CCG will be focusing more on mental health provision; to ensure it is not an ‘add on’ and that Mental Health has parity with physical health.

• Will targets be met, including A & E performance times? A & E performance is looking fairly good but this could this be negatively impacted by factors such specific investments that might come to an end or by the acquisition of Princess Royal University Hospital (PRUH) by King's College Hospital (KCH) Foundation Trust , which might  lead to a poorer performance of the A & E at Denmark Hill .  There are significant pressures on A & E, but there are differentials on population use of emergency services; Southwark residents are not increasing the pressure but other borough’s populations are. There is a continuing focus on other targets, for example, ongoing investment on reducing smoking. Primary Care is separately commissioned but there is a move towards integration between social care & health and commissioning for outcomes.

• Is there a focus on listening to people post the Francis Inquiry (which looked into the failings at Mid-Staffordshire foundation trust)? Can you speak about any use of "Patient Opinion" and the CCG work on engagement or any use of co-production? Patient experience is used  to improve outcomes and there  is a move towards measuring services on patient experience .We are changing the CCG set up to improve the ability of patient and staff to have their say about services and we are then using that information to improve commissioning . The CCG do have a structure to engage patients through General Practice patient groups, but we do want to hear other voices. We are interested in Patient Opinion and how the CCG can use this.

• My professional experience with the ambulance service is that handovers were sometimes managed to maximise meeting targets; can you comment on how collecting data, and the gaming of targets, can adversely impact on clinical care?  The CCG is not absolutely qualified to comment on the handover of London Ambulance Service and King’s Denmark Hill A & E. We are taking a more ‘in the round’ view of performance. Andrew Bland said he was not a fan of the 4 hour target; however A & E statistics do act as a barometer of hospital performance, particularly the figures on flow. The clinicians in the CCG have helped focus on quality with more rigour - but statistics are useful.

• When developing the SEL strategy what constituents do you give most weight to and who is leading the development of the strategy? Weight is given to both clinicians and patients and the governance decision is with commissioners. Currently we are using existing patient engagement networks, but we will be reaching out further.

RESOLVED

The SEL commissioning strategy will come back to the committee again between September and December.