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Local NHS publishes Issues Paper

Local NHS publishes Issues Paper

Local clinical commissioning groups and provider Trusts in south west London* have jointly published an Issues Paper, setting out the challenges faced by the local health service, some of the  emerging ideas to tackle them and some questions for local people to respond to.

The paper is published for discussion and to set out clearly the matters that local clinicians and managers are grappling with, in an attempt to promote a dialogue across south west London about how the local NHS should work in future. All six south west London clinical commissioning groups and all local acute, community and mental health trusts have signed up to the paper, which is also supported by NHS England.

Dr Chris Elliot, Sutton GP and Senior Responsible Officer for SWLCC said:

“There are two versions of the Issues Paper – the full version and the shorter summary. Local CCGs and Trusts recommend that people read both share their views on the questions raised. We hope that both individuals and organisations will respond and get involved in the discussion.”

Get involved!

  • Use the contact details in our Issues Paper to respond to the questions it raises on our website or in writing.
  • If you hold meetings, invite us along to discuss these issues in person.
  • If you have staff or networks, send them our Issues Paper and encourage them to respond.
  • If you have a website or social media account, draw attention the debate
  • If you want to find out more and send us your comments, please visit our website at       www.swlccgs.nhs.uk

*The Issues Paper is published by SWLCC and the following organisations: Croydon University Hospitals Trust, Epsom and St Helier University Hospitals Trust, Kingston NHS Foundation Trust, St George’s University Hospitals NHS Foundation Trust, South West London & St George’s Mental Health NHS Trust, Royal Marsden NHS Foundation Trust, West Middlesex University Hospital NHS Trust, South London & Maudsley NHS Foundation Trust, Hounslow and Richmond Community Healthcare Trust, Your Healthcare CIC and London Ambulance Service.

In Step with - Dr Andrew Murray, Chair - Merton CCG

What role will you play in the SWLCC programme?

As the Clinical Chair of Merton CCG and therefore as a leader in the programme, a key part of my role is to ensure that the voice and aspiration of Merton CCG, and more importantly the population that I serve, are met in a collaborative way. I chair the SWL Forum, a meeting where all our partners attend and I see the Forum as one of the many ways we can work with partners on the key issues we are grappling with. I will at times ask challenging and difficult questions which will help to ensure the SWLCC, our partners and provider colleagues remain focussed on our patients and public.

What attracted you to chairing a CCG?

The same thing that attracted me to becoming a doctor in the first place, wanting to help people. Being a GP is frustrating because as the patient's advocate you sometimes feel that you are fighting with the system on their behalf, you also recognise that so many of your patients problems are not simple and require more than what a GP or even the health system can deliver on their own. As chair of Merton CCG I am excited by the opportunity to transform healthcare for people in Merton and part of this is working with all our partners to join things up around patients.

If you had a magic wand, what one thing would you change about the NHS?

As a clinician I do feel that we at times can lose focus on the patient being at the centre of everything we do.  I have seen many people working hard on the business end of the NHS, like improved performance and contract management. Whilst these things are important my sense is that it has resulted in time and money being wasted on transactions and has created the impression for organisations that their responsibility for people's health begins and ends with what they are specifically contracted to do. So I would look to review how all partners work together to put the patient at the centre and truly commission collectively for real patient outcomes.

What are your hopes for the programme?

That we can deliver better at scale some of the things that individual CCGs struggle to do individually, such as IT, and that it will help shift focus and activity into the community, being the place where we can transform people's experience of health.
Describe yourself in three words?
Open, honest, determined

More information can be found here: http://bit.ly/1HAHMMn

Step Change - What is different this time? Dr Naz Jivani, Chair - Kingston CCG

I was recently part of a meeting to brief local authority colleagues about the work of South West London Collaborative Commissioning. One local councillor made the very good point that the NHS has been talking about why things need to change for several years, yet many of the changes that are clearly needed have not happened. What local people will want to know, she told us, is what has really changed? What’s different now to when changes were put forward under previous programmes like Better Services Better Value, Healthcare for South West London or Better Healthcare Closer to Home?

The reality is, of course, that the clinical and financial case for change has not changed. The challenges set out in our Issues Paper are matters we have been raising for several years. The case for change is much the same as that outlined in the past but the problems it causes are getting worse.

What has changed, though, is that the national NHS Five Year Forward View sets out new ways of delivering healthcare. It advocates changing the way in which services are delivered and funded, so that more care can be delivered in the community, by GPs, nurses, pharmacists, midwives, therapists and other health professionals. New ways of organising services around the patient are suggested, making the long term NHS goal of most care being delivered in community settings far more attainable. This dovetails perfectly with what we would like to achieve in south west London.

The NHS Five Year Forward View means that the way in which patients use the NHS is likely to change. Many more services and clinicians will operate outside hospital, in the community and in a different way. GP practices are set to work more closely together and services previously provided only by hospitals could move into the community. Hospitals and GP networks will be expected to offer services over 7 days a week. Nurses and pharmacists are also playing a much bigger role in delivering care to patients and keeping people healthy.
New roles such as care navigators and case managers are being developed to help people with physical and mental health problems to stay healthy and avoid a crisis, helping patients to get the right service at the right time to avoid an unnecessary hospital admission. New ways of working can now cut across old NHS and social care boundaries to avoid duplication and fragmentation of care.

The other key piece of work that has changed the landscape is the London Health Commission. In December 2013, the Mayor of London launched an independent London Health Commission to look at how healthcare could be improved for Londoners. The Commission reported in November 2014 and made a series of recommendations, including measures to tackle childhood obesity, get people living healthier lives, better support for people with mental illness, improving GP access and more support in the community for people with long term conditions. All of the recommendations and aspirations in the London Health Commission report are in line with those set out in our strategy and in the NHS Five Year Forward View.

If we do nothing then within five years patients in south west London will no longer have the services we currently provide. Patients will be left with sub-optimal care as we will not be able to meet the required quality and safety standards – ultimately putting lives at risk. We think that patients deserve better, with access to safe, high quality and sustainable services for years to come.

We expect big changes in the way patients receive the care they need. We want to see a greater emphasis on helping people to stay well and helping those with long term conditions to manage their own health, understand their conditions better and access support when they need it. This would mean much more joined up working between the different parts of the NHS (GPs, hospitals, primary care teams, community services, mental health services, the London Ambulance Service), the social care services run by local councils (and by Your Healthcare in Kingston), and services run by the voluntary sector.

We want future services to be built around the needs of our population, rather than the needs of different public bodies. Patients and carers would get better services. They would also need to take more responsibility for their own health where possible, ensuring that they use health services wisely and appropriately. We have strong communities and networks to draw on; we want everyone to play a part in delivering a better, sustainable health service.

All our services will need to change. We expect all of our hospitals to be there for when people need specialist care. It is possible that different hospitals may do different things in future, rather than trying to do everything everywhere. But we will not make major changes to any hospital without first putting an alternative in place – and consulting the public on the options. At present, we are still discussing with local hospitals what part each of them will play.

We recognise that ideas for change can be unsettling as well as exciting. While clinicians may be excited about the potential for changing the way things work for the better, we also know that many people find change difficult and will want reassurance that what we are proposing will make things better and that they will not lose out.

That is why we published our Issues Paper: we want to put our cards on the table and let you know our current thinking. Most doctors and nurses, as well as managers, agree that we cannot go on as we are. We want our patients and local people to be part of our decision-making process and part of building a better local NHS.

Forward Steps - News from the Collaborative

The South West London Maternity Network Annual Report for 2014/15 has now been published and it is available on the Network website.

The report outlines a successful year and this is greatly attributed to the dedication of the Network members and colleagues in South West London

The SWL Network looks forward to another successful year in 2015/16.

The SWL Maternity Network Annual Report can be found here: http://bit.ly/1dBwCux

Next Steps - For your diaries

The SWL Primary Care Co-commissioning Joint Committee will be meeting on Thursday 9th July at 3:00PM

Venue: Room 6.2 & 6.3, 120 The Broadway, Wimbledon, SW19 1RH

Contact Information: cliveallanso@nhs.net  / 0203 458 5726

If you would like to put forward any questions to the committee please send them to Clive Allanso (cliveallanso@nhs.net) before 5pm on Wednesday 8th July.

Five copies of the papers will be made available at the meeting on a first come, first serve basis

Papers can also be found on your local CCG website or here: http://bit.ly/1FXAU61