Erewash leads the way in transforming care - Erewash CCG

Erewash leads the way in transforming care - Erewash CCG

Newsletter N H S E R E W A S H C L I N I C A L C O M M I S S I O N I N G G R O U P N E W S L E T T E R I S S U E Erewash leads the way in trans...

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Newsletter N H S







Erewash leads the way in transforming care Erewash is leading the way in transforming the quality of health and social care through a ‘gamechanging’ Vanguard programme.


The Vanguard team met with representatives of NHS England and partner organisations


acked by a £200m transformation fund, Erewash is one of 29 pilot areas which are bringing together hospitals, community services, GPs and care homes to move specialist care out of hospitals into the community. Erewash has been chosen as one of the ‘vanguard’ Multi Specialty Community Providers (MCPs) to move towards a community system where people support themselves and take responsibility for their own care and have access to a community support service. The Vanguard project was launched challenges and barriers to achieving with a two day site visit on 20 and 21 these and reach outline agreement April where a team from NHS England on the support requirement to set the and Partner Organisations met with Vanguard’s programme up for success. us to discuss and define the Vanguard Under the Vanguard programme, programme in Erewash. On the Erewash will be spearheading new care second day the agenda included an models, with the aim of demonstrating engagement event where the progress success that can be adopted by other already made so far was highlighted areas across the country. All of the and reviewed to discuss what has selected care model sites will have gone well, what have been some of certain characteristics in common. the barriers, some of the practicalities Their shared purpose is to promote of implementation and what the next the health and wellbeing of their local steps will be. populations, to increase the quality of The aim of the site visit was to develop care for their patients, and to improve a shared understanding of the aims efficiency for the taxpayer within the and objectives (both clinical and available resources. non-clinical) for the Vanguard’s new care model, understand the specific > Continued on page 2 N H S E R E WA S H C L I N I C A L C O M M I S S I O N I N G G R O U P N E W S L E T T E R J U LY 2 0 1 5

> Continued on page 2

Under the Vanguard programme, Erewash will be spearheading new care models, with the aim of demonstrating success that can be adopted by other areas across the country.

QUEST dates See page 7


Erewash leads the way in transforming care > Continued from page 1 All are rethinking and redesigning the way care is delivered. The sites will show what the future NHS could look like: what integration can really mean in practice, for different communities, patient groups and staff; and across home and community based services, urgent and emergency care, elective care and specialised services. Erewash joins 28 areas nationally who have been chosen from amongst 269 groups of nurses, doctors and other health and social care staff from across the country that put forward their ideas for how they want to redesign care in their areas. For patients, this will lead to a significant improvement in their experience of health services. The Multispecialty Community Provider model proposed by the partnership in Erewash aims to develop a team of integrated, clinically-led care across health and social care This new model will see teams working “without walls”, taking shared responsibility for delivering shared outcomes centred around the person. Partners to the new model are Derbyshire Community Health Services NHS Foundation Trust, Derbyshire Health United, Erewash Health and Erewash CCG. Helen Rose, Erewash CCG’s former Primary and Community Care Director, is the Programme Lead for the MCP. “It’s about building community support, rather than health and social care services,” says Rakesh Marwaha, our Chief Officer. “We need to build resilience in our services and our communities. It’s not just about bringing the workforce together, but changing how we work together, what we deliver for people and what the people deliver for themselves.” “The Vanguard will build on our collective successes,“ adds Helen Rose. “Patients are now benefiting from an extended primary care service at two locality hubs in Ilkeston and Long Eaton. We have an integrated care team delivering innovative services such as ‘Welcome Home’ and the ‘Care Home Service’ and we are 2

making great use of the voluntary sector with initiatives such as VSPA.” The MCP service will include two main multispecialty hubs in the major towns in the area (MCP Ilkeston & MCP Long Eaton), with branches around the population to support ease of access for certain services. The community support service will encompass services that are currently being delivered separately, through integration of the workforce, to deliver a unique solution for the area.

For patients, this will lead to a significant improvement in their experience of health services. The skills/integrated support services delivered to the people of Erewash will include: ➤➤ Medical support (primary, community and secondary as appropriate and efficient) ➤➤ Nursing (cross sector) ➤➤ Mental health (self-help to enduring including dual diagnosis) ➤➤ Allied Health Professionals support (Supporting Long Term conditions, OH/OT/Therapies/Other)

➤➤ Outreach teams to support people in the community such as nursing/ residential homes, home-bound, seldom heard groups, home visiting ➤➤ Generic support (HCAs, Support Workers) ➤➤ Diagnostics (demand led appropriate efficient services) ➤➤ Community self-help services, drop-in and classes/clubs (reducing isolation and supporting social capital) ➤➤ Local council service support e.g. street pride, home alterations, home help ➤➤ Housing and benefit support ➤➤ Availability to nursing and residential home beds for short term support/rehab. This will require a significant change in people’s behaviour in Erewash as they will be encouraged to take greater responsibility for their health through Patient Groups, Stakeholder meetings, FT membership, local council panels and other forums. Staff will need to change their mindset to seeing the whole person and their family when commissioning and delivering services rather than the condition that they suffer from. The long-term aim is to have a joined up electronic health record for the population of Erewash. A key objective is to identify those patients who will benefit from the most intensive support. Currently there are around 30,000 families in Erewash and 5% of our population costs us 40% of our costs. So, we need to provide people with the most appropriate service to ensure that they get the right care at the right time and in the right place. It’s all about introducing dedicated services for different patient groups such as telehealth for patients in care homes.

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Time out to celebrate and reflect

Rakesh highlighted that we already have significant successes to build on...

Staff, GPs, partners and stakeholders took valuable time out at Eastwood Hall in May to celebrate successes and discuss the exciting next steps on the CCG’s journey to deliver better care, better health and better value for the people of Erewash.


he vision for the population of Erewash was shared by Dr Avi Bhatia, our Chair, and Rakesh Marwaha, our Chief Officer, who spoke about the importance of health, social care and the voluntary sector all working closely together to deliver better outcomes for Erewash people. The Multispecialty Community Provider model proposed by the partnership in Erewash aims to develop a team of integrated, clinically GP-led care across health and social care. Rakesh highlighted that we already have significant successes to build on such as the Care Home service,

7 day primary care clinics and the CCG’s effective partnership with the voluntary sector through projects such as VSPA. This new model will see teams working “without walls”, taking shared responsibility for delivering shared outcomes centred around the person. A key part of the day was spent working in teams to discuss topical issues and challenges facing the CCG and presenting back some highly creative solutions!

INFECTION PREVENTION AND CONTROL LINK FORUMS We would very much like to encourage all care homes and GP Practices to nominate a member of staff to come along to our IP&C Link Forums. Details of the next Forum meetings can be obtained by contacting the IP&C office on the number opposite The IP&C Link Forum aims to support care homes and GP Practices to promote

IP&C. Meanwhile, if you would wish to see any specific IP&C issues covered in this newsletter, please don’t hesitate to get in touch on the contact details opposite – we’d love to hear from you and if you would be willing to host the Care Home IP&C Link Forum / Practice Nurse IP&C Link Forum and have a suitable room please get in touch!

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Sally Bestwick

Lead Nurse Infection Prevention and Control

Donna Foulkes Infection Prevention and Control Nurse

IPC Team Base Toll Bar House 1 Derby Road Ilkeston Derbyshire DE7 5FH Telephone: 0115 931 6226 Email: [email protected] or [email protected]


Results of our stakeholder survey 78

The overall response rate was

Building strong relationships with health and care partners is crucial to our success as a commissioning organisation.


hese relationships provide us as commissioners with ongoing information, advice and knowledge to help us make the best possible commissioning decisions to improve the quality and efficiency of health services. A 360 Degrees stakeholder survey was carried out from 10 March – 7 April 2015 to gauge whether these strong relationships are in place. The survey, which was conducted by NHS England, allowed stakeholders to provide feedback on working relationships with CCGs. The majority of the results show that NHS Erewash CCG featured in the top third of all CCGs who were surveyed by NHS England. “These results highlight that we continue to develop productive relationships with our stakeholders which is vital in delivering better health, better care and better value for the people of Erewash,” says Dr Avi Bhatia, our Chair. “It’s particularly pleasing to see that stakeholders feel even stronger that their views have been listened to and that 86% feel that they have a very good relationship with us.” “In the majority of areas our results are in the top tier compared with other CCGs nationally,” adds Rakesh Marwaha, our Chief Officer. The results provide us with a wealth of data that



help with our ongoing organisational development and we will be looking in detail at how we can address the areas identified as requiring improvement.” The survey was conducted primarily online via email invitations. Stakeholders who did not respond to the email invitation, and stakeholders for whom an email address was not provided, were telephoned by an Ipsos MORI interviewer who encouraged response and offered the opportunity to complete the survey by telephone. Within the survey, stakeholders were asked a series of questions about

their working relationship with the CCG. In addition, to reflect each core stakeholder group’s different area of expertise and knowledge, they were presented with a short section of questions specific to the stakeholder group they represent. 35 of the CCG’s stakeholders completed the survey. The overall response rate was 78% which varied across the stakeholder groups shown in the table below.

Survey response rates for Erewash CCG Invited to take part in survey

Completed survey

Response rate

GP member practices




Health and wellbeing boards




Local HealthWatch/ patient groups




NHS providers




Other CCGs




Upper tier or unitary local authorities




Wider stakeholders




Stakeholder group

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What our Stakeholders said about us ➤➤ Stronger and more open conversations both formally and informally ➤➤ Joint Vanguard partner very positive ➤➤ Open to neighbourhood model of care very positive ➤➤ Erewash CCG has engaged with us through various meetings where they have ensured that the agenda included presentations from our organisation. In addition they have been proactive in ensuring that the voluntary sector are invited to their stakeholder presentations and forums ➤➤ We believe that NHS Erewash really listen and respect the work that our organisation carries out across Erewash and offers us very valuable support with raising our profile and by attending our AGMs and meeting our stakeholders ➤➤ Regular contact and meetings on service performance and commissioning plus attendance from Erewash staff at key organisational meetings to listen, learn and support our activity ➤➤ Erewash is a small organisation containing many passionate and committed people. It is more difficult for the CCG to implement agreed areas due to capacity issues ➤➤ The Erewash team always turn up and are professional and well engaged with the problems.

Comments on how the working relationship within/with the CCG has changed over the past 12 months ➤➤ I’m more involved now than before ➤➤ We can reach them at the end of the phone, or emails, they are responsive and they engage and they are supportive ➤➤ I have got to know everybody in the CCG more ➤➤ More dialogue/sharing of ideas, problem areas ➤➤ Generally more open conversations about challenges of care delivery and the pressures we face together to make care more joined up ➤➤ Our relationship with NHS Erewash and its staff is much closer now in that it is a more “personable organisation” (not faceless) with staff and we can actually meet the person who manages the contracts. Everyone we have dealt with has the experience and understanding of issues facing the voluntary sector. This has developed a two way process for the ECCG to get closer to the grass roots - hard to reach community through respecting our local knowledge and supporting us to deliver quality services.

Overall engagement and relationship summary Key

Comparison group

The CCG’s 2015 result is in top third of comparison group

The CCG’s 2015 result is in middle third of comparison group

The CCG’s 2015 result is in bottom third of comparison group

CCG in 2014 (Base: 35/*Base: 35/**Base: 35)

CCG in 2015 (Base: 35/*Base: 35/**Base: 33)

Extent of engagement by CCG in last 12 months (% A great deal / A fair amount)



Satisfaction with engagement by CCG in last 12 months* (% Very / Fairly satisfied)



Extent that the CCG has listened to views when provided (% Strongly / Tend to agree



Not comparable to 2014


Overall rating of working relationship with CCG (% Very good / Fairly good)



Change in working relationship with CCG in last 12 months** (% Got much better / Got a little better)



Extent that the CCG has taken on board suggestions when provided (% Strongly / Tend to agree)

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CCG Cluster (Base: 644/*Base: 631/**Base: 631)

All CCGs (Base: 8472/*Base: 8320/**Base: 8363)


Restructure in CCG Leadership Key changes have been made to our leadership structure to reflect our needs and priorities to deliver better care, better health and better value for the people of Erewash. The new structure is as follows:

Rakesh Marwaha Chief Officer

Falu Bharmal

Assistant Chief Officer and Corporate Director, responsible for Governance and Procurement.

Anne Maria Olphert

Chief Nurse and Director of Quality, now also responsible for Primary Care.

Charlotte Allen-Neale

Chief Finance Officer, now also responsible for contracting and performance.

Helen Rose

MCP Vanguard Programme Lead

Lynn Wilmott Shepherd

Director of Transformation (South Derbyshire)



Left to right: Donna Foulkes, Kathleen Cox and Sally Bestwick

The Infection Prevention and Control team

Sally Bestwick Lead Nurse - Infection Prevention & Control

Donna Foulkes Infection Prevention & Control Nurse

Kathleen Cox Infection Prevention & Control Administrator

The Infection Prevention and Control Team (IP&C) commenced in post mid-January 2015 to support the CCG in ensuring Infection Prevention and Control is addressed in all care environments, with an aim of maintaining the work already in place to ensure the risks of healthcare associated infections are minimised.


ur IP&C team covers the areas served by both NHS Erewash and NHS Southern Derbyshire CCG, working within the Quality Teams and our role is ultimately about supporting the provision of high quality, safe, effective care related to all things IP&C. This may be about supporting care homes/GP Practices on how best to achieve compliance with CQC Registration requirements including compliance with “The Health and Social Care Act 2008: Code of Practice on the prevention and control of infections and related guidance” (Department of Health 2010), or you may have a concern about how best to manage an outbreak of scabies or have queries about managing MRSA. We will support you to use evidence based practice to ensure residents, visitors, patients and your staff are cared for appropriately in an environment which minimises the risks of infection so promoting the quality of care at all times. Infection Prevention and Control can seem rather a grand title but is really all about

preventing ‘bugs’ that cause infections from getting into the wrong place at the wrong time. Our patients and care home residents are already at a greater risk of infection due to their age, other illness, medications and the possibility of having had their natural defense mechanisms breached by breaks to their skin due to wounds or possibly having a catheter in situ. Good infection prevention and control practice will help prevent the potential transfer of organisms that may cause infection, and as we already know good hand hygiene is single most important practice to reduce infection in any setting. A number of resources are available to support hand hygiene best practice including the WHO Save Lives: clean your hands campaign currently running – more details can be found at the link below and includes a self-assessment framework regarding hand hygiene plus other useful resources

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CCG shortlisted for national award NHS Erewash CCG has been shortlisted for a national award for forging a strong partnership with voluntary groups and delivering health services tailored to local needs in Erewash.


HS Erewash is the only CCG in the country to be selected for HSJ’s Value and Improvement in Commissioning Support Services award. The winner will be announced at the HSJ Value in Healthcare Awards on Tuesday 22nd September at the Grosvenor House Hotel, London. The CCG has worked closely with voluntary organisations when planning and buying health services and using their unique insight and knowledge to influence decisions. A range of local voluntary organisations have been commissioned to provide support services which support vulnerable people to stay at home longer and avoid crisis intervention. These include: ➤➤ Supporting parents to build better lives for their children through unique home visiting services from volunteers. The support is practical, emotional and friendship through the antenatal and postnatal periods. ➤➤ Support for parents with mental health issues through the Mums in Mind support group. ➤➤ Commissioning a winter survival scheme for vulnerable people who are at a higher risk of hospital admission during the winter months to provide provisions to keep warm and a path clearing service. ➤➤ Launching a home comforts team to support the challenges faced by lone,

older and vulnerable members of the community to enable to stay at home safety for longer than they would have done. Anne-Maria Olphert, Chief Nurse Quality Officer and Director of Nursing for NHS Erewash CCG, said: “We are delighted to be the only CCG in the country to have been shortlisted for this special award. As a CCG, we recognise that local voluntary groups and organisations have a unique relationship with the people they support. More specifically they have relationships with and are able to engage with local people who we often consider hard to reach. So, they are ideally placed to provide services tailored to meet individual local needs because of their involvement in the local community. “By working with local voluntary organisations we have been able to understand local need, develop services to meet this need and launch new services that support people to live independently for longer, reducing the dependency on health services.”

The CCG has worked closely with voluntary organisations when planning and buying health services...

QUEST Dates 2015/16 Dates




9th September



Blood Results

7th October




11th November




6th January



Adult Safeguarding

10th February




9th March




Speaker N/A


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MEDICINES MANAGEMENT TRAINING PROGRAMME Following a successful stakeholder event in July 2014 the Medicines Management Team (MMT) launched a Medicines Co-ordinator training programme in October 2014. The programme was aimed at General Practice prescription clerks and administration staff; it consisted of 4 workshops covering a variety of medicines management related topics. The programme has been well received with the majority of participants stating that they would like to continue training and would recommend the training to colleagues. As a number of practices did not participate in the 2014/15 programme and considering natural staff turnover it is proposed that the initial medicines co-ordinator sessions are repeated. It is anticipated that the sessions will start in September so please look out for the dates which will be circulated shortly. Later in the year we would also like to provide some workshops that will develop the skills of the medicines co-ordinators who have completed the initial programme. If you have any ideas or suggestions on the areas that should be covered in the development programme please let us know. Harriet Murch Lead Pharmacist NHS Erewash CCG


Support transformed for carers Our support for carers in Erewash has been transformed by identifying key areas of need and introducing a raft of initiatives that are making a positive difference to the lives of carers and the people that they care for.


trong engagement with carers, local service providers and the voluntary sector has taken place. Through the funding of specific voluntary services in Erewash, NHS Erewash CCG has been able to establish stronger links with carers of the more vulnerable members of the community. For example, those receiving Meals 4U, befriending schemes and support to young mums. This provides regular feedback on the experiences of these people as patients and carers. Many of the projects funded are directly related to carers, through Treetops Hospice bereavement services and a programme specifically supporting young people prior to bereavement. A grant scheme has also been funded through Derbyshire Carers, which helps carers financially. The CCG held a Stakeholder Event in March 2015 which was attended by service providers and service users including those who care for people young and old and patients with learning disabilities. The CCG identified key areas where carers needed vital support. A further session with 25 carers hosted by Erewash Voluntary Action CVS was held in June 2015 to explore opportunities for further support in the future. New initiatives funded by the CCG such as the Bright Street laundry programme have helped carers to keep the person they care for longer in their own homes, particularly at end of life, by providing a laundry service for bed linen. In some cases, carers were having to do in excess of eight loads of bed linen a week, this was often too much for them, especially older


carers, and resulted in the person being admitted to residential care. The laundry service has helped carers to carry on. Other voluntary schemes such as Dinners 4u and home comforts teams have also helped carers to continue in a caring role in their own homes for longer. Funding by the CCG contributed towards the purchase of equipment and running costs for the Community Concern Erewash Home Comforts Team who support elderly and vulnerable residents in Erewash to remain living independently at home.

Carers are an essential part of the journey of the person approaching the end of life and NHS Erewash CCG recognises that they need support... During 2014/2015 384 jobs were carried out to enable residents to remain living independently at home. Evaluation was undertaken with 279 people who all stated that they felt more able to cope, especially knowing that they will continue to be supported on a regular basis. Eighteen couples have been able to remain living together in their own home because of the work the team has carried out including practical services but by also signposting them for additional services and support. Two lone parents and two grandparents with caring responsibilities for children have been supported with one of the jobs taking several days/visits to clear the ‘tip’ in the garden before the ongoing maintenance work could be achieved.

The Home Comforts Team provides practical support with small tasks which make a large impact for those who are unable to carry out the task themselves, or have no friends / family able to assist them. For example supporting carers with moving a bed downstairs for an elderly and infirm resident, has a massive impact upon their safety, wellbeing and quality of life and can also result in an earlier discharge from hospital. Also, the clearing of health threatening hoarded clutter in homes and gardens is essential to prevent slips trips and falls. This ensures that environmental health standards are maintained keeping residents in their own homes and reduces the likelihood of people having to go into care who are unable to cope with such duties as they have physical/mental health issues. VSPA, a service launched by NHS Erewash, NHS Hardwick and NHS North Derbyshire CCGs, in June 2014 to help frail and elderly people stay at home rather than go into hospital, is also improving the quality of life for carers in Derbyshire. The service links local people at most risk of hospital admissions to the extensive range of support services that exist across the voluntary and community sector. Carers are an essential part of the journey of the person approaching the end of life and NHS Erewash CCG recognises that they need support throughout. In Erewash, 49% of people have been able to die in their preferred place, compared with a national average of 18%-35%, due to carers being supported more.

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New Macmillan GP Leads Appointed

Taking a step for health are from left to right: Foong Loo, David Martin, Gill Pullinger, Dr Kriss Owen, Jill Leatherland, Rebecca Hindson, Jackie Gray, Pat Campbell, Tony Rippon and John Stirland.

Patients take a step for health in Erewash

Patients in Erewash took a step for health in Erewash to encourage more local people to join their Patient Participation Group (PPG).


ocal people from all over Erewash gathered at Littlewick Medical Centre for a walk to raise awareness of the good work that PPGs are doing in the area. PPGs in Erewash help to identify where improvements can be made for patients and acts as a ‘critical friend’ to ensure services, plans and activities respond to patients’ needs and priorities. They also provide practical support to GP practice teams, such as conducting patient surveys and organising health awareness events. Patient representatives of each of Erewash’s 12 GP practices meet quarterly as a PPG network with NHS Erewash Clinical Commissioning Group to receive updates on important decisions and seek patients’ views on proposals. Equally, the PPGs keep the CCG informed on local health issues in Erewash. Also, the network allows the PPGs to share good practice and describe the challenges they face. “We are encouraging our patients to join with us in helping to shape and improve health services by becoming a member of their local PPG,” says Pam Watson, Lay Member (Patient & Public Involvement) at NHS Erewash CCG.

“It’s important that patients are involved in decisions not just about their care, but in designing better care for others. PPGs also play a pivotal role in helping to improve communication, encouraging patients to take more responsibility for their health and providing practical support for others in the community.” Dr Simon Kelly, Senior Partner at the Old Station Surgery, Ilkeston adds: “I believe that the Patient Participation Group play a vital role in GP practice. We are lucky to have a dedicated team of volunteer patients working in the PPG, committed to improving the practice for our patients. I attend the monthly meeting held by the PPG and value all of their input. “ Anyone wishing to become a member of their PPG should talk to their GP practice manager or email [email protected] for more information. A Walking for Health group meets every Thursday at 10am at Littlewick Medical Centre for a short walk. Everyone is invited and each walk is tailored to people’s needs. Refreshments are provided after each walk.

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We are pleased to announce that we have two new Macmillan GP leads working with the CCG and with Macmillan. They both started in June this year - Jon Mead and Eleanor Farrands. Jon and Eleanor will be leading on the Cancer Pathway and End of Life Care, supporting both practices and the CCG, to make a real difference to patients across Erewash.

SAY HOW TO HAVE YOUR With this newsletter we want to share important information, exciting news, innovative developments and powerful learning. So, if you have something to contribute or anything you need others to know about, please send it to us for inclusion in the next newsletter! We hope you continue to find this newsletter useful, informative and engaging. If you want to contribute to the newsletter or to tell us what you think of it, please email us at: [email protected] and put ‘Newsletter’ in the subject line. Next edition: to be published in October. Submissions for content need to be received by 25 September.

NHS England’s 2015/16 Planning Guidance sets out an expectation around introducing Personal Health Budgets [PHBs] beyond Continuing Health Care.


Local offer for personal health budg £ ts

s part of this, Clinical Commissioning Groups will put forward a local offer based on local health need that takes into account lessons learned from the 2011 PHB pilot sites. NHS England have stated their ambition for PHB uptake for the next 3-5 years will be approximately 0.1 - 0.2% of the population. For NHS Erewash CCG this equates to between 96 and 192 patients. For year one (2015/16), whilst processes are developed and established, NHS Our CCG is Erewash CCG has an working in partnership ambition to ensure with colleagues... that 5 Personal Health to guarantee an Budgets are created. This will be scaled up integrated and joined over subsequent years up approach in order to meet the NHS England guidance. Our CCG’s local offer will initially focus on individuals accessing mental health and / or learning disabilities services. This is because evidence shows that Personal Health Budgets in these areas achieve greater outcomes in terms of improving health and wellbeing. However, Personal Health Budgets will also be available for those individuals with a long term condition(s) who believe they will benefit. This local offer will be included within our Health and Wellbeing Strategy. NHS Erewash CCG’s work around PHBs is part of the wider personalisation agenda that focuses on ensuring that healthcare is truly person centred. A significant part of this plan involves developing our workforce and plans are in place to implement a programme “A Shared Language for Person Centred Approaches” that will be delivered to multi-disciplinary staff groups across health, social care and the voluntary sector. 10

It is intended this workforce development approach will enhance and embed what is already happening around person centred care within the community. This will ensure a shared language and understanding is adopted empowering individuals to be placed at the centre of their healthcare. Our CCG is working in partnership with colleagues across the health and social care community to guarantee an integrated and joined up approach is adopted for joint social / healthcare and, where relevant for children, educational support. Support provided by Think Local Act Personal [TLAP], a national partnership committed to transforming health and social care through personalisation and community-based support, is offering their support and expertise to Derbyshire based Clinical Commissioning Groups and Local Authorities, supporting us to develop Personal Budgets for a small group of children / young adults [aged 14 – 25] with complex needs. This programme will offer support in the Care Planning process for these individuals and their families to move towards accessing a Personal Health Budget offering them greater choice and control over their care. Evidence exists to support the success of Personal Health Budgets for children and young adults as shown in the following link uk/Regions/london/resources/ overview/?cid=10553 More details regarding Personal Health Budgets can be accessed via the NHS Choices website below or you can contact Joanne Goodison, Commissioning Manager – Personal Health Budgets on 01332 868727, Mobile 07795 887851 or e-mail [email protected] NHS Choices - choiceintheNHS/Yourchoices/ personal-health-budgets/Pages/ about-personal-health-budgets. aspx

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I Support Group for people with lung conditions in Erewash


atients with lung conditions are being urged by health leaders at our CCG to benefit from the expert help and support on offer from a Breathe Easy Group in Ilkeston which meets every month at Nottingham Road Methodist Church. ‘Breathe Easy Ilkeston meets on the 3rd Wednesday of every month,” says Darren Bailey, Breathe Easy Group Member. “Many have made new friends and been able to live their lives in a better way with the help and support they have received. Health care professionals attend the group each month so there’s always someone on hand if you need to have a chat.” Breathe Easy Groups are the British Lung Foundation’s network of support groups offering support and information to anyone affected by lung disease including family members, partners and friends of those with a respiratory illness. Breathe Easy Ilkeston is supported by our CCG and the British Lung Foundation (BLF). Breathe Easy Groups are a community of friends who understand what it’s like to live with a lung condition, bringing together families, friends and carers. The groups are for people with all types of breathing problems, whether caused by asthma, chronic obstructive pulmonary disease (COPD), lung cancer, or any other lung condition.

Most sessions are supported by specialist respiratory nurses. “Breathe Easy Groups are helping members to have a better quality of life by developing their understanding of their condition and strong friendships where they support one another and share our experiences,” said Dr Avi Bhatia, our Chair. “These groups are vital in helping members to continue living a healthy lifestyle and to better understand how we can self-manage our condition. Breathe Easy meetings are free of charge, anyone who has a lung condition is welcome to join, we also encourage friends and family members to come to the meeting because we believe that the support they provide is invaluable.” “Breathe Easy groups offer a wealth of support and information to anyone affected by lung disease,” adds Emma Percy, Project Development Officer for the British Lung Foundation. “We’d like to encourage anyone affected by lung disease including family members and carers to come along to Breathe Easy Ilkeston to find out more about the support that is available.’’ For more information about local Breathe Easy groups, please contact the British Lung Foundation on 03000 030 555 or [email protected]

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t’s now 10 years since electronic prescribing first began, enabling prescription details to be transmitted directly from the doctor’s surgery to the pharmacy where the medicine will be dispensed. The system is designed to improve efficiency and enhance patient safety by reducing any risk from misreading written instructions. Around half of Derbyshire’s GP practices are currently using the Electronic Prescription Service (EPS). But with more are signing up every week, 100% coverage could be less than a year away. The expansion of EPS is welcomed by Derbyshire Local Pharmaceutical Committee, which represents more than 200 pharmacy contractors in the county. LPC chairman John Sargeant said: “EPS does ease the workload for both pharmacists and surgeries by avoiding the need to physically collect prescriptions. Patients also nominate a specific pharmacy to dispense their medicines, which helps with building relationships.” After a practice registers for EPS, deployment takes eight weeks. The nearest pharmacies are notified, and then pharmacists and GPs are encouraged to work together to ensure the change goes smoothly. This includes the need to train staff in how EPS works. For a quirky assessment of EPS, read John Sargeant’s blog here.


Joined Up Care South Derbyshire

Working in partnership, all NHS and care organisations in the South Derbyshire Unit of Planning – the area covered by Erewash and Southern Derbyshire CCGs – are planning changes to the way in which local services are provided to make them fit for the future.


he overall vision is to ensure patients can plan their care with health, social care and other services which work together to understand their needs and the needs of their carer and achieve the outcomes important to them. This evolution towards our vision of Joined Up Care is only achievable through organisations working in partnership with each other and with local people. We must transform local services in the face of significant demographic and financial challenge but recognise that together we are stronger and more resilient than we are when working alone.

➤➤ An unprecedented financial challenge. So the health and care community in south Derbyshire will look to change the way services are delivered and work together in the future, meaning people have better access to services when they need them, have a better experience of the service when it is being used and have a better outcome from the care they receive.

Background The UK is regarded as having one of the most envied welfare systems in the world, where the whole population funds health and social care for everyone, with support from voluntary and other sectors in delivering services. But the current system of services is under strain due to a number of factors, including: ➤➤ An increasingly elderly population - people are living longer and have more complex health and care needs ➤➤ The changing needs and desires of the population - demand for quick access for increasing complex care and for care ‘close to home’ ➤➤ Skills shortages and recruitment challenges among some staff groups ➤➤ Services being provided from some buildings which are old and undesirable for the provision of modern day health and care 12

Our strategy already shows that we need to move more care from specialist, hospitalbased services to a model where more care is provided in the community The challenge is simple: if things stay as they are, access to quality services will continue to become more difficult, the quality of services could suffer and by 2019 there will be £150million deficit per year between the cost of local health services and the money available. This figure does not include deficits in funding for social care and the voluntary sector. It is both an important and exciting time for local health and care services to rise to the challenge.

What will change? Our strategy already shows that we need to move more care from specialist, hospital-based services to a model where more care is provided in the community and patients are empowered to take greater care of themselves. Our Joined Up Care approach will support this evolution and over the last few months has identified four transformation areas where local services feel changes must be made to meet the challenge: ➤➤ Redesigning community services to support more people outside of hospital ➤➤ Transforming general practice to ensure it can manage growing demand ➤➤ Improving care and support for people - and their families and carers – at the end of their life ➤➤ Ensure services work better together to make sure people only spend time in hospital when that is necessary and that people can more easily move between services without duplication. To ensure progress is made in making these changes, health and care professionals have formed ‘delivery groups’ dedicated to making the outcomes of each priority area happen.

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Chaired and sponsored by a local clinician and Chief Officer/Executive, the groups are in the process of forming their work plans for the

coming year and it is expected that these will be in place shortly. The delivery groups are:

Delivery Group

Delivery Group Board Sponsor

Delivery Group Clinical Chair

Urgent Care

Andy Layzell Chief Officer, Southern Derbyshire CCG

Dr Paul Wood GP Locality Lead, Southern Derbyshire CCG

Elective Care

Sue James Chief Executive, Derby Hospitals Teaching Foundation Trust

Arthur Stephen Consultant Orthopaedic Surgeon/Divisional Medical Director, Derby Teaching Hospitals Foundation Trust

Community Support (Southern Derbyshire)

Tracy Allen Chief Executive, Derbyshire Community Health Services NHS Foundation Trust

Dr Ian Lawrence GP Locality Lead, Southern Derbyshire CCG

Out of Hospital Care (Erewash)

Rakesh Marwaha Chief Officer, Erewash CCG

Dr Duncan Gooch GP, Erewash CCG

Children’s Services

Steve Trenchard Chief Executive, Derbyshire Healthcare Foundation Trust

Dr Andrew Mott GP Locality Lead, Southern Derbyshire CCG

Mental Health

Steve Trenchard Chief Executive, Derbyshire Healthcare Foundation Trust

Steve Trenchard Chief Executive, Derbyshire Healthcare Foundation Trust

The Delivery Groups are in the process of outlining the work programmes for the coming year and we already know that proposals will be developed in co-creation with service users and staff and we will start this engagement work shortly. Meanwhile, work will commence to begin to help local stakeholders understand the challenge facing

local services and to outline the way in which health and care organisations are coming together to meet these challenges. We will continue to keep you updated as the programme progresses and it will be critical to seek your involvement and support as the delivery groups get into their work programmes.

OUR REPUTATION DEPENDS ON GOOD GOVERNANCE Our Governance Team works behind the scenes and alongside colleagues to ensure that we not only comply with a myriad of legislation and regulations but also promote best practice. Working within Health it is important that we demonstrate compliance with information governance and satisfy the requirements of the Information Governance Toolkit (IGTK). You will be delighted to know that Erewash CCG has submitted a positive response for this year’s IGTK with a higher score than in previous years which reflects all the hard work done by everyone associated with the CCG. Other work that underpins Governance includes: ➤➤ Maintaining the Conflict of Interest Register – this ensures transparency in how the CCG conducts its business and requires all those members of staff and other health professionals involved in decision making to declare anything that could be interpreted being in the own interest of the person concerned. This could include Directorships with organisations bidding for work through to partners or family members working for an organisation the CCG could potentially do business with. ➤➤ Ensuring all gifts and hospitality that are connected to working for the CCG are declared. Again this ensures transparency and reduces the possibility that individuals can be accused of being influenced in decision making by limiting the type and monetary value to a minimal amount. ➤➤ Ensuring that all decision making bodies within the CCG are informed and are fully involved in decision making around Governance issues. This ensures that Governance is “embedded” within all aspects of the CCG’s work. > Continued on page 14

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> Continued from page 13 ➤➤ Working closely with colleagues from around the County and the Clinical Support Unit to develop and further refine Governance issues. This includes the development of policy, procedure and good practice relating to Information Governance for example through the work of the Information Governance Committee and Working Party. ➤➤ Feeding in Governance issues into the development of other policies and procedures. This includes Human Resource policies which directly impact on all those employed by the CCG. ➤➤ Maintaining the Board Assurance Framework (BAF) and Risk Registers. This ensures that the highest level risks are kept at the fore and discussed and acted upon to reduce the risk to the organisation, partners and patients / public. The lower level risks are included on the Directorate Risk Registers which are regularly reviewed and reported on to Committees of the CCG. ➤➤ Coordinating and where necessary investigating relevant incidents. This ensures that even the lowest level incidents are investigated, primarily with the spirit of “learning the lessons” and recommending actions to minimise or prevent a reoccurrence in the future. (Incidents can be reported simply by using the icon on your desktop. If you do not have an icon installed please contact any member of the Governance Team). ➤➤ Working alongside Security Management and Fraud Specialists to further develop controls in place to protect staff and other “assets” that belong to the NHS. ➤➤ Being the lead for Health and Safety matters. This includes servicing the Health & Safety 14

Committee and ensuring that safe systems of work are in place for all staff and visitors. Legislation drives much of the work, however, the CCG is keen to apply standards over and above those requirements. ➤➤ Working with NHS England and other CCG’s in respect of Emergency Planning. This helps to maintain continuity of service within the county and surrounding districts in the event of an emergency. This could range from a natural disaster (flooding, severe weather) through to pandemic flu for example. The CCG have recently been involved with real time exercises to test the resilience of a coordinated multi-agency response on a number of key issues which have identified learning points to strengthen any future emergency situation. ➤➤ Developing Business Continuity Plans for the CCG. This is to ensure that there is a streamlined, effective and easily applied process to follow in the event that the CCG cannot function as normal including a recovery plan to get back to normal. An example of this is loss of the building and the contingencies that are in place to maintain continuity for key services. (Identifying alternative locations / methods of work are just a couple of examples). Future newsletters will include articles of interest on some of the key work we do, however, in the meantime thanks to all staff for their hard work that ensures that we continue to keep governance at the heart of all our business. For further information please contact: Falu Bharmal – Assistant Chief Officer and Corporate Director (SIRO), Richard Heaton – Head of Governance (Deputy SIRO) or Ian Barlow – Governance Officer.

Key Contacts Dr. Avi Bhatia    CCG Clinical Chair and Leader of the CCG 0115 931 6100 [email protected]

Rakesh Marwaha Chief Officer 0115 931 6100 [email protected] Falu Bharmal Assistant Chief Officer and Corporate Director, responsible for Governance and Procurement. 0115 931 6100 [email protected]  Anne-Maria Olphert   Chief Nurse and Director of Quality, now also responsible for Primary Care. 0115 931 6100 [email protected] Charlotte Allen-Neale Chief Finance Officer, now also responsible for contracting and performance. 0115 931 6100 [email protected] Helen Rose   MCP Vanguard Programme Lead 0115 931 6100 [email protected] Lynn Wilmott-Shepherd   Director of Transformation (South Derbyshire) 0115 931 6100 [email protected]          


Did you know?

NHS Erewash CCG represents 12 GP practices. We act on behalf of 96,000 patients in Ilkeston, Long Eaton and the surrounding villages.

If you would like to be added to the electronic distribution list for the newsletter please email us at [email protected]

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