Agenda item

To receive a progress update on the work of the Bracknell and Ascot CCG, including co-commissioning and joint working with other CCGs.

Ms Slevin-Brown, Director of Strategy and Operations from the Bracknell & Ascot Clinical Commissioning Group (CCG) and Dr Kittel, Board Director CCG, attended the meeting and gave an update on the work of the CCG. The presentation covered the following areas:

·         Significant developments over the past year

·         Nine ‘must dos’ for 2017-19

·         Plan on a page

·         The Operating Plan linking to local priorities

·         Examples of future developments

·         Working collaboratively

·         Primary Care Co-commissioning

·         Delegation

Dr Kittel made the following points:

·         The CCG were passionate about self care and they were the only CCG locally to have a work stream dedicated to self care. There had been a lot of activity around self care which included Self Care week and a range of free activities and services that could be accessed around the local area. The CCG had supported a range of work delivered by the Public Health team. Self Care week had been hugely successful with over 2000 instances of contact from the public.

·         They were the only CCG locally to offer a Musculoskeletal service which was delivered from Brants Bridge, however this service was proving very costly and so would need to be looked at again.

·         The total hip and knee replacement avoidance specialist physiotherapist service was proving successful and introduced a complete non surgical approach as well as savings for the CCG in the longer term. There had been a reduction in the number of hip and knee operations as a result of this work. The Panel were impressed with the reduction in the waiting list for operations in this area.

·         Healthmakers were working successfully to improve resilience in the community.

·         The CCG had attempted to improve referral rates for respiratory conditions but that the referral rate had not increased significantly despite lots of messages to encourage referrals being put out by the CCG.

·         In response to Members queries, Dr Kittel reported that the CCG based its provision around NICE guidelines and their published list of restricted services. For example, the CCG no longer offered the removal of skin lesions for cosmetic purposes.

Ms Slevin-Brown made the following points:

·         The CCG were currently awaiting feedback from NHS England on their Operating Plan, it was hoped that a finalised version of this Plan could be produced by 8 February.

·         There was a huge project to connect primary care records with other partners underway and it was hoped that by the autumn the results of this work would be seen and improve patient care.

·         Cancer was very important locally, particularly bowel and breast cancers where survival rates and take up of screening were not as good as national figures. It was hoped that the age of screening would be reduced to the age of 50 nationally to improve survival rates of these cancers. There were currently too many late presentations of breast cancer in the CCG area.

·         Hypertension was not being picked up early enough, this was in the CCG’s Operating Plan for this year.

·         Work was also underway to repatriate more services locally from London.

The Panel made the following points:

·         The Consultant in Public Health reported that there was a good whole system approach to young people and mental health. She also stated that the ‘stop before you op’ project was working positively to encourage people to take greater responsibility for their health.

·         Members reported that two London boroughs were now withholding services from people who were obese or smokers and this was likely to become more widely undertaken in the future as pressures on budgets continued and populations grew.

·         Dr Kittel reported that given the larger STP footprint, attempts were being made to work more closely with the CCGs in neighbouring boroughs such as the Royal Borough of Windsor & Maidenhead and Slough.

·         Dr Kittel reported that the CCG had recently participated in away days with the aim of bringing teams together, as unless morale was high, the significant changes required for the future could not be achieved. This was a difficult balancing act as it meant that clinical time was lost.

·         Ms Slevin-Brown reported that the CCG would also be working with Farnham, Surrey Heath and Frimely Park, this would ensure that population focus was maintained. It would also allow a collaborative approach to tackle problems faced by the whole area and to make the best use of resources.

·         In response to Members queries around joint funding and the difficulties around this, Ms Slevin-Brown reported that each organisation was statutorily separate and would have an individual budget which was intended to be spent on behalf of their local population. Dr Kittel assured the Panel that the CCG would be working hard to ensure that budgets were maintained locally and not lost to other areas. Ms Slevin-Brown added that this collaborative way of working also allowed the opportunity to negotiate contracts with big providers such as Frimley Health Trust. Negotiating on behalf of three CCG’s would bring advantages.

·         Dr Kittel reported that most GP practices were now available throughout the daytime.

·         CCG agreed to comment on any concerns arising from the reported delays in patients being attended to at Accident and Emergency.