Helping you keep well Patient Prospectus – 2013/14
On April 1st 2013, Doncaster Clinical Commissioning Group (CCG) became responsible for organising and paying for the health services used by over 300,000 people who are registered with a GP practice based in the borough of Doncaster. Clinical commissioning groups like ours are the new face of the local NHS. They are ‘clinically led’, which in simple terms means our aims and priorities are set by GPs – the family doctors who practise in your local surgery – supported by lay members, NHS managers and other health professionals. April 1 2013 marked a major change in the way the NHS operates. It placed doctors and nurses at the heart of the local NHS. They have been given the responsibility and freedom to make decisions about the care and services provided for their local communities. They will ensure that health services are designed around patients and where they live. Doncaster’s GPs are now in the driving seat, committed to working with patients and residents to bring about changes where they are needed but also to supporting those services that are working well. Doncaster has many areas with high rates of poverty and a lot of poorly people. The Borough is worse than the average across the country when it comes to the number of people who die from health problems like heart disease, stroke and cancer. We are determined to have more people diagnosed earlier, so they have a better chance of getting the treatment they need to survive these potentially killer diseases. We have set ourselves a number of healthcare improvement ‘goals’, which are explained on pages 4 and 5. Some will be evolutionary by seeking different, more efficient ways of providing care. Others will be more revolutionary, where we look at major ways of transforming services and providing them in different ways and, in some cases, in different settings. We want to provide more care closer to where you live where it is safe and
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possible to do so. For example, we’re currently looking at how children’s services, like autism, can be brought out of hospitals and made available in local communities. But equally, some services - like the urgent treatment people need after having a heart attack - have to be provided at specialist centres operating across a bigger geographical area, simply because it is safer to do so. Crucial to making those changes will be an effective on-going conversation with Doncaster people. We are committed to having open, honest discussions about the challenges we face in managing the local NHS budget in this tough economic climate. We want to involve you, so you can understand the background to the sometimes tough decisions we have to make. This document is intended to give a brief summary of our plans and ambitions for the future. We intend to add to the information contained in here with additional regular updates as we take forward our plans to improve the health of the people of Doncaster.
How we are organised
Doncaster CCG operates across the same geographical area as Doncaster Council and the Council is one of our key local partners. The CCG is a membership organisation and our members are the 44 GP practices based within the borough of Doncaster. They help to determine the priorities of the organisation, using their expertise and local knowledge to influence how, where and when services are provided. To make it easier to involve local GPs, each of the 44 practices has been placed into one of five geographical ‘localities’ in Doncaster. Each locality has elected two GPs to represent them on our Governing Body, which meets monthly in public to make important decisions. The organisation is led by Chair, who is also a GP and has been appointed following an election involving all the GPs in Doncaster.
Map
GP Practices Central locality North-West locality North-East locality South-West locality South-East locality
Senior NHS managers, including a Chief Officer, are also members of the Governing Body, which meets on the third Thursday of the month at Sovereign House – details are on the back page. Members of the public and representatives of other organisations are welcome to attend. The agenda and papers for the meetings are placed on our website: www.doncasterccg.nhs.uk
Our budget for 2013/14 This financial year our budget of around £420 million will pay for a wide range of health services, from routine visits by local district nurses to complex surgery at local hospitals and some further afield. Our budget works out at roughly £1370 for every patient registered with one of our 44 GP practices. As GPs are major providers of healthcare, to avoid any conflict of interest the CCG does not have contracts with them to provide the routine services you receive from your local surgery. Those contracts are the responsibility of NHS England.
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The picture of health in Doncaster In the national league table of ‘haves’ and ‘have nots’, Doncaster sits near the bottom. It is the 41st most disadvantaged of the 345 boroughs in England and many of the health problems facing the local NHS today are directly linked to that stark statistic. The picture is even worse than that in some parts of the Borough. It’s believed that around 21 per cent of the Doncaster population live in areas that are considered to be amongst the 10 per cent most underprivileged in the country. Our most deprived communities are Askern, Carcroft, Clay Lane, Denaby Main, Highfields, Hyde Park, Mexborough, New Rossington, Stainforth, Toll Bar and Woodlands. There are considerable health issues locally: •W e have an ageing population. There are about 50,000 people aged over 64 living in the borough, but over the next 10 years this number will increase to over 60,000. An increasingly older population will result in more people with dementia and other mental health problems associated with old age. •A round 25 per cent of mums-to-be smoke during pregnancy •T he number of teenage girls who become pregnant is higher than in areas similar to ours •M ore people are diagnosed with lung cancer than in similar areas •T he number of people dying from alcohol related liver disease is rising faster in Doncaster than the rest of the country •T here are an estimated 3,000 problem drug users in the borough – around one per cent of the population •D eaths from chest disease are very high
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Some of these health problems fall within the responsibility of our public health colleagues, who are now employed by Doncaster Council. They continue to work with us to improve local health, in particular through our joint membership of the Doncaster Health and Wellbeing Board, which is taking a strategic ‘bird’s eye’ view of the Borough’s entire health and social care needs. From the CCG’s perspective, we have identified the following five areas as being our priority to make healthcare improvements for our patients: 1. Developing better unplanned care services for people who need the NHS at short notice. We intend to create better unplanned care services – these are the services you need at short notice when you have sudden health problem. We will do this in a number of ways, including promoting the new 111 telephone service; helping people with long-term health problems to manage their condition better; providing more specialist ‘assistive technology’ equipment in people’s homes to help them maintain their independence; and by seeing what we can learn from carrying out a review of Doncaster’s 8am to 8pm health centre. 2. Enhancing mental health and dementia services. Currently, over 3,800 Doncaster people have dementia and next year another 100 will join them. By 2020, there will be 20 per cent more people in Doncaster with dementia than there are now and the number of new people diagnosed with the disease is expected to reach around 1,350 a year. It’s going to place a massive amount of pressure on NHS services. We will ensure that more people will receive an early diagnosis of the disease and people with dementia, and their carers, will be supported to live well. We will also work with our partners to help make Doncaster a dementia friendly community.
3. Creating better children’s services. Doncaster’s children’s health services have historically been hospital based and this has made it difficult to develop similar services in our communities. We plan to change this by introducing community based paediatricians, clinics, nursing services, child health development centres and care programmes that easily move between community, hospital and specialist care settings. Services will be better joined up, with locally based teams formed around schools and GP practices. These teams will include health visitors, school nurses, social workers and family support services. Importantly, we will improve the way that patients move from children’s to adult services so they can progress from one to the other without problems. We will pay special attention to the needs of looked after children and those with a disability, mental health or long term health condition. 4. Improving the survival rates of people who have cancer. Every year 1,500 people are diagnosed with cancer in Doncaster. Death rates are higher than the national average and are not falling fast enough to close the gap between here and the rest of the country. More Doncaster people are being diagnosed with cancer and the length of time they survive following diagnosis is short compared to other parts of the country. This poor survival rate is influenced by the generally poorer state of health of Doncaster patients at
the time they are diagnosed, but also because the disease tends to be at a more advanced stage before it is identified. We will ensure that more patients get an earlier diagnosis of cancer. We will do this by making screening facilities easier to access and by raising awareness amongst patients of the early warning signs to look out, so they can make an appointment to discuss them with their GP. 5. Continuing healthcare and personalisation. Doncaster’s ageing population, coupled with the high number of local people who have long term health problems, means that many more people in the future will be dependent on on-going care to help them maintain their independence. The introduction of personalised health budgets is now enabling people with lasting health needs to assess the support they want and to then fund it from their personal health allowance. We will develop a better way of assessing and reviewing patients to ensure their applications are dealt with in a timely manner.
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How we will achieve this
Our financial plan
We have produced a document called a ‘Single Integrated Plan’ (SIP) that sets out how we will turn our vision for health services in Doncaster into reality over the next four years. You can download it from our website. It takes into account the challenges we face in having services that are affordable and sustainable in these tough financial times. What we know is that we cannot simply keep doing more of what we have always done. We have to transform the way some services are provided so we can make them more efficient, whilst still keeping them high quality and safe.
The Government has set the national NHS a target of reducing its costs by £20 billion without having any impact on patient care. Doncaster’s contribution to that figure is £16.5m of efficiency savings over three years, including £5 million in the current 2013/14 financial year and £4.5 million next year. We‘re making savings by becoming more efficient at how we look after people, including making hospital stays as short as possible and then providing more care at home, or closer to where people live. And we’re saving around £800,000 by cutting medicine waste and using ‘generic’ drugs, which are exactly the same as better known branded ones, but cost less.
The Plan has been developed by clinicians, who know local services inside out, with input from patients and members of the public. Its aims and objectives are in line with the priorities of the newly formed Doncaster Health and Wellbeing Board.
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Who’s who at Doncaster CCG Chair
Dr Nick Tupper
North East locality GP representatives
Dr Jeremy Bradley Dr Andrew Oakford
North West locality GP representatives
Dr Marco Pieri Dr Niki Seddon
Central locality GP representatives
Dr Anna Kirkman (covering Dr Sam Feeney’s maternity leave) Vacancy
South East locality GP representatives
Dr Pat Barbour Dr Ayesha Zafar
South West locality GP representatives
Dr Lindsey Britten Dr Gill Harding
Secondary care doctor
Dr Emyr Wyn Jones
Lay member (Governance)
Albert Schofield
Lay member (Patient engagement/ experience champion)
Anthea Morris
Chief Officer
Chris Stainforth
Deputy Chief Officer / Chief of Strategy and Delivery
Jackie Pederson
Chief Finance Officer
Hayley Tingle
Chief Nurse
Mary Shepherd
Chief of Corporate Services
Sarah Atkins Whatley
Our Vision We will work with others to invest in quality healthcare for Doncaster patients.
Our Values • The needs of patients are paramount •W e will drive forward continuous improvement •R elationships will be based on integrity and trust
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Our Governing Body meetings will held in public on the following dates, starting at 12.30pm in the Boardroom at the Sovereign House address below. The papers will be placed on our website: www.doncasterccg.nhs.uk ahead of the meeting. 2013 20 June 18 July 15 August 19 September 17 October 21 November 19 December 2014 16 January 20 February 20 March
Contact us or follow us NHS Doncaster Clinical Commissioning Group Sovereign House Ten Pound Walk Doncaster DN4 5DJ Tel: 01302 566300 Email: enquiries@doncasterccg.nhs.uk (general enquiries) Facebook: www.facebook.com/nhsdoncasterccg Twitter: @doncasterccg YouTube: NHS Doncaster CCG Chair’s blog: www.drnicktupper.com June 2013
Some images supplied by Doncaster Council
www.doncasterccg.nhs.uk