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East Surrey
Clinical Commissioning Group
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Contents
Who are we? ... 4
Our vision ... 6
Health needs of our population ... 7
Commissioning ... 8
Joined up working ... 9
Money ... 10
Getting involved and having your say ... 11
Creating our prospectus
This is a short guide to the Clinical Commissioning Group, what we are about, our key health
priorities and the ambitions we have to improve health services for our local population.
We have shaped the content of this prospectus to reflect the information needs of local people,
while taking into account the national guiding principles.
This document has been tested with our Patient Reference Group (PRG) at their June meeting,
and with the CCG’s Governing Body members, and has been amended as a result of their
comments.
The PRG comments have been positive, feedback includes commendation for “its straightforward
language and intent”.
We are committed to openness and transparency. We want information about the CCG and its
work to be accessible and readily available. Therefore, we have also sought feedback from our
PRG on the appropriate distribution of this document.
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Welcome
East Surrey Clinical Commissioning Group is a new organisation, committed to planning and buying high quality patient services which delivers the right healthcare, at the right time, by the right healthcare professional, in the right environment.
We are a GP-led organisation. We are using our local knowledge as GPs to shape health and care services that are responsive to the needs of our community, ensuring that they are the highest quality and best value for public money and to improve the health and wellbeing of our local population.
We know that we face significant challenges. Yet we have a unique opportunity to modernise, transform and secure the future of NHS services, while improving the health of people in East Surrey.
Our patients tell us they want to see as many services as possible transferred away from a hospital environment and nearer to patients’ homes when clinically appropriate, and that they want our local hospital to become a centre of excellence.
There is much to do but working with GPs firmly in the driving seat and by putting the patient at the heart of all that we do, we believe we will achieve these ambitions.
We believe that the ‘NHS belongs to us all’ and by working in partnership with an unrelenting focus on quality, integration, patient engagement and tackling health inequalities, we have a real opportunity to make a difference.
We trust and hope that you will join with us on this ambitious journey, working together to make the local NHS something we can be proud of.
Dr Joe McGilligan Chair
Mark Bounds Chief Officer
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Who are we?
From 1 April 2013 East Surrey Clinical Commissioning Group (CCG) took over responsibility for planning and buying hospital, community and mental health services across the boroughs of Tandridge, Redhill, Reigate and Horley.
The changes were a result of Government reforms which created Clinical Commissioning Groups to replace Primary Care Trusts. The aim was to improve the NHS by putting local GPs in charge so they can use their first hand knowledge to tailor services for their area.
In addition, NHS England took over the commissioning of primary care services, such as GPs, dentists, community pharmacists and optometrists; and specialised services including renal, specialist women’s and children’s care and cardiac surgery. Surrey County Council is now responsible for public health.
At East Surrey CCG, we will build on the established strengths of general practice to ensure patients are at the heart of what we do; commissioning high quality and safe health services whilst making best use of our available resources.
What makes us different?
We are a GP-led organisation with a much more local focus. This means that we can really get to know our patients and be more responsive to local needs while ensuring that we are spending your money wisely. The patient voice is a key part of this and we are working hard to ensure that local people can be involved and have their say when we make decisions about health services in East Surrey.
Our GP member practices
We are a membership organisation made up of 18 local GP practices (with one branch surgery). Our member practices are:
Birchwood Medical Practice (Horley) South Park Medical Centre (Reigate) Caterham Valley Medical Practice (Caterham) The Hawthorns Surgery (Redhill) Elizabeth House Medical Practice (Warlingham) The Moat House Surgery (Merstham) Greystone House Surgery (Redhill) The Wall House Surgery (Reigate) Holmhurst Medical Centre (Redhill) Townhill Medical Practice (Caterham)
Lingfield Surgery (Lingfield) Warlingham Green Medical Practice (Warlingham) and Chaldon Road Surgery (Caterham)
Oxted Health Centre (Oxted) Wayside Surgery (Horley)
Pond Tail Surgery (Godstone) Whyteleafe Surgery (Whyteleafe) Smallfield Surgery (Smallfield) Woodlands Surgery (Redhill)
The CCG is accountable to its member practices, acting on their behalf to commission health services in East Surrey.
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Our Governing Body
The Governing Body oversees the work of the CCG by both seeking and providing assurance that the CCG is properly fulfilling its duties, meeting its objectives, and appropriately managing any key risks. It comprises a GP Chair and 5 GP members, Practice Manager, a Chief Officer, a Chief Financial Officer, a Board nurse, secondary care consultant and 3 lay members with experience in governance and patient and public involvement.
Our key partners
It is vital that we work closely with other NHS organisations and key partners, listening to what they have to say about the services we commission. Key partners include:
Crawley Clinical Commissioning Group
Horsham and Mid Sussex Clinical Commissioning Group Surrey Downs Clinical Commissioning Group
Surrey Clinical Commissioning Group collaborative (six CCGs across Surrey) Surrey and Sussex Healthcare NHS Trust
Surrey County Council
First Community Health and Care Voluntary and third sector organisations HealthWatch Surrey
Chair Dr Joe McGilligan GP members Dr Elango Vijaykumar
Dr Heidi Fahy Dr Jill Rasmussen Dr David Hill Dr Patrick Kerr Practice Manager Sue Latham Chief Officer Mark Bounds Director of Finance and
Corporate Services
Alison Skinner Board Nurse Camilla Wiley Secondary Care Doctor Mike Baxter Lay members Graham Hanson
Lay Member for Governance Dr Chris Burgess
Lay Member Patient and Public Involvement Vacant
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Our vision
We believe in the NHS and want to secure its future by shaping services locally that are responsive to the needs of our community and are affordable.
That is why our vision is:
“Shaping healthcare together”
CCGs are very different organisations to what was before and are constituted as membership organisations. Therefore, our decision making is truly GP led, and by virtue, patients and improving patient outcomes is at the heart of all that we do.
Every referral or prescription a GP makes is a commissioning act. It spends the public pound and so encouraging GPs to get the best outcomes from their decisions and be responsible and accountable for that spend – patients will benefit.
We commission to meet the health needs of local people, by covering a smaller geography we can be much more local in our approach and attune to the needs of our patients.
We can also listen more to local patients and people. We have good engagement via our practice patient participation groups and patient reference group, and we are looking at other more innovative ways to engage and respond to our local population and their healthcare needs.
Our key priorities are:
To improve commissioning of effective, safe and sustainable services, which deliver the best possible outcomes, based upon best available evidence
To increase life expectancy and reduce inequalities To encourage healthier lifestyles
To support vulnerable people
Deliver CCG functions effectively, efficiently and economically in accordance with generally accepted principles of good governance and as an employer of choice.
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Health needs of our population
We commission healthcare for 170,000 people in the boroughs of Tandridge, Redhill, Reigate and Horley. East Surrey is a relatively affluent area with small pockets of deprivation. In general, people are healthier than the national average.
East Surrey has a higher proportion of older people compared with England with more than 28,000 people aged 65 plus or 16.2% of the population. Life expectancy for both men and women is higher than the national average, although this varies in different parts of East Surrey. For example, in the most deprived areas of Reigate and Banstead, life expectancy for men is 7.4 years lower than in more affluent areas. Over the last ten years, death rates have fallen. The numbers of early deaths from cancer, heart disease and stroke have fallen and are better than the national average. Childhood obesity varies across the area with approximately 13.9% of year six children in the Tandridge area classified as obese and approximately 15.4% in the Reigate and Banstead area. Estimated levels of adults smoking and levels of physical activity are generally better than average. Rates of sexually transmitted infections, smoking related deaths and hospital stays for alcohol related harm are better than the England average.
Health improvements
Although we have a relatively healthy population compared to the England average, we are working hard to address the health needs of our population and to reduce health inequalities. Here are the ways we are aspiring to meet our priorities:
Increasing life expectancy and reducing health inequalities
Reducing early death from cardiovascular diseases by further improving the prevention, management and treatment of cardio vascular disease in primary care and community care
Reducing early death from cancer
Meeting the needs of the ageing population, specifically around mental health, dementia services and frail elderly pathways
Addressing long term conditions management and treatments, specially around chronic obstructive pulmonary disease and diabetes
Improving life chances for young people and reducing the number of teenage pregnancies
Encouraging healthier lifestyles
Addressing obesity rates in adults and children
Reducing the number of alcohol related admissions in both adults and children
Improving access to information regarding lifestyle advice and good nutrition ensuring services are delivered through front line staff
Reducing smoking attributable hospital admissions and deaths by smoking intervention programmes
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Commissioning
We are responsible for the planning and buying of healthcare from hospital, community and mental health services across East Surrey. We commission services from a number of providers including:
East Surrey Hospital – Surrey and Sussex Healthcare NHS Trust
Ambulance services – South East Coast Ambulance NHS Foundation Trust
Specialist mental health, drug, alcohol and learning disability services – Surrey and Borders Partnership NHS Foundation Trust
Community healthcare services (including Caterham Dene Hospital) – First Community Health and Care
East Surrey Clinical Commissioning Group is the lead commissioner for Surrey for the new non-emergency NHS helpline, 111 provided by South East Coast Ambulance NHS Foundation Trust in partnership with Harmoni.
Quality
Quality and patient safety is paramount. This is reinforced by the Francis report and its recommendations to the NHS. As a GP-led organisation we bring a relentless focus on quality. Our clinicians’ frontline contact enables their view to be shaped by patients’ real experiences, identifying areas for improvement and ensuring that the services we commission meet our patients’ needs.
We look for continuous improvement in the standards of care we commission. We closely monitor quality and performance indicators and patient experience. Where providers might fall below the standards we expect for our patients, we hold them to account, ensuring thorough and detailed investigations are done and lessons learnt are properly shared and embedded.
Our Director of Nursing and Quality takes the lead in this area; having regular contract and quality review meetings with our providers, and undertakes a programme of clinical visits. Our Governing Body oversees this process via our Quality, Finance and Delivery Committee.
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Joined up working
We believe that greater integrated working across our local health economy plays an integral part in building a sustainable future. We want our local hospital to become a centre of excellence and where possible we are working closely with neighbouring CCGs when looking at the provision of services. Where appropriate we want to see as many services as possible transferred away from the hospital environment and nearer to peoples’ homes. Joining up health and social care will help make this happen – by supporting people to live independently in the community for as long as possible while ensuring that they have access to community care to reduce unplanned admissions to hospital. As a result we believe that public money will be better spent and result in measurable improvements in healthcare for our patients.
Health and Wellbeing
Surrey’s Health and Wellbeing Board is where key leaders from the health and care system work together to improve the health and wellbeing of their local population and reduce health inequalities. Our Chair, Dr Joe McGilligan, is Co-Chair of the Surrey Health and Wellbeing Board.
We are working hard to support the priorities of the Surrey Health and Wellbeing Board and take these into consideration when planning health services for our community. Their priorities are:
Improving children’s health and wellbeing
Preventing ill-health and promoting wellness (a preventative approach) Promoting emotional wellbeing and mental health
Improving older adult’s health and wellbeing
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Money
For 2013-14 we have an allocated budget of £192.366m to buy healthcare from local hospitals, community services, social care, ambulance services, mental health care and many other services for local people. The pie chart below shows how the budget is spent across the various parts of the health system.
*i.e. drugs, local enhanced services, medicines management, out of hours, 111, PTS, oxygen, projects and NHS Property Services recharge
The financial challenge
East Surrey is one of six CCGs established across Surrey, taking on the role and responsibilities for commissioning healthcare from the former Surrey Primary Care Trust. The PCT faced significant financial challenges over its lifetime as a result of increasing demand for healthcare and the rising costs of treatment and drugs. These challenges remain.
In addition, East Surrey CCG sits in the health economy focused on Surrey and Sussex Healthcare NHS Trust. They have been a challenged trust with the NHS Trust Development Authority.
Living within our budget will require all parts of the health and social care system to play a part. Our patients tell us they want as many services as possible transferred away from a hospital environment and nearer to patients’ homes when clinically appropriate, and that they want our local hospital to become a centre of excellence. It is vital that we work closely with our GP members, neighbouring CCGs, acute trust and social care to make this a reality and transform the way healthcare is provided. Our aim is to create an affordable and sustainable health economy that best meet the needs of our local populations and improves outcomes. Acute Commissioning £109.7m (56%) Community Healthcare Commissioning £16.6m (8%) Continuing & Funded
Nursing Care £19.2m (10%) Mental Health Commissioning £13.5m (7%) Other * £5.5m (3%) Prescribing £22.0m (11%)
Contingency and Reserves (statutory requirement)
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Getting involved
Improving health and health services locally requires us to understand and act on what really matters to you. There are a number of ways that our patients and members of the public can get involved to help improve local health services. Your feedback, thoughts and ideas really can make a difference.
Making your experience count
If you’ve had a good experience or if something has gone wrong we’d like to hear your feedback. We are always on the lookout for improvements that would make a real difference to patients, based on your experiences. Contact Carol Rowley with feedback:
NHS East Surrey CCG The Officers’ Mess Coldstream Road Caterham Surrey CR3 5QX Tel: 01883 333033 or 07827253111 Email: carol.rowley@eastsurreyccg.nhs.uk
Practice patient participation groups
Most of our GP member practices have a Patient Participation Group (PPG). These groups support the practice - giving thoughts, ideas and opinions, helping with specific pieces of work that call for a patient perspective, and acting as a communicator between the practice and their community.
The Chair of the PRG is a member of the CCG Governing Body to help ensure patients views are represented throughout the CCG.
To find out more about your practice’s PPG check out their website or speak to your Practice Manager
East Surrey CCG Patient Reference Group
The Patient Reference Group (PRG) helps us make decisions about the services we commission and to ensure that these services meet the health needs of the local population. Membership is drawn from the Patient Participation Groups of the East Surrey GP practices.
To find out more about the Patient Reference Group visit www.eastsurreyccg.nhs.uk contact Carol Rowley on the details above, or get in touch with your practice’s PPG.
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NHS East Surrey
Clinical Commissioning Group
The Officers' Mess Coldstream Road Caterham Surrey CR3 5QX 01883 333033 www.eastsurreyccg.nhs.uk
