Agenda item

As part of the NHS England planning cycle, Clinical Commissioning Groups are required to submit improvement trajectories for a range of indicators. This paper outlines the indicators in question and NHS Hammersmith & Fulham CCG’s approach to setting improvement trajectories.

Philippa Jones introduced the strategic and operational planning report, which set out the improvement trajectories for a range of indicators, required from  CCGs as part of the NHS England (NHSE) planning cycle. In some cases, CCGs were asked to detail improvements over a two year period, whilst other indicators were linked to five year trajectories.

Some targets were nationally mandated, whilst others had been developed across the Central West, Hammersmith & Fulham, Hounslow and Ealing Collaborative of CCGs and some had been set locally by the CCG. CCGs had also been asked to identify one local priority for improvement in 2014/2015.

Achievement in some of the trajectories was linked to financial incentives as part of the CCG Quality Premium Fund, which could be invested in improving the quality of local health services. However, a number of targets would be difficult to influence in the short term.

The CCG had sought advice from Public Health in order to ensure the priorities were of an appropriate level of ambition and were supported by public health commissioning priorities. The trajectories and the approach taken to their development was outlined in the report.

An initial submission had been made to NHSE on 14 February 2014, and there was an opportunity for adjustments to be made to the plan before final submission on 4 April 2014.

Of the 2013/2014 targets, those in respect of the X-PERT programme for diabetes and physical health checks for people with severe and enduring mental illness exceeded, but the MMR year 2 first dose target of 87% had not been achieved. 

The local priority for 2014/2015 was proposed as health checks for people with learning disabilities. This was a three year target. The baseline was 54%. The target in year one was 60% and it was hoped to achieve 80% by 2016/2017.

Ms Jones and Dr Spencer responded to members’ queries.

In respect of the emergency admissions indicator, risk stratification was used to profile those people at high risk of unplanned hospital admission and to put in place care plans. Some practices were in their fourth year of using this approach, and there was reasonably strong evidence that this benefited residents by enabling them to remain independent at home. The target of 13% reduction in emergency admissions between 2014/2015 and 2018/2019 was demanding. The target had been derived from ‘Shaping a Healthier Future’ plans for hospital reconfiguration. The CCG also had strong plans in place for the development of Whole Systems Integrated Care to support this objective.

All GPs would be moved on to one IT system, and sharing of care plans with acute trusts and the community would be negotiated.

Ms Bruce stated that Adult Social Care fully supported this priority.

In respect of patient experience, the CCG considered that it had reached the easy to reach groups, and was looking for ways in which to engage with harder to reach groups and to encourage attendances. Bespoke training for practice nurses was being developed. 

The MMR target had not remained a priority. At the beginning of the year, 83% of patients registered with GPs had been achieved and this had temporarily increased to 85%. The CCG was considering other mechanisms for engaging with parents and the Council officers were asked to inform the CCG about any ways in which it could help.

Dr Peachey stated that there was a 95% immunisation target, and this was the responsibility of NHSE. The Local Authority role was to oversee the whole area of health protection.

It was confirmed that the target for potential years of life lost from causes considered amenable to healthcare, would contribute towards closing the health inequalities gap in areas such as coronary heart disease and cancer.

RESOLVED:

1.    The report be endorsed.

2.    An update report be brought to the next meeting.