Shaping Health Services Together Community Conference and Annual General Meeting (AGM)
Transcript
Shaping Health Services Together Community Conference and Annual General Meeting (AGM)
Contents
Holding slide
Slide 2
Welcome
Slide 3
Slide 4-5
Slide 6
Slide 7
Slide 8
Urgent and Emergency care
Slide 9
Slide 10 - Care Home Video
Slide 11
Meeting the Workforce Challenge
Slide 13
Slide 14
Slide 15 - Leyton six form college video
Working together GP Collaborative Model
Slide 16
Digital Health and Wellbeing
Slide 17
Slide 19 - GP online video
Changing Health – Diabetes
Slide 20 - 22
Slide 23 - 24
Slide 25 - 26
Slide 27 - 29
Slide 30
Digital Wellbeing
Slide 31 - 32
Slide 33
Slide 34
Slide 34 - 35
Slide 36
Slide 37
Roles for residents – Cancer screening
Slide 38
Roles for residents – Prevention, Public Health
Slide 39
Slide 40
Slide 41
Slide 42
Slide 43
Roles for residents – Medicines
Slide 44
Video – Medicines waste campaign
Development in Patient and Public Participation (PPP)
Slide 46
Slide 47
Slide 48
Slide 49
Video – Capturing the voice of children and young people
Involving children and young people with special educational needs and disabilities
Slide 51
Slide 52
Slide 53
Slide 54
Slide 55 - 56
Questions and answers session
Slide 57
Page 1
Shaping Health Services Together Community Conference and Annual General Meeting (AGM)
Holding slide
Slide 2
Richard Griffin:
This is a 5-minute warning. Unfortunately tonight the wi-fi isn't working, so if you try to sign on to the wi-fi it's just not working, we're trying to get it fixed, but I think that's going to be impossible. Grab some food and we'll start in five minutes.
Welcome Listen here
Slide 3
Dr Anwar Khan:
Good evening. I have already told you that we're late anyway, thank you for joining me. Great to see so many people. I'm Anwar Khan, the chair of Waltham Forest Institute. Before I start, a few housekeeping points. Fire exits are lit in green, and you go left and around the cenotaph. There are toilets round the back on the stairs, and also an accessible toilet.
Okay, each year our theme is about we can work together as a community practice, not just across the organisation, but as -- CCG healthcare service for the borough. This year, the theme has changed, and I hope as we go through the various presentations.
There will be a question and answer at the end, and so if you have a question please note them down and we'll do our best to answer them at the end of the session.
This year your speaker will make it more interactive, it's going to be a game in a way. You are all invited to play. It is really about the work going on in the workforce, because it's all very well having a vision, and just having people do the jobs, and it is along the lines of (inaudible) and you can play on your mobile phones or there is paper versions in your pack. Unfortunately, as you've heard, the wi-fi is not working.
We're also talking about the GP online booking system, and people say to me: "oh, you've disadvantaged the elderly." I'll just remind you, like a bird used to fly south to India, and there was a man sat on the computer, you know, didn't understand, but even they started to use Skype and the free phone calls.
Okay, we've also got the award winning Mental Health Act, started here in Waltham Forest. We'll also be introducing members of our Patient Participation Group, and we'll be doing work also, trying to (inaudible) younger generation. I don't need to tell you about the NHS face huge challenges across the country, as well as the austerity, we're all living that, and there's too many people turning up at A&E, probably because it is not signposted well enough, but we're using all the services we can use in the community and people also in hospitals are staying there longer, which at Bart's Health, my job as a GP is to protect patients from hospitals, but later tonight we've seen how Waltham Forest are bucking the trend, not by accident, and we're reducing the number of people admitted to hospital.
Okay it is my great pleasure to produce Counsellor Asghar, and it is really important that by sharing the platform together we're sharing everything together across health and social care.
Slide 4-5
Councillor Naheed Ashgar:
Good afternoon, or good evening. It is fantastic to see such engagement from the public and professionals at this event. We're doing our best to improve the health and wellbeing, it is important because it highlights what work is being done by the hospital services to reduce the number of admissions as has been referred to, improving mental health where possible and discovering various other services available to residents and the public, and some of the challenges the health service has faced.
Many of the focus challenges that are faced by our residents against the background of changes in the health systems. Since becoming a member, I've been impressed by their commitment and the level of preparation in meeting challenges to come and willingness to cooperate with us in the council to improve services.
I look forward to working with the partnership with the CCG, and to take all the local authorities, this includes our drive to improve people's life chances to make health and wellbeing such an important thing.
I would also like to (inaudible) this year. This is to redevelop Whipps Cross hospital and transform to improve (inaudible). Finally, our health and wellbeing work has an ambitious agenda for the next few years, focusing on the CCG playing a key role in delivering.
Finally, I would like to thank the CCG on behalf of Waltham Forest and look forward to building a relationship with the CCG.
Thank you.
Slide 6
Dr Anwar Khan:
Thank you very much. Right. Okay, so I just want to say that you can join in with the game coming up later but what we'd thought we'd do is you can actually join in. It is anonymous, and you can join in with your IT, your phones, or by paper. We thought we'd just go through how to log in, so you type in Kahoot.it. Okay. Then you put in that PIN number. Press okay, the name should be on your screen now. Is everybody logged in?
I'll give you a bit more time. Kahoot.it, put in the PIN number and press okay. Are we okay? People are not ready, they're not ready yet.
First question. Ready? Okay. Three questions.
First one is, I am here today because ... you've got the options: I'm a local resident, I work for or with the NHS, I work for or with the council, or another reason.
Right, okay. So NHS is -- residents, okay.
Second question: When did you last visit the local health service? And that includes not just the doctor but the pharmacy, and et cetera? In the last week, the last month or the last year, or more than 12 months ago?
I hope you mean as a patient not as a GP, yeah?
Okay, right, now the telling question. How well do you feel managing your own healthcare? That's very well, sometimes, not at all, I am not involved or I leave it to the healthcare professionals. Okay.
Right. So, I do the fun bit as the chair. Terry can you join me? You've got the formal part now. That's where we go through the accounts, and ... Thank you.
Slide 7
Terry Huff:
Good evening, everyone. I'm Terry Huff, the chief officer at the CCG. It was really useful seeing some of those answers, I was quite surprised that so many felt they were so involved with their own healthcare. That's brilliant. I thought I was going to open up by saying we need to see how you can get more involved. It is great to see so many, I'm told there are 300 of you, and in the bright lights it is difficult to see. This is going to be our biggest event yet, our fourth AGM, and hopefully it will be one of our best.
As Anwar said, before we get started I have a couple of formalities to undertake within the AGM, so if you bear with me, I have a couple of things to do. The first of which is to agree our minutes of last year, so the GPs who were here last year, and even better if they remember what we said, you'll see in your packs, you've got a set of pages there, and I am just going to quickly go through to check that it is an accurate record of last year. So page 1, 2, 3, 4, 5, 6, 7, 8 and 9.
Great. I'm glad, it would be very difficult to go through all of that and change it. Thank you. The other thing to do as part of the AGM, is I've got the job of taking you through the annual accounts. Now, if you're into the detail of the accounts, they're on our website, and unfortunately I won't be going through that in real detail today but there's myself and our finance director over there, who you're more than happy to talk to on that detail. If you're one of the many here, that's what I'm going to do, I'm going to go over the next five minutes a brief overview of our performance last year.
Slide 8
So, right. So, as some of you will be aware, most of the health service in the borough is paid for by the CCG which means that if a resident of the borough visits their GP it is funded by CCG commissioners, if you visit A&E at Whips or anywhere else in the country, we pick up the bill. If you have a hip operation or visit the district nurse or are in a care home, that's funded with nursing care that's all funded by the CCG and last year we spent in total £383 million, which is 12 million more than last year. And that works out about £1,300 for every single resident of the borough.
Now, thankfully we spent almost the whole we got, not quite all of it, there was 270,000 left over which was great, that means we met our statutory requirement, and that's 270,000 available in future years to spend.
Now, we spent 1300 on average, on every individual, it is not spent evenly. We spent about half the money on just 10 per cent of the population. We spend three-quarters of the funding on just the top 20 per cent. And this is because most of our spend is on the high expensive treatment. If you look at the pie chart behind me, you'll see 50 per cent of our money is spent on hospital care and that's why some people have described the health service as a national illness service, we spend our money treating illnesses rather than National Health and wellbeing service that we'd all like it to be.
Now we recognise that we have an aging population and we can't focus all our resource on treatment, and there is two reasons for this: the first one is we don't change the way we work, we eventually need to build an additional hospital. At the moment, worth over half a billion pounds, to rebuild Whipps Cross Hospital, and what I'm clear about is we won't get any money to build another hospital on top of that and even if we did we wouldn't have the staff to manage it.
That's the first reason why we need to focus more on prevention. The second, and I think it is more important, is it's better for the individual. If we intervene early, we prevent the illness. We've got better at helping people, managing weight and avoiding conditions such as diabetes, better than spending money on treating it. Last year we spent £2 million on medication alone for diabetes.
I was looking at some of the figures for last year and we had 31 amputations last year for people suffering diabetes, it costs the taxpayer 300,000 but the individual far more, a far higher personal cost.
Prevention and elder treatment is the responsibility of the NHS, which is why you see this we've got over 90 organisations, partner organisations, that we're working with, we also need to work with schools, parents and individuals themselves all have a role to play, and many of you of you are represented here today.
Tonight you'll hear a lot about how we're working both as the CCG with all these partners and patient groups and begin to change the way we spend money so we start to make it more of a health and wellbeing service and less of a illness service. You'll hear about more support is going into nursing homes so spending more on the community in supporting staff so they can take trips to hospital and having lengthy stays there, we work with mums to encourage home births in the community and we also got new midwives and support workers to support new mums in the period after birth and helping them with their babies.
Now it is clear that if we are going to start moving care out of the hospital we need to also spend more on primary care, and I'm talking about GPs and practice nurses and physicians associates. In the last 2 years we started to spend more, we're spending 35, nearly 40 million over 2 years, quite a big increase. If you look at the chart, it barely makes up 10 per cent of the spend, and we need to spend far more.
Already, our GPs and their colleagues have organised almost 2 million consultations a year in Waltham Forest alone and this needs to be increased. And you're going to hear tonight a little bit about how using technology to take some of this burden, how we have lots of clever IT, the artificial intelligence, self-service applications, learn more about how you can access your own records and how people start to take control of their health and treatment and it is great to see those initial surveys. A lot of people are taking responsibility for their own treatment and feel involved.
But as much as we need to do more with technology, that won't solve the problems. We still need more GPs, nurses and other professionals. So again tonight you'll hear what we're doing to retrain of the workforce to help work in teams, to start sharing expertise and the workload and helping people access those services. I hope tonight we'll know a little bit more abouthow the health service is changing and how you can get involved. Remember, we don't have all the answers.
This is your health service and you need to be involved in shaping a sustainable health and wellbeing service for the future. The formal presentations are due to end tonight by eight, we'll keep to time, and then we'll have a time after for questions, and you can start asking questions. Then there will be some more time at the end, if we haven't already done so, to go round to the schools, there are 40 subject areas, and I know we've got some really enthusiastic partners who have given up their free time because they feel passionate about what they do and are keen to meet you so please take the opportunity to talk to them and enjoy the rest of your evening.
Thank you.
Urgent and Emergency care
Slide 9
Dr Ken Aswani:
Thank you very much, Terry, for that introduction, and just giving an idea of the huge amount of work that goes on between health and social care, and our partners. And throughout this evening I think you'll get some detail on what has been done, but also how you can contribute to that, and I will give you some examples of that. What we're going to talk about is the urgent and emergency care system we have, and I'm sure we'll all agree it is critical system, because if any one of us felt very ill and we needed the service, then we would want to know that we can access the service promptly and get the best possible service.
With urgent care, because it is such a broad definition, it is about making sure that the one gets the right care, but also in the right setting. We all talked about the hospital and yes, in certain cases a hospital is going to be for major emergencies or resuscitation or acute trauma it is very appropriate, but in a lot of cases either for example if it is primary care, or illnesses or children, most of these can actually manage in the community very safely, and much more successfully.
It is also true in terms of a number of elderly, potentially, because of the number of conditions they have, it can actually break down, but they can be managed in the community, and I'll give some examples.
So one of the things I can tell you is the fact that in 2016 or 17 we managed to get 1,000 fewer admissions, that's almost 20 per cent reduction, that's a huge success. That means these patients were successfully managed alternatively in the community. And how has that happened, and what have we developed? We've got an excellent rapid response team so we have a nurse team, and they can do things at home, blood tests, ECGs, help the GP diagnose and have treatment, but all in the comfortable of their own home, and that's turned out to be very successful.
We also have integrated case management and general practice, so we know the patients that are high risk, and therefore we proactively manage them and make sure they've got time to manage any exacerbation. In terms of Whipps Cross Hospital, most people think in an urgent situation it is through the front door of A&E, but actually, there's ambulatory care where if you need diagnoses or for a straightforward treatment they can refer there and get a consultant-led service, and that's very valued by general practitioners and patients have said it is excellent.