Events and Consultations: Developing Services: Local Health Priorities

Telephone enquiries please contact Kay Hines on 01274 237368

To: Local voluntary and community groups

Tel: 01274 237368

24 September 2007

Dear Colleague

Developing Services: Local Health Priorities.

I am writing to invite you to attend a meeting to discuss local health priorities. Your organization has worked closely with local PCTs in the past.

Bradford and Airedale Teaching PCT has been looking at the health needs of people from across the district and has identified a number of key areas for improvement.

However, the PCT acknowledges that local people, communities of interest, and local voluntary and community groups may be aware of important health needs that are not currently being addressed.

The PCT is to hold four stakeholder meetings to allow local groups and individuals the opportunity to identify the health issues that matter most to them. The PCT can only start to develop the services people need if it knows what people want.

Two meetings are to be held in Keighley, two meetings are to be held in Bradford, on the following dates:

Sir Swire-Smith Hall, Keighley College, Keighley

Tuesday 30 October 10.30 a.m. – 12.30 p.m. to be followed by lunch

Tuesday 30 October 1.00 p.m. – 3.30 p.m. to begin with lunch from 1.00 p.m.

Main Hall, Carlisle Business Centre, Manningham, Bradford

Wednesday 7 November 10.30 a.m. – 12.30 p.m. to be followed by lunch

Wednesday 7 November 1.00 p.m. – 3.30 p.m. to begin with lunch from 1.00 p.m.

You can confirm your attendance by email to: dave.ross@bradford.nhs.uk . Please state any specific dietary or langauge requirements you have.

Thank you for helping us to give local people the health services they need.

Yours sincerely,
Dave Ross
Dave Ross
Improving the Patient Experience Manager

Feedback: Health Improvement Forum

Feedback posted on behalf of Jane Howie (HealthNet Rep)

The meeting held on the 6^th of September had a pretty heavy agenda with 14 items on. We only managed to get to finish item 8 and overran by half an hour. Eleanor Green Chaired the meeting. One of the main topics was the SCS (Sustainable Community Strategy). It was a bit confusing because there was talk about phase 3 and I asked for clarity on the phases. Phase 1 was evidence gathering; Phase 2 Consultation and Phase 3 is Bringing it all together, but people did seem a bit vague about this and Imran agreed that calling Phase 2 the ‘first take’ was confusing. The Partnership Delivery Team apparently has taken on board comments made on the draft Critical issues and theme profiles. Feedback will be provided in the near future. I asked to be informed what VCS/HealthNet involvement is to be expected in Phase 3. Two actions are occurring in the next few weeks regarding the SCS all Councillors are attending a conference to discuss each of the themes and presentations are to be made to each of the scrutiny committees.

There was no opportunity to discuss the new commissioning framework, and one of the questions I wanted to put across was for some guidance for HealthNet groups on what commissioners are looking for.

HIF asked, again, for some ‘impact stories’ from groups that it funds. I asked if this information was not apparent from the narrative and supplementary information submitted with the monitoring reports that groups had to provide to (HCFT) SHIP FM. Imran said that the monitoring information is being used at the moment for the basis for a commissioning review. Elizabeth Brookfield said that it is the ‘impact stories are wanted to use to send to the GOYH (Gov Office for Yorkshire and Humberside) and these need to be ‘lively’ individual stories/soundbites, which attract photo opportunities’. So if anyone has something like this let me know and I will pass it on.

There has been an underspend of about £40K. There was much discussion about how to spend this and it was voted on option 1 – to give an extra £10k to pump prime the four new SHIP priorities:

Reducing infant mortality
Reducing alcohol abuse
Improving sexual health and reducing teenage conceptions
Improving mental health

The HIC Scrutiny Committed has chosen alcohol misuse as a main focus to seriously address – like it did with obesity previously. Comments on this are welcomed by Peter Marshall, Bfd Council.

Local Update: Practice Based Commissioning

Practice Based Commissioning

What is Practice Based Commissioning (PBC)?
Practice Based Commissioning is a Government policy which places responsibility for commissioning services with GPs. Although this is voluntary for GP practices they are encouraged to ‘opt in’ to PBC. A consortium of front line clinicians, including GPs and Practice Managers will be given a commissioning (indicative) budget to provide services for their area. This process will involve; identifying patient needs and setting priorities, designing responses to those needs, identifying and allocating resources. The budgets are not held by GP practices/consortium, the PCT still acts as the agent to procure services.

Why Practice Based Commissioning?
Commissioning in this way is intended to reduce bureaucracy and enable the commissioning of services in response to the needs of the local community. PCB identifies those it feels best placed to make those decisions. Often this is likely to be GPs and Practice Managers, but it can also include other primary care professionals such as nurses, pharmacists, optometrists amongst others. A requirement of PRB is that stakeholders, in particular patients are involved in the process. As a result of PBC it is expected that there will be improved choice and quality of services. National tariffs for many (but not all) services means that there is no incentive to bargain on price. Any savings that are made must be spent on patient services.

Background to Practice Based Commissioning in the Bradford District from Jacquie White, General Manager for South and West Commissioning Alliance

Practice based commissioning (PBC) has a high profile in the Bradford and Airedale health economy with PBC recognised as a priority area of work in order to improve patient care. The GP practices within the district voluntarily formed into 4 Alliances largely reflecting 4 localities - Airedale Alliance, Citycare Alliance (Bradford City area), South and West Commissioning Alliance and Yorkshire Primary Care Alliance (North Bradford area). The alliances are currently setting out their commissioning priorities for the future which so far include Mental Health services, Reducing emergency admissions, and Sexual Health services. As these plans develop, the tPCT is keen to ensure that new service plans are broad in scope, addressing health and wellbeing. We are anticipating a key role for the community and voluntary sector in delivering services that address the wider needs of patients.

Nationally there is a clear expectation that PBC should be the driving force behind innovation in commissioning and service development. With an enthusiastic local group of Alliances there are great opportunities to work in partnership with other local organisations in order to deliver effective and efficient services that meet the needs of local patients

What Next?
HealthNet will be running a half day conference for the Voluntary and Community Sector on Practice Based Commissioning. The conference will be an opportunity to gain a greater understanding of the process, identify commissioning opportunities and get the relevant development support. Look out for details in the next issue of Briefing Bradford and sign up to our email list health@bradfordcvs.org.uk

WEB TOOL LAUNCHED TO IMPROVE LIFE EXPECTANCY IN DISADVANTAGED AREAS

Thursday 23^rd August 2007

Dawn Primarolo, Minister of State for Public Health today launched the Health Inequalities Intervention Tool - an interactive website to help local health services and councils improve life expectancy in areas with the worst health and deprivation.

The tool is designed to help Primary Care Trusts (PCTs), Practice-Based Commissioners and local authorities in Spearhead areas to understand the impact of simple, effective, evidence-based measures can have on the life expectancy gap of their local populations. It can be used as part of a comprehensive local strategy to reduce health inequalities

It presents both a national and local picture, showing current life expectancy for each of the 70 Spearhead areas, and the gap between life expectancy in the Spearhead area and that for the rest of England.

Dawn Primarolo, Public Health Minister said:

“Tackling health inequalities is a priority for the Department of Health and the NHS. We have set targets that need to be achieved by 2010, including a 10% reduction in the difference in life expectancy at birth between the fifth of areas with the worst health and deprivation and England as a whole.

“Our task now is to support local NHS and local authority service planners, commissioners and front-line staff to deliver on those targets and this is an excellent example of giving staff in Spearhead areas the tools to do the job and to do it well.”

The tool shows the diseases which are causing low life expectancy in each Spearhead area and provides a “ready reckoner” for the high impact interventions that will help narrow the local gap quickly, based on real data. These are:

· Smoking cessation

· Reducing infant deaths

· Antihypertensive prescribing for people whose cardiovascular disease has not yet been diagnosed

· Statin prescribing for people whose cardiovascular disease has not yet been diagnosed.

The tool also assists PCTs in “case finding” by calculating the number of people locally who are likely to need treatment for cardiovascular disease.. Encouraging those people to present to their GPs or other health services will have a significant impact on their life expectancy, and on the average life expectancy within their locality.

Life expectancy is a key element of the Department of Health’s Health Inequalities Public Service Agreement (PSA) target: “By 2010 to reduce health inequalities by 10%, as measured by infant mortality and life expectancy.”

Whilst life expectancy is improving everywhere, the gap between that in the Spearhead areas and that of the population as a whole continues to widen. The average life expectancy in England (as at 2003-05) is 76.9 years for men and 81.1 years for women. However, in Spearhead areas (as at 2003-05) it is 74.9 for men and 79.6 for women. But some Spearhead areas are making progress, with some three-fifths on track to narrow their own life expectancy with England by 10% by 2010 compared to baseline for either males or females or both.

Dr Bobbie Jacobson, Vice-chair of the Association of Public Health Observatories (APHO) and Director of the London Health Observatory said:

"Our tool is the first of its kind to provide hard-edged, local evidence to planners and commissioners, on the causes of their life expectancy gap and how it can be reduced. The tool is easy to use and saves local agencies time and analytical effort. More importantly, we hope it will help Spearhead authorities to close the gap."