Prime Minister's Challenge Fund update

The PMCF is designed to establish pilot programmes of work to explore a number of ways to improve access to general practice, to develop a more integrated approach to providing general practice and wider out-of-hospital services and to develop more innovative ways for people to access and relate to general practice. Demonstrating sustainability of the pilot schemes was identified as a key factor from the outset. A funding pot of £100m was identified for organisations/groups of practices to bid for.

Following the development of the General Practice Strategy in Halton, practices were contacted and asked to develop and propose schemes that could be collated into an overall bid for non-recurrent funding from the national PMCF programme. In total, the bid from Halton CCG and practices totalled £1.6m and in May, it was confirmed that we had been successful. A final budget of £1.548m was awarded which needs to be spent in full in 2015/16.

“Together for the health of Halton” contains eight schemes. Five of the schemes will provide direct patient and public services.  One scheme focusses on engagement, communication and pathway development. The final two schemes are a combination of Project Managers to support the delivery of all schemes and funding to support practice discussions around future development and joint working.

The five patient and public services are a blend of schemes providing additional General Practice access, schemes providing alternative access and choices and finally, a scheme focussed on reducing demand on General Practice for specific patient groups.

Each scheme has a designated lead (with all patient/public service schemes having a clinical/practice lead and operational lead), an identified budget and intended benefits. A summary of the schemes is provided below.

Extended access to GP practices
More than 200 additional appointments will be made available each week across selected GP practices in Runcorn and Widnes outside of core hours including 7am-7pm on Mondays and Tuesdays and Saturday mornings at Brookvale practice, and a centralised service across Widnes which will be run from the Urgent Care Centre. The Widnes scheme will offer appointments every evening of the week as well as at the weekends. The scheme in Runcorn went live in August, with the Widnes scheme commencing in early November.

E-Consultation
The e-Consultation service provides patients with the opportunity to undertake online consultations for approximately 100 common conditions.Patients are able to correspond with a GP and receive a timely response, ensuring easier access to GP services. This service is currently being trialled at Grove House, Murdishaw and the Beeches with more practices coming online later in the year.

Community Pharmacy
Community Pharmacies in Halton will be commissioned to deliver additional innovative services which dovetail with GP services. The schemes are focussing initially on two areas - Respiratory health (in both adults and children) and offering additional minor alignments services (e.g. Blood Pressure and Atrial Fibrillation). These schemes will provide information and education, offering more convenience for patients and reducing the number of avoidable GP appointments.  Schemes will go live in November.

Patient Connect
Providing a range of services in the community for specific patient groups and communities experiencing different forms and aspects of isolation, focusing on children, families and older people. These services will be delivered in partnership with local statutory and non-statutory organisations. The scheme is aimed at helping Halton residents to choose the most efficient and effective means of accessing health support and advice. As such, it is anticipated that this scheme will have a positive impact by reducing demand for GP appointments – which in itself will improve access locally.

Other elements of the PMCF in Halton
The CCG will be working with the University of Chester who will be the evaluation partner for this programme of work. The University bring a wealth of experience and expertise that will support the evaluation of each scheme to consider its effectiveness, sustainability, impact and value for money.

The CCG has established a multi-agency communications group to launch a borough-wide communications strategy to raise awareness of the programme across Halton. This will be targeting all communities and age groups across Halton.

Simon Banks

Governing Body Appointments

We told you last month that, due to a variety of circumstances, including the timing of the election process, candidates for the position of Chair of NHS Halton Clinical Commissioning Group (CCG) have decided not to pursue with their application for this role at this time. The Constitution of NHS Halton CCG requires the organisation to have a clinical Chair. There is no provision in the Constitution to cover the eventuality of a Chair not being in place. NHS Halton CCG therefore now has to consider what interim arrangements are required for the position of Chair.

We have proposed that the Constitution of NHS Halton CCG is amended to allow for Dr Richards to remain as Chair until March 2017. Elections for the position of Chair will be held in September 2016, which will allow for greater preparation by potential candidates. The views of the Member Practices are being sought through Service Development Committee before changes to the Constitution are made, probably at the Governing Body in November or December 2015. 

This does not impact upon the appointments process for other Governing Body positions. These are continuing according to an agreed timetable and will involve appointing four GPs or other healthcare professionals from Member Practices, three Lay Members, a Secondary Care Doctor and a Registered Nurse to the Governing Body.

A visit from Roy Lilley

We were delighted to have welcomed Roy Lilley, the influential NHS commentator, to Halton over the last weekend of September.  Roy makes great use of social media, regularly using Twitter and writing a blog that reaches thousands of people across the NHS.  Roy is not a massive fan of Clinical Commissioning Groups (CCGs) but came to find out about our work.  This is what he said in a blog titled “Owen”:

Here's a question for you? When did you last use the word 'perfidia'. It's a great word isn't it? In case you are wondering it means an act of betrayal or disloyalty. See if you can work it into a conversation today!

I was reminded of the word by Owen. Owen lives in Widnes, his body is in a wheelchair that is built like a tank; it has batteries, levers and knobs and a communications device that sounds like Stephen Hawkins. Owen's body may be in the chair but his mind is focused and sharp and lives in a world of thoughtfulness, challenge and rich, self-deprecating humour.

Owen has conversations by bashing and wrestling with a screen. How he made it say 'perfidia' I'll never know!

To know Owen is to live where you are challenged, provoked and made to think. Owen has no room in his life for perfidies.

We debated the balance of efficiency and the democratic deficit between health and social care. Owen's erudite responses made me wonder if there was a cable connecting his box to Hawkins!  No!  Owen is just heroic and really good company.

Owen is employed by Halton CCG. He is the Engagement and Involvement Manager. He is a manager like no one else! He is a colleague and a mate, an employee and a part of the team. When the team goes out for the night he goes with them. If the pub doesn't have decent disabled access, they find someplace else to go.

That's the way Halton does business. They are a CCG but not like any other CCG. They are Vanguard, pioneers, beacons, pilots and ground breakers. If Carling did CCGs they'd probably all be like this.

The way Halton does business is an example to us all. Their minor injuries unit looks like a hospital, pulling together; an imaging unit, GP surgery, a dentist's, a pharmacy and a pathology lab. It is very, very clever and very, very busy. Reducing the load on A&E by astonishing figures.

The way Halton does business is to partner the local rugby league club in wellness clinics, being blood donors, reading classes, health checks and community public health. The players are part of the community team and are local icons. They help touch the lives of hard to reach groups and shape the lives of the youngsters who idolise them.

If half the rugby and soccer clubs in the country did half as well as they do in Halton we would all be a whole lot better off.

I have grave reservations that CCGs are sustainable or worth perusing. So many are GP dominated bridge clubs. The imminent arrival of population based capitated budgets casts a dark shadow. 

Halton is different. They don't commission, they make things happen. They don't buy healthcare they shape its future. If they were in Formula one they would be changing four tires in under two seconds. If they were climbers they would be up and over Everest. If they were sailors they would be around the world.

Halton are ringmasters and Svengalis. They perform, virtuoso. If they were painters they would be in the RA summer exhibition.

As it is, they are none of these things; they are simply men and women who go to work to make things better, faster, more equitable and more accessible. It's exciting, refreshing and completely different. They plan to take over a pub as part of a public health campaign.... don't ask!

This is one of the very few places I have been that 'gets' public health. They understand the lunacy of fixing people up, when keeping them fit in the first place makes so much more sense.

They want to make sure no one is left behind and certainly not Owen.