Rushcliffe Clinical Commissioning Group

Together patients, GPs, other health professionals and partners will lead the transformation of local health services. Our culture of liberating thinking and encouraging innovation will enable us to approach improvements in health and wellbeing from a fresh and realistic perspective. We will work with partner organisations to develop opportunities to integrate services that are centred on the patient. Our commissioning decisions will drive improvements in the quality of services and we will increase productivity and efficiency through better use of people and funds. We will be a thriving local commissioning organisation, which acts within our health and local government community and is financially sustainable.

Updated:
30 June 2016
Location:
East Midlands
Sectors:
Health, Clinical Commissioning Group, Commissioners Sector
Local Alliances:
Nottinghamshire Dementia Action Alliance

1. Action Plan

1. The National Dementia Declaration lists seven outcomes that the DAA are seeking to achieve for people with dementia and their carers. How would you describe your organisation’s role in delivering better outcomes for people with dementia and their carers?

1. The National Dementia Declaration lists a number of outcomes that we are seeking to achieve for people with dementia and their carers. How would you describe your organisation’s role in delivering better outcomes for people with dementia and their carers?

Our vision defines our mid to long term goals:-

Together patients, GPs, other health professionals and partners will lead the transformation of local health services. Our culture of liberating thinking and encouraging innovation will enable us to approach improvements in health and wellbeing from a fresh and realistic perspective. 

We will work with partner organisations to develop opportunities to integrate services that are centred on the patient.  Our commissioning decisions will drive improvements in the quality of services and we will increase productivity and efficiency through better use of people and funds.

 We will be a thriving local commissioning organisation, which acts within our health and local government community and is financially sustainable.

In pursuing this vision, and based on local health need our clinicians and patient representatives have identified “commissioning to improve the health of the whole population of our area with better quality and outcomes for all patients” in line with 3 priority areas including improving mental health and wellbeing as one of their clinical objectives.

As local commissioners we will continue to participate in quality reviews as well as contractual and service reviews from our providers including dementia services – see action plan.

2. What are the challenges to delivering these outcomes from the perspective of your organisation?

In the context of our ageing population and significant rises in the prevalence of a number of long term conditions including dementia coupled with the current financial challenges in the NHS we need to drastically change the way in which we manage our existing resources to meet growing demand and the deliver the health outcomes our population deserve.

Collaborating with other local health and social care commissioners is essential, to ensure economies of scale, and deliver integrated care for patients. A memorandum of understanding for collaborative commissioning has been developed among the six CCGs within the Nottinghamshire health economy that details the framework for collaborative commissioning activity including the process to include QIPP in contract negotiations. This framework will be applied to the collaborative commissioning of five key contracts that exist for the provision of clinical services in Nottinghamshire including our main mental health provider Nottinghamshire Healthcare NHS Trust.

2. Actions

  • Awareness, training and diagnosis

    Embed and promote dementia awareness, training and diagnosis.

    Status:
    Implementation

    2016 - Second Quarter Update

    On-going actions maintained.

    2016 - First Quarter Update

    In partnership with the Area Team, continuation of the enhanced service to GPs - “Facilitating timely diagnosis and support for people with dementia” specifically those at risk.  Completed: Q1, 2016

    In partnership with NHSE, support early diagnosis and awareness through GPs’ surgeries and NHS Health Checks.  NHS Health Checks now also include a requirement to make those aged 65-74 aware of the signs and symptoms of dementia.

    Reporting on improvement in Dementia Diagnosis Rates as part of the 2015/16 Annual Report - as at the end of March 79.6%

    2015 - Fourth Quarter Update

    On-going actions maintained.

    2015 - Third Quarter Update

    The 5 Ways to Well-being focus of the Sunday Fun-Day Event held at Rushcliffe Country Park on the 13th September 2015. Day focused on the 5 strands and having different services/groups there representing/linking to these strands e.g. Talking Therapies, leisure centres.

    2015 - Second Quarter Update

    Dementia Diagnosis monthly collection of practices' diagnosis rates embedded as is the quarterly reporting to the Clinical Cabinet on the dementia diganosis rates peformance.  Completed: Q2, 2015

    Promotion of Dementia Friends Training completed by promoting to practices that this can be undertaken by attending a face to face information session or by wathcing an on-line video.  Done for both CCG staff and GP practice staff via the staff bulletin and the weekly practice newsletter. Completed: Q2, 2015 

    2015 - First Quarter Update

    In partnership with the Area Team, introduction of new enhanced services as part of the 2014/15 GMS contract changes on Dementia “a proactive approach to the timely assessment of patients who may be at risk of dementia”.  Completed: Q1, 2015

    In partnership with EMAS, introduction of CQUIN Target – ‘Improving Care of Patients with Dementia’. This will focus on improving the safety and experience of patients with dementia by facilitating early identification and appropriate referral resulting in reduced levels of inappropriate conveyance. Completed: Q1, 2015

    In partnership with NHT, adherence to the Dementia Clinical Leadership CQUIN by appointing a named lead clinician and developing a planned training programme to improve staff skills and knowledge of dementia. Completed: Q1, 2015

    Local Dementia Diagnosis Trajectory Rates submitted as part of formal planning submission to NHS England and will be monitored as part of quarterly review. Completed: Q1, 2015

    Dementia to be part of a Practice Learning Time (PLT) Event to encourage CCG and practice staff to become Dementia Friends and have a greater understanding around Dementia.  Dementia Awareness Session delivered at the Non-Clinical PLT Event on the 08th January 2015. Completed: Q1, 2015

    2014 - Fourth Quarter Update

    On-going actions maintained.

    2014 - Third Quarter Update

    Specific PLT event on the Dementia Diagnosis Rates including the tools available to identify patients with dementia and support offered from the MH Clinical Lead, the MH Management Lead and the Memory Assessment Nurse (MHSOP).  Took place September 2014. Completed Q3, 2014

    Highlight the Dementia work being carried out by the CCG as part of the Mental Health & Wellbeing presentation at the Annual AGM.  Took place on the 14th Sept 2014. Completed Q3, 2014

    2014 - Second Quarter Update

    Using the Dementia Prevalence Calculator tool, practice level diagnosis targets have been set for GPs to work towards to ensure compliance with NHS England’s diagnosis target of 66.67% by 2015. Completed: Q2, 2014

    Practices will report their progress each quarter and support will be offered to practices not on track to meet their target. On-going (To be finalised Q2, 2015)

    Provide practices, via the Clinical Cabinet, with tools to identify patients with dementia. Completed: Q2, 2014

    2014 - First Quarter Update

    In partnership with the Area Team, introduction of new enhanced services as part of the 2013/14 GMS/PMS contract changes on Dementia “a proactive approach to the timely assessment of patients who may be at risk of dementia”. Completed: Q1, 2014

    In partnership with EMAS, introduction of CQUIN Target – ‘Improving Care of Patients with Dementia’. This will focus on improving the safety and experience of patients with dementia by facilitating early identification and appropriate referral resulting in reduced levels of inappropriate conveyance. Completed: Q1, 2014

    In partnership with NHT, adherence to the Dementia Clinical Leadership CQUIN by appointing a named lead clinician and developing a planned training programme to improve staff skills and knowledge of dementia. Completed: Q1, 2014

    Local Dementia Diagnosis Trajectory Rates submitted as part of formal planning submission to NHS England and will be monitored as part of quarterly review. Completed: Q1, 2014

    In conjunction with NHT, support offered to practices from the Memory Assessment Nurse for Rushcliffe MHSOP, to offer to speak to practices or host 1:1s to discuss the   referral and diagnosis pathway Completed: Q1, 2014

    2013 - Fourth Quarter Update

    Introduction of the new Memory Assessment Service (MAS) and the continuation of the Working Age Dementia Service (started April 2009). Completed: Q4, 2013

    PLT Training event for clinical staff on the Memory Assessment Service and best practice.  Took place in November 2013.  Completed Q4, 2013

    Develop awareness campaigns to support earlier diagnosis through ‘memory services’ at Bingham Market and West Bridgford Alzheimer’s café. Completed: Q4, 2013

    Alzheimer’s Society leaflets distributed to practices via the practice managers to help raise awareness of memory loss amongst patients.  Completed: Q4, 2013

  • Service Provision and Improvements – CCG specific

    Service Improvements led by the CCG.

    Status:
    Implementation

    2016 - Second Quarter Update

    Commissioined a Primary Care Psychological Therapies pilot from Oct 15 to Mar 16 covering 3 Long Term Conditions including Dementia to ensure that both patients and their carers have appropriate support. Final report and recommendations/actions being taken forward presented to the Clinical Cabinet on the 02nd June 2016.

    2016 - First Quarter Update

    Improve access to treatment for dementia and support to carers by providing provision of support sessions for carers of dementia patients. Sessions commencing Jan 16 will cover a different aspect of dementia at each session and  run through-out 16-17.

    Supported and promoted the expansion of support services in Rushcliffe such as memory cafes via members of the Rushcliffe MH&LD Group and other wider CCG neworks e.g. Cotgrave Memory Café, Renew 37, Rosemary Café at Keyworth.

     

     

     

    2015 - Fourth Quarter Update

    On-going actions maintained.

    2015 - Third Quarter Update

    Mental Health Link Liaison Service started in June 2015 as a pilot until December 2015 to work with Long Term Condition nurses to provide a Mental Health service in primary care setting.  Interventions include supporting people with low mood or anxiety and signposting.

    Compass Workers presented at the Rushcliffe MH&LD Group on the 17th Sept 2015 highlighing their on-going work.

    Opportunities for patient engagement and feedback on carers support services made possible via the Rushcliffe Carers forum.

     

    2015 - Second Quarter Update

    Care Home Pharmacist Business Case for additional capacity approved to enable pharmacists in Rushcliffe to go into the care homes aligned with their respective GP practices.  Completed: started May 2015

    Opportunities for patient engagement and feedback on dementia services made possible via the Rushcliffe patient mental health and wellbeing forum. On-going: Q2 2015

    Opportunities to discuss issues relating to dementia, for example reviewing the diagnosis diagnosis performance and DAA action plan, made available through the Rushcliffe Mental Health & Learning Disabilities Group of which there are 3 patient rep members. On-going: Q2 2015

    Ensure guidance on best practice and outcomes from research into Dementia is fed down into GP practices e.g. recently information around research on dementia prevalance cascaded. On-going: Q2 2015

    2015 - First Quarter Update

    On-going actions maintained.

    2014 - Fourth Quarter Update

    Liaised with PALs officer to understand if there have been any specific complaints related to patients with dementia. Three related incidents in 2014/15 all around wanting information/guidance which were dealt with.  Communication set-up for routine feed-back and annual review to be conducted. Completed:  Q4 2014.

    2014 - Third Quarter Update

    Participate in the promotion and support of the Compass Worker service i.e. how GP practices work with the compass workers. (Done at the GP PLT Event Sept 2014) Completed: Q3 2014

    Opportunities for patient engagement and feedback on carers support services made possible via the Rushcliffe Carers forum. On-going: Q3 2014

    2014 - Second Quarter Update

    In partnership with NHT, introduction of ‘Compass Workers’ to work in community care supporting those with needs post-dementia diagnosis. Promotion and awareness-raising of these ‘Compass Workers’ to follow. Completed: Compass Workers to start September 2014.

    Ensure guidance on best practice and outcomes from research into Dementia is fed down into GP practices. On-going: Q2 2014

    Opportunities for patient engagement and feedback on dementia services made possible via the Rushcliffe patient mental health and wellbeing forum. On-going: Q2 2014

    Opportunities to discuss issues relating to dementia, for example reviewing the diagnosis targets set at a practice level, made available through the Rushcliffe Mental Health & Learning Disabilities group. On-going: Q2 2014

    Continuation of the landline version of Flo for a number of dementia patients requiring medication prompts. On-going: Q2 2014

    Liaised with PALs officer to understand if there have been any specific complaints related to patients with dementia. Only one incident which was dealt with.  Communication set-up for routine feed-back and annual review to be conducted. Completed:  Q2 2014.

    2014 - First Quarter Update

    On-going actions maintained.

    2013 - Fourth Quarter Update

    Antipsychotics in dementia included in prescribing reports as a reminder to practices. Completed: Q4 2013

    The CCG’s Head of Financial Strategy visited dementia care homes in Rushcliffe to gain insights into how community dementia care is delivered. Completed: Q4 2013

    The CCG’s dementia action plan was cascaded to relevant stakeholders inviting comments and feedback to refine and improve the CCG’s dementia care strategy. Completed: Q4 2013

    Findings from “Memory Services” questionnaires at Bingham Market & West Bridgford’s Alzheimer’s Café to be reviewed and progressed as specific actions. Completed: Q4 2013

    Ensure linkages with Notts CC regarding commissioning of community based support services (‘Compass’ workers) for carers of people with dementia. Supporting both the commissioning of the service and its design e.g. through consultation. Completed: Q4 2013

  • Service Provision and Improvements – CCG and Providers

    Service improvements in conjunction with providers.

    Status:
    Implementation

    2016 - Second Quarter Update

    On-going actions maintained.

    2016 - First Quarter Update

    Oin-going actions maintained.

    2015 - Fourth Quarter Update

    Unwind your mind event took place on 10 October 2015 as part of Mental Health Awareness Fortnight in partnership with Rushcliffe's Community and Voluntary Service & Library Service. 

    2015 - Third Quarter Update

    On-going actions maintained.

    2015 - Second Quarter Update

    Dementia Leaflet "Your memory matters.  Help is out there", to signpost patients and carers to dementia services, finalised and distributed across the CCG e.g. practices, libraries, pharmacists and uploaded to the CCG's website.  Completed: June 2015 (Q2 2015)

    2015 - First Quarter Update

    Signposting service for carers in place.  Carer's Federation appointed as provider and service in place as at 01st March 2015. Completed: Q1 2015

    2014 - Fourth Quarter Update

    On-going actions maintained.

    2014 - Third Quarter Update

    Commissioned the development of ‘Dementiacarer.net’ by ARC Research. Website provides advice, information and support for carers of people with dementia, mainly by video clips relevant to their specific locality. Went live April 2014, developed further and publicised as West Bridgford Library (“Unwind Your Mind” Event Oct 2014). Completed: Q3 2014.

    CCG proposed and the Clinical Cabinet approved the sign-up to the DAA “Carers Call to Action” Declaration at its meeting in October 2014. Completed: Q3 2014. 

    2014 - Second Quarter Update

    Following discussions taken place in July 2014 at the Rushcliffe Carers Forum, and specific actions being taken as part of this action plan to support carers of those with dementia, the CCG, with the support of the Carers Forum & the Clinical Cabinet, will propose it sign-ups to the Carers Call to Action. Completed: Q2 2014

    Every practice to have a named carers champion. Completed: Q2 2014

    An information leaflet is currently being developed across the South Nottinghamshire CCGs to signpost patients and carers to dementia services. In-progress (To be completed 2014/2015)

    The CCG is developing a new signposting service to offer support to carers in Rushcliffe, which will be available to carers of those with dementia. A provider will be appointed to start Q3, 2014. In-progress (To be completed 2014/15) 

    2014 - First Quarter Update

    NHT CQUIN Target - Supporting Carers of people with dementia. Complated part of 2013/14 Contract.

    2013 - Fourth Quarter Update

    On-going actions maintained.