The Chair, Councillor Maggie Mansell, explained the CCG and Council are working together to provide an integrated plan. Another strand, regarding in-hospital estate services, is at the early stage of development. Public engagement will take place in November, when the plan will be agreed in principle.
Paula Swann introduced the CCG report. NHS England has emphasised the need for tight alignment between the NHS Operational Planning process and the SWL STP and there is a target date for all 2017-19 contracts to be signed by 23 December 2016.
The Croydon CCG Commissioning Intentions cover the following broad headings:
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Planned Care and Long Term Conditions
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Urgent and Emergency Care
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Children and Young People
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Mental Health and Learning Disabilities
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Out of Hospital services
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Primary Care
The CCG has worked with colleagues across south London to set out all the changes expected and how services will be offered differently to meet local needs. This is all within a context of special measures.
Stephen Warren elaborated on the main points:
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Financial challenge
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Asset based commissioning
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Prevention and self care - embedding into Primary Care
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Commissioning appropriate services
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Programme of work to reduce hospital admissions
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Service reviews
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Primary care is increasingly important
Issues raised included:
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How far do Croydon's plans reach into the CCGs in other boroughs?
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Croydon appears to be on its own - where does it sit?
Paula Swann: SW London has a collaboration of CCGs working together, along with providers. There is a long history of partnership working.Originally the strategic planning authority came from the CCGs but it is now recognised that all providers should be involved. There are significant benefits in working together in order to deliver more effectively and we are looking at how to use commissioning support more effectively. Currently it is not appropriate for Croydon to look at a shared Chief Officer along with the other CCGs in South West London, as Croydon is pursuing an Accountable Care Organisation approach. There is however no suggestion that Croydon is not working with the other CCGs - the future could look very different for strategic commissioning.
Cllr Maggie Mansell: Croydon has 30 years of history with CCGs working together with the local authority. Historically Croydon has been under-funded and it has the largest number of ethnic minorities and highest deprivation in the London area.
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How will you ascertain what services are provided for children's mental health services (CAMHS)
Stephen Warren: We will look at what are the most important outcomes for them in terms of their care.
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The NHS in Croydon is under significant financial pressures - the ways in which solutions are transmitted to users need to be joined up. The correct message needs to get out to the public
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Social workers are strained - more young individuals are dealing with some horrendous illnesses - how can we deal with it?
Paula Swann: 40% of placements in the mental health trust are able to be discharged. The review illustrates that a full system response is needed - social care, commissioning, provision - in order to get them back into the community in their own homes.
Stephen Warren: There is investment in mental health services, with liaison services in the Council. It is important for schools to play their part. We are developing a single point of access, working with schools and primary care.
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We need discussions about the review of mental health services with communities and parents - what is their understanding? How can they access services?
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Access criteria has been tightenened so there is even more pressure on parents and teachers, so we need to raise teachers' skill levels to deal with children having mental health issues
Cllr Callton Young asked if an overview could be provided as the report was 'a bit of a web of strategies, policies and plans'.
Paula Swann: The operating plan will be more structured. It will come out later in the year. It will condense the information so it can be communicated better.
The Board NOTED the report.
Sarah Ireland introduced the Council report.
Croydon Council’s key commissioning priorities for 2016/17 build on the previous Joint Commissioning Intentions, signed off by the Health and Wellbeing Board in December 2015. Inevitably many of the commissioning plans and objectives represent joint areas of work with Croydon CCG. The report illustrates the range of commissioning plans and priorities for 2016/17, which are either commissioned by the Council or commissioned jointly between the Council and the CCG.
Cllr Hopley asked about how commissioning takes the latest legislation into account.
Barbara Peacock: The commissioning intentions bring statutory legislation into play - the Children & Families Act. There is an overlap, so we are trying to move together to have a more integrated focus. From the Council perspective, a service planning process is to be launched. This will embed the operational detail into high level strategic intentions.
The Board NOTED the report.