Partnership NEWS Working together to get the best out of life for our communities

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1 Partnership NEWS Working together to get the best out of life for our communities Issue 3 Welcome from the Chair Welcome to the third issue of Partnership News from NHS North Norfolk Clinical Commissioning Group (CCG). Through this newsletter we aim to keep our patients, partners and local agencies updated about the commissioning of local health care in North Norfolk. Please help us to spread the word about the work we are doing by sharing this newsletter on your networks, and among your colleagues. Over the last three months we have seen some key developments including the Care Home Access Direct (CHAD) project, a software pilot within the Living Well with Dementia Project, and our Wellbeing Service consultation. Please feel free to ask us more about any of the programmes and services mentioned in this newsletter by ing nnccg.contactus@nhs.net or calling Dr Anoop Dhesi - Chairman, North Norfolk Clinical Commissioning Group Integrated Care 2014 The Integrated Care Programme (joined-up health and social care) is already receiving positive feedback, especially from social care teams. The programme is designed to support people with Long Term Conditions (LTCs) such as diabetes, heart disease, dementia and asthma helping them receive care closer to their homes during the winter and beyond. Our Council of Members agreed that promoting this new approach is a priority and guidelines for integrated care meetings in GP practices have been drawn up, including: Setting up regular integrated care meetings with an Integrated Care Co-ordinator Finding the right patients who will benefit from integrated care support, using the risk profiling tool Seeking consent from patients to be part of the programme Since the programme was launched in December, we have expanded the team and recruited Amanda Widdows to work with Aylsham, Reepham, Horsford and Drayton surgeries. The team of four co-ordinators now covers the entire North Norfolk CCG catchment area making regular contact with GP practice teams, sharing information across health and social care and supporing more referrals to local community agencies. In the last 9 months more than 1,500 patients have received an integrated care review. Other organisations are keen to learn more about our systematic approach to integrated care; in February, members of our Integrated Care teams met with representatives from Nottingham City CCG and Dr Charlotte Croft, from the Univesity of Warwick. They wanted to find out more about the role and function of the Integrated Care Co-ordinators. 1

2 Dementia Audit Update Last Autumn, the University of East Anglia conducted an audit of Dementia services covering North Norfolk. The results of this research prompted us to trial a new ipad app called CANTABmobile which can help detect the early signs of Dementia through a 10-minute assessment. The app features rapid and consistent memory testing and is designed to give health professionals a clear idea of whether a patient should be referred for further tests. We are the first CCG in Norfolk to trial this software at five GP practices in North Norfolk during a 3-month pilot as part of our Living Well with Dementia Project. We are looking forward to seeing the results and the effectiveness of the app in promoting early diagnosis of Dementia. Ultimately, this knowledge will help us to ensure adequate services are in place in North Norfolk to support individuals and their carers after diagnosis. Ellis Layward, Clinical Commissioning Manager, who is leading the project, said: Dementia is more commonly a disease of age and with the largest proportion of over 65s of any CCG in England, this is a big priority for us. Our commitment to improving care for patients with Dementia has also been strengthened through the enrolment of two practice nurses in the Dementia Care Coach Programme which is offered by the Norfolk & Suffolk Dementia Alliance. Care Home Access Direct (CHAD) Care Home Access Direct is an eight-week pilot programme launched in January this year to enhance care for patients in care homes in North Norfolk during the cold weather. Its purpose is to provide care homes with anticipatory medication for their residents, meaning: Patients can be cared for in their own environment where possible, making it easier and more comfortable for them should a need arise for anticipatory medication. Care home staff can administer medication according to individual patient plans drawn up by a visiting clinician who will work closely with the Care Home Manager or Key Nurse. The visiting clinician will write prescriptions for any anticipatory medication and the care home will nominate a pharmacy to dispense the medication if and when needed. Care homes will be directed to call 111 out of hours with any issues relating to anticipatory medication, asking for the CHAD doctor. The 111 operator will request a duty GP to call back who will then talk directly with the care home staff to support them with the patient. In this way, the CHAD service can offer quicker throughput at 111 level. By working closely with care home staff, we are helping care homes to be as prepared as possible when it comes to administering relevant medication to their residents, which is especially important during the difficult winter months. 2

3 Wellbeing Service Consultation We recently ran a consultation for people to have their say on the Wellbeing Service (also known as Improving Access to Psychological Therapies IAPT), along with four other CCGs. The Wellbeing Service provides support for people aged 16 or over who face mild or moderate mental health challenges such as depression and anxiety. In the period from April 2012 to June 2013, the current Wellbeing Service: Mental Wellbeing in Norfolk and Waveney - Shaping the Future - Consultation Document 4th November st January 2014 Treated nearly 15,000 people. Helped 48% of those people feel they had recovered from their presenting need. Helped 533 people move off sick pay/benefits and into meaningful activity. The public consultation was set up to review the way the Wellbeing Service is provided and how people and carers are using it or plan to use it in the future. We collected views from current and previous users of the service, carers of current and previous users, people who are thinking about getting help for anxiety or depression and other local people. The consultation process also included focus groups with service users and workshops with GPs. The results of the consultation were analysed independently by researchers at the University of East Anglia (UEA). The final reports, including a summary document are available on the NN CCG website: Do you have a life limiting condition? Or do you know or care for someone that does? - North Norfolk CCG want to hear from you! North Norfolk Clinical Commissioning Group (CCG) is the local NHS body led by family doctors that plans and buys healthcare for local people. We want to hear what it s like to be a patient living in North Norfolk and rural Broadland. If you or someone you know or work with, would be interested in telling their story, then please contact Rebecca Champion on: rebecca.champion@nhs.net 3

4 New Local Approach to Testing for Irritable Bowel Syndrome Irritable bowel syndrome (IBS) is a common gut disorder, the cause of which is not yet known. Symptoms are variable and tend to come and go they include abdominal pain, bloating, and sometimes bouts of diarrhoea and/or constipation. There is no cure for IBS but symptoms can often be eased with treatment. It can be difficult to distinguish between IBS and inflammatory bowel diseases (IBD) such as Crohn s disease or ulcerative colitis. As a result many of these patients need to undergo a colonoscopy to differentiate the cause of their problem. This places considerable pressures on endoscopy services at Norfolk and Norwich University Hospital (NNUH), and for those patients with IBS represents an unnecessary and unpleasant experience. We have worked with gastroenterologists at NNUH to implement recent guidance from the National Institute for Health Care and Excellence (NICE) that will improve the differential diagnosis of IBS and IBD and free up capacity within the endoscopy service. This will be done by offering a recently developed test on a stool sample for a protein called calprotectin, the levels of which are usually only raised in patients with IBD. These patients will then be referred promptly to a specific IBD clinic at NNUH, whilst those with IBS will be treated in primary care, saving at least 300 unnecessary colonoscopies a year. North Norfolk Provider Forum The North Norfolk Provider Forum meets quarterly and includes representatives from health, housing and social care. Its purpose is to enable effective communication and engagement between commissioners, operational teams and organisations providing services within the locality. It presents an ideal opportunity to share knowledge and encourage consultation and collaboration, whilst providing a link between North Norfolk CCG and Norfolk County Council locality operational and integrated commissioning teams. When organisations were asked why they attended the forum and what benefits they found, these were some of their answers: Enables organisations to make contact with others in the locality. Provides a place to find out what s going on within the locality and within Norfolk. It is supportive of integrated working. Can help to share ideas and good practice. Helps to build relationships. continued over page 4

5 The following agenda items have been identified through the discussions and will help to shape discussions when planning future agendas: Learning Disability Dementia End of Life Hospital Discharge Integrated Care Programme Market Development Procurement processes Personal Budgets The forum is looking to increase the number and variety of organisations attending in order to build on good practice and better support the sharing of ideas. Adult Audiology Service Update In the last issue of Partnership News we reported a new adult audiology service being provided by three commercial companies at 21 locations across North Norfolk. In addition to this, the Audiology Departments at the Norfolk and Norwich University Hospital Trust, Cromer Hospital and the Queen Elizabeth in Kings Lynn are also involved in this scheme and are all available for patients to choose from. You can find out more information about North Norfolk Clinical Commissioning Group by going to our website at: 5