TVSCN > Medical Director Update Q3 2017/18

Medical Director Update Q3 2017/18

Dear colleagues,

I’d like to wish you a happy new year, and to thank you all for your hard work in 2017. Whilst the NHS faces unprecedented challenges, the calibre of people working for the NHS in South Central gives me confidence that we will both meet our challenges and share learning with others.

Clinical leadership changes

Within the South Central area, two new clinical chairs have been appointed to lead two of our clinical commissioning groups. Dr Kiren Collison and Dr Richard Sandford-Hill are the new clinical chairs for Oxfordshire and Wiltshire CCGs respectively.

• Kiren has worked in Oxfordshire for 13 years and has recently played a central role in setting up in-hours GP urgent access hubs, leading a workforce of 30 clinicians across five areas in the county. She has also held the role of CCG Clinical lead for diagnostics and maternity.
• Richard qualified from St. George’s Hospital Medical School in 1988 and his clinical interests include minor surgery and palliative care.

These are two fantastic appointments and I trust that you’ll all join me in extending a warm welcome to them and lend them your support. I would also like to take the opportunity to thank Dr Joe McManners and Dr Peter Jenkins the respective outgoing clinical chairs for Oxfordshire and Wiltshire CCGs for their sterling work over the past few years. Joe has made a significant contribution to the work of Oxfordshire CCG to develop plans for sustainable health care services and to tackle inequalities in the health of the most deprived members of the population. Peter has made significant contributions to the way the CCG have re-shaped primary care services in Wiltshire.
Thank you both.

GP appraisals

Our 200 GP appraisers and senior appraisers in South Central do a fantastic job. Not only is this a statutory requirement, necessary to allow GPs to see patients, but it’s an invaluable way of improving quality. I was delighted to be invited to the Regional Appraiser Training session in Berkshire and see first-hand the dedication our appraisers have to maintaining and improving the quality of appraisals.

Leading local research

In early November I met with Professor Richard McManus from the Nuffield Department of Primary Care Health Sciences at the University of Oxford, whose team is doing groundbreaking research around managing hypertension in primary care. Our local academic departments have some deeply knowledgeable people and as we chart new territory, it will be important that we tap into their knowledge, experience and skills in research and evaluation. As an example of this, Becky Furlong, Thames Valley SCN Network Manger – Children & Maternity and Jane Herve, Thames Valley SCN Clinical Lead – Maternity have started to work with Richard on a study of hypertension in pregnancy.

BMA events

I was delighted to be invited by the British Medical Association (BMA) to give two presentations about Sustainability Transformation Partnerships (STPs) to BMA members in the Berkshire West, Oxfordshire and Buckinghamshire and Frimley Health and Care STP areas. As ever, the debate was lively, but it was clear to me that the clinicians in the room had a real passion for helping to shape the future of health services and making sure that their patients received the highest quality care possible. I’d like to thank Hugh Townsend for organising the events, and Ian McNab and Jane Orr for so ably chairing the meetings. I look forward to working closely with them in the future.

Thames Valley and Wessex Leadership Academy

On 10th November I was delighted to join the board meeting of the Thames Valley and Wessex Leadership Academy. During the meeting, board members described their vision, three strategic objectives and how they are delivering those objectives. There were also discussions about talent management and the NHS management training scheme, and you can see the slides here: http://bit.ly/2DCMnm9. For more information please contact Maggie Woods (Maggie.Woods@hee.nhs.uk) or Ali Jennings (Alison.Jennings@hee.nhs.uk).

I would like to take this opportunity to congratulate Caroline Chipperfield, Director of the Thames Valley and Wessex Leadership Academy, on her appointment as Deputy Managing Director for the national NHS Leadership Academy.

Cardiac

The British Heart Foundation hosted the national cardiac leads meeting. It was interesting to see how just how many Strategic Clinical Networks were still maintaining cardiac networks. Tony Rudd (National Clinical Director for Stroke) gave a presentation about thrombectomy for stroke, and he and Huon Gray (National Clinical Director for Heart Disease) led a conversation about the potential for cardiologists to be trained up to perform thrombectomy.

Thames Valley Clinical Senate

At its meeting in November, the Thames Valley Clinical Senate discussed the Senate report on smoking cessation services in secondary care and the implications of the report. The report provides evidence that while the smoking prevalence rate of hospital patients is higher than the general population and an inpatient stay is an optimal time for patients to consider their lifestyle, 32% of inpatients were not asked whether they smoke and only 25% of identified smokers were asked if they would like to quit. The Senate agreed a set of recommendations to improve the rate of interventions.

Regional service reconfiguration masterclass

Service reconfigurations can lead to enormous improvements in quality of care for patients and working practice for staff, but working on transformation can be challenging.. In order to share best practice, our Communications and Engagement team led a superb masterclass on service reconfiguration across the South region. Speakers included David Radbourne, Director Commissioning Operations, NHS England South East who set the context for service reconfigurations across the South currently, Peter Edwards, Partner, Capsticks who spoke about the legal framework, Richard Jeavons, Chief Executive of the Independent Reconfiguration Panel who shared his advice on engaging with scrutiny committee, Tim Gilling, Director of the Centre for Public Scrutiny who spoke about finding common ground between health, social care and scrutiny, Frances Newell, Head of Engagement and Communications (Public Engagement), NHS England spoke about co-producing proposals from the start, and our very own Wendy McClure, Thames Valley Senate Manager shared her insight into the valuable contribution of clinical senates.

Musculoskeletal partnership event

I was delighted to be asked to open the SCN Musculoskeletal Partnership event on 24 November. Musculoskeletal (MSK) diseases are the biggest cause of years lived with disability in the South. It was therefore quite right that partners from CCGs, NHS trusts, RightCare, GIRFT (Getting It Right First Time), as well as Public Health England (PHE), NHS England and Professor Peter Kay (National Clinical Director for Musculoskeletal Services) came together to share the national perspective on MSK as well as examples of excellent local best practice, such as the Berkshire West Integrated Pain and Spinal Service.

Living Within Our Means – South regional event

This was closely followed by the South Region ‘Living Within Our Means’ event held in Bracknell on 30 November, which again brought together the GIRFT and RightCare initiatives. These national programmes focus on a desire to improve the services we provide by reducing unwarranted variation. GIRFT has tended to be more provider focused and RightCare more commissioner focused. The presentations at the event looked at how we can start to combine these two initiatives to improve the service for our local population. The day was well attended, and the audience spent the afternoon attending workshop sessions that showcased examples of best practice from systems who have delivered innovative solutions to both improve clinical outcomes and achieve productivity benefits.

Cardiovascular disease prevention

Following the cardiovascular disease (CVD) prevention workshop in September, Public Health England convened a further meeting of the South CVD Prevention Board. There is a strong economic case for CVD prevention and a real appetite to tackle hypertension, atrial fibrillation, high cholesterol and smoking. Following this we brought together diabetes and cardiac GP leads from across the Thames Valley to discuss how we could support them to take the agenda forward. We are lucky to have such talented leaders in our patch who are so passionate about working together to reduce CVD mortality and morbidity.

Diabetes Reference Group

The Thames Valley Diabetes Reference Group meeting was, as ever, well attended. Partha Kar, National Associate Director for Diabetes presented the national picture for the type 1 pathway. He praised the Thames Valley for having ‘excellent clinical leadership’. He cited that Diabetes UK and ABCD have very good clinical champions programmes. Partha also discussed the work on accreditation for patient structured education, the progress on a single tariff for continuous blood glucose monitoring, and the new GIRFT datasets.

Jan Durrant (Diabetes specialist nurse, Royal Berkshire Hospital) was invited to join the national group looking at education accreditation, and Kathy Hoffman (GP lead for Bucks CCG) the national group looking at QOF indicators and the impact of remission for type 2 diabetes.

Diabetes IAF

CCGs have been informed of their additional assessment under the Clinical Commissioning Group Improvement and Assessment Framework (CCG IAF) for 2016/17, for diabetes. This was undertaken by the independent panel and draws on recently published National Diabetes Audit data for 2016/17.

Each CCG is provided with one of four ratings, described as: ‘outstanding’, ‘good’, ‘requires improvement’, and ‘inadequate’.

Our congratulations to Aylesbury Vale for an ‘outstanding’ rating.

South Central Leadership

On 13 December we held the South Central Leadership Forum. We had some wonderful presentations: Ian Orpen described the work of the West of England Academic Health Sciences Network; Matt Smith from PHE presented his Renal Needs Assessment and outlined ways that our services could be improved; Adrian Hayter gave a superb presentation about how multiple health and wellbeing boards can work together; Abid Irfan described the new musculoskeletal service in Berkshire West; Karen West described Buckinghamshire’s replacement of QOF and finally Maggie Woods led a session on clinical leadership.

Our South Central Communications and Engagement team did a superb job working with local media to promote NHS winter planning and to signpost the public to alternative services to Accident and Emergency Departments. In an interview with ITV Meridian, http://bit.ly/2qsuWiT, Dr Tim Ho described ambulatory care services in Frimley and Carol Trower, Chief Officer of Pharmacy Thames Valley talked about the role community pharmacists can play to support patients to self-care.

On 12 December the Thames Valley Cancer Alliance held its Board meeting in Oxford; despite the travel disruption caused by snow on the day, many members managed to attend in person. Those unable to travel participated using the webinar facilities and in all there was good representation from across the Alliance geography including hospital trusts, Clinical Commissioning Groups, Health Education England, Specialised Commissioning and Public Health England.

Don’t forget your flu jab

I live a long way from where I work which makes it difficult for me to get a flu vaccination at my GP surgery during the working week. Fortunately, I was able to walk into a high street pharmacist one Sunday and get my vaccination. I think it’s really important for healthcare professionals to get their flu vaccination and to make it as easy as possible for patients and the public to get their vaccination.

Finally I would again like to thank you all for your incredible dedication and hard work. We know this is an extremely busy time for you all.

SHAHED AHMAD

MEDICAL DIRECTOR
NHSE ENGLAND (SOUTH CENTRAL)

Needlestick injuries and Occupational Health

Heales, the chosen provider for Occupational Health Services for GP and Dental Performers in the South, have been providing services since April 2017. Feedback indicates that the new service has good uptake and is being well received.

There has been a significant rise in reported needlestick injuries with over 60 calls to the confidential advice line provided by Heales every month. We encourage practices to ensure that all clinical staff are aware of procedures to prevent sharps injuries and that these are readily available and visible to staff to review on a regular basis. In the unfortunate event that an injury occurs, the confidential advice line offered by Heales is open Monday to Friday 9am-5pm on 0333 449 006. The advice line can provide a risk assessment, confidential advice and immediate support. Outside these hours there is pre-recorded advice and a messaging service.

Opportunities for practice nurses

The ‘All our Health Framework’ includes summary information and top actions for professionals on 22 public health/prevention topics such as obesity, homelessness and the NHS Health Check. It is a free online resource and be used by anyone: http://bit.ly/2DwrmXi

Anyone involved in immunisation might be interested to look at their local area immunisation COVER (Cover of Immunisation Evaluated Rapidly) statistics. This is the coverage for each vaccine group on the interactive NHS digital site http://bit.ly/2DFuaob

It is easy to use. If you put in the year and the area, you can then look at each vaccine group http://bit.ly/child_vaccstats_annual 

The Public Health Outcomes data fingertips tool http://bit.ly/2F62HJm provides a useful guide to look at the key indicators of public health at a local level and encourage practitioners to think about the local community and population needs. The data can be compared to other areas and shows trends and comparison information for a particular area.

Includes data against:

  • Overarching indicators e.g. life expectancy.
  • Wider determinants e.g. children on low income or school readiness
  • Health improvement e.g. low birthweight breastfeeding and obesity
  • Health Protection e.g. Sexually Transmitted infections, TB Infectious disease and vaccination
  • Healthcare and premature mortality e.g. Mortality and morbidity rates for specific conditions.​

The Independent Reconfiguration Panel seeks new clinical members

The Independent Reconfiguration Panel (IRP) is the independent expert on NHS service change, and is looking for new members. Full details can be found here: http://bit.ly/2n7ennX Please contact Richard Jeavons, Chief Executive(richard.jeavons@dh.gsi.gov.uk) for an informal discussion in the first instance.

Opportunity to join the Q Community

Q is an initiative connecting people who have health and care improvement expertise across the UK, led by the Health Foundation and supported and co-funded by NHS Improvement. There will be a new opportunity to join the community in Spring, for more details see here: http://bit.ly/2Bo7gfD

High Blood Pressure: Action plan

Public Health England has updated evidence-based advice on how to effectively identify, treat and prevent high blood pressure, see the full advice here: http://bit.ly/2n3ioJW

Newsletters

The Thames Valley Strategic Clinical Network produces a range of newsletters, which you can view here:
End of Life bulletin
Dementia Matters
Cancer Alliance