Welcome to Cheshire Chat - NHS Cheshire Clinical Commissioning Group is committed to hearing from our local people and communities and continuing ...

NHS Cheshire Clinical Commissioning Group is
committed to hearing from our local people and
  communities and continuing to give you the
    opportunity to shape the future of local
                  healthcare.

Welcome to Cheshire Chat

Agenda
1      Welcome and overview of Cheshire Chat      Tracey Cole
2      NHS Cheshire CCG’s response to COVID-19    Tracey Cole
3      Our commissioning work:                    Dr Andy McAlavey
       Primary Care
4      Our commissioning work:                    Dr Katherine Butler
       Cancer
5      Our commissioning work:                    Dr Ian Hulme, Lesley Cleworth
       Mental Health                              and Melanie Brown
6      Closing comments and next steps            Tracey Cole

    Using Twitter today? Make sure you use our #CheshireChat!

Welcome and Overview
• First ever virtual Cheshire Chat webinar
• Start of our new way of sharing information and listening
  to you
• Webinar how-to guide:
   – You’re all muted and we can’t see or hear you
   – The question function is to the right of the screen-
     please add your question here and we will try and
     answer as many as possible
• We will collate some Frequently Asked Questions (FAQs)
  to share following the event with all questions and
  responses

NHS Cheshire CCG response to
COVID-19

• National NHS ‘level 4’ incident
• Work as part of a Cheshire system
• CCG Incident Management Team and Co-ordination
  Centre
• Mutual Aid – Personal Protective Equipment (PPE)
               and Testing

Commissioning against a backdrop
of COVID-19

• We have had to do things differently
• Majority following national guidance
• Local decisions to support safety and care of our local
  communities, patients and staff
• This first Cheshire Chat will describe work that is ongoing
  in the following areas:
   – Primary Care
   – Cancer
   – Mental Health

Primary Care

•   The Standard Operating Framework document from NHS England outlines the key
    principles for how practices should operate. This has had to be reviewed and
    processes amended since the outbreak of COVID19.

•   There have been fundamental changes to how practices deliver Primary Care.

•   All patients are being triaged remotely and remote consultations carried out
    where possible. All practices have adopted video consultations during this time.

•   All practices have had to work together to safely separate different cohorts of
    patients including patients with symptoms of COVID19 and shielded patients who
    are the most vulnerable group within our population.

•   The number of patients presenting with important clinical symptoms has
    dramatically decreased. ‘Help Us Help You’ has been launched across the NHS to
    persuade the public to seek the urgent care and treatment needed.

•   Do not hesitate to contact your practice if you develop any worrying symptoms.
    Practices are happy to assess all patients, this may just be carried out in a
    different way.

Primary Care

•   The NHS have entered the 2nd phase of the response to COVID19 and Primary
    Care need to ensure patients have clear information on how to access care and
    are confident in how to make appointments. Work also needs to be completed
    on the implementation of digital and video consultations.

•   Primary Care are proactively contacting all shielded patients to ensure they are
    aware of how to access care and are receiving all medication and services they
    require. Lots of effort is being made to ensure this clinically vulnerable group feel
    supported.

•   A package of support for care homes is being put in place which forms a
    collaboration between Primary Care and Community Teams. This includes a
    virtual care home round of residents needing clinical support, a named Clinical
    Lead to help care homes co-ordinate the care of residents, maintains medication
    support to care homes and the development of personalised care and support
    plans for all residents.

•   We need to accept we are entering a ‘new normal’ and everyone needs to adjust
    to these new ways of working in order to maintain the safety of all patients and
    staff.

Dr Katherine Butler
                GP Clinical Lead
for the Prevention & Thriving Programme Team
      NHS Cheshire Clinical Commissioning Group

    Saving Lives Together

Screening Programmes
Testing apparently healthy people for early signs

  Breast screening test - Mammography
  Women 47 to 73 every 3 years
  Invitation through GP surgery
  Women 73+ can request screening via GP

  Cervical screening test – Smear test
  Women 25 to 64 in England
  Every 3 years up to 49, then every 5 years to 64
  Invitation through GP surgery

  Bowel screening test – FIT (Faecal Immunochemical Test)
  Men & women 60 to 74
  Every 2 years by Postal testing kits – just one sample
  needed now (unlike the old test)
  Age 55 – one off invitation for bowel scope (programme being
  gradually rolled out over our area)

  If someone wants a replacement kit, or is over 74, they can
  just call the Bowel Screening Service 0800 707 6060

Signs & Symptoms of Cancer
 - most common

Blood in                         Unexplained
your pee                         weight loss
 or poo
                   Heavy night
changes
Unusual

                     sweats
 breast

           Post-menopause
                                           Difficulty
           vaginal bleeding                swallowing
Persistent                            Sore that won’t heal
 bloating

Lots of possible symptoms …
                      but we have one over-riding message…

Mental Health & Wellbeing

•   The 1st April 2020 NHS Cheshire CCG became one organisation incorporating
    what used to be 4 separate CCGs.
•   Services, contract values and approaches to commissioning across Cheshire, are
    variable due to the complex historical background in which decisions were made.
    We are working towards having a single all age approach across Cheshire and
    work is underway to align commissioning models.
•   Although COVID-19 has impacted on this transition period, a rapid shift to digital
    provision and reconfiguration means that services has still been in place to
    support individuals either through advice information, 1-1 virtual assessment or
    face to face where required.
•   Some planned services have been implemented sooner such as the introduction
    of the 24/7 crisis line and also enhanced online services for Children and young
    people.
•   We aim to maintain beneficial changes, such as the use of virtual assessments,
    increased online support as well as triaging and prioritising assessments for
    those that require face to face assessments and therapy input Services are
    anticipating extra activity as we emerge from lockdown and ongoing work is
    underway to ensure this is managed.

Priorities for Mental Health

•    Address inequalities in access to mental health services

•    Transform services to support all-age open access

•    Prioritise the development of community assets to reduce the reliance on inpatient
     care, including virtual or telephone support where appropriate

•    Increase access to mental health services for Children and Younger People
     (acknowledging the impact of COVID on some of the face to face services planned for
     2020)

•    Prepare for a possible longer-term increase in demand as a consequence of the
     longer term impact of the pandemic on mental health and wellbeing

•    Ensure proactive contact and support is provided to those people already using our
     services, prioritising those who are severely mentally ill and /or with a learning
     disability or autism

•    Provide enhanced psychological support for all NHS staff. We are also exploring
     options of how this can be expanded to Social Care staff and Care Home staff.

How do I access Support?

•    24/7 Crisis Line (All Age): The dedicated phone number: 0300 303 3972 should
     now be everyone’s first port of call for urgent mental health help in Cheshire and
     the Wirral.

•    You should still call 999 or go to A&E if you have a life-threatening
     emergency requiring immediate mental or physical health assistance

•    For non-urgent help and general wellbeing advice, including links to resources to
     support people with anxiety, low mood, and worries relating to the current Covid-
     19 pandemic visit www.cwp.nhs.uk

•    For children and young people there is also a dedicated website MyMind.org.uk

•    www.nhs.uk supports you to find NHS services and information

•    You can also contact our psychological therapy services (IAPT). To find out more:
     West https://bit.ly/2z1Z89q or East http://bit.ly/2tmJIX1

Next Steps

• Thank you for your time and your input
• Start of conversation about our commissioning work
• Survey – link in invite and will follow
• Video of each topic will be available shortly
• We want your feedback – let us know what you think of
  this event
• Cheshire Chat virtual sessions will continue – watch this
  space
• Stay in touch

Healthwatch Cheshire Survey

  www.healthwatchcheshireeast.org.
          uk/coronavirus
  www.healthwatchcheshirewest.org.
          uk/coronavirus

8pm Clap for our Carers
and Keyworkers

                 Thank you!