How you influence our commissioning decision making

How you influence our commissioning decision making.

The CCG has to make a wide range of decisions or choices – about what issues to prioritise, what approaches will best address those issues and how to deliver those approaches. There are a number of issues to consider when making these decisions – for example what does any applicable guidance say, what is the available clinical evidence and what has worked well elsewhere.

However it is vitally important that our commissioning decisions also reflect the preferences, perspectives and experience of people who use services. They have information which commissioners don’t – for example: what it’s like to live your life managing one or more long-term condition, how it feels to be supported though a degenerative illness or what would really make a difference to their day to day quality of life.

For this reason, all our key decisions reflect insight we have gained through a range of interactions with service users and the wider public.

We undertook a consultation into Urgent Primary Care, including pre-consultation work about really mattered to people about accessing primary care urgently.

Following this, at the June 2018 meeting of the Oldham Health and Wellbeing Board, our Clinical Director for Urgent Care Dr Shelley Grumbridge presented a brand new Urgent Primary Care Strategy based on the insights from the consultation exercise.

The purpose of the Urgent Care Strategy was to set out, in a single document, the future plans for commissioning and developing urgent care across Oldham to ensure it is effective, affordable and sustainable. Whatever the urgent need was, and in whatever location, the aim was to ensure that the population had access to the best care from the right person in the best place and at the right time.

 

You said about urgent primary care…

We did (our strategic aims)…

People said they lacked confidence to treat themselves and their families for minor illnesses and preferred to seek professional medical attention on the precautionary principle.

To provide better support for self-care.

It was not clear where authoritative information and advice could be received. Sometimes they had received conflicting advice from different professionals.

To help people with urgent care needs get the right advice in the right place, first time.

Although people found the idea of A&E reassuring, they felt waits were too long and the department was often clogged up with people who did not need to be there.  They would prefer to have care for less serious injuries and illnesses nearer to home if the care was comparable.

To provide highly responsive urgent care services outside of hospital, so people no longer choose to queue in A&E.

People felt most strongly that A&E must be protected from being overwhelmed by inappropriate presentations and so credible alternatives needed to be developed which made those patients a better offer than attending A&E. They wanted to know that A&E would have the resources to treat them should they ever have to attend in a life threatening situation.

To ensure that those people with serious or life-threatening emergency care needs receive treatment in centres with the right facilities and expertise in order to maximise chances of survival and a good recovery.

Generally people wanted most care closer to home but they felt that their experiences showed disjointed approaches with no one taking overall responsibility for their care and treatment and they felt they were being left to navigate a confusing system of care.

To connect all urgent and emergency care services together around place (population of 30-50k) so the overall system becomes more than just the sum of its parts. (Integration and transformation)