For me, the patient experience is very much at the centre of everything – and we're taking the whole area of public engagement very seriously. Our remit as a pathfinder is ‘focusing on assurance of high-quality primary care to deliver demonstrable improvements in health outcomes, patient experience and value for money'. It means incorporating the views of the local community and the experience of patients and GPs into the commissioning process.
We are working with the local authority on developing a new state-of-the-art integrated care centre and recently attended a community fun day in Chester, where GPs and CCG staff talked to people about the new centre. We will shortly hold a community event and invite residents and voluntary organisations to discuss plans for the new building. We're also looking at why people access A&E instead of using urgent care services such as out-of-hours or extended-hours GP services.
Our GPs work closely with managers on projects such as QIPP and our chief operating officer Alison Lee is central to this. Our links with our local authority – Cheshire West and Chester Council – are really good. We've already been working together on setting up our health and wellbeing board, and our joint commissioning work is developing well.
Localities
West Cheshire is very varied and we unite three very different localities:
- Rural – 11 practices, population 65,000
- Ellesmere Port & Neston – 13 practices, population 87,000
- Chester City – 14 practices, population 102,000.
These vary widely in terms of geography and deprivation levels and the health needs of patients. The localities date back from PBC.
I think our overall size and structure is about right in terms of ownership of decisions and influence with providers.
We already have a clinical senate – although it's more local than those envisaged in the health bill amendments, and so we may have to rename it.
We've always tried to ensure that local providers are involved in the decision-making process, and our senate involves the medical directors of our local acute trusts and our mental health and community service providers. We also have the heads of children's and adult services, public health, allied health professionals and nursing as well as GP leads.
Our major provider is the Countess of Chester Hospital – a foundation trust – and we've made significant strides in planned care.
GP referrals are falling – our referral management system cut referrals by around 6% on last year – and our emergency admission initiatives are working.
Finances
We are confident we will deliver on our financial duties, and believe we will be running on £25 a head. Towards the end of the year we'll know better what we're going to need to buy in and what we can do inhouse. We have one unusual local financial problem in that people living across the border in Wales have been using the Countess of Chester and our dentistry services, which means a recurring £3m hole in our finances.
Success
Success for us would lie in the quality of health provision as measured by the patient experience. We want patients to not notice any divide between primary and secondary care. Overcoming the problems of the internal market has been difficult, but signs are that there is now a willingness to overcome this.
It's that horrible word ‘seamless', but I think that is the goal. And to pull that off, I think we need to look after each other so that we can look after patients.
We want to be a caring organisation, because if we develop our staff and look after them they'll work and perform better.
Dr Huw Charles-Jones is chair of West Cheshire CCG and a GP in Chester
