Can PCTs Make a Difference?

Chris Humphris, Chief Executive, Cambridge City PCT

Yes they can!!

Bit about me

• Started in the NHS near this very spot

• Acute hospital

• Health Authorities

• Community Trusts

• Health Action zone

• Nursing / Residential Care Company

• Community Trust

• Primary Care Group

• Primary Care Trust

You may know Cambridge as

But it is a city of contrasts

Cambridge City PCT

• Started in April 2002

• Well resourced PCG

• 143,000 population (108,000 live in the City)

• Budget of £108 million

• 18 GP Practices

• Community Hospital, Hospice, and range of community services

• Big teaching hospital (Addenbrooke’s) in the city

What does a PCT actually do?

a) Provide Community Services • Manage Brookfields Hospital, Arthur Rank

Hospice, Community Nursing, Intermediate Care and other community services (some on behalf of South and East/Fenland PCTs)

b) Commission Services

• Commission services from Addenbrooke’s NHS Trust and other organisations

c) Develop primary care• Serving a population of 143,000, registered with

18 General Practices• We also support the development of Pharmacy,

Dentist and Optician services

d) Work in partnership with Local Authorities

• Work closely with Social Services to integrate health and social care (e.g. Occupational Therapy and Discharge Planning)

• Work closely with the City Council and others to improve the health of the population (e.g. accident prevention, addressing inequalities, reducing smoking, Sure Start)

Who is the PCT?

• The Board

• The Professional Executive Committee

• The Senior Management Team

• “Headquarters” Staff

• Employees of the PCT

• GPs and their staff

• Dentists, Pharmacists, Opticians

All of the above!

Ask not what the PCT can do for you

Ask what you can do for the PCT

Can we make a difference?

Yes we can!!!

Making Connections

The strength of the PCT lies in our ability to make connections

Some Cambridge Examples - Delayed Discharges

Friday 8am meeting!

Tackling Delayed Discharges

• Building nursing and residential care capacity

• Building domicilary care capacity

• New Integrated Discharge Planning Team

• New process (estimated date of discharge)

• Marlowe House

• Continued focus on numbers

• Using the “fines” money up front

• Community support for vulnerable older people

• Investing in Rapid Response

Homeless Service

• Special PMS for the “Homeless”

• City Council funding premises

• Joint Strategy

Trumpington Branch Surgery

• 3 months notice from previous practice

• Assistance from local entrepreneur

• Persuaded a City practice to take it on

• Temporary accommodation with a view to the future

Operation Ortolan

• Preventing crack cocaine from taking a hold in Cambridge

• Had to move quickly to deal with the threat

• Criminals targeting vulnerable people in North Cambridge

Sure Start

• Unexpectedly selected

• PCT led the process

• Creating an “inclusive” Board

• Identifying local need

Health and Social Care Integration

• OT - Tackling waiting lists

• Equipment

• Aids and adaptations

• Social Services Manager in PCT Senior Management Team

• Mapped pathways across whole system:-

- Falls - Stroke - CHD - COPD

• Maps populated with activity data

• 4 maps ‘generic’ medical pathway

• The 4 pathways were redesigned

• Some changes within existing resources

• Proposals developed for additional funding

Care Pathways

So what about the Local Delivery Plan?

……and all those targets!!!!!

……..and all those pressures!!!!!!

Dealing with the Pressures

We are in this for the long term

Trying to avoid short-term expedient measures if at all possible

if they get in the way of the long-term plan

Make connections

Some of our challenges

• To reduce the demand for secondary care services by doing more, and doing it differently, in Primary Care

• Integrating health and social care for older people in a way that improves services and offers better value for money

• Working with the public to reduce drug expenditure

• Developing mental health services outside Cambridge

Can PCTs Make a Difference?

Yes we can!!!