locality 2 – practice and population overview

SPARKBROOK PRACTICE BASED

COMMISSIONING PLAN

2008 – 2009

TABLE OF CONTENTS

1. Executive Summary………………………………………………...….page 3

2. Introduction ……… …………………………………………………...page 5

3. Financial Position ……………………………………………………...page 8

4. Commissioning Priorities 2008/9………………………………………page 10

- COPD Screening ………………………...............................page 11

- Primary Care Gynaecology ……………...............................page 13

- Cardiology ………………………………………….. ……..page 15

- Rheumatology …………………………...............................page 18

- Ophthalmology …………………………………………….page 21

- Patient Education ………………………..............................page 23

- Dermatology ……………………………………….............page 25

- Chiropody ………………………………………………….page 27

- Counselling ………………………………………………...page 28

5. Workplan …………………………………............................................page 29

Sapna Sharma, Scott Lamb & Dr Sharad Pandit, September 2008 2

EXECUTIVE SUMMARY

The Sparkbrook Commissioning group has identified a set of commissioning

priorities for 2008/9, some of which are applicable to the larger commissioning group

and other which are priority areas for only 1/2 of the 3 sub commissioning groups

within Sparkbrook. The following briefly summarises the proposed initiatives and

their relevance to the strategic objectives of the PCT.

COPD Screening: Enhanced COPD screening provision through Spirometry

to ensure proper identification of at risk patients. Aimed to meet the strategic

objective of improving services and outcomes for chronic disease patients.

Gynaecology: Establishing a Gynaecology service within a community setting

to manage a set number of conditions suitable for primary care diagnosis and

treatment. Aimed to meet the strategic objective of improving the range and

quality of primary care services and shifting services out of hospital.

Cardiology: Establishing a Cardiology service within primary care to manage

a set number of conditions suitable for primary care diagnosis and treatment,

including access to echocardiography. Aimed to meet the strategic objective of

improving the range and quality of primary care services and shifting services

out of hospital as well as improving services and outcomes for chronic disease

patients.

Rheumatology: Establishing a Rheumatology service within primary care to

manage a set number of conditions suitable for primary care, focusing on

follow up management of patients with long term conditions. Aimed to meet

the strategic objective of improving the range and quality of primary care

services and shifting services out of hospital as well as improving services and

outcomes for chronic disease patients.


Ophthalmology: Establishing a service to see the large volume of follow ups

within ophthalmology that require basic annual checks. Aimed to meet the

strategic objective of improving the range and quality of primary care services

and shifting services out of hospital.

Patient Education: Addressing the general themes of enhanced patient

education, focusing on patient self care, chronic disease management and

appropriate utilisation of NHS services. Aimed at improving the health and

well-being of patients

Mental Health Counselling: Providing in-practice support for patients who

require counselling, but for whom current services are not suitable. Aimed at

the strategic objective of improving the range and quality of primary care

services and improving the health and well-being of patients


INTRODUCTION

Practice based commissioning (PBC) is one of the main initiatives driving change

within the NHS. Over the years, the Heart of Birmingham tPCT has introduced a

number of initiatives through PBC which have been designed to bring care closer to

the patient, improve the quality of health care, and reduce existing health inequalities.

One of the many challenges of PBC includes the effective use of PBC resources to

address both national and local priorities. These priorities include; improving health

outcomes for babies and children, improving health and social services for the elderly,

improving the management of patients with a chronic disease, reducing health

inequalities, and improving access and reducing waiting times for health services.

Other relevant priorities, both regional and local include, improving women’s health

services, especially around sexual health and maternity, improving mental health

services, reducing avoidable hospital admissions, and improving the patient

experience.

The GPs involved with PBC recognise the need to work with other PCT initiatives,

particularly the Towards 2010 programme. In developing these priority areas the

consortium has taken into consideration these PCT developments, both national

commissioning priorities and local priorities for the Heart of Birmingham tPCT and

actively sought feedback from patients and the public.


The tables below provide a practice and population overview by consortium.

LOCALITY 1 – PRACTICE AND POPULATION OVERVIEW

SPARKHILL

The Sparkhill Commissioning Group comprises 28,113 patients in 6 practices within

Heart of Birmingham Teaching Primary Care Trust, as listed below:

GP Practice Address List Size

Hall MG, Jassel GS, Mavi BS 578 Stratford Road, Sparkhill, Birmingham. B11 4AN

7,212

Karzoun FK, Gill SK 26 Oakwood Road, Sparkhill, Birmingham, B11 4HA

4,986

Shah SY, Mann AB, Poltock TL

Fernley Medical Centre, 560 Stratford Road, Sparkhill, Birmingham, B11 4AN

6,211

Ramachandram RS Moor Green Lane Medical Centre, 339 Moor Green Lane, Moseley, Birmingham, B13 8QS

3,352

Rajput VK, Rajput S Springfield Medical Practice, 739-741 Stratford Road, Springfield, Birmingham, B11 4DG

3,408

Melchior AM, Fleming GC 183A Woodlands Road, Sparkhill, Birmingham B11 4ER

2,944

SMALL HEATH

The Small Heath commissioning group comprises 29,759 patients in 6 practices

within Heart of Birmingham Teaching Primary Care Trust as follows;


Dadheech VK, Dadheech HH The Limes Medical Centre, Cooksey Road, Small Heath, Birmingham, B10 0BS

6,766

Thomas MK, Thomas V Birmingham Heartlands Surgery, Gray Street, Bordesley Village, Birmingham B9 4LS

3,509

Khattak SH, Khattak SS 58 Benton Road, Sparkbrook, Birmingham, B11 1TX

3,481

Verma SK, Zafar SA, Zafar A 192 Charles Road, Small Heath, Birmingham B10 9AB

4,380

Ahmad Y, Ahmad N, Ahmad S, A Ahmad

Coventry Road Medical Centre, 448 Coventry Road, Small Heath, B10 0UG

7,873

Shah VM, Shah MJ Bordesley Green Surgery, 143-145 Bordesley Green, Birmingham B9 5EG

3,750



LOCALITY 2 – PRACTICE AND POPULATION OVERVIEW

BALSALL HEATH

Locality 2 comprises 53,671 patients in 14 practices within Heart of Birmingham

Teaching Primary Care Trust. Details are listed below:


Abdel-Malek GT Farm Road Health Centre, 32 Farm Road, Sparkbrook, Birmingham, B11 1LS

5,504

Pandit SS 1 Brinklow Tower, Upper Highgate Street, Highgate, Birmingham B12 0XT

3,677

Ramarao MV Sparkbrook Health Centre, Farm Road, Sparkbrook, Birmingham, B11 1LS

3,173

Walji MTI Balsall Heath Health Centre, 43 Edward Road, Balsall Heath, Birmingham, B12 9LP

4,902

Sinha AK Balsall Heath Health Centre, 43 Edward Road, Balsall Heath, Birmingham, B12 9LP

2,710

Ahmed B 1 Newport Road, Balsall Heath, Birmingham, B12 8QE

6,719

Chunduri DR The Balaji Surgery, 2 Blackford Road, Sparkhill, Birmingham, B11 3SH

3,092

El-Sheikh OAA Strensham Road Surgery, 4 Strensham Road, Balsall Heath, Birmingham B12 9RR

3,107

Agarwal MD Warwick Road Medical Practice, 220-222 Warwick Road, Sparkhill, Birmingham, B11 2NB

4,124

Hafeez A, Hafeez F 158 College Road, Moseley, Birmingham B13 9LH 3,811

Kulshrestha RP Aberdeen Street Medical Centre 1,641

Firstcare Mobarak Health Centre, 8-10 Cannon Hill Road, Balsall Heath, Birmingham, B12 9NN

6,225

Mayor V 52 Chesterton Road, Sparkbrook, Birmingham, B12 8HE

2,115

Cheema MN 35 Warwick Road, Sparkhill, Birmingham, B11 4RA

2,871


FINANCIAL POSITION

In addition to national and local objectives the commissioning priorities have also

been developed within the context of existing freed up resources (FURs) available to

practices. Sparkbrook has a large amount of FUR’s available for PBC projects.

Currently, Locality 1 (Small Heath and Sparkhill) have just over £2 million available

and have committed around £1.5 million on PBC schemes. Locality 2 (Balsall Heath)

have just over £465,000 available having spent over £440,000 on PBC schemes. The

table below details the financial position of each practice in Sparkbrook.

In August 2008, a decision was taken to write-off overspends from 2005/6 (just over

£300,000). For some practices this led to additional available FUR’s whilst others

were unaffected by the decision.

The total value of FUR’s will be available to each practice until April 2009. Once we

enter the 09/10 financial year all FUR’s that have not been committed from previous

years i.e. 05/06, 06/07 and 07/08 will be managed by the Clinical Director of

Commissioning. The CDC will dedicate these funds for collaborative schemes in an

effort to distribute the resources equally. Practices will still have the option to submit

business cases for practice level initiatives but they must be approved by the CDC.


The CDC will retain responsibility of these FUR’s for twelve months, until April

2010, after which all remaining FUR’s will be transferred back to the PCT.

Although FUR’s from the previous years will be managed by the CDC, practices will

retain responsibility for committing any newly freed-up resources from 08/09


COMMISSIONING PRIORITIES 2008/9

This part of the document sets out the practice based commissioning priorities for the

Sparkbrook commissioning group for 2008/9. The Sparkbrook commissioning group

is split into 3 smaller commissioning groups known as the Balsall Heath, Sparkhill

and Small Heath commissioning groups. The 3 groups have been holding regular

meetings to develop their commissioning priorities. These priorities are in response to

a wide range of information available to practice based commissioners including,

local and national priorities, secondary care activity, public health data, financial

activity, GP’s own experiences of delivering care to their patients as well as feedback

from patients and the public. Upon approval of this plan the commissioning groups

will proceed to develop the proposed ideas into business cases in conjunction with

their local PBC team.

The table below provides details for the Sparkbrook PBC team:

Name Position Email

Dr Sharad Pandit Clinical Director of Commissioning [email protected] Sharma PBC Manager [email protected] Lamb PBC Data Analyst [email protected]

The following sections of this document outline the proposed commissioning

priorities for Sparkbrook, some of which are applicable to the larger commissioning

group and other which are priority areas for only 1/2 of the 3 sub commissioning

groups within Sparkbrook.


mailto:[email protected]



COPD SCREENING

(Sparkhill, Balsall Heath and Small Heath)

Proposal: The Sparkbrook Commissioning group propose to commission a COPD

screening programme. This will involve a Spirometry testing and interpretation

service for all patients at risk of developing COPD. The service aims to identify

patients with COPD as early on during their illness as possible and also improve the

long-term management of these patients.

Outcomes:

Increase in recorded prevalence of COPD

Reduction in emergency admissions and ACS spend for COPD related

conditions

Linkage to PCT priorities:

Long-term Conditions

Evidence of Need: The Heart of Birmingham tPCT has the lowest recorded

prevalence of COPD in the West Midlands (0.69%). The average prevalence of

COPD within Sparkbrook (0.59%) is significantly lower than the HOB average

prevalence and is less than half of the National average of 1.48% (see example 1).

In 2007-2008 there were almost 300 COPD related emergency hospital admissions

with a cost of around £321,000 to Sparkbrook practices. It is thought that the majority

of these admissions could have been avoided with earlier diagnosis and better

management of the condition within Primary Care.


Example 1

Sparkbrook COPD Prevalence Rates vs National Average

0.00

0.20

0.40

0.60

0.80

1.00

1.20

1.40

1.60

Pre

va

len

ce

%

Spirometry is the test most commonly used to diagnose COPD. The test is also used

to assess the progression and severity of COPD and help guide treatment and monitor

if treatment is working or of it needs to be modified. Thus, spirometry testing plays an

integral part in both the early stages of capturing patients with the risk factors

associated with COPD and also the long-term management of the condition. Although

the majority of practices offer this procedure to their patients there are, however,

some concerns associated with this e.g. the amount of time required to carry out the

procedure, the complexity of spirometry interpretation and the difficulties associated

with maintaining the level of skill required to carry out spirometry effectively.

On the basis of the above observations as well as the low prevalence and high

number/cost of emergency COPD admissions, commissioning a spirometry testing

and interpretation service would tackle the first crucial step towards the effective

management of patients with COPD.

Service Delivery: The service will be delivered by establishing a COPD screening

programme. This will be by either a locally enhanced service (LES) where practices

have the appropriate level of competency to screen patients for COPD or alternatively

by commissioning a specialist team to deliver an in-practice COPD screening service.


PRIMARY CARE GYNAECOLOGY


Proposal: The Sparkbrook commissioning group propose to develop a Primary Care

based gynaecology service for a range of gynaecology conditions that are suitable for

treatment within the Primary Care setting. The service will be aimed at reducing the

number of gynaecology outpatient attendances in secondary and will be provided

either by GP’s with a special interest (GPwSI) in gynaecology or an equivalent

provider.

Outcomes:

Bringing services closer to home

Reductions in secondary care referrals


Planned Care

Acute Care

Evidence of need: In 2007/8, spending on gynaecology outpatient attendances

represented the 4th highest speciality within the Heart of Birmingham tPCT (6% of all

outpatient attendances) costing over £600,000. Example 2 provides a breakdown of

this cost into new, follow-up and consultant-consultant referrals for Sparkbrook.

Example 2

Locality 1 Activity CostFollow Up 1599 £134,063New - Cons2Cons 148 £21,417New - GP 891 £129,322New - Other 118 £16,367Total 2756 £301,169

Sapna Sharma, Scott Lamb & Dr Sharad Pandit, September 2008

Locality 2 Activity CostFollow Up 1695 £143,712New - Cons2Cons 80 £11,206New - GP 1039 £149,874New - Other 171 £23,673Total 2985 £328,465

14

Furthermore, it is thought that the following conditions (which represent

approximately 70% of all secondary care gynaecology activity) can be managed

within Primary Care:

Initial assessment of infertility

Initial assessment of pelvic pain

Initial screening for sterilisation

Menopause management

Management of difficult smears

Menstrual bleeding

Post menstrual bleeding

Service Delivery: A Primary Care based Gynaecology service should ideally be

delivered as a combination of provision within General Practice as well as within a

community clinic e.g. low-level conditions (that do not require GPwSI accreditation)

can be treated within general practice whilst high-level conditions unsuitable for

treatment within general practice would be treated within a community gynaecology

service. This service could also be used to “fill in the gaps” where GP practices do not

have the capacity/meet the requirements to provide a gynaecology service for low-

level conditions. Possible providers for the community gynaecology service would be

GPwSI’s or secondary care gynaecologists.


CARDIOLOGY


Proposal: The Sparkbrook commissioning group recognise the need for the

development of a diagnostic pathway for Primary Care Cardiology and specialist

teams to improve the management of patients with cardiac conditions. In particular,

the commissioning group supports the development of community based ECG,

echocardiography, 24 hr BP monitoring and 24 hr ECG testing.

Outcomes:




Planned Care

Acute Care

Evidence of Need: The number of outpatient attendances for cardiology in Heart of

Birmingham PCT were significantly higher than both the West Midlands and National

average in 2007/8 (see example 3). Consequently, cardiology is currently the 8th

highest costing outpatient speciality in Sparkbrook; the total cost for new and out-

patient follow-ups in 2007/8 was £292,189.


Example 3

Sparkbrook Cardiology Outpatient Attendances Per 1000 Patients 2007/8

0

5

10

15

20

25

M85

146

M85

075

M85

128

M85

766

M85

781

M85

679

M85

127

M85

699

M85

713

M85

116

M85

733

M85

164

M85

078

M85

093

M85

174

M85

015

M85

756

M85

774

M85

783

M85

794

M85

085

M85

024

M85

735

M85

153

M85

051

M85

686

Sta

nd

ard

ised

Rat

e

Furthermore, congestive heart failure was identified as the highest costing

Ambulatory Care Sensitive (ACS) condition within Sparkbrook in 2007/8 (see

example 4). Hence, the available evidence points to both better diagnostic assessment

for cardiac conditions as well as improved management.

Example 4

Highest cost ACS Conditions for Sparkbrook 2007/8

£332,033

£309,315

£276,602

£257,057

£229,710

Congestive heart failure

COPD

Dehydration & gastroenteritis

ENT infections

Asthma


Service Delivery: The Sparkbrook commissioning group support the development of

a community based outpatient and diagnostic service provided by either an accredited

GP with a special interest in cardiology or a secondary care cardiology specialist.

The Balsall Heath commissioning group have also expressed an interest in investing

in those elements of the service that are suitable for provision within general practice

i.e. 24 hr BP monitoring by purchasing the relevant medical equipment for use within

the practice. In-practice provision will save on the costs associated with secondary

care referral for this service.


RHEUMATOLOGY

(Sparkhill and Balsall Heath)

Proposal: The Sparkhill and Balsall commissioning groups have identified

Rheumatology as a commissioning priority as this is an outpatient speciality which

has a high follow up ratio (7.45 in 2007/8). The commissioning groups propose to

transfer (where appropriate) a proportion of this activity into Primary Care.

Outcomes:




Acute Care

Long-term Conditions

Evidence of Need: In 2007/8, 88% of all Rheumatology activity was for follow-up

attendances (Example 5) with a total cost of £170,359 in Sparkbrook (Example 6).

The high number of patients on methotrexate (a drug prescribed for rheumatoid

arthritis) accounts for a high proportion of this activity as these patients attend

secondary care for regular monitoring; these patients could easily be monitored within

primary care, thus, saving the cost of outpatient follow up appointments.


Example 5

Example 6

Service Delivery: The Sparkhill and Balsall Heath commissioning groups propose to

develop a locally enhanced service (LES) aimed at reducing the number of

Rheumatology follow-up appointments within secondary care by delivering an in-

practice follow-up service for patients who are suitable to be treated within the

Primary Care setting.


Rheumatology activity in Sparkbrook for 2007/8

236, 12%

1714, 88%

New

Follow-up

The cost of secondary care Rheumatology activity for Sparkbrook in 2007/8

£52,884, 24%

£170,359, 76%

New

Follow-up

20

Although a Nationally Enhanced Service (Near Patient Testing) has previously been

introduced to encourage GP’s to monitor some of these patients within Primary Care,

this initiative has received poor uptake from GP’s within the Heart of Birmingham

tPCT. In addition, there is little evidence of follow-up reductions within the practices

that have taken part in this enhanced service. Thus, there is a clear need to introduce

an alternative service which not only addresses these issues but also ensures that the

outcomes are achievable.


OPHTHALMOLOGY

(Sparkhill and Balsall Heath)

Proposal: The Sparkhill and Balsall Heath commissioning groups recognise that there

is currently a large volume of follow-up patients in Ophthalmology who attend

secondary care for basic annual checks. The group are in support of establishing a

community ophthalmology service to screen and monitor selected patients and thus

transfer some of this activity from secondary to primary care.

Outcomes:


Reductions in ophthalmology follow-ups


Planned Care

Acute Care

Evidence of need: In 2007/8, the average number of follow-up appointments for

every new outpatient appointment was 6.8. Example 7 illustrates the proportion of

new and follow-up activity for this speciality with 87% of the total being accountable

to follow-up’s. Further, ophthalmology has been identified as the 6th highest costing

outpatient speciality within Sparkbrook with a total cost of £361,309 in 2007/8.

Finally, the number of ophthalmology out-patient attendances over the last year has

been considerably higher than both the West Midlands and National average (see

example 8).


Example 7

Example 8

Sparkbrook Ophthalmology Outpatient Attendances Per 1000 Patients 2007/8

0

5

10

15

20

25

30

35

M85

146

M85

075

M85

128

M85

766

M85

781

M85

679

M85

127

M85

699

M85

713

M85

116

M85

733

M85

164

M85

078

M85

093

M85

174

M85

015

M85

756

M85

774

M85

783

M85

794

M85

085

M85

024

M85

735

M85

153

M85

051

M85

686

Sta

nd

ard

ised

Rat

e

Service Delivery: The commissioning group supports the development of a

community based ophthalmology service provided by either an accredited GP


Ophthalmology activity in Sparkbrook for 2007/8

956, 13%

6521, 87%

new

follow-up

23

with a special interest in ophthalmology or a secondary care specialist.

PATIENT EDUCATION

(Small Heath and Balsall Heath)

Proposal: The Small Heath and Balsall Heath commissioning groups have identified

patient education as a priority in order to reduce the number of inappropriate self

referrals to both general practice and secondary care. There are a number of ways in

which patient education can be addressed, some of which will be explored in more

detail.

Outcomes:

Improving self-care

Reductions in unnecessary attendances


Long-term conditions

Staying healthy

Evidence of Need: There is general consensus amongst clinicians that a high

proportion of patients lack sufficient knowledge about their condition and

consequently turn to these services for advice on problems which could easily be self

treated and thus avoid unnecessary attendances to GP services and secondary care.

Furthermore, research on patient education consistently highlights those patients with

low health literacy as:

Being at greater risk of hospitalisation and having longer hospital visits

Having higher rates of admission to emergency services

Being less likely to adhere to prescribed treatments and self-care plans

Having less knowledge of disease management and health-promoting

behaviours

Having decreased ability to communicate with healthcare professionals and

sharing in decision-making


Being less able to make appropriate health decisions

Making less use of preventive services

Incurring substantially higher health costs

Thus, the group feel it is fundamental to invest in education programmes for these

patients not only to improve their general health and well-being but to also encourage

the appropriate use of NHS resources.

Service Delivery

Chronic Disease Educators/Health Trainers:

The Birmingham Health Exchange offer a choice of patient education services

ranging from on-line resources, public access points at community locations and more

recently, Chronic Disease Educators and Health Trainers. The Small Heath and

Balsall Heath commissioning groups have expressed an interest in commissioning the

latter 2 services.

The health trainer service offers one-to-one support for patients on changing a range

of health behaviours such as smoking cessation, healthy eating and exercise. On the

other hand, the chronic disease educator service provides groups of patients suffering

from CHD, CKD or Diabetes with more specific education including:

Improved symptom management

Improved quality of life through knowledge of condition and health

behaviours

How to slow disease progression

Improving medical management of the condition

Helping patients and their carers to manage the emotional impact of their

condition

Information Leaflets on how to cope with specific illnesses: The Balsall Heath

commissioning group are keen to develop a set of local patient education materials

which are sensitive to the individual practice population. Some potential themes

around this material include education around specific illnesses, general lifestyle

advice as well as information used for signposting patients to local services.


DERMATOLOGY

(Small Heath)

Proposal: The group have expressed an interest in establishing a local dermatology

service for the treatment of skin conditions that are suitable for treatment within a

community setting.

Outcomes:




Acute Care

Evidence of need: Dermatology has been identified as the 5th highest costing

outpatient speciality within Sparkbrook with a total cost of £361,869 in 2007/8.

Furthermore, the number of dermatology out-patient attendances over the last year has

been considerably higher than both the West Midlands and National average

.

Example 9

Sparkbrook Dermatology Outpatient Attendances Per 1000 Patients 2007/8

0

5

10

15

20

25

30

35

M85

146

M85

075

M85

128

M85

766

M85

781

M85

679

M85

127

M85

699

M85

713

M85

116

M85

733

M85

164

M85

078

M85

093

M85

174

M85

015

M85

756

M85

774

M85

783

M85

794

M85

085

M85

024

M85

735

M85

153

M85

051

M85

686

Sta

nd

ard

ised

Rat

e


Service Delivery: The Small Heath commissioning group recognise that there is

now a community based dermatology service (Greet Health Centre, Sparkbrook).

However, the group are concerned about the travelling distance for patients

attending from Small Heath practices. Consequently, the group wish to explore

ways in which to establish a dermatology service which is closer to home for their

patients. This could involve identifying an alternative provider with a special

interest in dermatology or negotiating more local delivery of the current service.


CHIROPODY

(Small Heath)

Proposal: The Small Heath commissioning group have identified the need to extend

the current service provision of chiropody services for their patients. The current

service provides priority to diabetic patients; however, the commissioning group

believe that this service should be more widely available to other patient groups and

in particular elderly patients.

Outcomes:



Long-term conditions

Acute care

Evidence of need: Good foot health is paramount in maintaining older people's

independence, mobility and social contact. Lack of even the most basic foot care puts

the elderly at risk of complications that can lead to dangerous falls, severe restrictions

on mobility and social isolation.

It is generally acknowledged that healthy feet have a huge impact on the quality of

life for most people.

Service Delivery: The Small Heath commissioning group are keen to invest in an in-

practice chiropody service open to referrals for a selected range of foot conditions.

The service could be based in either all practices within the commissioning group or a

selected number of practices open to referrals from neighbouring GP’s.


COUNSELLING

(Sparkhill)

Proposal: The commissioning group have expressed a need to provide support to

patients who present with minor/borderline mental health conditions such as stress

and anxiety, mild depression, bereavement, low self-esteem and sleep disorders.

Outcomes:

Improving the general well-being of patients


Mental Health

Evidence of need: The commissioning group have identified a number of patients

that present to the practice with sometimes very complex issues that are not always

appropriate to be referred to the mental health team. Many of these patients simply

need someone to talk to and so GP’s are left in a position where they tend to see these

patients on a regular basis which is, in effect, a counselling service. This inevitably

has a knock-on effect for other patients who need to access GP services.

Service Delivery: The Sparkhill commissioning group propose to establish an in-

practice counselling service which will work in conjunction with the current mental

health service provision. The service will be open only to minor mental health

conditions (as outlined above) and could be delivered either from a range or all

practices within the commissioning group.


WORKPLAN

The commissioning priorities set out in this document will be developed into business plans throughout the coming 12-18 months. Where there

is overlap between Sparkbrook priorities and those of other commissioning groups in HoB, the 3 PBC managers have agreed to share these

priority areas and develop them as HoB wide initiatives. The following table summarises the responsible PBC Managers, clinical leads and

timescales for each Sparkbrook commissioning priority:

Commissioning Priority PBC Manager Clinical Lead

Business Case

Completion 18/0

8/20

08

01/0

9/20

08

15/0

9/20

08

29/0

9/20

08

13/1

0/20

08

27/1

0/20

08

10/1

1/20

08

24/1

1/20

08

08/1

2/20

08

22/1

2/20

08

05/0

1/20

09

19/0

1/20

09

02/0

2/20

09

16/0

2/20

09

02/0

3/20

09

16/0

3/20

09

30/0

3/20

09

13/0

4/20

09

27/0

4/20

09

11/0

5/20

09

25/0

5/20

09

08/0

6/20

09

22/0

6/20

09

29/0

6/20

09

06/0

7/20

09

13/0

7/20

09

20/0

7/20

09

27/0

7/20

09

03/0

8/20

09

10/0

8/20

09

17/0

8/20

09

24/0

8/20

09

31/0

8/20

09

07/0

9/20

09

14/0

9/20

09

21/0

9/20

09

28/0

9/20

09

05/1

0/20

09

12/1

0/20

09

19/1

0/20

09

26/1

0/20

09

02/1

1/20

09

09/1

1/20

09

16/1

1/20

09

23/1

1/20

09

30/1

1/20

09

07/1

2/20

09

14/1

2/20

09

21/1

2/20

09

28/1

2/20

09

Balsall Heath

Small Heath

Sparkhill

Implementation Period

Patient Education Sapna Sharma Dr V Shah & Rashda Shahnaz

Counselling Sapna Sharma Dr Melchior

Dermatology

Ophthalmology

Sapna Sharma Dr Y Ahmad

Jon Lear Dr Kulshrestha/Dr Gill

COPD Screening Sapna Sharma Dr Ramachandram

Sparkbrook Commissioning Priorities

October 2008

Rheumatology Sapna Sharma Dr Abdel-Malek/Dr Hall/Dr Rajput

Chiropody Sapna Sharma Dr Verma

December 2008

December 2008

December 2008

Cardiology Nuala Woodman Dr Pandit

Gynaecology Jon Lear Dr Gill

September 2009

February 2009

April 2009

April 2009

July 2009

Date post:	02-Jun-2015
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locality 2 – practice and population overview

Documents