11. Resources to support CCGs

Informed by the joint strategic needs assessment, both NHS England area teams and local authority public health teams should be able to provide practical assistance to commissioners in terms of understanding local priorities and setting an achievable level of ambition.

11.1   Strategic Clinical Networks (SCNs)

Contacts for Cancer and CVD SCNs are provided below.

Contacts and more information on Strategic Clinical Networks for Mental Health can be found here.

11.2   Academic Health Science Networks (AHSNs)

AHSNs have been set up to align education, clinical research, informatics, innovation, training and education and healthcare delivery. The goal is to improve patient and population health outcomes by translating research into practice, and by developing and implementing integrated health care services.  A webpage has recently been added on the NHS England site here.

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11.3   Other sources of information for commissioners

There are a number of other resources available to support CCGs in setting a level of ambition on mortality.

CCG outcomes tool: We would strongly recommend that commissioners familiarise themselves with the CCG outcomes tool which NHS England has published.  The CCG outcomes tool allows users to view maps, charts and tables of individual outcome indicators across CCGs, and to view a spine chart of all the outcomes for one or more CCGs. It enables local commissioners to assess how outcomes for their CCG compare with other comparable CCGs.

CCG outcomes indicators: The Health and Social Care Information Centre publishes information relating to CCG level indicators of PYLL, including aggregate information at Area Team level.

Commissioning for value packs: Produced for each CCG by NHS England, PHE and NHS Right Care, these packs provide tailored advice about ‘where to look’ as a first stage to identify real opportunities to improve outcomes and increase value for local populations.  The packs are intended to support discussions about prioritising areas for change, utilising resources and making improvements in healthcare quality, outcomes and efficiency.

NHS Improving Quality (NHS IQ): The overall aim of NHS IQ’s work programme ‘Living longer lives’ is to reduce the number of people who die too soon from illnesses that could have been prevented or treated, in line with the NHS Outcomes Framework and Public Health Outcomes Frameworks. NHS IQ is working with a range of partners across health and social care to maximise the contribution that the NHS can make to preventing disease.

NHS England patient safety guidance: There is a range of guidance that has been developed by the former National Patient Safety Agency (whose responsibilities have now been transferred to NHS England) relating to the topics outlined in this resource. These include:

  • Towards Safer Radiotherapy: Report: The purpose of this report is to look at ways of reducing errors in radiotherapy which are caused by individual human error or failure of systems of work, with a view to finding practical and cultural solutions which will result in patient safety being optimised
  • Towards Safer Radiotherapy: Self-assessment tool: The Towards Safer Radiotherapy: Self-assessment tool is designed to assist Radiotherapy Departments in reviewing the safety of their services. The tool contains the recommendations and allows electronic entry of responses so that individuals can forward this to colleagues for additional entries, facilitating multidisciplinary involvement in the process.
  • Preventing suicide: A toolkit for mental health services: The suicide prevention toolkit provides mental health organisations with a simple method to:- establish a system for suicide audit in the local context; use case note reviews to change how performance is measured and risks are identified; support the development of local suicide prevention strategies; and produce data which can be merged at regional and national levels to identify trends for further learning.
  • Understanding the patient safety issues for people with learning disabilities: This report outlines the work that the former NPSA has done to find out what the patient safety priorities are for people with learning disabilities.
  • Delayed diagnosis of cancer: thematic review: Delayed diagnosis of cancer: thematic review presents the findings of a project at the former NPSA, which was designed to explore issues of patient safety around delayed diagnosis of cancer, and provide the NHS with potential solutions.
  • How to guide to venous thromboembolism risk assessment: This how to guide will support NHS organisations in the implementation of venous thromboembolism risk assessment for all patients admitted to hospital.

Guidance from Gov.uk on direct referral by GPs to specific diagnostic tests: For the assessment of particular symptoms where cancer may be suspected but the urgent GP referral (two week wait) process is not applicable, guidance has been published here.

PHE data and knowledge gateway: PHE provides many high quality data and analysis tools and resources for local government and health professionals; the data and knowledge gateway provides direct access to over 100 of these.  These cover a broad range of areas including:

  • specific health conditions – such as cancer, mental health, cardiovascular disease;
  • lifestyle risk factors – such as smoking, alcohol and obesity;
  • wider determinants of health – such as environment, housing and deprivation; and
  • health protection, and differences between population groups, including adults, older people and children.
  • Some specific sources are identified below, but CCG colleagues should note the new single point of access to data and analysis tools from across PHE.

PHE longer lives web resource: The longer lives web resource highlights premature mortality at local authority level in England, giving people important information to help them improve their community’s health. It quantifies premature deaths from the four most common causes of mortality in England – heart disease and stroke, lung disease, liver disease, and cancer, highlights inequalities in premature mortality across the country and provides examples of effective local interventions. PHE is currently looking to include further information on additional causes of death, risk factors and for lower tier local authorities.

GP practice profiles: This resource provides data at CCG and individual GP practice level, the profiles include local demography, performance against the Quality and Outcomes Framework clinical domain, disease prevalence estimates, some admission rates and patient satisfaction. The profiles are intended to support GPs and CCGs to ensure they are providing and commissioning effective and appropriate healthcare services for their local population.  NHS England is further developing data tools from primary care.  Information can be accessed by GP practices, CCGs and area teams.

Public Health Outcomes Framework: The Public Health Outcomes Framework: Healthy lives, healthy people: Improving outcomes and supporting transparency sets out a vision for public health, desired outcomes and the indicators that will help us understand how well public health is being improved and protected. The framework concentrates on two high-level outcomes to be achieved across the public health system, and groups further indicators into four ‘domains’ that cover the full spectrum of public health. The outcomes reflect a focus not only on how long people live, but on how well they live at all stages of life.  This tool currently presents all indicators at England and upper tier local authority levels, collated by PHE. Selected indicators are available at lower tier local authority level. The tool allows you to:

  • Compare your local authority against other authorities in the region, PHE Centre or ONS cluster
  • Benchmark your local authority against the England average
  • Examine trends in indicators over time

Resources from the former Health Inequalities National Support Team: This collection of resources provides practical support relevant to CCGs, to tackle variation in practice and improve health outcomes for all.  They originate from a programme of work with areas of the country with poorest health and greatest disadvantage. There are practical documents, guides and toolkits, many illustrated with tangible examples of improvements made in local areas, as well as providing a step-by-step checklist of how to take certain approaches and initiatives forward. There is an opportunity for all CCGs to build upon the work and resources from this initiative, which include a guide to priority actions that could impact inequalities in mortality and life expectancy in the short term and tools to support local identification and planning of initiatives to achieve the greatest reductions in mortality.

Evaluation and review of NICE implementation evidence: NICE produces implementation reports which measure the uptake of specific recommendations taken from selected pieces of NICE guidance. These reports, along with other internal and external literature sources relating to the uptake of NICE guidance are stored on and can be accessed from the ERNIE database, which is fully searchable and regularly updated.

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11.4   Future resources

PHE is taking forward a project to support Health and Wellbeing Boards, local authorities and the NHS to make the case for prevention and early intervention.

Work will include public awareness campaigns, for example on breathlessness, and   supporting the production of business cases within local authorities and the NHS, incorporating the tools and sources of help which are available.  A link to further information will be included here in due course.

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Move on to section 12: Examples of local initiatives