"Delivering the smooth and effective roll out of EMIS Web - GMCSU's story"Read more
"Developing a public health campaign for Stockport - GMCSU's story"Read more
"Supporting Wigan Borough CCG with its first emergency preparedness, resilience and response compliance review - GMCSU's story"Read more
"Using utilisation management to improve care quality across Greater Manchester - GMCSU's story"Read more
"Delivering the electronic document transfer (EDT) project across Greater Manchester - GMCSU's story"Read more
"Developing a new data centre for CCGs in Greater Manchester - GMCSU's story"Read more
"Rolling out the Electronic Prescription Service across Greater Manchester - GMCSU's story"Read more
"Collaborative working with CCGs to establish a lay member network - GMCSU's story"Read more
"Working with CCGs to help them with their submission for ASH status - GMCSU's story"Read more
"A matrix-working approach to pharmaceutical needs assessments - three local authorities' story"Read more
"Robust CCG risk management through collaborative working – GMCSU's story"Read more
"Comprehensive communications and the Keogh Review – Tameside and Glossop CCG's story"Read more
"Procuring high-quality community services, closer to the patient – Oldham CCG's story"Read more
Greater Manchester Commissioning Support Unit (GMCSU) works in partnership with healthcare commissioners, healthcare providers, local authorities and others, to enable excellence in the commissioning and delivery of healthcare services.
We pride ourselves on providing clients with access to an unparalleled portfolio of tailored services, which encompass specialist clinical support, healthcare commissioning and business support services. GMCSU is at the forefront of innovation and best practice. We are also committed to continually identifying, implementing and driving innovation in health. This is embedded within all the services we deliver. Motivated by the desire to help clients systematically drive improvement across their local healthcare economies and deliver tangible benefits for communities, we see ourselves as an expert and trusted partner, with shared values and common goals. This perspective, coupled with our agile and flexible approach, enables us to provide:
- Services designed with our clients, built on detailed insight and focused on results
- Locally delivered services which benefit from our economies of scale
- A high degree of resilience at costs that are often unachievable when delivering services in-house
- The ability to respond rapidly and effectively to the changing needs of our clients and their populations.
We have brought together more than 500 talented individuals with experience and expertise gained across the NHS, government and private sector organisations. This background gives us a unique understanding and ability to navigate the constraints and challenges facing our clients and the wider health economy. These range from finite resources and addressing health inequalities, to managing ever increasing demand and the growing expectations of patients and the public. We expect a lot from our talented teams and that includes living our values of integrity, teamwork and accomplishment. We reflect this in our work and our relationships, both with our clients and within our teams. We also believe it’s important to reinvest in the communities where we and our clients work and are an organisation which is committed to being socially responsible.
From October 1, 2014, GMCSU will become one organisation with Cheshire and Merseyside Commissioning Support Unit. The new organisation will take the strengths and learning from each CSU, to create an organisation that provides high-quality services designed around the needs of our clients. Covering a population of 5.1 million people, with a combined income of more than £80m, our new organisation is set to hold one of the largest portfolio of support services in the country.
At GMCSU, we believe that our strength lies in the people who work for us, and we aim to ensure development and opportunity, and make sure this is a great place to work. For our latest vacancies, click here.
GMCSU is led by a team of directors, providing a wide range of experience, knowledge and leadership from the public and private sectors, and a particular background in healthcare. To contact any of our directors, fill in our contact form and select General Enquiries.
Leigh Griffin, Managing Director
Leigh has led GMCSU since October 2012, having previously worked as a PCT Chief Executive in the North West and the West Midlands. A passionate advocate of collaborative commissioning and system-wide improvement, he is committed to the need to co-design and deliver services tailored to local needs.
Cathy Gritzner, Commercial Director
Cathy joined GMCSU in May 2013. She has extensive experience in both the private and public sector, having worked for ATOS and KPMG in England and the Middle East. Cathy joined the CSU from her role as Chief Officer at Herefordshire CCG guiding them through a challenging year and the authorisation process. Prior to this role she worked in the North West as Director of Commissioning at NHS Wirral, before helping to establish Cheshire, Wirral and Warrington CSU.
Seamus McGirr, Director of Clinical Development
Seamus is a registered nurse, whose previous roles include Director of Nursing and Director of Performance. His speciality expertise and academic interest is in urgent care, and he leads the North West Utilisation Management team which provides services across the north west, Northern Ireland, for and on behalf of NHS England (IMAS) and CCGs and Trusts across the country. Seamus’s responsibilities in the CSU include leading our clinical teams, developing our clinical commissioning support and, currently, providing the director leadership for contracting and performance. He is a familiar speaker at national and local conferences. He lives in Stockport and is married to a local GP.
Jo Purcell, Partnerships Director
Jo has a background in commissioning, partnership working and service redesign. Jo has been a director for over 10 years with commissioning organisations and has been responsible for developing partnerships across the health and social care system, commissioning new service models and, more recently, supporting the development of commissioning support across Greater Manchester.
In order to maximise our reach locally, regionally and nationally, GMCSU is always seeking to establish partnerships with appropriate organisations in all sectors. Opportunities range from individual, short-term, projects of mutual benefit, to ongoing corporate partnering.
For more information, and to discuss potential partnership working, fill in our contact form and select Partnership Working.
Greater Manchester Commissioning Support Unit (GMCSU) works in partnership with healthcare commissioners, healthcare providers, local authorities and others, to enable excellence in the commissioning and delivery of healthcare services. Currently, our main clients are the 12 clinical commissioning groups in Greater Manchester.
Bolton Clinical Commissioning Group
Bury Clinical Commissioning Group
Heywood Middleton and Rochdale Clinical Commissioning Group
Central, North and South Manchester Clinical Commissioning Groups
Oldham Clinical Commissioning Group
Salford Clinical Commissioning Group
Stockport Clinical Commissioning Group
Tameside and Glossop Clinical Commissioning Group
Trafford Clinical Commissioning Group
Wigan Clinical Commissioning Group
Celebrating Rochdale borough’s stars
Developing a staff and GP recognition scheme – GMCSU’s story
Migrating GP practices to new software systems in Manchester
Delivering the smooth and effective roll out of EMIS Web - GMCSU's story
Stockport hypertension public health campaign
Developing a public health campaign for Stockport - GMCSU's story
Improving resilience in Wigan
Supporting Wigan Borough CCG with its first emergency preparedness, resilience and response compliance review - GMCSU's story
Improving care quality
Using utilisation management to improve care quality across Greater Manchester - GMCSU's story
Addressing the ‘paperless NHS’ challenge
Delivering the electronic document transfer (EDT) project across Greater Manchester - GMCSU's story
Transforming data storage
Developing a new data centre for CCGs in Greater Manchester - GMCSU's story
Electronic Prescription Service
Rolling out the Electronic Prescription Service across Greater Manchester - GMCSU's story
Developing a lay member network for North West CCGs
Collaborative working with CCGs to establish a lay member network - GMCSU's story
Information governance: Accredited Safe Havens
Working with CCGs to help them with their submission for ASH status - GMCSU's story
Pharmaceutical needs assessments
A matrix-working approach to pharmaceutical needs assessments - three local authorities' story
Managing risk through collaborative working
Robust CCG risk management through collaborative working – GMCSU's story
The Keogh Review: Tameside and Glossop CCG’s response
Comprehensive communications and the Keogh Review – Tameside and Glossop CCG's story
Procuring Oldham's Community Services
Procuring high-quality community services, closer to the patient – Oldham CCG's story
The extra mile
reflects the work that GMCSU does over and above our core service delivery to
give something back to our local communities and ensure that we are a great
place for people to work. To do this, we have
split our extra mile into three areas – our people, our communities and our
In order to enhance the working lives of our colleagues, there are a number of things we do. One of the major vehicles through which we recognise and reward our staff is our Pride in Excellence awards. These internal awards reward colleagues who go over and above the requirements of their job and highlight the high quality of work taking place across the organisation. Furthermore, through a variety of simple but important initiatives – from providing social opportunities to ensuring that working environments are comfortable and well-equipped – GMCSU aims to look after our most valuable asset – our people.
As an organisation, we know that we have a responsibility to consider our impact on wider society and the environment. To do this, we intend to investigate a wide range of plans to reduce and mitigate our carbon footprint. This process has already begun with the promotion of a greener travel plan. This places an emphasis on using public transport where possible, but we have also entered into a partnership with Liftshare to encourage colleagues to travel to work and meetings across the region together.
We have made a specific commitment to support three local charities:
Francis House Children's Hospice
Francis House Children’s Hospice provides care for children and young adults with life-threatening conditions, as well as providing support for their families. Francis House is open to all families who have children diagnosed as having a life-threatening or life-limiting condition, and are under sixteen years of age on referral. Care is given free of charge and regardless of faith or cultural background. For more information, visit www.francishouse.org.uk.
Macmillan Cancer Support
Macmillan Cancer Support provides practical, medical and financial support for people with cancer and pushes for better cancer care in and around Manchester, as well as nationally.
Mustard Tree is a charity committed to providing life support for the homeless, marginalised and vulnerable across Greater Manchester. It provides food, clothing, furniture and training, aiming not only to improve life for deprived communities in Greater Manchester, but also work to care for the environment through continual re-use and recycling of resources for the benefit of those in need.
Celebrating Rochdale borough’s stars
NHS Heywood, Middleton and Rochdale Clinical Commissioning Group (CCG)
A new staff and GP awards scheme has instilled confidence and boosted morale across NHS Heywood, Middleton and Rochdale CCG.
The HMR Star (Special Thanks and Recognition) Awards were introduced to recognise and celebrate CCG employees and staff from the 38 member GP practices for the excellent work they do to help the CCG deliver its objectives and achieve its vision of healthier people, better future.
The awards scheme, which included a celebration event, was planned and delivered by members of the Greater Manchester Commissioning Support Unit (GMCSU) communications team.
Suggestions to introduce the awards scheme came from a GP practice towards the end of 2013, with recommendations worked up, presented to and approved by the CCG Executive Management Team the following January.
An early decision was made that the scheme would support the organisational culture and be recognition focused, without financial reward. Nominations opened on April 1, 2014, marking the CCG’s first anniversary.
HMR CCG buys the full GMCSU communications service, enabling the communications team to project manage the scheme and event, supported by a small committee of CCG staff.
Regular meetings were held between January and the celebration event on 12 June to seek views and support in decision making, planning, publicising, launching, delivering and evaluating.
Five award categories were agreed, with one – People’s Star – open to local people and patients to nominate GPs, practice managers, practice nurses or GP receptionists who deserve recognition. The other categories were: Shining Star, Silent Star, Innovation Star and Star Team.
An impressive 124 online and paper nominations were received across the five categories from a mixture of CCG staff, GP practice staff and members of the public. These were encouraged through a sustained drip-feeding of emails, staff briefings, social media and press releases during a month-long nomination period.
Following the close of nominations, the communications team led a process of checking, verifying and anonymising nominations in readiness for shortlisting by a carefully selected decision panel. The decision panel was also coordinated by the comms team to ensure optimum objectivity, confidentiality and a clear brief.
Finalists were informed and names communicated, but the winners remained a closely guarded secret until the ceremony.
From the outset, significant importance was placed on the celebration event and its inclusivity.
The CCG chair, Dr Chris Duffy, compered the ceremony, which took place at a local hotel. Key figures and clinical leads from the CCG presented the awards. There was also an addition of a special award requested by a local family for their GP.
Feedback on the night and post-event from all who attended was extremely positive. CCG staff and GP practices acknowledged the hard work and effort that went in to making the night a success, with some taking the time to send thank you emails.
An evaluation of all aspects of the scheme and event is being carried out by the communications team to build on the success and identify improvements and developments for next year.
"The event went really well and it’s been great to receive so much positive feedback, especially from member practices. Such a lot of work was put in behind the scenes to make this happen, so a big thank you to the GMCSU communications team for their part in making our first HMR Star Awards a huge success. I look forward to the awards becoming an annual fixture."
Dr Chris Duffy, Chair, HMR CCG
Migrating GP practices to new software systems in Manchester
The 96 practices across Manchester had a variety
of different software solutions in place to manage a range of patient records,
appointments, consultations and test results. The CCGs chose to rationalise
this to a single solution - EMIS Web. GMCSU was commissioned to manage the project
to complete the transition, including upgrading hardware and providing training
support. This was not just about new software, at the beginning of the
migration the first step was to check network speeds and address any problems
with the hardware or systems so that the new software will work as designed,
from day one.
Upgrading and installing new software is always a project full of challenges, never more so than at a GP practice where the software is the appointments booking and patients’ consultation notes. These systems are absolutely essential for the smooth running of the surgery. If they are off line even for a few hours the impact on both the workload of staff and the reputation of the practice can be significant.
practices are currently operating several different software packages and have
hardware and networks in a number of configurations, all of which would mean a
degree of flexibility was required in the approach adopted by the GMCSU project
The 12 week migration process for each practice starts off with a visit to the practice by the project manager to explain in depth what they should expect, and what preparation work is involved for that practice. Shortly after, EMIS trainers confirm pre and post go-live training dates directly with the practice. Practices are fully supported throughout the migration process by various members of the team at different key stages of the project - to ensure smartcards are ready, data quality and templates are fully mapped to the new system, and any technical issues are identified and resolved as early as possible in the migration period. Both the project manager and project support officer are in regular contact with the practice prior to go live to ensure a smooth process.
The project team has identified that
“go-live day” is particularly important for GP practices because of the
additional risks to a practice’s reputation inherent in any perceived failure.
With web based training as well as specific support from EMIS trainers in
advance the practice staff are well prepared. Surgeries are encouraged to plan
their go-live day well ahead with double appointments to provide clinical staff
with extra time to record consultation information on the new data platforms. The
dedicated trainers also operate as “floorwalkers” on go-live day to provide
training on specific items where staff are unsure or
dealing with items they have not encountered during their training. IT
engineers are also on site from early morning to ensure that the hardware was
installed, and network connections are made and working correctly so that staff
are able to concentrate on proving appropriate care to patients and not having
to troubleshoot the technology.
The care taken by the GMCSU project team is reflected in the comment of one practice manager, who said: “Go-live day is very busy, and I would advise any practice manager going live to ensure they don’t give themselves any other jobs to do on that day! We had the CSU Project Team, EMIS trainer and the IT engineers here from 7.30am on the day to get everything up and running, and we didn’t open the practice doors until 9.30am. Clinics started at 10am and we allowed extra spaces throughout the day. Taking a practice through a large project such as this is very satisfying as a practice manager. As with the other projects we have been through as a practice, it is great when we have met these challenges”.
Where surgeries were operating with older versions of EMIS software the transition to a web based system was straightforward with much of the same functionality. However, surgeries migrating from other systems had a steeper learning curve with some preparatory work to do, notably where differences in the underlying drug dictionaries on different systems need to be managed to ensure patients get the continuity of care they expect.
Clinicians have seen the benefits of EMIS Web. GP Dr Paul Wright, said: “One of the clinical benefits is the user interface; the visual presentation is significantly improved, allowing for more clinically relevant information to be easily accessible”. Dr Wright also uses the EMIS Web mobile app, so he can log in to the system from his portable device, which is useful for home visits “I can access the patient record and document home visits while I am out of the practice, which is great.”
“The reception staff like the fact they can bring up a patient much quicker, and the booking system is easy to use and also quick. This is much better for the patient who is waiting. The GPs particularly like the consultation screen layout which enables them to put on a more structured and detailed consultation, and the nurses like the chronic disease management templates.”
Michael Pursglove, Practice Manager, The Avenue, Blackley
“Initially it was quite daunting; however it wasn't as stressful as I anticipated. The migration process itself was almost seamless, and the project as a whole was very good; a learning curve.”
Dr Frame, GP, Ashcroft surgery, Levenshulme
Stockport hypertension public health campaign
Client profileNHS Stockport Clinical Commissioning Group
Hypertension, the medical term for high blood pressure, rarely has obvious symptoms and, if left untreated, increases the risk of a heart attack or stroke.
It is estimated that one in four adults – 15,000 people – in Stockport has high blood pressure without knowing it. Each year in Stockport this contributes to 450 heart attacks and 220 strokes.
NHS Stockport Clinical Commissioning Group (CCG) is committed to addressing local health inequalities. Commissioners believe that public awareness and education are key to cutting the risk of heart disease and stroke.
The CCG had identified that there were 12,948 adults in Stockport between the age of 40 and 74 who had not had their blood pressure checked in the last five years. Anecdotal evidence collated by commissioners also suggested that working people did not have time to get their blood pressure checked.
Greater Manchester Commissioning Support Unit’s campaigns team worked with the CCG and Stockport Council’s public health department to develop and deliver an effective public health campaign aimed at reducing the number of people in Stockport who hadn’t had a recorded blood pressure test in the past five years.
The campaign supports the CCG’s aim to ensure better prevention and early identification of the disease, and forms part of a long-term strategy to improve heath and reduce inequalities.
- raise awareness of the importance of knowing your blood pressure
- raise awareness of the associated risks of high blood pressure
- outline preventative measures such as diet, exercise and salt intake.
- decrease the number of people between 40-74 who have not had a recorded blood pressure reading in the past five years
- raise awareness of the free blood pressure check available to those aged 40-74
- increase take-up of free blood pressure checks by 50 per cent
- identify people with high blood pressure and encourage them to seek treatment and improve their lifestyles.
- we listened to the aims and objectives for the campaign
- we considered the challenges and perceived barriers
- we kept in mind the audience and stakeholders and the need to keep the campaign local.
With the above considered:
- we developed a phased campaign plan in line with pre-defined budgets and timescales
- we developed a thorough design brief for creative execution
- we presented initial creative concepts, and provided materials to allow for public evaluation and insight
- we designed, developed and project-managed all agreed deliverables to artwork and production.
A key part of the work involved developing a strong brand that would engage people and instill a sense of community. We used a red balloon to demonstrate high blood pressure, along with an illustration of the people of Stockport to get across a friendly, community feel.
Phase 1: We began with a soft launch, placing Wellpoint kiosks at seven community sites in Stockport for a three month period. The kiosks electronically measured blood pressure, weight, and body mass index to check an individual’s risk of developing heart disease. This was relayed directly to the patient’s GP.
Phase 2: We launched the campaign in April with a week-long health awareness roadshow at the town’s main shopping centre. A team of health professionals, including GPs and nurses, attended each day to record blood pressure and to push the campaign message from the CCG.
Phase 3: Outreach activity is currently taking place with Stockport employers to target men aged between 40 and 74. Two events will take place every week from June until November at local businesses with 50 or more employees to raise awareness of the campaign and offer free blood pressure checks. The outreach activity also extends beyond the target group to community events such as carers days, carnivals and social housing.
This campaign is supported by outdoor media, including billboards, bus advertising, petrol pump covers, and beer mats. Promotional items include banner stands, leaflets, posters and banner pens, as well as press adverts and web banners. There has also been a dedicated PR with the local media.
Social media has been used to support the campaign through Twitter and a dedicated Facebook page. The hashtag #CHECKIT has been used consistently throughout, and monitoring and ongoing analysis was carried out using specialist software. This allowed us to hone our social media messages to match the expectations of our audience.
- the campaign launched in April and is ongoing until November, with results being recorded and filtered through to GPs throughout Stockport
- early indications from the campaign launch show targets have exceeded expectation by more than 10 per cent in the first three days
- approximately 1,000 blood pressure checks were undertaken at the launch alone
- good coverage of the campaign in the local press – Stockport Express East and Stockport Express West – each publication has a circulation of around 40,000
- 60 Facebook posts, 63 Twitter posts, 65 retweets, 66 likes, approximately 500 clicks to more information, with a reach of 243.8k
- the campaign has achieved results that have gone beyond expectations, for example:
o improved relationships and collaboration between the CCG, GPs, practice nurses and hospital staff
o practice nurses are very keen to support future events and taking what they learn back into their own practices
o 38 per cent of people who attended the launch event had hypertension, more than the one in four that the CCG predicted
o the campaign launch and outreach events are picking up a number of people who are classed as ‘hypertensive
emergencies'. Many of these people have no idea that their health is at risk and are being advised to seek treatment quickly.
“GMCSU’s campaigns service provides the kind of high-quality specialist advice that you need when planning a campaign. The approach that was taken enabled innovative ideas to flow from the whole team, but also helped us to plan the activity in a structured way.
“The support from our campaigns lead was fantastic. She has provided a consistently high level of service, is hardworking, committed, creative and enthusiastic about our priorities. We have an excellent relationship with the team as a whole, who clearly understand our business and our needs.
“GMCSU’s impact on our drive to reduce high blood pressure has been significant and reflects their strengths in the campaigns field.”
Louise Hayes, Head of Communications, NHS Stockport Clinical Commissioning Group
Improving resilience in Wigan
Wigan Borough CCG
The Civil Contingencies Act (2004) requires NHS organisations and providers of NHS-funded care to prepare for, be able to respond to and recover from, a wide range of incidents and emergencies that could affect health or patient care while maintaining services for patients.
This could be anything from extreme weather conditions to an outbreak of an infectious disease or a major transport accident. This programme of work is referred to in the health community as ‘emergency preparedness, resilience and response’ (EPRR).
In April 2013, the changes to the NHS brought about by the Health and Social Care Act 2012 saw Clinical Commissioning Groups (CCGs) taking on responsibility for the majority of healthcare commissioning in their areas. Alongside this, CCGs were identified as Category 2 responders under the Civil Contingencies Act. As well as the duties placed upon CCGs by the Civil Contingencies Act, the Health and Social Care Act identified a role for CCGs in respect of emergencies, including a duty to be properly prepared for dealing with an emergency. The specific requirements in relation to EPRR that CCGs, and other NHS organisations, are expected to achieve are set out within the Core Standards for EPRR
The Core Standards are a national framework for NHS EPRR and form the basis of assurance processes monitored by NHS England and the recently established Local Health Resilience Partnerships, which provide a strategic (typically county level) forum for health EPRR matters.
Wigan Borough CCG took a proactive approach to its new responsibilities and began to work closely with Greater Manchester Commissioning Support Unit (GMCSU) on EPRR.
GMCSU provides core resilience services to the
12 CCGs in Greater Manchester, with each CCG having a named Resilience Manager working
on their behalf. With valuable knowledge, skills and relationships from legacy PCT
organisations, GMCSU’s Resilience team was well equipped to assist the CCG
navigate EPRR requirements and processes.
As ‘Category 2 responders’, CCGs have a duty to share information and cooperate with Category 1 responders. Category 1 responders are those organisations, such as acute and ambulance NHS trusts, Public Health England and NHS England, that have a greater number of duties under the Civil Contingencies Act and which are likely to play a leading or hands on role in emergency response; Category 2 responders are typically supporting organisations.
As Category 2 responders, CCGs are less likely to be involved in the heart of incident response, but they are expected to contribute towards and be engaged with emergency preparedness within their sector. Although Category 2 responders have a lesser set of duties, it is vital that they share relevant information with other responders so that EPRR arrangements are robust and coordinated.
Category 1 and 2 responders come together to form a multi-agency local resilience forum based on police areas. These forums help to co-ordinate activities and foster co-operation between local responders.
The NHS England Core Standards for EPRR state that NHS organisations and providers of NHS funded care must:
- have suitable, up-to-date plans which set out how they plan for, respond to and recover from major incidents and emergencies as identified in local and community risk registers;
- test these plans through:
- a communications exercise every six months;
- a desktop exercise once a year; and
- a major live or simulated exercise every three years;
- have suitably trained, competent staff and the right facilities available round the clock to effectively manage a major incident or emergency; and
- share their resources as required to respond to a major incident or emergency.
NHS organisations are also expected to have suitable, up-to-date plans for service resilience, which set out how they will:
- maintain continuous service when faced with disruption from identified local risks; and
- resume key services which have been disrupted by, for example, severe weather, IT failure, an infectious disease, a fuel shortage or industrial action.
This planning should follow the principles of ISO 22301 and PAS
Through its Resilience Team, GMCSU provides Wigan Borough CCG with advice and support for resilience on an ongoing basis. The knowledge and skills within the Resilience team means the CCG has access to the expert guidance required to help it navigate the EPRR process and allow it to be an informed partner in matters relating to civil emergencies.
GMCSU’s Resilience manager for Wigan worked closely with the CCG to:
- assess compliance against the NHS England EPRR Core Standards
- develop a health economy incident response plan for Wigan
- ensure arrangements were in place for an incident coordination centre or control room
- develop and deliver appropriate training to CCG employees.
GMCSU assessed the CCG’s alignment to the national Core Standards and provided the CCG with a compliance score that was reported back to NHS England.
As part of its support to the CCG, the Resilience team reviewed and updated the local health economy incident response plan, which describes arrangements for incident management, communication and coordination during a significant incident or emergency within the locality. The plan also ensures that one recognised management framework is used by all health commissioners and providers across the health economy.
The Resilience team also reviewed arrangements for an Incident Coordination Centre, or control room that may be activated in the event of a major incident or emergency, and developed a guide for setting up and operating this facility.
As previous training needed to be refreshed in light of the significant organisational changes to the NHS, GMCSU initiated the development of a new EPRR training programme in alignment with the Core Standards, collaborating with NHS England on the design and delivery of this training, which initially focused on preparing on-call managers.
GMCSU’s Resilience team also worked with the CCG
to ensure that plans were in place to test local EPRR. This involved ensuring
that a schedule was developed for the EPRR testing arrangements required by NHS
England; namely a live exercise to take place every three years, a desktop
exercise every year, and communications exercise every six months.
The outcome of Wigan Borough CCG’s first annual EPRR compliance review was an outstanding score of 95 per cent. The assessment was based on the CCG incident response plan and supporting documents, the CCG incident coordination centre guide, training of all on-call staff, and business continuity work.
Local health economy incident response plans have been signed off by the CCG and shared with the local health economy resilience group.
All on-call members of staff have been
trained to National Occupational Standards. GMCSU is continuing to deliver
resilience awareness training to new members of staff as well as ongoing refresher
GMCSU’s Resilience Manager for Wigan has
built a good working relationship with the CCG’s Risk and Governance Director
and Accountable Executive Officer.
As part of the ongoing resilience service, GMCSU
will continue to work with the CCG to ensure that EPRR plans remain up-to-date
with the latest guidance, that new staff are trained, and that participation in
relevant EPRR tests and exercises is maintained.
Graham Coxon, Head of Integrated Governance at GMCSU, who has accountability for the Resilience team said:
“This excellent score reflects the good practice adopted by Wigan Borough CCG. It is a testament to effective partnership working between GMCSU and the CCG, and the commitment from the CCG to the EPRR process. It is particularly impressive given that we only had 12 months to develop all the necessary structures and processes involved.”
Improving care quality
Three clinical commissioning groups in Greater Manchester.
A group of clinical commissioning groups (CCGs) in Greater Manchester turned to GMCSU’s Utilisation Management (UM) team for assistance when it became clear that a local acute trust was failing to see 95 per cent of patients arriving at its emergency department (ED) within four hours, as national targets demand.
Commissioners wanted to understand why the trust was underperforming and what they could do to hit ED targets, maintain quality standards and improve patient care.
Using a combination
of data intelligence skills and clinical expertise, the UM team was able to
analyse and interpret a range of datasets to provide commissioners with
detailed information about delays, care quality and the impact on ED performance.
Resource utilisation reviews were also conducted in the hospital and community
The team coordinated daily conference calls on behalf of commissioners, inviting relevant health and social care professionals to share information and agree ways of supporting each other to improve performance and pathway quality.
The UM team also facilitated weekly tactical meetings so stakeholders could discuss a joint approach to monitoring key issues and develop appropriate strategies for managing activity and sharing responsibilities for performance improvement.
The CCGs involved said: “Involving GMCSU has greatly enhanced tactical meetings; the Utilisation Management team offered impartial expertise and advice; challenged and worked with us to focus our attention in the right place.”
Equally, the acute provider noted: “Daily UM reports and predictive data were invaluable in planning services and monitoring pressures. Input to tactical meetings and the management of urgent care reviews has been helpful to the whole urgent care economy and contributed to the strong performance over Quarter 4. A real strength of UM is the clinical credibility and impartiality, they function very well as the honest broker.”
Addressing the ‘paperless NHS’ challenge
All 12 CCGs and 14 hospital trusts in Greater Manchester
On April 1, 2010 the Department of Health introduced a new target requiring NHS hospitals to send patient discharge notes to GPs within 24 hours.
Once a patient is discharged from hospital a document, called a patient discharge summary needs to be sent directly to the patient’s GP. Historically, clinical correspondence, such as this was posted to GP practices and could take a number of days to arrive.
When a practice received this correspondence, practice staff needed to scan the information and upload it to their own GP system, which took additional time. This meant that a patient could visit their GP immediately after being discharged from hospital and the GP may not actually have been able to access the patient’s discharge notes.
In line with the new government requirements, hospitals and GP practices in Greater Manchester began to consider the use of an electronic system to send clinical correspondence to help overcome these issues.
NHS hospitals in Bolton, Stockport and Salford were already using various electronic systems to send clinical correspondence to GP practices, which worked well and highlighted many benefits.
In 2012, the Greater Manchester health economy invested in an electronic document transfer (EDT) system to connect hospitals with GP practices and began to plan and deliver the project through Primary Care Trusts.
The EDT system is an off-the-shelf software solution that integrates with patient administration systems (PAS) and electronic patient record systems (EPR). It allows data to be transferred electronically between organisations - in this case the hospital and the GP practice - securely within the national NHS computer network. The system also integrates with the document management system used by many GP practices, NHS hospitals and community centres.
Hospitals upload clinical correspondence to the EDT system, which becomes immediately available to the associated GP practice. Hospitals can upload clinical documents in batches or as and when they need to.
Practices connect to the system and use their own document collection systems to pull the correspondence down. The information is then instantly transferred onto the practice system for GPs to access. This process happens automatically every two hours and can also be done manually if practices are expecting urgent information. This ensures that clinical information is guaranteed to be with GPs within 24 hours.
On April 1, 2013, when the NHS landscape changed, GMCSU began to deliver the EDT project on behalf of the 12 CCGs and 14 hospital trusts in Greater Manchester. This involved leading on the roll-out of the project to connect hospitals and GP practices to one another and could effectively use the EDT system.
GMCSU’s Total Provider Management service pulled together a specialist team from the IT project management office (PMOi) made up of highly skilled project management professionals with the knowledge and experience of delivering large scale IT programmes for the NHS. The team brought the added value of being able to build on existing relationships with CCGs and hospital providers.
The project team has been working closely with GP practice managers and the CCG clinical leads for IT to ensure that each practice has the right software and systems in place to connect to the EDT system. The PMO team also provides CCG boards with monthly update reports and arranges IT training for GP practice staff so they know how to use the new systems.
The PMOi team is currently working on linking the hospital EDT systems together. At present, hospitals can only send information to GP practices that are connected to their EDT system on a geographical basis. For example, Salford Royal Hospital can upload clinical documents to the EDT system for all Salford GP practices to see. However the aim is that in the future, clinical correspondence from any NHS hospital in Greater Manchester can be accessed by any GP practice in Greater Manchester.
Work is also taking place to build resilience levels for business continuity and consistency. This will involve embedding elements of EDT hub into operational teams at GMCSU so that the GMCSU IT service desk can provide technical support to practices, adding significant value.
GMCSU has been leading on the rollout to GP practices since April 2013, on behalf of the local health economy.
A total of 385 out of 507 GP practices are now connected to the EDT system.
The system is already adding value and bringing about a number benefits, including increasing costs savings, enhancing clinical decision making and improving patient experience.
It costs the NHS approximately 65p each time a letter is sent, with five million letters sent every year. The system will bring significant costs savings for hospitals by reducing paper consumption and associated printing and postage costs.
The EDT system is also benefitting GP practices, by improving work flow and cutting down the time that practice staff previously spent scanning and uploading information, so they can make better use of their time. It not only speeds up delivery and improves productivity but also reduces the risk of losing or duplicating documents.
GPs themselves are benefitting from immediate access to clinical information following a patient’s discharge from hospital. This is improving clinical decision-making - and ultimately patient care - as patients can be seen and treated quicker and more effectively.
Using an electronic system also addresses the wider NHS sustainability agenda by reducing the amount of paper that is used for administration purposes.
GMCSU’s PMOi team is on track to roll the system out to the remaining GP practices over the next two months. The aim is to get all of the practices that are technically ready to receive the necessary software required to connect to the relevant EDT systems by March 2015.
Transforming data storage
All Clinical Commissioning Groups (CCGs) in Greater Manchester.
A data centre is a dedicated space where organisations keep and operate the majority of the ICT infrastructure that supports business requirements. This can include servers that run application software, processing data and storage equipment to store content.
Data centres come in all shapes and sizes; from a simple rack of equipment to a computer room full of cabinets. It all depends on the scale of the operation.
Prior to April 2013, the ten Primary Care Trusts in Greater Manchester were responsible for managing, storing and housing data in a number of data centres - 17 in total.
When commissioning arrangements changed on April 1, 2013 Greater Manchester Commissioning Support Unit (GMCSU) became responsible for these data centres on behalf of the 12 Clinical Commissioning Groups (CCGs) in Greater Manchester.
GMCSU is responsible for providing and managing data storage solutions for CCGs clients. This means ensuring that all electronic systems and associated data are hosted in a secure environment and can be backed up effectively.
Following a review of the 17 data centres, which were housed in a variety of locations and settings across Greater Manchester, GMCSU’s Information Management and Technology team took the strategic decision to centralise and improve data storage.
This involved developing a brand new data centre, which would use up-to-date technology and bring significant benefits to CCGs.
A major programme of work was launched in November 2013, known as the data centre migration project. This involves decommissioning the existing 17 data centres and transferring the data to a brand new data centre housed in one location.
The new data centre, located in Wigan, has two data halls each with its own power supply, back-up generator, NHS N3 link, internet link and diesel tank. So should any of these items have a problem causing one hall to fail, the other can take over and keep services online.
Work to transfer the data centres is expected to be completed in February 2015. Salford CCG is the first organisation to have data moved across to the new data centre.
This work programme is closely aligned with another of GMCSU’s major IT infrastructure transformation project, which involves upgrading the computer network across Greater Manchester.
Improving the way that data is housed and stored will bring about a number of significant benefits for CCGs:
Having two data halls running simultaneously means that in the event that one fails, the other will kick in almost immediately, providing increased resilience.
The new data centre is housed in an unmarked building, with CCTV, floodlights, access controls and 24 hour security.
Improved back up
The new data centre offers improved back up times - it will restore systems much quicker than previous arrangements and can reach back further from an earlier time period. This has a direct impact on operational business continuity, allowing employees to recover saved work and reducing downtime.
The data centre has more capacity for data processing and storage, so rather than having to add a physical server for more processing power, one can be added “virtually”. No more waiting for order processing and delivery. Using the same approach, more data can be stored in the same physical space.
Hosting servers in one place rather than on separate sites will enable CCGs to downsize their office environment and reduce associated running costs for air conditioning, fire proofing and security measures.
Electronic Prescription Service
All Clinical Commissioning Groups (CCGs) in Greater Manchester.
The Electronic Prescription Service (EPS) is a system that allows GPs and practice staff to generate and transmit prescriptions electronically.
Patients have the option to choose, or 'nominate' a pharmacy or other dispensing contractor to receive their electronic prescription automatically – without the need for any paper.
EPS makes the prescribing and dispensing process more efficient and convenient for both patients and practice staff. It also cuts down on what can be a lengthy administration process.
NHS Connecting for Health has a commitment to ensure that patient choice and patient safety are not compromised with the introduction of any new service. EPS is being delivered across England using two releases to ensure that these commitments are upheld.
In order to operate EPS, GP practices and pharmacies must have the right clinical system in place. As with all NHS health IT systems, access is controlled through the use of smartcards.
Roll out of the EPS in Greater Manchester originally began in 2011 under the remit of Primary Care Trusts, with the system being implemented to 75 GP practices.
In April 2013, when the NHS commissioning landscape changed, GMCSU took on responsibility for EPS on behalf of the 12 Clinical Commissioning Groups (CCGs) in Greater Manchester.
Keen to progress the
implementation of EPS, GMCSU approached the Health and Social Care Information
Centre (HSCIC) to requested funding to deliver EPS to GP practices in Greater
GMCSU successfully secured £35,000 from the HSCIC in November 2013 to continue delivery of the initiative during 2013/14. This funding enabled GMCSU’s IT Project Management Office (PMOi) to plan a consistent rollout of the system to 58 GP practices across the 12 CCG areas.
The PMOi project managers have significant NHS background and project management expertise and are trained PRINCE2 practitioners.
The team used their wide-ranging skills and experience to deliver an effective implementation process, building strong relationships with practice and pharmacy staff along the way.
The work programme involved running an initial workshop with the designated practice and relevant pharmacy staff to explain the EPS implementation process, the benefits and the anticipated impact on day-to-day activities. This was followed by a series of business process sessions, which explained how EPS integrates with current GP practice business systems. Practice and pharmacy staff were also given a demonstration of EPS using a test site.
Three specialist teams assisted the PMOi team with implementation. The GMCSU Registration Authority handled upgrades and access for Smartcard users, while GMCSU’s People Consult team delivered practical training sessions alongside system supplier EMIS.
GMCSU’s Information Management and Technology team handled all the technical aspects of implementation, which involved installing the software and ensuring the system was tested thoroughly before it was launched.
By the end of March 2014 a total of 132 GP practices in Greater Manchester are expected to be able to use EPS.
GPs and practice staff are benefitting from:
- a reduction in workload generated by patients requesting and collecting individual prescriptions and the ability to make wider use of the repeat dispensing service
- a reduction in workload by the ability to review electronic prescriptions on screen, and either sign electronic prescriptions individually or select multiple electronic prescriptions to sign making the prescribing process more efficient
- the ability to cancel electronic prescriptions at any point up until they are dispensed and to record the reason they were cancelled
- saving time and money as practice staff no longer need to sort or post prescriptions.
The GMCSU project managers gained valuable knowledge and experience of EPS implementation and have built strong relationships with practices.
GMCSU is working closely with HSCIC and others to explore funding opportunities to continue this work in the future.
Developing a lay member network for North West CCGs
All Clinical Commissioning Groups (CCGs) in the North West.
On April 1, 2013 Clinical Commissioning Groups became responsible for the commissioning of healthcare services across England. Each CCG has a governing body made up of clinicians, NHS healthcare managers, and lay members that manages the organisation.
Lay member representatives bring specific expertise and experience to the work of the governing body in a number of key areas including: finance; patient and public engagement; clinical input; and governance. Lay members have a key strategic and impartial role, providing an external view of the work of the CCG, which is removed from the day-to-day running of the organisation.
Following discussions with lay members from the 12 Greater Manchester CCGs, Greater Manchester Commissioning Support Unit (GMCSU) identified the need for a local network to support lay members in the new NHS landscape.
While this initiative was not directly commissioned by the CCGs it was
felt that the planned support could add significant value to the work of lay members
in CCGs. GMCSU agreed to lead and host the planned network and to review progress
at six and twelve month intervals.
GMCSU collaborated with Chief Operating Officers and lay members from the Greater Manchester CCGs to determine if there was appetite a lay member network. Responses indicated that there was both a need and enthusiasm for a network; some lay members had already begun to think about establishing local networks.
The main aim of the network is to support lay members in their corporate and specialist roles on CCG governing bodies by providing opportunities to:
- Share experience and expertise through peer support
- Develop capability in their role
- Consider commissioning issues and topics through discussion and external input from relevant speakers or organisations
- Develop a network in the North West to share good practice in four key areas; governance, patient and public involvement, clinical expertise and quality outcomes for patients
- Make connections locally, regionally and nationally to support lay members in their role.
GMCSU responded to an identified need, collaborating with lay members from the start, to provide a value added service for CCGs.
The purpose and format of the proposed network was agreed and a steering group was established to plan and develop the network further. The steering group, which is representative of lay members, ensures that planning is driven by the needs of lay members.
GMCSU hosts the network, providing administration support and coordination of the necessary communications and planning determined by the steering group. Social media is also used to make connections, regionally and nationally.
Meetings take place on a quarterly basis at a central Manchester venue. The meetings provide time for lay members to network informally, listen to expert speakers, take part in a panel questions and answers on hot topics, and experience shared peer support through focused discussions in responsibility groups.
The responsibility groups are led by lay members in the areas of governance, patient and public information and clinical input. The groups enable lay members to have detailed discussions about their wider corporate responsibilities.
The network operates at a minimal cost and is supported by the Local Area Team, which provides the venue. GMCSU has a key role in supplying expert speakers who share knowledge and advice from GMCSU specialist teams. Additional speakers often include network contacts and other lay members.
Lay members unable to attend network meetings have the opportunity to contribute
by email or telephone. Following the meetings, a summary document is sent out
to all North West CCGs for information.
Development of the North West Lay Member Network is proving to be very positive with lay members benefitting from valuable peer support opportunities. It is also fulfilling a need to make new relationships and connections in the new NHS landscape.
Continuing collaboration between GMCSU and lay members ensures that the needs of CCG’s are understood and that the network continues to add value to their work.
The initiative, which originated in Greater Manchester, has been extended across the North West in response to enquiries from lay members. The network is growing in numbers with membership increasing from 30 to around 90 registered members in a period of six months.
Lay members are appreciative of the opportunity for peer support offered by the network. Meetings are evaluated and feedback has predominantly been ‘Very Good’ or ‘Excellent.’
The network is becoming better known regionally and nationally. A number of links have been established to develop the network and to avoid duplication with alternative provision of CCG support:
- The network is part of the Community England Learning Environment website, currently being developed by NHS England (http://www.community.england.nhs.uk/)
- GMCSU’s Lead Business Advisor is chair of the North West Leadership Academy Sub Group for Non Executive Director and Lay Member development
- An informal partnership has been created with Mersey Internal Audit Agency (MIAA).
Future successful developments of the NHS will depend on collaboration and relationships to respond to the challenges of the day and beyond. Having a motivated and experienced group of lay members working on CCG governing bodies can only be a positive force in enabling excellence in their work.
Information governance: Accredited Safe Havens
Across Greater Manchester, 12 Clinical Commissioning Groups (CCGs), including Bolton CCG, Salford CCG and North, South and Central Manchester CCGs, work in localities to improve health and healthcare for the public, commissioning high-quality healthcare services that represent value for money and put the patient at the heart of decision-making. Each is led by a governing body that includes GPs, other health professionals and lay people.
Changes to the Health and Social Care Act on April 1, 2013 affected the laws around the flow of personal confidential data (PCD).
New information governance regulations stated that only the Health and Social Care Information Centre (HSCIC) is able to receive and process PCD for commissioning purposes without patient consent.
changes placed restrictions on how Clinical Commissioning Groups (CCGs) could
implement and evaluate their strategic objectives and monitor and evaluate some
of their commissioning activities.
NHS England sought permission from the Confidentiality Advisory Group to allow CCGs and Commissioning Support Units to have access to PCD for a limited range of commissioning uses until details of the new environment are fully defined.
CCGs can still receive PCD to support direct patient care but if they want to use PCD for commissioning purposes they must become an Accredited Safe Haven (ASH) or have patient consent.
ASH status allows organisations to legally process data in ways that prevent the identity of individuals from being identified. This data may include a single identifier such as the NHS number or postcode.
To attain ASH status, CCGs needed to achieve Level 2 of the HSCIC’s information governance toolkit by October 31, 2013.
was commissioned by Bolton CCG, Salford CCG and North, South and Central
Manchester CCGs to help them with their submission for ASH status.
The IG team worked closely with CCG clients to pull together a significant amount of evidence to demonstrate that the CCGs were able to attain Level 2 of the HSCIC IG toolkit.
- Establishing an IG management framework
- Review, approval and publication of all IG related policies and procedures
- Ensuring procedures are in place for dealing with Subject Access and Freedom of Information requests
- Establishing and monitoring IG awareness and mandatory training programmes
- Establishing procedures for incident management
- Ensuring personal data is only used where there is a legal basis to do so
- Confirming all new processes and systems are developed and implemented in a secure and structured manner, complying with confidentiality and data protection requirements.
GMCSU also developed an action plan detailing the tasks that the CCGs needed to undertake to achieve the necessary rating by this date. This involved putting a data sharing agreement in place and obtaining a signed data-sharing contract as required by HSCIC.
Despite the deadline being brought forward in an already extremely restricted timeframe, GMCSUs IG team successfully delivered the submission on time, enabling the CCGs to be considered for ASH status. GMCSU also applied for ASH status at the same time, so it could continue to effectively support CCG clients.
GMCSU’s IG team enabled Bolton, Salford and North, South and Central Manchester CCGs to successfully complete Level 2 of the HSCIC IG toolkit - in just six months. This means that the CCGs can now legally process PCD data and extracts from the HSCIC to support their commissioning purposes.
The Greater Manchester CCGs are five of only 26 CCGs nationally to have achieved ASH status. GMCSU also achieved ASH status and can now continue to support CCG clients.
Grace Birch, Associate Director of Outcomes Delivery and Business Support, at Bolton Clinical Commissioning Group, said:
“Bolton CCG has now received its interim ASH status. This has been the result of great partnership working between the CCG and the GMCSU Information Governance team. Both teams put in an incredible amount of effort, with the GMCSU team providing us with invaluable support and knowledge.
“The introduction of the new Health and Social Care Act and the resulting restrictions placed upon the flow of PCD to CCGs caused a huge wave of concerns in Bolton. There are a number of CCG initiatives that have been developed in partnership with local member practices, which are key to the delivery of local objectives and the local vision of an integrated health and social care system. Being able to access patient data as an ASH will now enable this important work to progress, whilst keeping us compliant with the legal framework.”
Pharmaceutical needs assessments
Manchester, Salford and Trafford local authorities are responsible for providing a wide range of services to their local populations, from education and environment, to public health and social care. In a number of health-related areas, they work closely with Greater Manchester Commissioning Support Unit (GMCSU) to ensure a comprehensive, high-quality service.
Among their many responsibilities, local authority Health and Wellbeing Boards are responsible for assessing the health needs of their respective populations, and ensuring that their local pharmacy services meet these needs.
To do this,
they must produce a Pharmaceutical Needs Assessment (PNA) – a document required
by national legislation that typically runs to more than 100 pages – which
identifies how well pharmacy services meet the needs of a local population, and
highlights any gaps between this need and current provision. The can then
inform either new services or new pharmacies in a locality.
While there is a legislative requirement to complete a PNA by April 1 2015, in order to fit in with wider assessment of pharmacy services and allow better informed commissioning, Manchester, Salford and Trafford local authorities requested that this work was completed by April 2014. During the production and updating of the PNA, they work closely with members of GMCSU’s Medicines Management service.
Following the restructure of the NHS in April 2013, information required to complete PNAs now sits with a number of different organisations, including local authorities, clinical commissioning groups and the Greater Manchester area team representing NHS England. Previously, PNAs had been completed entirely by primary care trusts, who held every piece of data needed – from the location of local pharmacies and the specific services each offered, to local population health needs.
The fact that this was no longer the case causes potential difficulties, as there is a high level of uncertainty over where data sits. As a result, GMCSU needed to invest time to ensure that all information was consistent, and most importantly, accurate and comprehensive, including all pharmacy services in the locality. In order to do this efficiently, GMCSU’s medicines management team would need to work with colleagues across a number of services, including total provider management, business intelligence, and communications, engagement and marketing.
In order to guarantee comprehensive information was available in one, central place, GMCSU’s medicine management team liaised with all the organisations involved, such as CCGs and the Greater Manchester area team representing NHS England, as well as the local pharmaceutical committee – the representative body for contractors – for each area.
wide-ranging combination of skills
within GMCSU then combined effectively to produce the three
documents. With people drawn together from across the region, the medicines
management team has both the detailed, specific local knowledge required to
inform a PNA, alongside robust regional benchmarking. Equally, the experience
within the team meant that the detailed requirements of a PNA were understood.
This work was entirely overseen by GMCSU’s project management office, who drew up the plans and timelines, both of which were included in the PNAs to inform their Health and Wellbeing Boards. Thanks to this matrix-working approach, the medicines management team were able to draw on colleagues working within provider management to provide background information into which services each pharmacy provides.
Further information was gained using two surveys designed by GMCSU’s communications, engagement and marketing team. One garnered public opinion on whether existing pharmacy services were sufficient, while the other was sent to pharmacists to ascertain which services they would ideally like to offer. Once that was done, business intelligence specialists based with GMCSU’s IM&T service produced mapping and statistical analysis to the specifications set out by the medicines management team.
As a result of this approach, a draft PNA document was produced in time for the required 60-day consultation period. Once the consultation period is complete, GMCSU will analyse it and agree any changes with each individual local authority, before taking it forward as a final document to be published in April 2014.
three clients received added value through GMCSU’s matrix working approach,
with a final product that went beyond the original specification through the
addition of mapping and communications support.
“We found the support and guidance from the CSU to be excellent, in what has been both a time of establishing new organisations and processes, and forming new working relationships.”
Manchester Council’s Consultant for Public Health, Barry Gillespie
Managing risk through collaborative working
Across Greater Manchester, 12 Clinical Commissioning Groups (CCGs) work in localities to improve health and healthcare for the public, commissioning high-quality healthcare services that represent value for money and put the patient at the heart of decision-making. Each is led by a governing body that includes GPs, other health professionals and lay people.
work is underpinned by comprehensive commissioning support from Greater
Manchester Commissioning Support Unit (GMCSU).
As commissioners, CCGs are driven by standards set nationally by the Department of Health and by local expectations impacting on the business critical areas of governance and risk management. To meet those standards and expectations, each organisation’s system for identifying and managing risk, and reporting it through the governance structure, must be robust, and deliver assurances to CCG boards and committees that risks are being managed effectively and to the level required.
this in mind, it was apparent that our CCGs could benefit from the collaborative
ways of working embedded within GMCSU’s Governance and Risk service – as well
as the economic benefits of procuring this service from a provider with a
larger geographic footprint.
The service has developed a philosophy that in order to offer a quality product, it is imperative that timely and comprehensive communication channels are established and embedded, both internally within GMCSU and with clients. This required the GMCSU to adopt a matrix-working approach to service delivery for its clients.
In order to ensure clear lines of communication within GMCSU, the first part of the process was to identify all the different services provided to the client that could inform and contribute to the process of managing the different risks faced. In this particular case these services were Business Intelligence (housed within IM&T), Total Provider Management, Service Redesign and Governance itself. The next stage was to identify a potential representative with specialist knowledge from one of those service areas that would take responsibility for leading on the updating the CCGs’ Risk Register.
from GMCSU’s Service Redesign team were identified as best placed to lead on
this task. They were given risk management training updates from GMCSU’s Head
of Governance and Risk that provided operational insight into a CCG’s risk monitoring
and reporting system, as well as an awareness session to highlight the
importance of the lead role. However,
these sessions soon identified that this approach did not take full advantage
of the in-depth specialist knowledge held within GMCSU.
As a result, a meeting was held between senior colleagues within each GMCSU provided service, to open up clear lines of communications and identify each service’s interdependencies and exact input to the process. It was then possible to devise a solution that made the most of GMCSU’s expertise, knowledge and resources.
The interim agreement was that colleagues from Service Redesign would now share responsibility for updating key areas of the client’s Risk Register, with each service area now clear on their revised roles and responsibilities, and each drawing from their own knowledge and experience.
A robust process was established to ensure regular liaison between the service leads to obtain different perspectives on risks faced by the client, and allow the updating of the client’s Risk Register within specific timelines. In order to ensure quality of service delivery, it was decided that this collaborative process would remain in place for three months at which point it would be reviewed.
This matrix approach worked well and provided reassurance to the CCG client that their Risk Registers would be maintained robustly and in a timely fashion. Bringing GMCSU provided services together provided clear benefits for clients that take up GMCSU’s Governance and Risk offer, including:
- a structured multi-disciplinary approach to the clients’ needs
- specialist skills and knowledge drawn from across GMCSU combine to ensure that the CCG’s Risk management approach is fit for purpose
- multidisciplinary perspective to each client’s risk issues developed
- comprehensively informed Risk Registers and reportingclient expectations are met.
The Keogh Review: Tameside and Glossop CCG’s response
Tameside and Glossop Clinical Commissioning Group (CCG) commission a wide range of health services for a local population of nearly 250,000 people in parts of Greater Manchester and Derbyshire, and in 2013-14 has an annual budget of £337m.
The CCG is made up of 128 local GPs from its 43 member practices and, alongside other health colleagues, including local councils, is responsible for advancing the way that health services are currently delivered; commissioning services aligned to local demand that represent value for money, leading to improved health and wellbeing outcomes for the patient population.
The communications, engagement and marketing for the CCG is provided by Greater Manchester Commissioning Support Unit.
Tameside Hospital NHS Foundation Trust (TFT) is the main provider of services commissioned by Tameside and Glossop CCG.
In February 2013, TFT was identified as one of 14 trusts to be investigated by Sir Bruce Keogh and his team as part of the Keogh Review into Mortality Rates. The Review Team visited TFT on May 23 and 24, with the CCG invited to observe the site visit.
Between the visit and publication of the findings, private minutes of a CCG board meeting were leaked and published in the Guardian newspaper. This created a huge amount of local, regional and national interest in the CCG. The CCG had been asked to provide comment and interviews to all these outlets. However, the position remained, as it had done prior to publication of the minutes, that it would be inappropriate to comment on specifics of the hospital until the Keogh Review had been published.
In the aftermath of the report the Chief Executive and Medical Director of TFT resigned from their posts. A new Chief Executive and Medical Director were appointed in the interim with almost immediate effect and were in place for the review’s publication. The Keogh Review into Tameside Hospital NHS Foundation Trust was published on July 16. Media interest around the TFT was extremely high.
A strategic response plan was put into development as soon as GMCSU officially took over the communications function for the CCG.
The first stage was to identify key spokespeople, along with deputies, for the CCG in anticipation of suspected high media interest. An initial group, including the CCG’s chair and chief operating officer, took part in media training delivered by GMCSU, tailored around likely questions that would arise during the review.
A media plan was developed between GMCSU’s Communications, Engagement and Marketing team and the CCG’s chief officer, regarding proactive materials and media activity, as well as reactive media protocols.
The formal inspection took place over two days during which time GMCSU provided the CCG governing body with morning, lunch and mid-afternoon media updates on coverage of the visit.
As a result of the leaked board minutes, the initial media plan for publication was scrapped in favour of a revised plan developed by NHS England, GMCSU’s Communications, Engagement and Marketing team, and other trusts and CCGs involved in the review. A dynamic and flexible approach was required as an array of elements changed in the days leading up to publication.
TFT would be the focus for media interest on the day but we advised that the CCG spokespeople should make themselves available for any press enquiries, including TV interviews after the review had been published and all press releases issued. To assist with this we produced a series of difficult questions and answers, to prepare spokespeople for the worst case scenario.
A three stage plan was implemented for before, during and after publication of the report.
Before publication, media calls were taken and monitored by GMCSU to maintain a consistent system, while other members of the team finalised the draft press release with NHS England and TFT
During publications a member of our team watched the live delivery of the report, from the Secretary of State ready to make any changes to the CCG’s response. At the same time another monitored all social networks.
Immediately after the publication, the press release was distributed to all local and regional media outlets, as well as national outlets that had shown interest, and key stakeholders. Digital and social media channels were used to promote the press release further to the media distribution. The press release made clear the times for interviews, and the GMCSU team handled resultant enquiries.
As a result of GMCSU’s support, the CCG remained in a strong position throughout this situation with its reputation protected and enhanced, building on the positive coverage garnered during the coverage of the Guardian article.
GMCSU ensured that the CCG showed clear support for both the Keogh Review process and Tameside Hospital in implementing the action plan that arose from the review. The CCG was also clear that patients and public must be listened to in order to improve and assist in the changes needed at the hospital and in this new era of opened and transparency, those making the decisions would be held to new levels of accountability.
Procuring Oldham's Community Services
NHS Oldham Clinical Commissioning Group (CCG) is made up of every GP in Oldham, and led by a governing body that includes GPs, other health professionals and lay people.
purpose is to improve health and healthcare for the people of Oldham by
commissioning the highest quality healthcare services, provided near to the
patient, in an integrated fashion and representing best value for money.
Oldham CCG, in line with its vision of commissioning high-quality services near to the patient, is undergoing a process of procuring its community health services.
have been provided by Pennine Care NHS Foundation Trust since 2011, in a
contract lasting a maximum of three years. However, the CCG have decided that
these services need to be delivered in a community, rather than hospital,
part of the market management service that the CCG receives from GMCSU, they
were supported in all aspects of this procurement process.
Oldham’s vision for integrated care requires providers of services to be much more closely focused on effective planning and delivery for individual patients, particularly the most vulnerable.
CCG feels that integrated care is best provided when different services come
together, rather than one provider offering a one-size-fits-all approach.
Market Management team, with a wide and deep understanding of different
providers across the area, were well-placed to achieve this type of
GMCSU and the CCG appreciate that community needs can be common, but also know
that in there are major differences between different parts of Oldham, and
these need to be analysed and catered for.
As part of the procurement process, GMCSU’s Market Management team analysed the make-up of Oldham’s community services, and divided them into six sub-groups, allowing providers to bid for either one particular area, or for a more comprehensive service:
were brought together in this way based on the team’s knowledge of similar
arrangements, and following engagement with stakeholders.
approach would achieve the CCG’s stated aim of creating a structure in which
different providers can offer an integrated structure
was then necessary to use a rigorous tendering process to select a shortlist. Using
recognised industry best practice, potential bidders were asked by GMSCU to
express their interest through the EU supply system by a fixed deadline.
order to consider every aspect their bids are evaluated by an expert
multidisciplinary team within GMCSU, to decide whether they will be
short-listed for the next stage, and given an opportunity to formally tender.
There were significant benefits to both Oldham CCG and patients.
As a result of the way that GMCSU divided community services into categories, the full potential of the provider market had an opportunity to tender – from small social enterprises to large NHS Foundation Trusts and independent sector providers. This meant that the procurement process could provide Oldham CCG with the best outcome for patients at high quality and low price
The range of services offered by GMCSU meant that the project could be considered in the round. A team was brought together, led by market management, including specialists in finance, IM&T, communications and engagement, service redesign, people’s services and provider management. This meant that the approach to procuring Oldham’s community services took into account all possible consequences, impacts and opportunities for the CCG and the population they serve.
NEWS AND VIEWS
Two of the NHS’s biggest professional services suppliers have been shortlisted to become a ‘lead provider’ for NHS England’s commissioning support framework.
The Commissioning Support Units (CSUs) of Greater Manchester and Cheshire and Merseyside, coming together on October 1 as North West CSU in an £80m merger, have passed the first phase of the procurement process for NHS England’s Lead Provider Framework (LPF).
The two organisations’ portfolios are extensive, providing business, clinical and commissioning support to NHS commissioners, hospitals, local authorities, GP practices, NHS England and others.
Their work includes:
- an internationally recognised team working with hospitals and community trusts across the UK to review health systems, helping to spot, analyse and monitor problems
- the delivery of a £5.4m transformation programme to integrate IT across Greater Manchester
- the management of contracts with hospitals and other NHS trusts worth up to £3bn
- working with other CSUs to deliver a patient and public engagement programme across the North of England.
The framework was developed by NHS England to aid clinical commissioning groups (CCGs) in the procurement of services for commissioning support. It will provide access to a full range of health and social care support services in a fast, simple and cost effective manner, making it easier for CCGs and other customers to choose accredited suppliers.
Over the next four years, it is anticipated that between £3bn and £5bn of services will be procured through the LPF.
Securing a place on the framework is a quality mark from NHS England. Organisations on the LPF will be known for being excellent, affordable providers of high quality commissioning support services.
The two CSUs are continuing to work through the procurement process, which involves submitting an Invitation to Tender to NHS England by October 29. The framework is expected to launch in January 2015.
Leigh Griffin as Managing Director of GMCSU, Acting MD of C&MCSU and Chair of the National CSU MD’s Network said: “I am delighted that Greater Manchester and Cheshire and Merseyside CSUs, pending our merger to become North West CSU on October 1, have been successful in the first phase of the national Lead Provider Framework. This recognises our experience and abilities in providing support to the public sector across the North West, and our potential for further growth and development.
“The next stages are going to be challenging, and looking ahead, we must ensure that we focus first and foremost on the delivery of excellent services to our clients and build on local partnership working.”
Together GMCSU and CMCSU cover a population of 5.1m, with 24 CCGs, 898 GP practices, 3 Area Teams, 19 Local Authorities and 18 Acute Trusts – seven of which are specialist trusts and five Mental Health Trusts.
The impending £80m merger will secure the long-term future of the two organisations, which offer expert professional services at a large scale to the NHS and other parts of the public sector and have bases in Salford, Warrington, Chester, Liverpool and Nantwich.
An NHS employee from Oldham is halfway through a challenge to raise money for a Manchester cancer charity.
On New Year’s Eve 2013, Andy Eastwood, Project and Bid Manager from the Greater Manchester Commissioning Support Unit (GMCSU) set himself a challenge; to complete 14 charity events in 2014, to raise money for The Christie in conjunction with Chadderton Park Sports Club.
Like most people, Andy knew someone who had been affected by cancer, and by competing in these events he hoped to contribute some much needed funds to help beat the disease.
He is now halfway into his #GoingTheExtraMile14 challenge, having abseiled, cycled, ran, and swam his way around various places in England, raising £489 of his £1000 target so far.
Asked which of the events he has enjoyed and which he found most difficult, Andy said:
“To be honest I have enjoyed all of them, but if I was to pick out the most enjoyable I would say the Great Manchester Swim (one mile in Salford Quays) as it was a totally new experience for me completing an open water swim. The most difficult I would say was the Manchester to Blackpool bike ride, but only because of the strong wind factor for the last eight miles!”
Next month sees Andy take on the Salford Triathlon at Salford Quays, consisting of a 750m swim, 20K bike ride and a 5K run.
Future events include the Salford 10K, the HellRunner off-road running challenge and the Benidorm 10K in November.
Jo Purcell, Director of Customer Relationships at GMCSU said: “We are really proud of what Andy has achieved. It is an amazing personal challenge and it is for a great cause too.”
When he isn’t taking part in these races, Andy helps GMCSU to identify new business opportunities. He facilitates, plans and project manages potential bids for new work with input from subject matter experts.
To find out more
about Andy’s past and forthcoming challenges visit his JustGiving page - www.justgiving.com/AndyEastwood-GoingTheExtraMile14/.
This September, GMCSU will be hosting a special summit to discuss mental health commissioning across the region.
the event, representatives from all agencies in Greater Manchester and Cheshire
and Merseyside with an interest in the way that mental health services are
delivered will get together. They will discuss key issues and challenges,
including responding to parity of esteem, the integrated care agenda and future
demands, with a view to considering a functional system-wide approach.
In order to better understand the current pressures and challenges on mental health commissioning, and where mental health sits on organisations’ lists of priorities, we are currently conducting a very brief survey, and would welcome your views here.
Professor Chris Heginbotham
OBE will be leading the summit. Chris is Emeritus Professor of Mental Health
Policy and Management at the University of Central Lancashire. He was Chief
Executive of Mind, the National Association for Mental Health, for much of the
1980s, when he represented the World Federation for Mental Health at the UN
Commission on Human Rights in Geneva.
The summit will take place on September 5, from 8am until 12.30pm, at The Studio, on Lever Street, Manchester. For further information and to book your place, visit www.gmcsuevents.co.uk
A new service has been established at GMCSU to offer CCGs with year-round support for operational resilience and capacity planning.
The aim is to help commissioners to maintain and improve quality patient care,
for example, by optimising achievement of the national four hour emergency
Designed by GMCSU following feedback from commissioners, the service will help CCGs to effectively manage the year-round delivery of operational pressures and capacity planning within their local health economy. This is in line with recently released guidance from NHS England. You can read the guidance here.
key element involves support with the development, prioritisation and
implementation of operational resilience and capacity plans. The service
operates in partnership with GMCSU’s clinician-led Utilisation Management team,
which offers practical support, reviews a variety of urgent care datasets to
predict pressures, and assists with the management of demand and capacity
across the Greater Manchester health economy.
Traci Berry, Seasonal Planning Lead at GMCSU, said: “Access to a variety of datasets gives us a clear picture of capacity and demand pressures at a local level and across Greater Manchester. This insight enables us to assist commissioners with the management and delivery of existing activity and to help them to predict future pressures, with the aim of improving the quality of patient care.”
For more information
contact Traci Berry on 0161 212 6206 or email firstname.lastname@example.org
An NHS organisation in Greater Manchester has been rewarding its employees achievements, in a novelty way – by presenting them with their very own pie.
Greater Manchester Commissioning Support Unit (GMCSU), based in
Salford, has been recognising colleagues who go over and above the requirements
of their role, through their ‘Pride in Excellence’ or ‘PiE’ awards. As well as
receiving an award certificate, the winners of the award also get to choose
their very own pie from a local bakery.
The latest PiE winner is Charlotte Lawless, a Project Support Officer from Swinton. Charlotte was awarded with a delicious meat and potato pie for leading a major deployment project, updating operating systems and computers with the most up to date software for GP practices in Salford. Charlotte took the lead on escalating technical issues and resolving them as quickly as possible, ensuring minimal impact on the day-to-day running of GP practices in the Salford area.
Charlotte was also commended for her outstanding communication skills. She said: “I feel really honoured that members of my team have nominated me for this award and I am so happy to have won. My team have been really supportive and encouraging in developing my skills and I will certainly be sharing the pie with them!”
Leigh Griffin, Managing Director, said: “The PiE awards are an important way of recognising some extremely talented individuals and teams who make a substantial contribution to GMCSU. Through their dedication and support our colleagues are making GMCSU a great place to work. Each one is a valued addition to our organisation. The real pies just add a bit of fun to the occasion.
“Charlotte is a worthy winner of the latest PiE award, and her hard work deserves to be acknowledged. She has gone above and beyond in her day to day role, in order to successfully deliver this project.”
Charlotte received her meat and potato pie - courtesy of Pryce the Bakers in Walkden – along with shopping vouchers and a certificate.
This month, GMCSU will be exhibiting at the Commissioning Show at the Excel Centre, London on June 25 and 26.
We will be promoting the full range of support we offer, with particular focus on the way we use clinical input to guide and underpin a number of our services and products. If you’re attending the event, do pop over to our stand (J32) and say hello.
At the exhibition, we will also be discussing our partnership with the Good Governance Institute in offering commissioners and providers access to a commissioning simulator. The simulator mirrors the commissioning cycle, allowing a greater insight into strategic decision-making and the impact of commissioning decisions.
David Goldberg, International Associate at the institute, and our Commercial Director, Cathy Gritzner, will be speaking about the simulator at the event at 4.10pm, on June 25 on the Innovation Pavillion stage.
GMCSU’s Communications, Engagement and Marketing team has been assisting NHS England with a project designed to promote innovation in healthcare commissioning.
Our Communications, Engagement and Marketing team was asked to develop a set of case studies for the Pinboard, part of NHS
England’s online learning environment for commissioners.
The case studies highlight best practice across a number of key areas, including leadership, governance, integration, collaboration, patient engagement, strategic and operational planning, quality, and transformational change. You can view the Pinboard here.
We have now uploaded more than 40 case studies to the site, showcasing innovation across the country. Contributions have also been received directly from clinical commissioning groups (CCGs). Our case studies have been well received by NHS England’s Oversight Committee.
NHS England is now seeking feedback on the learning environment, which can be submitted online here.
More information about our
Communications, Engagement, and Marketing service can be found here.
GMCSU is continuing its pledge of supporting three charities within Greater Manchester, after raising a total amount of £1,800 in the last year.
Greater Manchester Commissioning Support Unit (GMCSU) employees raised the amount through taking part in a number of fundraising events including bake offs, picnic hamper raffles and a monthly dress down Friday. Since April 2014, a further £800 was also raised at a recent charity Dragon Boat Race.
The money raised will be split between GMCSU’s three charity partners:
- Mustard Tree, a charity committed to providing life support for the homeless, marginalised and vulnerable across Greater Manchester
- Macmillan Cancer Support, which provides practical, medical and financial support for people with cancer in and around Manchester, as well as nationally
- Francis House Children’s Hospice, a hospice in Greater Manchester that provides care for children and young adults with life-threatening conditions, as well as providing support for their families.
Picture illustrations were created to represent how the money raised would be used for each charity; £25 will pay for a Macmillan Nurse for one hour to support people with cancer, £600 will go towards developing Francis House’s lodge, which offers comfort and rest for young people receiving respite care treatments. Every £70 raised for Mustard Tree will feed at least one person for a whole week, through the organisation’s food bank facility.
“We are really keen to give back to the communities where we work. Our employees have been getting involved in a number of events over the past year, to go the extra mile for the three charities that we support. We hope to make a real difference to the charities’ work and the lives of the people they help."
Leigh Griffin, Managing Director of GMCSU
“The £600 raised by GMCSU will help support two grants for people affected by cancer. This includes things like new clothes for people going through chemotherapy or a respite break away. Our aim at Macmillan is to ensure that no one faces cancer alone and working with companies, like GMCSU, helps us to reach this goal.”
Becky Bainton, Fundraising Manager at Macmillan Cancer Support
“The demand was so high for our services that we’ve extended the facility, by doubling the number of bedrooms from seven to 14 at a cost of £3.5 million. We are therefore grateful for the help of GMCSU employees for their fundraising help in contributing towards the £4.6 million a year we need to keep Francis House running.”
Emma Siddle, Fundraising Officer at Francis House
“We believe that working together with GMCSU will help us to make a profound and lasting impact through the funds raised, connections made and expertise offered. I would like to thank the organisation for their efforts and for partnering with us in this life changing initiative.”
Adrian Nottingham, Chief Executive Officer at Mustard Tree
Employees from a Salford based NHS organisation competed in the Dragon Boat Festival at Salford Quays, on Sunday May 11, to raise money for two of the charities it supports:
- Mustard Tree, a charity committed to providing life support for the homeless, marginalised and vulnerable across Greater Manchester
- Francis House Children’s Hospice, a hospice in Greater Manchester that provides care for children and young adults with life-threatening conditions, as well as providing support for their families
Sixteen individuals from Greater Manchester Commissioning Support Unit (GMCSU) took part in the high adrenaline team sport and completed the race in one minute and 16 seconds. More than £800 was raised in total for the charities.
The event included 22 teams all coming together to compete in the largest charity dragon boat festival in the North West. Most team members were first timers at dragon boating, but they worked hard to complete the challenge, which consisted of three timed races during the day.
“The race was a great opportunity to have some fun and at the same time we raised money for GMCSU’s charity partners – Mustard Tree and Francis House. It was something different, that most of the team had never tried before.
“The weather was awful – but overall the dragon boat race was a good team-building exercise and the whole team worked hard and developed a great team spirit, throughout the whole race.”
Paul Byrne, Information Governance Manager and captain of the dragon boat team
“I am very proud of the whole team involved in the race – we have some great charity ambassadors and multi-talented staff working at GMCSU. The race was a great example of people going the extra mile to raise money for a good cause."
Jo Purcell, Director of Customer Relationships
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As GMCSU is hosted by NHS England we do not have a legal requirement to have a publication scheme or Freedom of Information (FoI) procedures.
How to make an FoI request about GMCSU
Any Freedom of Information requests concerning GMCSU should be sent to NHS England. NHS England is also responsible for answering information requests about previous Primary Care Trusts (PCTs) as well as NHS England Area Teams. To request information, please contact NHS England on 0300 311 22 33.
How to make an FoI request about a CCG
GMCSU supports the following CCGs to handle their Freedom of Information requests: Bolton; Bury; Central Manchester; Heywood Middleton and Rochdale; North Manchester; Oldham; Salford; South Manchester; and Wigan. All CCGs are required to have a publication scheme and the information you require may be available on the CCG website. If the information you require about the CCG is not on their website, please complete the form in our 'contact us' section, selecting the FoI option.
Any requests for information under the Freedom of Information Act 2000 have to be made in writing. You will be informed if any charges are incurred in providing this information and asked if you wish to proceed with the request. Some types of information are exempt from publication and if this is the case you will be informed of the exemption applied and the reason why. If the information is available on the CCG’s Publication Scheme you do not have to make a formal request for that information.