Report of the Clinical Director, Manchester Health and Care Commissioning

This report provides information on how Manchester Health and Care Commissioning (MHCC) is working collaboratively with partners on a respiratory work programme. The aims are to improve health outcomes and quality of life for patients, support self-management, personalisation and early intervention in the community; and strengthen the quality of end of life care.   

HSC/18/51    Adult Respiratory

The Committee considered the report of the Clinical Director, Manchester Health and Care Commissioning(MHCC) that described how MHCC were working collaboratively with partners with the ambition to improve health outcomes and quality of life for patients, support self-management, personalisation and early intervention in the community; and strengthen the quality of end of life care.   

The Clinical Director referred to the main points of the report which were: -

·                Describing the work of NHS RightCare teams, who worked locally with systems to present a diagnosis of data and evidence across the population to identify opportunities and potential areas where quality could be improved;

·                A description of the work streams identified by the Manchester Adult Respiratory Steering Group;

·                A data analysis of respiratory emergency admissions for the first 6 months of 17/18 compared to the first 6 months of 18/19, noting the considerable pressure in emergency admissions for respiratory patients and how providers were managing these admissions;

·                A description of the Primary Care Respiratory Standards developed by MHCC;

·                The work underway to review how these standards were applied to those in receipt of Homecare;

·                A description of the COPD (Chronic Obstructive Pulmonary Disease) Virtual Clinic and the impact of this innovation;

·                An update on the procurement and distribution of spirometers, noting that Spirometry was a simple test used to help diagnose and monitor certain lung conditions by measuring how much air you could breathe out in one forced breath;

·                A description of the Manchester Integrated Lung Service;

·                A description of the collaborative work undertaken by Primary, Community and Secondary Care to produce the Manchester Respiratory Referral Criteria that covers the minimum information that should be contained in all respiratory referral letters;

·                A description on Pulmonary Rehabilitation, a programme of exercise and education for people with long-term lung conditions;

·                The programmes developed through Health Innovation Manchester (HIM);

·                The activities to address smoking including information on the CURE Project;

·                An update on the developments in relation to social prescribing with a description of the Breathe Better model; and

·                Information on the partnership work undertaken in Greater Manchester.

Members welcomed the report and noted the information that had been provided that gave the numbers of COPD and Asthma reviews undertaken at a ward level, and requested that this information, along with other relevant health data is shared with local Members.

In response to a comment regarding the difference in figures relating to these reviews across wards the Clinical Director Members commented that establishment of Neighbourhood Teams would address the issue of variation across the city. The Chair sought clarification as to why some practices appeared to be undertaking significantly more reviews than others. The Primary Care Information Manager responded by saying that this was primarily due to Practices not recording the information correctly on the system. He advised that this information was collected periodically and enquiries were made to individual practices if their returns were low. He said advice and training was offered to those sites to ensure this information was accurately recorded, he also added that Practices were paid for delivering these reviews so it was in their own interest to accurately record this work.

The Clinical Director commented that the majority of GP practices in Manchester were rated as ‘Good’ or as ‘Outstanding’ by the Care Quality Commission (CQC), and the couple that were rated as ‘Require Improvement’ related to improvements around issues of practice management rather than the delivery of care for their patients. She said that for those few practices rated as ‘Require Improvement’ support was provided to help them address any issues identified. She commented that if Members wished to view the latest CQC reports these could be viewed via their website.

Members discussed the issue if shisha smoking, noting that one hour of shisha smoking could be as damaging as 100 cigarettes and asked what was being done to regulate these premises. The Chair informed the Committee that the Neighbourhoods and Environment Scrutiny Committee would be considering a report on this topic in the new year and asked that the report be circulated to the Committee when this was available.

The Director of Population Health and Wellbeing responded to a comment from a Member regarding the lack of reference within the report to air quality and emissions by commenting that the Manchester Public Health Annual Report 2018 addressed the issue of air quality. He added that the Manchester Health and Care Commissioning Board had considered a report on this issue at their October meeting and this linked into activities at a Greater Manchester level to address this issue of poor air quality. In addition, he commented that the issue of shisha smoking was also being addressed by the Manchester Tobacco Alliance who worked collaboratively with GPs and enforcement agencies.

Decision

The Committee notes the report and request that any future update report include information on the recording of activities undertaken at GP practices.