NHS Brent
Brent
Tessa Sandall
Assistant Director of Primary Care Commissioning
Brent PCT NHS Brent
NHS Brent commissioned £127 million of primary medical care
services in the year up to March 2008.
Achieved turnaround in April 2008, from a £25.3 million deficit.
Total registered population of 350,388.
Total of 70 GP practices, with 184 GPs (168.5 WTE).
Expected population growth linked to the redevelopment of
Wembley stadium and the surrounding areas.
Significant proportion of population is transient, difficulties in
registering patients with practices.
PCT Context
NHS Brent
Financial and governance failure in 2006-07 (£25m deficit)
2007-08 Year of financial turnaround
Complete change of executives and non-executives- new chair March 07,
new CEO October 2007
Double weak in Healthcare Commission ratings 2007-08
Financially recovered- paid back ALL deficit, £12m surplus this year
2008-09 year of rebuilding:
- relationships (council, primary care, PbC, staff, community)
- quality and safety of services
- management systems
2009-10 step change
- management capability and capacity
- investment in the key determinants of health
- partnerships with population, council and PbC
NHS Brent
GP Led Health Centre
Harlesden Medical Centre
Divided into 5 wards, co-terminus with the Local Authority.
Local Social
Challenges NHS Brent
2007 Index of Multiple Deprivation places Brent within the 15% most deprived local
authorities in the country, 53rd most deprived borough in England.
50% of the adult population do not take part in any form of physical exercise.
43% of residents are under 30.
Regeneration of 85 acres around Wembley stadium – increased number of tourists –
likely increased demand for unplanned care.
Large sections of community are affluent, pockets of deprivation in the south of the
borough.
Close to a quarter of Brent’s population live in overcrowded conditions.
Brent has the 4th lowest average income levels in London.
Most deprived areas also have lowest income levels, highest unemployment, poor
overcrowded housing and worst health outcomes.
Local Health
Challenges NHS Brent
Health inequalities present at neighbourhood levels, demonstrated by 9 year gap in
life expectancy throughout Brent.
Circulatory diseases, cancers and respiratory diseases are the largest cause of
death.
Most deprived neighbourhoods also have high mortality ratios and high rates of key
health behaviours such as smoking, obesity, diabetes.
One in four people in Brent smoke
High prevalence of diabetes and tuberculosis, particularly in ethnic minorities,
especially in in ethnic minorities.
55% of residents are from black and minority ethnic communities.
Low uptake of preventative services such as smoking cessation and breast
screening.
Goals NHS Brent
Goal 1: To reduce premature mortality in Brent by 20%
by 2013 Why?
Goal 2: Reduce the gap in life expectancy between the Most relevant to needs of local
most deprived quintile of wards in Brent and the
borough average by 25% by 2013 population, and our local
Goal 3: Promote good health and prevent ill-health
circumstances.
Goal 4: To increase the proportion of activity How?
commissioned from providers who perform at or
above benchmarked quality and performance Extensive stakeholder
standards
engagement through a series of
Goal 5: To meet or exceed nationally–reported
benchmarked patient satisfaction rates for all events
services commissioned
Underpinned by JSNA and Health and Wellbeing Strategy, our discussions with neighboring PCTs
to identify those issues most effectively tackled at a sector level, and the insights provided by the
Healthcare for London and Next Stage Review consultations
Importance of the
NHS Brent
procurement to Brent
Improve access to primary care – particular problem in
Wembley.
Improve % of practices in Wembley meeting 24/48 hr
access target.
Future-proof for increase in population in Wembley.
Set meaningful performance indicators using APMS.
Set the future standard for GP practices within Brent –
raise the bar.