Hertfordshire and West Essex Sustainability and Transformation Partnership. Welcome

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1 Welcome

2 What is an STP? Herts Valleys CCG, East and North Hertfordshire CCG and West Essex CCG working together with county and district councils

3 The challenges we face

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5 Prioritising health services in our spending survey, residents told us: Deliver lasting health benefits and improve patients quality of life Make the best use of resources available to the local NHS Prioritise significant health needs (like cancer and heart disease) above less serious conditions and treatments (like colds and dry skin) Prioritise treatment which is scientifically proven to be effective Prevent the need for further costly treatments and services in future Support people to take responsibility for their own health and wellbeing Help disadvantaged residents and communities and those in poor health to improve their health and wellbeing

6 A Healthier Future Let s Talk What is it? 10 week public consultation on proposed changes to local NHS services.

7 Why are we doing this? To encourage behaviour change promoting healthier lifestyles and self-care for minor ailments To make best use of doctors and nurses limited time To reduce increasing demands on available budget

8 IVF and specialist fertility services Our area s three CCGs have different IVF policies and fund different numbers of IVF cycles. In our area East and North Hertfordshire CCG funds three IVF cycles for women under 40 Other local CCGs fund two or one cycles, other CCGs in the country don t fund these services at all. In our area, approximately 900,000 is spent on funding IVF and specialist fertility services

9 IVF and specialist fertility services Around patients registered with GPs in Hertfordshire and west Essex are given NHS funding for IVF and specialist treatment every year. 31% of IVF cycles result in a successful delivery Women who do not conceive after their first IVF cycle are less likely to conceive at all chances of success drop to 21% on a third cycle of IVF An independent panel process (IFR) could still decide that funding could be given in clinically exceptional circumstances.

10 IVF and fertility services Any questions? Please take a look through the IVF and fertility services document and complete the questions on pages 11 to 14

11 Fit for surgery We are proposing tightening the rules that are already in place about non-urgent surgery: Patients with BMI of 30+ will be expected to lose weight bringing more patients within scope Patients with BMI of 40+ will be expected to lose a bigger percentage of their bodyweight What is BMI? BMI is calculated using a formula which considers your weight and height and generates a number called a Body Mass Index which places your weight within a range. A BMI of over 30 is classed as obese and a BMI of over 40 is defined as morbidly obese

12 Fit for surgery Patients will be expected to stop smoking for eight weeks before planned, non-urgent surgery A carbon monoxide breath test will be used to check patients have stopped before the op Exceptions can be made if a patient s health will be affected by waiting for surgery. If you smoke 20 cigarettes a day, you are up to twice as likely to develop a wound infection as a non smoker

13 Gluten-free food on prescription Around one in every 100 people are affected by coeliac disease and must not eat gluten. The NHS in Hertfordshire spends around 500,000 a year on prescriptions for gluten-free products Gluten-free foods are now more widely available than ever before. A gluten-free loaf costs between 2-3 Gluten is not essential for a healthy diet. Other sources of carbohydrates include rice, potatoes and cornflour We are proposing to stop prescribing gluten-free food, except for people with learning disabilities or if there is a welfare concern.

14 Gluten-free food on prescription The most cost-effective and healthy way to follow a gluten-free diet is to seek out naturally gluten-free food groups, which include: Corn and corn flour, potatoes, quinoa, rice and rice noodles Fruits Vegetables Meat and poultry Fish and seafood Dairy Some brands of porridge oats Beans, pulses and nuts

15 Fit for surgery Gluten-free food on prescription Any questions? Please take a look through the Healthier Future, Let s Talk document and complete the questions on pages 8, 9 and 12

16 Medicines, treatments, and food items available without prescription We are proposing to limit the prescribing of items which are available without prescription. 20% of GPs time and 40% of appointments are used for minor illnesses and common conditions Last year the NHS in Hertfordshire spent over 4 million on providing items like antihistamines, indigestion treatments and laxatives A packet of paracetamol costs the NHS five times more to prescribe than it would cost to buy in a shop We are NOT proposing changes to the prescribing of medicines for long-term conditions. These proposals ONLY apply to items you can buy without a prescription.

17 Medicines, treatments, and food items available without prescription Oral painkillers and pain rubs Head lice treatments Antihistamines, nasal sprays and some eye Cold sore treatments drops Wart and verruca treatments Indigestion treatments Threadworm tablets Laxatives for short-term use Cough, cold and sore throat treatments Medication for short-term diarrhoea Eye drops and eye ointments available over the Probiotics counter for dry eyes and conjunctivitis Colic treatments for infants Dental products e.g. toothpastes, Medicines for travel mouthwashes, gargles and teething gel Haemorrhoid treatments Vitamins and supplements Bath oils and shower gels, moisturising creams, Formula milk for children aged over 2 years old gels and ointments for dry skin conditions Antiperspirants Barrier creams and sun screens Earwax removers and softeners Antifungal treatments for athlete s foot, nail Shampoos - e.g. for dandruff infections and thrush Acne treatments

18 Female sterilisation We are proposing to only fund female sterilisation in exceptional circumstances Approximately 100 female sterilisations ( tube ties ) were carried out in Hertfordshire last year A wide range of other forms of contraception are available free on prescription, including methods that last for several years Exceptions would be considered on a case-by-case basis, if alternative forms of long-acting contraception are unsuitable

19 Medicines, treatments and food items available without prescription Female sterilisation Any questions? Please take a look through the Healthier Future, Let s Talk document and complete the questions on pages 15 and 17

20 Next steps These public consultations launched on Thursday 6 July and are open for feedback until Thursday 14 September. We are working to promote the consultations and hope to gain a broad range of views from a wide range of people. Your views are very important and will help shape our policies. You can complete the survey online at: or return a printed copy using the pre-paid envelope supplied.

21 Next steps Following the close of the engagement and consultation period everyone s responses will be collated and analysed by an independent market research agency, with the findings then presented to each of the CCG s Governing Bodies. A full time-table of when those meetings will be held will be published on the Healthier Future website: Any final questions?

22 Thank you Please hand your completed survey back to a member of staff