Welcome to our Annual General Meeting 20 th September 2018 Healthier. Stronger. Together
Live participation: How to use Slido • Connect to Somerdale Pavilion wifi network on your laptop, tablet or smartphone: Network: SOM_Guest Password: Aqu4t3rr4 • Open slido.com • Enter the code: #AGM2018
Live participation: How to use Slido • Click the ‘Questions’ tab to ask a question • View other participants’ questions on the screen • Click the ‘thumbs up’ to vote for other questions you ‘like’. These will move to the top of the presentation screen.
Financial Review Sarah James, Chief Financial Officer
How we spent our money in 2017/18
Our key financial duties in 2017/18 Target Performance Achieved Total expenditure not to £1.471m surplus Yes exceed total income delivered CCG remains within its £4.210m spent against Yes administration/running allowance of £4.257m costs allowance
What is the breakdown of the surplus? Target Surplus £000 Actual Surplus £000 Operational Surplus 96 99 National Prescribing 0 232 Rebate National Risk Reserve 1,140 1,140 Total 1,236 1,471
… key financial duties continued Target Performance Achieved 95% of invoices by >95% achieved by Yes volume and value paid volume and value for within 30 days NHS and non-NHS creditors Cash balance at year end Cash balance of £0.079m Yes of no more than 1.25% of against a limit of £0.238m cash drawn in March
2017/18 Savings Achievements • £10.4m savings (90% of target achieved and 4% of our funding allocation) MSK £0.5m Urgent • Strong programme approach and clinical Care £1.2m buy in to support service transformation Other CHC/FNC £3.9m £1.3m • Focus on managing demand and avoiding activity of low qualitative value Elective Demand £0.8m • Successful schemes included Early Medicines Finance & Business £1.1m Home Visiting and Falls Rapid £1.6m Response • Enhanced scrutiny of transactions • Some difficult choices to limit access to services based on stricter clinical criteria
Challenges for 2018/19 Funding growth • 2.8% funding increase • £1.9m new funding to meet key national priorities Funding gap Key expectations £6.2m • A&E 4 hour and waiting list performance • Mandated investment in adult & child mental health and primary care • Provider inflation and tariff increases • Population and demand growth • Other cost pressures e.g. prescribing • Investments to deliver change and savings
Review of 2017/18 and future plans Tracey Cox Chief Officer
The NHS in the Headlines • Brexit • Demographic growth & Ageing Population, Patients with long term conditions • Health & Care Services under pressure – “Winter” • The monetary position is still really challenging • Workforce Shortages • New Health Secretary
Some of the solutions …….. • Integration & integrated working across health and care providers • Working differently and finding new ways of delivering services • Digital agenda & advances in medical treatment • The Long Term Plan for the NHS
Our primary care services • 91% of patients rate their experience of GP care as good • All our practices are rated as ‘good’ or ‘outstanding by the Care Quality Commission • Our practices are starting to work closer together to ensure resilience and sustainability and provide more services in the community • The CCG’s Primary Care Strategy sets out our vision
Primary care is changing • Practices merging or coming together as federations e.g. Heart of Bath Medical Partnership and Minerva Health Group • St Augustine’s moved to purpose -built new premises • Developing and supporting practices to work as an integrated team of multi-disciplinary professionals via work of Clinical Integrators
How is Integrated working developing across B&NES?
Joining up health and care services • Closer working between the Council & CCG • Benefits of more person-centred services, reduced duplication, making best use of limited resources • Pooled budgets for some areas • Established a joint Health and Care Board in Shadow form, first Public meeting in early 2019
Managing the needs of children with Complex health needs • We are one of the first areas to create a pooled budget for children and young people with multiple and complex needs • A Joint Agency Panel meets every month to decide how to use this budget to commission, monitor and review packages and placements • Budget made up of education (45.1%), social care (41.2%) and CCG (13.7%)
What difference has it made? • Brings together knowledge and expertise to improve outcomes for children • Quicker and better decision making on complex cases • Improved dialogue and relationships between professionals • No more arguing about which organisation pays for what • Improved financial efficiency, sustainability and accountability
Looking Ahead Challenges ahead and how is the CCG responding ?
The challenges ahead • Number of people aged 65 & over will increase by 19·4% : from 10·4M to 12·4M • Number with disability will increase by 25·0%: from 2·25M to 2·81M • Life expectancy with disability will i ncrease more in relative terms
We are focusing on Older People • It crosses health and social care, so can drive integration • Large increases in over 65s in B&NES by 2030 • Impact on the NHS, from a greatly increased incidence of chronic long-term health conditions, including dementia, arthritis, diabetes, stroke and heart disease • Change needed in attitudes to ageing • We want to support older people and those with frailty to stay healthy and independent
Frailty Work Across B&NES • Developing multi-disciplinary team working in 2 Residential Homes launched on 6 th September (Pilot) • Advanced Nurse practitioner seconded from the RUH to support community staff in developing their skills in management of frailty • End of Life Care - Advanced Care Planning Specialist Nurse appointed until March 2019 to help with training and developing staff in End of Life Care
Digital Agenda
Digital developments Fun facts Used internet in last 3 months: -90% adults -99% 16-34 -80% 65-74 -44% 75+ Two practices have more than 40% of their population registered with GP services online. Across BaNES this falls to 26%.
Other technological advances Consultant Connect Paediatric HandiApp
Have your say on the long term plan • Three key themes: 1. life stage (early life/ageing well) 2. clinical priorities (e.g. cancer, respiratory), 3. enablers of improvement (e.g. workforce, primary care) • Discussion guide with some questions to consider • Deadline for submission is the 30 September • Visit www.engage.england.nhs and search on ‘long term plan’
Local outcomes for 2017/18 • Cancer Outstanding • Mental Health Outstanding • Maternity Outstanding • Dementia Good
Thank you and any questions?
https://youtu.be/x-B784RP800
REFRESHMENTS
The Wigan Deal Cllr Keith Cunliffe Deputy Leader Wigan Council
Different relationships between Public sector and the Citizen Confident Place, Confident People.
Wigan in Profile • 320,000 Population. Ninth-largest metropolitan authority in England, second largest Council in Greater Manchester. • Local Authority responsible for an annual revenue budget of £864m a year. • Adult Social Care accounts for around a third of the Councils net resource. • Over 7,000 people supported within adult social care each year. • Annual Health & Social Care spend across the place - £669m. Confident Place, Confident People.
Confident Place, Confident People.
A Familiar Challenge: Our Response • Opportunity to do thing differently Achieved • Wigan one of six to be awarded In Progress ‘Creative Councils’ funding to test new Planned ideas about how public services are delivered • A new relationship with residents and communities • People at the Heart of Scholes’ - integral to this thinking supported by NESTA and the LGA • Work in Scholes - powerful impact and challenged the way we work with services users and the wider community • Commitment to invest at scale Third largest proportionate reduction in funding across the country through Government austerity Confident Place, Confident People.
Context – Adult Social Care: The Ca Case for r Ch Change • 2011/12 projected overspend of £6.9million, with rising demand for services • A traditional service model - care management focus • Lack of leadership and direction • Accountability issues throughout the service • Dis-engaged and risk averse staff; multiple assessments; bureaucratic processes Confident Place, Confident People.
• Listen to what is important to you • Be open minded to our new approach • Support you to have more independence • Share your ideas and be honest • Give you support that is unique to you • Get involved in planning your care • Provide you with greater choice • Think differently about what you need • Give you access to new opportunities • Focus on what really makes you happy Signed Signed Lord Peter Smith of Leigh, Leader of Wigan Council
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