AGENDA ITEM NO: 024/18 GOVERNING BODY MEETING: Governing Body Meeting 9 th May 2018 DATE OF MEETING: REPORT AUTHOR AND JOB Pam Broadhead TITLE: Chief Performance Officer 2017/18 summary presentation regarding the REPORT TITLE: Improvement and Assessment Framework STRATEGIC OBJECTIVES: Please tick which strategic objectives the paper relates to Improve quality of services Sustained financial balance Build an effective and motivated Sound governance arrangements whole system workforce Ensure integration and joint working arrangements OUTCOME Approval Assurance Discussion Information REQUIRED (tick) EXECUTIVE SUMMARY This presentation provides an overview of the key successes and challenges related to the Improvement and Assessment Framework (IAF) for NHS Warrington CCG. This was presented to NHS England to summarise the 2017/18 year-end position, approach to improvement and plans for the future. RECOMMENDATIONS Report for information and assurance only Not applicable Outline any engagement – staff, clinical, stakeholder and patient / public None known Are there any conflicts of interest which may be associated with this paper? Does this paper address any existing A1 - Failure to performance manage to ensure risks which are included on the continuous improvement Performance Report NHS Warrington CCG Governing Body Meeting 9 th May 2018
AGENDA ITEM NO: 024/18 Assurance Framework or Risk Register? A2- Failure to agree and measure outcomes Have the following areas been considered whilst producing this report? Yes N/A Equality Impact Assessment (if yes, attach to paper) Quality Impact Assessment (if yes, attach to paper) Regulation, legal, governance and assurance implications (reference in the report if applicable) Procurement process (reference in the report if applicable) Document development Has this document been presented to any other Committee or Forum? If yes, please list which meeting, date and outcome of presentation Yes – NHS England Year End, Improvement & Assessment Framework Meeting, Thursday 3 rd May 2018. Performance Report NHS Warrington CCG Governing Body Meeting 9 th May 2018
AGENDA ITEM NO: 024/18 Strategic Objectives and Risks 2018/19 A1 Failure to performance manage to ensure continuous improvement A2 Failure to agree and measure outcomes A3 Failure to ensure clear arrangements are in place for quality management of non- commissioned providers in the independent sector B1 Failure to implement the financial strategy B2 Failure to ensure sound business practices are at the heart of running the CCG B3 Failure to secure best value B4 Failure to adequately provide for external factors, which impact on financial sustainability C1 Failure to continuously develop the organisational culture that meets the needs of the changing needs of the workforce C2 Failure of delivery by outsourced critical business functions C3 Failure to establish primary care capacity D1 Failure to ensure that we are compliant with our statutory duties D2 Failure to demonstrate patient and public engagement E1 Failure to provide appropriate reporting, for joint working arrangements E2 Failure to describe benefit of integration and joint working arrangements to local people Performance Report NHS Warrington CCG Governing Body Meeting 9 th May 2018
Improvement & Assessment Framework 2017/2018 Year End Review
Governance (Committees & Governing Body) Monitoring & Approach to Ownership Contractual Improvement Mechanisms Actions & Risks
• Personal Health Budgets – 200 in place at end 17/18 against a plan of 130 • Continuing Health Care – consistently less than 15% of full CHC assessments taking place in acute setting • One-year cancer survival – one of the 20 CCGs with most improved survival rates • Primary Care – overall experience of primary care increased from 82% to 86% from 2016 to 2017 Key surveys. 100% of registered population offered full extended access Successes • IAPT Recovery and Access – annualised position from quarter four local data shows both recovery and access above national standards • Prescribing – antibiotic prescribing consistently below requirement and also dropped below England median in 2017/18. • Cancer 62 day – performance consistently below 85% from July 2016 to Sept 2017. Subsequent to this, four out of five months have been achieved.
• Cancer patient experience - 8.6 / 10 (decreased from 8.7 in 2016) • Early cancer diagnosis – 47.8% in 2016 (decreased from 51% in 2015) • Dementia care planning and post- Challenges – diagnostic support - 77% (decreased from 78% in 2015/16) Better Care • A&E admission, transfer or discharge within 4 hours - February 2018 80.5% v 90% STP trajectory • Population use of hospital beds following emergency admission - National rate 571.8 in Q2 17/18 (decrease from the 2 preceding quarters but remains in the lowest quartile)
• Diabetes education attendance - 0.5% of patients diagnosed in 2015 were recorded as attending a structured education programme • Injuries from falls in people aged 65+ - National rate of admissions for falls per 100,000 Q2 17/18 = 2,967 (decrease from Challenges – 3,059 in Q1) Better Health • Inequality in emergency admission for ACS and UCS conditions (links also to Better Care admissions for UCS) - Ranked 189/207 for the inequality measure. Data suggests that the UCS conditions are the main challenge. The ranking of emergency admissions for UCS is 191/207.
• 2017/18 Year-end Position - £0.4 million above break-even • 2018/19 Finance Plans, Key Risks and Issues Sustainability • Plan for in-year break-even • Key risks & issues: • Activity based performance • Growth above planned levels • In-year national risks
• Leadership capability & capacity • Organisational Development Programme • Interim integrated Management Team • Quality • Quality Surveillance Group member • Contractual levers utilised • Patient voice • Governance • Statutory Duties and Powers reviewed Leadership • Assurance Framework in place • Conflict of Interest managed in line with national guidance • Leadership through transformation • CCG Clinical Chief Officer is the Place Based Lead and a member of the Integrated Care System Partnership Board (Warrington Together) • CCG is an active member of the Warrington Together Senior Change Team and the Enabler Group work streams • CCG engages and leads on work across Cheshire & Mersey Health Partnership
360 ° Survey - Comparisons Effectiveness as system Overall engagement leader Clear leadership Confidence in leadership to deliver outcomes Confidence in leadership to deliver plans and priorities Confidence that CCG will act on feedback Involving the right individuals and Have opportunity to have a organisations when say / influence plans and commissioning/ priorities decommissioning services Effective communication of plans
360 ° Survey Focus on Engagement 2018/19 Actions for Ownership Support Improvement Evaluation
• Working with our partners ensuring services are of the highest quality • Continued Improvement in performance indicators from CCG Summary Dashboard Where we • Specified requirements for a hospital of the future at the heart of an integrated care system in Warrington want to be… • Maintaining NHS England Business Rules and breaking out of an Annual Recovery Cycle • Commissioning services from Warrington Together progressing towards Alliance Contracting • Improved relationships with Member Practices
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