#SwkCCGAGM17 Annual General Meeting 31 August 2017
Welcome Jonty Heaversedge, CCG Chair
Agenda Time Title Presenter 15:00 Welcome and introductions Jonty Heaversedge 15:15 Presentation of CCG Annual Report and Key Achievements 2016/17 Andrew Bland 15:35 Presentation of CCG Annual Accounts 2016/17 Christine Caton 15.50 Questions and answers from members of the audience Mark Kewley 16:00 Five Year Forward View: Next steps on segmentation Rob Davidson Mike Wilson 16:35 Questions and answers from members of the audience 16.50 Closing comments and thanks Jonty Heaversedge 17.00 Close 3
CCG Annual Report and Key Achievements 2016/17 Andrew Bland, CCG Chief Officer
Annual Report 2016/17 and key achievements NHS England annual assurance rating • Southwark is one of only three CCGs in south east London to receive the overall rating of good for 2016/17. We are one of only two CCGs to receive this rating for the last two years. • Improved our rating for dementia from ‘requires improvement’ to ‘ outstanding ’; and for mental health from ‘greatest need for improvement’ to a rating of ‘ good ’. • Our significant improvement in the rating for dementia reflects an increased identification of people with dementia and the proportion of these people who have a recently reviewed care plan. • The improvement in mental health reflects the progress made on the transformation of services for children and young people; crisis care; liaison mental health services; and for people placed out of area for acute mental health inpatient care. • The CCG’s rating for cancer services was confirmed as ‘requires improvement’. We have a clear action plan in place with our partners to improve cancer care and this is a priority as part of the south east London Sustainability and Transformation Plan. 5
Annual Report 2016/17 and key achievements Quality achievements • Changing our quality approach to a rotation of system-wide learning, quality improvement and quality assurance each quarter. • ‘Reverse quality alerts’ in primary care – good engagement of GPs in the significant event analysis process with identification of lessons learnt, which are shared. • Development of the Quality Resource Tool for Primary Care in response to themes from the CQC visits in primary care. • Development of the quarterly GP Safeguarding Leads Forum, which is a thriving forum attended by representatives from at least 30 practices. • Promoting awareness and supporting work around Female Genital Mutilation led for health by our Designated Nurse. This work was recognised in the recent Single Assessment Framework inspection. • Medicines Optimisation Team work on antimicrobial stewardship and antibiotic guardianship. 6
Annual Report 2016/17 and key achievements Transformation: developing sustainable general practice, and at scale-working • Federations established in north and south Southwark involving all member practices supported by embedded teams. Delivering services to patients such as 8am-8pm EPCS and Population Health Management contract supporting practice resilience. • London’s biggest “Super Partnership” established in Southwark and working towards transforming general practice by improving care quality and reducing variation. • Establishment of new innovative roles including embedded teams within federations; clinical pharmacists; population health fellows; clinical associates (for example HIV). Transformation: developing new models of collaborative working across our Local Care Networks and supporting new models of commissioning and contracting • Continued development of Local Care Networks in the borough involving all main health and social care organisations. • Innovated to create much greater alignment between different contracts in the system for people with 3+LTCs, so that it is easier for general practice, federations and the rest of the system to work together. 7
Annual Report 2016/17 and key achievements A high-performing organisation • Delivery of NHS constitutional standards for: cancer 62 day pathways; IAPT access; c.difficile infections; and significant improvement in diagnostic waiting times. • Control of unscheduled care demand: lowest DToC rate, halved the numbers of MFFDs, exemplars in admission avoidance. • Extended Access: 18 months ahead of national targets, improved utilisation, trebled re-direction from A&E. • Achieved all financial statutory duties including a QIPP delivery of £6.6m. • Accelerated contracting round completed ahead of schedule. • CCG’s engagement work rated as ‘outstanding’ and achievement of patient experience awards. • First stage business case approval for the new Dulwich Health Centre and significant progress on other estates projects (such as Aylesbury). • A number of GP premises upgraded with assistance from Improvement Grant funds and Wi-Fi set up in all GP and community premises for public, patient and staff use. 8
Annual Report 2016/17 and key achievements System leaders • Achieved the highest 360 stakeholder survey response rates in London, with excellent feedback received on a range of criteria. • Leading the transformation of primary care programme across London. • CCG and members of the leadership team have key roles as part of South East London’s Sustainability and Transformation Partnership, particularly it’s approach to community based care, estates, digital and continuing healthcare. • Led the successful bidding for more than £17m of transformation funding across south east London (e.g. diabetes structured education and treatment). • Lead roles for LAS commissioning across south east London and for King’s College Hospital NHS Foundation Trust for London. • Established a new Partnership Commissioning Team with the local authority, created processes for joint planning and governance and jointly led the development of the Better Care Fund. • Newly ‘delegated’ commissioning of primary care. 9
Presentation of CCG annual accounts 2016/17 Christine Caton Acting Chief Financial Officer
Key financial performance duties 2016/17 2016/17 Duty RAG Target Performance Achieve planned surplus (Expenditure not to £7,673k £10,213k exceed income) Capital resource does not exceed the £350k £345k allowance Revenue resource does not exceed the £417,963k £407,750k allowance Capital Resource use on specified matters N/A N/A does not exceed the allowance Revenue resource use on specified matters N/A N/A does not exceed the allowance Revenue administration resource use does £6,460k £6,372k not exceed the allowance 11
2016/17 Annual Accounts • Met all of the statutory financial performance duties in 2016/17 • The CCG has demonstrated continued strong financial performance, achieving a surplus of £10,213k against a plan of £7,673k. The main driver of the increased surplus was the NHS England requirement not to commit the 1% non-recurrent reserve which CCGs are required to establish in their planning. • Excluding the release of the 1% above, the CCG overspent on programme costs by £1,484k. The main driver of this overpsend was £1,750k relating to the CCG’s share (1/6th) of a £10.5m South East London liability with Lewisham & Greenwich NHS Trust relating to the Trust Special Administrator Agreement at South London Healthcare NHS Trust in 2013 • In addition to the above, the CCG underspent by £87k on running costs. • The CCG received capital funding for the first time in 2016/17 and underspent by £5k on a budget of £350k • CCG accounts were audited by Grant Thornton UK LLP. The CCG received an unqualified audit opinion . 12
CCG expenditure 2016/17 Acute Hospital Services £227m Mental Health Services £62m Continuing Care £13m Community & Primary Health Services £36m Prescribing £32m Better Care Fund £21m Corporate Costs £9m Transformation £2m Running Costs £6m 13
Financial forward view: opening allocations Opening Allocations 2016-17 2017-18 2018-19 2019-20 2020-21 2016/17 – 2020/21 £’000s £’000s £’000s £’000s £’000s 393,667 403,334 414,410 424,994 440,548 Recurrent Allocation Delegated Primary - 43,208 44,749 46,469 46,469* Care Running Costs 6,457 6,496 6,533 6,565 6,594 allocation 402,124 453,039 465,692 478,028 493,611 Total Resources Target surplus for the 7,673 9,743 9,743 9,743 9,743 year with drawdown % change over previous year’s 3.05% 2.45% 2.51% 2.55% 3.66% allocation 14
Financial forward view: QIPP requirements 2016/17 – 2020/21 estimated net 2016-17 2017-18 2018-19 2019-20 2020-21 £’000s £’000s £’000s £’000s £’000s QIPP programme requirements Total QIPP programme- net of 6,659 15,241 13,971 14,640 13,950 investment QIPP programme as a 1.7% 3.4% 3.0% 3.1% 2.83% percentage of allocation 15
Questions and answers
Five Year Forward View: next steps on segmentation Mark Kewley, Dr Rob Davidson & Mike Wilson
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