Annual General Meeting 6 September 2018 Presented by Dr David Crichton, Chair
Welcome • Who we are • A review of our year • Financial position • Summary of performance • Public questions
Chair of the CCG • Dr David Crichton • GP at Bentley Surgery • Elected Chair of the CCG by our Member Practices from 1 April 2016 • Membership organisation: 40 Member Practices
What we do • A statutory NHS body • We buy (or “commission”) local healthcare services for the population of Doncaster – Planning services based on our population’s needs – Securing services that meet these needs – Monitoring the quality of care provided – Partnership and collaborative working with the Local Authority, other CCGs, Providers and relevant stakeholders
Our Governing Body • Chair Governing Body • 4 elected Locality Leads • 3 Lay Members Quality & Engagement & Primary Care Audit Remuneration Executive Patient Safety Experience Commissioning Committee Committee Committee Committee Committee Committee • Chief Officer • Chief Finance Officer • Registered Nurse • Secondary Care Doctor
Our Member Practices
What we stand for Our Vision: Work with others to invest in quality healthcare for Doncaster patients Our Values: • The needs of our patients are paramount • We will drive forward continuous improvement • Relationships based on integrity and trust Mission Statement: A high quality and accountable Clinical Commissioning Group, encouraging responsible partnership engagement in a transparent climate of ongoing learning in order to create a patient-centred yet financially astute and corporate approach to commissioning
A review of our year Presented by our Chief Officer
2017/18 Priorities
CCG Highlights 2017/18 • Most importantly we continue to focus upon ensuring the improvements in quality of care for Doncaster population. • NHS England rated the CCG ‘outstanding’ – one of only 11 in the country for 2 nd consecutive year. • NHS England Annual 360 Stakeholder Survey: demonstrates our good partnership work and leadership within the system • Generally good staff survey and stability of workforce. • Significant steps in ensuring a partnership and Health and Social Care approach for Doncaster population in the future.
Primary Care Highlights • Fully fledged GP Federation holding a number of contracts e.g. Extended Access. • All of Doncaster’s 40 GP practices rated either ‘good’ or ‘outstanding’ by Care Quality Commission. • Successfully procured and merged practices across Doncaster. • Provided more enhanced services within practices. • Some Positive GP Survey results – 82% Doncaster patients rate there experience GOOD.
Hospital Care Highlights • Reduction in “Delayed Transfer of Care for patients”. • Some of the shortest waiting times in Accident & Emergency in the country. • Implementation of psychiatric liaison in Emergency departmen.t • Significant engagement with partners and public on missed appointments. • Consultants/GPs and other professionals have worked together to redesign pathways and ensure appropriate patients are cared for within hospital – including virtual appointments and conversations.
Community, Mental Health and Learning Disability Highlights • Integrated Rapid Response pathways has ensured 76% of patients are supported at home rather than hospital • Improvements in Community continence services • Improvements in Oral Nutrition within Care Homes • Commissioned additional hours of End of Life Care – raised public awareness of dying well • Reduction in the length of stay for Children and Young People with autism and/ or Learning disabilities
Other Key Highlights • Introduction of Integrated Care Record for patients and staff in Doncaster. • Significant improvements timeliness of assessments for Continuing Healthcare. • Began review of functions across ourselves and local authority – led by our staff.
Doncaster Place Plan • Continued our plans to ensure collaboration across Health and Social improvements in Doncaster. • In the future we will take a partnership life stage approach to plans and implementation. • This will be wider than health and involve all aspects of public and voluntary sector where applicable – TEAM DONCASTER.
SY&B Integrated Care System • Continue to play a key partnership role in SY&B collaboration • Take the lead in Mental Health and Learning Difficulties • Taken part in Hospital Services Review – consultation to begin in 2018/19 • Continue to inform redesign in other key priorities e.g. Elective & Diagnostic Care
2017/18 Key Challenges • Has been some deterioration in performance of some constitutional standards. • Need to improve in Cancer and Maternity Care. • We have improved our engagement approach , but this will need to be fit for purpose in “new world”. • Financial pressures will set in – especially when undertaking more health and social care approach. • Workforce pressures of all our main providers. • Scale and the pace of change.
Types of engagement . . . Social media Health Campaigns Our website Videos of NHS70 Public Events patient stories
Annual Accounts Presented by our Chief Finance Officer
Annual Accounts • Year-end accounts for 2017/18, fully met our statutory financial duties • Prepared under International Financial Reporting Standards (IFRS), in accordance with the Department of Health and Social Care Manual for Accounts 2017/18 • The Statement of Comprehensive Net Expenditure captures our gross expenditure and income – £493,513,000 allocation – £490,646,000 net operating costs – £2,867,000 surplus requirement
Summary of Financial Performance Duty Target Performance £’000 £’000 Expenditure not to exceed income (Achieve a Surplus) 495,318 492,451 Capital resource use does not exceed the amount specified 0 0 in Directions Revenue resource use does not exceed the amount 493,513 490,646 specified in Directions (Total Allocation) Capital resource use on specified matter(s)does not exceed 0 0 the amount specified in Directions Revenue resource use on specified matter(s) does not 42,544 41,112 exceed the amount specified in Directions (Programme) Revenue administration resource use does not exceed the 6,978 6,209 amount specified in Directions (Admin/Running costs)
Summary of Expenditure
Summary of Expenditure The CCG spent £490.6m on – Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust (Acute Services) £194.8m – Rotherham, Doncaster and South Humber NHS Foundation Trust (Mental Health and Community Services) £67.2m – Prescribing £59.6m – Other Acute Services Providers £50.2m – Delegated Primary Care Medical Services £41.1m – Continuing Healthcare £28.7m – Other Mental Health Providers £19.7m – Other Community Services Providers £12.6m – Other Primary Care Services £6.5m – Running Costs £6.2m – Other costs £4.0m
Financial Position Moving into 2018/19 • Financial allocations for 2018/19 have created a very challenging financial position – Growth Funding 1.44% i.e. £7.0m – Additional Funding for Local Pressures and Transformation priorities £3.5m (utilised to fund historic pressures) – Additional costs exceed the growth allocation • Inflation on contracts • Elective Activity pressures and Referrals • Prescribing • Continuing Healthcare and Specialist Placements • Demographic growth • Gap deficit of £10.6m – efficiency programme needed
Managing the Finances • System transformation will be critical – e.g. intermediate care model • Strong financial control during 2018/19 will be crucial to ensure delivery of the CCG’s financial targets • Added complexity of the ICS and a System Control Total • The local health system will only remain financially sustainable through integration and collaborative commissioning, through working closely with primary care, providers and the Local Authority • Close monitoring of efficiency programme
A Summary of Our Performance
Our Annual Review 2017/18 by NHS England NHS England reported the CCG as Outstanding against the Assurance Framework 2017/18
Governance • Annual Governance Statement: no control issues • Head of Internal Audit Opinion: significant assurance of a sound system of internal control • ISA 260 Report from External Auditors to those charged with Governance: proper arrangements to secure economy, efficiency and effectiveness in our use of resources
Annual Report and Accounts We would like to formally present to you our Annual Report and Accounts 2017/18: http://www.doncasterccg.nhs.uk/wp- content/uploads/2018/05/CCG20Annual20Report202017- 182028Published20Version29.pdf
Public questions
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