Hammersmith and Fulham CCG Annual General Meeting 6 October 2020
Welcome to Hammersmith and Fulham CCG’s Annual General Meeting Today’s agenda: Welcome and AGM James Cavanagh, CCG Chair Achievements 2019/20 James Cavanagh, CCG Chair Janet Cree, CCG Managing Director Jenny Greenshields, Chief Finance Officer 2019/20 Annual Reports and Accounts Janet Cree, Managing Director NW London plan 2019/20: Finance Jenny Greenshields, Chief Finance Officer Diane Jones, Director of Nursing & Quality Quality CCG Governing Body Members CCG Covid-19 Response James Cavanagh, CCG Chair Questions 2
Who We Are and What We Do Dr James Cavanagh Chairman
Who we are and what we do • NHS Hammersmith and Fulham CCG plans and buys healthcare services for the borough and ensures these are of good quality and value for money. • We work with clinicians, patients and carers to make sure your health and social care services are effective and coordinated. • We have 29 GP member practices for a population of over 250 000 • We don’t commission alone but as part of an Integrated Care Partnership and in accordance with the NHS’s long term plan • We are part of the North West London collaboration of clinical commissioning groups along with Ealing, Harrow, Hillingdon Hounslow, Central London, West London and Brent 4
2019/20 Some Key Achievements Dr James Cavanagh Janet Cree Chairman Managing Director
Achievements 2019/20 Primary Care • Primary Care Networks (PCN) were established and commenced delivering population-based care in line with national service specifications • Completed the procurement and roll out of the online consultation offer to complement existing access channels • PCNs have recruited new roles building the pharmacist and link worker staffing base to provide population-based care • Agreed joint working principles with PCN Clinical Directors and the GP Federation to support the development of PCNs and deliver on shared priorities • Pride in Practice programme was rolled out across general practice to provide training and support to strengthen and develop primary care services’ relationship with their LGBT patients. 6
Achievements 2019/20 Perinatal Mental Health • Received a positive CQC report highlighting consistently good practice across the board including examples of outstanding practice • Positive feedback from peer review including: “There is a clear sense of strong leadership, coordination and organisation in the service, as well as a strong ethos.” Early intervention in Psychosis (EIP) • Expansion of service to treat all people between the ages of 14-65 with a first episode of psychosis • Royal College of Psychiatrists audit puts us as one of the top performing EIP services for Cognitive Behavioural Therapy, employment support and support for carers . 7
Achievements 2019/20 Children’s Mental Health • Successful application to NHSE to be a trailblazer site for the implementation of mental health support teams in schools. • Established Dynamic Support Register and multi-agency oversight for children and young people with ASD and/or Learning Disability at risk of admission to inpatient mental health or residential settings • Agreement to jointly commission an Intensive Behaviour Support Team for children and young people with behaviour that challenges. 8
Achievements 2019/20 Patient and Public Engagement • Maintained a strong and effective Patient Reference Group • Continued to increase the number of groups and individuals on our stakeholder list • Undertook a full consultation on the proposed overnight closure of Hammersmith Hospital Urgent Treatment Centre • Established a Patient Participation Group support programme with Healthwatch Central West London • Provided support to SOBUS to help facilitate community involvement 9
Annual Report and Accounts 19/20 Jenny Greenshields Chief Financial Officer
Fin inancia ial Posit ition 2019/20 The below table shows that the CCG delivered its planned deficit of £6.7m in 19/20. The CCG also achieved its financial duties with regards to Running Costs.
How we sp spent your r money – £352.9m in in 2019/20 The pie chart below shows a breakdown of CCG expenditure by programme area.
NW London plans 2019/2020 Janet Cree Managing Director
In 19/20 we started working towards our vision for NW London: Our vision for NW London Integrated Care System (ICS) is to reduce inequalities and achieve health outcomes on a par with the best global cities. Care will be integrated within a single system, focused on the needs of the individual and unhindered by organisational boundaries. We will combine our collective resources, clinical expertise and local knowledge to build a fair, effective and accessible health service for all. This meant that key focuses for the year were: • The development of our five year (Long Term Plan) • Working towards a single CCG and building relationships as part of our Integrated Care Partnership and local borough partnerships • The Covid19 pandemic changed accelerated our focus and joint working. 14
Our five year plan • We developed a five year strategic plan with our partners, public and stakeholders. • This plan was developed to meet the new national requirements set out in the NHS Long Term Plan, to improve the quality of patient care and health outcomes, while focusing on building an NHS fit for the future. • It also focuses on reducing local health inequalities and variation in services across NW London. • To deliver our ambitions set out in the plan, throughout 19/20, we have focussed on seven interconnected areas: 15
Clinical and care strategy In conjunction with our five year plan we developed our clinical and care strategy. The clinical strategy has nine clear priorities for delivery in 2020/21: • Access to specialist opinion • Frailty/last phase of life • Care planning • Long term conditions • Early detection of cancer • Social isolation • Safer care – maternity • Proactive urgent care • High intensity users 16
A single CCG for NW London As part of merging the eight CCGs we are making the following six commitments: 1. Move resources across NW London and within boroughs to reduce inequalities over the next four years In September 2019, the CCG agreed that a single CCG for 2. Increase our proportion of investment in out of hospital NW London was the right services, as a first step we will level up investment in direction of travel. It was also primary care services outside the core contracts agreed that 20/21 would be a transitional year focused on financial recovery, developing 3. Ensure consistency in services across NW London a single CCG operating model and working through financial 4. Ensure equity of access to services, to enable our implications. providers to improve outcomes for patients and reduce health inequalities 5. Patients and GP member practices will continue to be involved in the single CCG and at local level 6. We will devolve decision making on delivery and integration of services to neighbourhood and borough level as our integrated care partnerships develop. 17
Our system’s financial challenge Jenny Greenshields Chief Financial Officer
Financial position 2019/20 2020/21 • • The year ended with a deficit of £50.9m A new financial regime was put in place for the NW London CCGs – this is in for 2020/21 following the Covid19 line with our plan. pandemic. • • Five CCGs reported a deficit (Brent, For the first six months of the year we Central, Ealing, Hammersmith & Fulham are expecting to receive a resource and Harrow). allocation that matches both our Covid • The major pressure in 19/20 was acute and non-Covid spend. • spend. NHS providers receive a block payment • Achievement of the 19/20 plan was to meet their costs and the opportunity to claim for a ‘top - up’ of this block largely through non-recurrent measures, therefore our underlying deficit has not payment is insufficient to cover their improved significantly. costs. • We are awaiting guidance on what the funding arrangements will be for the second half of the year. 19
What we have achieved Reduction of the deficit System alignment • Whilst we achieved the planned deficit target, • Our five year plan is a combined plan for the underlying position remains broadly the providers and commissioners same at the end of the year at just under • Introduction of new payment regime moving £100m • from purely costs and volume for acute We have continued to reduce our management costs under-spending by £6m contracts to agreed contract values with against budget marginal rates for over and under • Towards the end of the financial year we did performance start to see a reduction in acute (hospital) activity growth, which should impact on future costs Controls established System recovery • • Vacancy freeze and review of interim staff System recovery linked to five year plan and continued through 19/20 key programmes of work • • Investment Scrutiny Panel imbedded to review Development of ICS (Integrated Care System) every proposed contract change or new recovery work streams • business case Focus on schemes that will deliver system wide savings 20
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