NHS Croydon CCG Annual General Meeting Tuesday 25 September 2018
A very warm welcome to our Annual General Meeting 2018
Dr Agnelo Fernandes Clinical Chair
In memory of Photo here Bosco Saldanha 1943 to 2018
Welcome Tudor Academy Choir
Governing Body
Governing Body
Croydon in numbers… Key facts about Croydon
Andrew Eyres Accountable Officer www.croydonccg.nhs.uk
Our vision Longer, healthier lives for the people of Croydon Our strategic approach: • ambition • innovation A nice picture here • working with our partners • using resources wisely • transforming healthcare • high-quality services Delivered through five clinically-led programmes
Highlights of the year
How are we performing? Annual CCG overall rating: 2017/18 Clinical Priority Areas Requires Improvement Outstanding Cancer Leadership Finance Good Maternity This is an improvement from Inadequate last year London CCGS
NHS 70
NHS 70
Croydon NHS70 Stars Susan McCarthy Elsie Sutherland Memuna Sowe Sally Innis Dr Kamran Kahn Head of Family Learning Midwife of the Year Volunteer Designated Nurse for GP and Development Croydon CCG and Croydon Health Safeguarding Stovell House Surgery Tudor Academy School Croydon Health Service Croydon CCG Services Kerry Starrett Brian Dickens Rachel Carse Sean Crilly Sylvarani Nair Sex and Relationship Education Practice Manager Social Inclusion Co- Team Leader Programme Lead and Training Specialist Parchmore Medical Ordinator Croydon CCG Age UK Croydon Health Services Centre Dementia Action Alliance
Staff Awards 2018
Staff Awards 2018 Edward Odoi and Ros Spinks
Local people influencing commissioning
Looking ahead
Thank you to patients, public and colleagues involved in improving health and providing care in Croydon
Financial Performance Mike Sexton Chief Finance Officer
In 20017/18, we spent £559m on healthcare: We are funded £1,199 per person (£490m) We spent £1,365 per person in Croydon. Our key providers of healthcare are: • Croydon Health Services NHS Trust • South London & Maudsley NHS Foundation Trust (FT) • St George’s University Hospitals NHS FT • Kings College Hospital NHS FT • Epsom & St Helier NHS Trust • London Ambulance Service
In 2017/18, we performed as follows: Description Source Target Actual Achieved Target Expenditure Deficit: - CCG Original Plan NHSE £15.0m £13.9m - NHS Set Target (In Year) NHSE £6.9m £13.9m - NHS Set Target (Cumulative) NHSE £61.4m £68.3m - Statutory Duty (In Year) Stat. Breakeven £13.9m QIPP Savings Target - Identified Programme Savings NHSE £21.2m (4%) £21.2m (4%) - Unidentified Programme Savings £8.1m (2%) Nil (0%) Capital Resource Limit Stat. £0.4m £0.4m Administration Costs Stat. £8.4m £8.3m Stay within Cash Forecast NHSE £562.7m £555.7m Cash Balance - % of initial drawings NHSE 1.25% 0.9% held at 31/03/18 Public Sector Payment Policy DH 95% 96.9%-97.2%
External Audit Assurance Type of Opinion Description Opinion Achieved Financial Statements “True and Fair View” Unqualified Opinion Qualified : “expenditure incurred as Regularity Opinion Expenditure exceeded intended by parliament” resource limit Securing economy, Qualified: Value for Money efficiency and Did not meet NHSE target Assessment effectiveness deficit Governance The Council of Members approved the Annual Report / Annual Accounts on 24 May 2018.
In the future, we plan meet our financial targets: In 2018/19, Croydon CCG received £17.0m (3.59%) allocation growth Target performance is £1.2m surplus (18/19) and £5.2m/1% (19/20) The QIPP challenge for 18/19 is £27.6m. Note: Above average growth funding is only available if more than 5% below target. At 4% below target the expectation is that the CCG must simply live within its allocation. Source: Financial Improvement and Recovery Plan June 2018
Financial Improvement and Recovery • Long journey from 2013 when CCG was established with a significant underlying deficit (£30m) and underfunding position (£40m/10%) • Our Financial Improvement Plan (June 2018) builds on the success since 2013 of clinically led quality improvements and we continue to spearhead more efficient use of our limited resources. • On the back of recent improvements, the CCG is no longer in Financial Special Measures. • CCG is planning to meet full business planning rules from 2019/20 (ie 1% surplus). • The backbone of this success is joint working across local clinicians, senior leadership, and alliance partners, to continue to drive the delivery of these quality improvements for Croydon citizens. 26
Creating a Dementia Friendly Croydon Rachel Carse Dementia Action Alliance & Social Inclusion Coordinator September 2018
Why Dementia? • Costs UK economy £26.3 billion per year £11.6 billion in unpaid care • Two thirds of people with dementia live in the community
Dementia figures for Croydon • In 2017 there were an estimated 3,611 people aged 65+ living with dementia • In 2016/17, only 2,322 were formally diagnosed with dementia • They, their family and carers are customers of many businesses, shops and services across the borough • 51% of people caring for someone with dementia are still in work and might need support from their employers. Some of your existing employees may also develop dementia
We want Croydon to be dementia friendly
What is the Croydon Dementia Action Alliance?
The CCG’s commitments 1. All staff to receive training in dementia awareness 2. Develop a dementia roadmap with other members of the Croydon Dementia Action Alliance for local carers and health and care professionals 3. Work with care homes to review approach to falls with dementia care in mind
Memory as a bookcase Facts Emotions
Dementia friendly community - people Raise awareness of dementia by getting everyone to The more understanding and awareness of dementia, the more understanding the community
Dementia friendly community - place
Mat or black hole?
Dementia friendly community - process • Remind carer of appointments made for person living with dementia • Send a reminder text or a member of staff could ring about the appointment • Where possible allow person living with dementia to see the same advisor • Allow plenty of time for appointments
Dementia friendly community - process • Shops – designated worker to support vulnerable shoppers and help maintain their independence • Banks – support people by being alert to requests for unusually large withdrawals - in Croydon, people have been prevented from being victims of fraud
If you want to find out more, join the Croydon Dementia Action Alliance, please contact me: rachel.carse@croydon.gov.uk
Social Prescribing Brian Dickens and Les Persaud Croydon Social Prescribing Community Engagement Team
Where are we: The Journey July 2017 – 1 Practice July 2018 – 42 Practices Why? How? Impact?
Community Engagement Why • Practices have increasing and unmanageable patient lists • Increasing complexity of medical care provided by GPs • 20% of GP consultations do not require clinical intervention • Currently practices have a few patients taking up 90% of practice time • Those who need to engage do not attend or manage their own health • Shortage of GPs fuelled in part by pressures of workload • Reducing available NHS Budget • Need to change patient and community behaviour around health self management for more effective use of resources
Community Engagement Why • We are in the thick of it • Majority of our area and some patients are in either from 5% to 10% most deprived in the country of 10% to 20% • We deal with a cohort that includes health issues such as 2 in 3 adults, roughly 181,000 Croydon are obese / overweight • Half the number of women giving birth are overweight / obese / morbidly obese and 5% of these are diabetic • 23% of children live in poverty • 58% of females and 43% males are not physically active • Life expectancy is 9.1 years lower for men and 7.7 for women than the national average Social Prescribing
Community Engagement LOCAL SOCIAL ISSUES • Social Isolation • Financial / Debt advice • Health and Exercise / Health management • Diet • Mental Health issues • Community Safety / Mentoring • Unemployment Rate – Highest in London • Community Cohesion / integration Social Prescribing
Community Engagement • Need to look at long-term behavioural change • Change Patient Dependency • Capacity Build the local provider • Develop patient self referral to more community structures • Develop more holistic community interventions • Multi Agency- Multi disciplinary Approach • Community Hubs / led by the community / for the community / owned by the community / SUSTAINABLE • One stop shops for community development / health interventions Social Prescribing
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