NHS Mansfield and Ashfield CCG Annual Public Meeting 17 September - PowerPoint PPT Presentation

“ NHS Mansfield and Ashfield CCG Annual Public Meeting 17 September 2018 Civic Quarter, Civic Centre Mansfield

Welcome and Introductions Dr Gavin Lunn Clinical Chair

Annual Review 2017/18 Amanda Sullivan Chief Officer

2017/18 – Making an impact • Continued progress as a national Vanguard, leading the development of better ways to meet local health needs • Keeping people at home where possible and working in local communities • Intensive home support • Care home enhanced services • Joined up care for people with high intensity needs • Urgent and emergency care – a whole system approach • Best use of precious NHS resource – 5.7% savings (£27.7m), with significant level of financial challenge

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System Objective 1 – 17.3% Reduction in A&E Attendances – Mid-Nottinghamshire 13,000 3,961 fewer 11,000 9,000 A&E 7,000 attendances 5,000 3,000 16/17 Actuals 17/18 Actuals Monthly Target 1,000 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar System Objective 2 – 11.6% Reduction in Emergency Admissions – Mid-Nottinghamshire 3,500 2,344 fewer 3,000 2,500 stays in 2,000 hospital 1,500 16/17 Actuals 17/18 Actuals Monthly Target 1,000 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 7

System Objective 3 - Reduction in Non-Elective Bed Days – Sherwood Forest Hospitals for Mid-Notts 16,000 7,941 fewer 15,000 days spent 14,000 13,000 in SFH 12,000 11,000 16/17 Actuals 17/18 Actuals 10,000 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar System Objective 6 - Reduction in Paediatric Emergency Admissions – Mid-Nottinghamshire 600 137 fewer 500 stays in 400 300 hospital for 200 100 children 16/17 17/18 0 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 8

FIT FOR PURPOSE FIT FOR TODAY FIT FOR THE FUTURE Financial turnaround Financial strategy, position and Alliance development moving delivery of savings towards population approach Business cycle and processes requirements and population health management Staff restructuring to maximise Service performance and delivery impact and constitutional standards Integration of services triangulation across business Vanguard delivery – new model functions Service quality and of care development safeguarding Governing Body and staff development Stakeholder relationships and engagement Improve NHSE rating

Staff views of working at the CCGs; Top 5 key achievements Question 2016 result 2018 result My work contributes to organisational performance 64% 91% My appraisal met my expectations 55% 84% My manager helps me celebrate my successes 48% 85% My manager recognises my efforts in the team 55% 90% My manager values my contributions 55% 90%

2017/18 Annual Ratings NHS Mansfield & NHS Newark & Ashfield CCG Sherwood CCG Overall 2016/17 Assessment Inadequate Inadequate Overall 2017/18 Assessment Requires Requires improvement improvement Cancer 2017-18 CCG IAF Assessment - Cancer Inadequate Good Dementia Q4 2017-18 CCG IAF Assessment - Dementia Outstanding Outstanding Elective Access Patients waiting 18 weeks or less from referral to hospital treatment 89.5% 89.6% Requires Requires Maternity improvement improvement Mental Health Q4 2017-18 CCG IAF Assessment - Mental Health Good Good Evidence sepsis awareness raising amongst healthcare professionals has been Patient Safety prioritised by the CCG Green + Green + Primary Medical Care Patient experience of GP services 84.8% 85.1% Urgent and Percentage of patients admitted, transfer Inadequate or discharged from A&E Emergency Care within 4 hours Requires Diabetes Initial Assessment - Diabetes Inadequate improvement Health Inequalities Quality of life of carers This CCG is This CCG is similar to the similar to the average for other average for other CCGs CCGs

NHS Newark NHS Mansfield & & Sherwood Ashfield CCG CCG Sustainability Financial plan - assessment of whether the CCG is likely to meet the plan Inadequate Inadequate Utilisation of the NHS e-Referrals Service to enable choice at first routine elective 96.2% above 90.8% above referral target of 80% target of 80% Well-led Probity and corporate governance Fully compliant Fully compliant Staff engagement index (engagement index on a 1 to 5 scale (5 good) 3.8 3.8 Progress against workforce and race equality standard (higher scores indicate higher differences, 0 indicates equality) 0.05 0.062 Effectiveness of working relationships in the local system 67.2 66.2 Requires Requires improvement improvement Quality of CCG leadership Requires Requires Compliance with statutory guidance on patient and public participation in improvement improvement commissioning health care (7 out of 15) (8 out of 15)

Quality of our local healthcare services Elaine Moss Chief Nurse and Director of Quality & Governance

Mansfield and Ashfield CCG monitor, challenge and support providers around a range of quality measures for example; • CQC Inspections • Healthcare associated infections • Sepsis • Mortality rates

Care Homes – increase in care homes during year Mansfield and April 2017 (90 Homes) March 2018 (105 Homes) 2017 = 67% Good Ashfield 67% Good or 69% Good or or Outstanding Outstanding Outstanding Inadequate 1 (circa 1%) 1 (circa 1%) 2018 = 69% Good or Outstanding Requires Improvement 17 (circa 19%) 16 (circa 15%) Good 59 (circa 66%) 68 (circa 65%) Outstanding 1 ( circa 1%) 4 (circa 4%) Awaiting inspection 12 (circa 13%) 16 (circa 15%)

GP Practices April 2017 Rating March 2018 0 Inadequate 0 5 Requires 3 improvement 15 Good 20 3 Outstanding 3 4 Awaiting 1 inspection

Sherwood Forest Hospitals April 2017 April 2018 Good response to quality, risk and assurance processes Concerns from CQC All areas inspected by CQC good Strong staff focus and good patient experience Stable leadership team

Reducing Healthcare Associated Infections (HCAI) Improving rates Clostridium difficile infections (CDI) Target Achieved Total Total Total Objective Set Total CDI 2017-18 CDI cases CDI cases CDI cases cases 2017/18 April 2015 - March 16 April 2016 - March 17 April 2017 - March Organisation 2018 NHS Newark & 37 44 37 39 Sherwood NHS Mansfield & 107 51 78 94 Ashfield Target Sherwood Forest 45 39 28 48 Hospital Trust Improving rates MRSA bloodstream infection Total Total Total National Target CCG assigned CCG assigned CCG assigned Target Achieved MRSA cases MRSA cases MRSA cases MRSA 2017-18 Organisation April 2015 - March April 2016 - April 2017- March cases 16 March 17 18 NHS Newark & 1 0 0 0 Sherwood CCG NHS Mansfield & 0 0 0 0 Ashfield CCG

Sherwood Forest Hospitals During 2017/8 we have seen significant improvements in: • Management of sepsis – training, reporting mechanisms. • Reduction in mortality rates (the rate of deaths in a particular health care related grouping ) – case review, staff training, incident reviews. • Supported through the CQC assessment findings.

2017/18 Finance Review Michael Cawley Chief Finance Officer

2017/18: Performance on Key Duties Financial Duty Achieved Details  Fully utilise allocated funds £301.7 million spent on healthcare services.  Met revised financial target Agreed £9.1m in year deficit. Represents an improvement of £0.1m compared to forecast of £9.2m in the financial recovery plan.  Remain within running cost Spent £3.9 million on running costs allowance £21.60 per head of population against a limit of £22.03.  Cash balance of £47,419 at 31 st Remain within maximum cash drawdown March 2018.  Pay suppliers within 30 days 96.6% of invoices paid within 30 days.

2017/18: How the CCG spent the allocation. The CCGs key providers were (as a % of total CCG budget): • Sherwood Forest Hospitals 42% • Nottingham University Hospitals 4% • Nottinghamshire Healthcare 7% • East Midlands Ambulance Service 2% • County Health Partnerships 6%

What services were delivered for patients? Acute Services: hospital based services 649 hip/knee replacements 1,109 cataract treatments 58,004 seen in Outpatients First Attendances 22,200 Non Elective admissions (including pneumonia, COPD, heart conditions, urinary tract infections) 77,400 diagnostic tests including 8,563 endoscopic tests Primary Care & Prescribing Ambulance Services Prescribing: 4.7 m items issued (Statins = 0.3 m ) 42,759 calls to the service Diabetes and Prostate Cancer checks 22,026 were transported to hospital Anticoagulation & rheumatology monitoring 13,162 patients were provided telephone Minor injury clinics advice or received treatment at location Home visits for complex patients with acute illness