WELCOME City and Hackney CCG and Hackney Council Commissioning Intentions Event 2016/17 Tuesday 2nd of February 2016 6pm-8.30pm The Tomlinson Centre 1
AGENDA 5.30-6.15pm Arrival, registration, refreshments 6.15-6.30pm Welcome 6.30-6.55pm Round table discussions 6.55-7.05pm Break 7.05-7.30pm Round table discussions 7.30pm-8pm Devolution presentation 8-8.30pm Q&A 2
NHS City & Hackney CCG
INTRODUCTION Welcome from Clare Highton, GP and CCG Chair and Catherine Macadam, Chair of Patient and Public Involvement Committee Tonight is about getting your ideas and feedback… 4
YOU SAID, WE DID We had a great turnout at last year‟s event and your comments and feedback helped inform our plans for 2015/16 as well as the second round of the Innovation Fund. 5
“We need a longer consultation We commissioned “time to talk” when diagnosed with a long term extended GP consultations for people condition.” with multiple conditions and extra time for consultation for those newly diagnosed. We set up a Duty Doctor scheme that “ We want better access for takes urgent calls from patients during working hours. We also commissioned a patients to see their GP for Paradoc service which enables GPs to urgent care and more support for people suffering crisis at home.” visit people at home in an emergency, preventing unnecessary A&E visits. We‟ve formed an alliance “We need wider access and with other NHS and support for children and community based mental health service providers and young people with mental health issues.” implemented a single assessment policy with no wrong door.
INNOVATION FUND 2015 • Result of feedback from patients, the public, GPs and the voluntary and community sector • Co-produced with patients • Innovative practice, new ideas • Helping patients to better understand their own health needs and to access services • Thirteen projects funded in 2015 7
PATIENT AND PUBLIC INVOLVEMENT • We want our services to reflect our local populations and their needs • Patients and members of public can get involved and help shape local services through Becoming a member of the PPI Committee Becoming a Programme Board Representative Attending the NHS Community Voice meetings • Our plans for next year include Input into the Sustainability and Equality work Better shared decision making Patient experience work stream for East London Cancer Board PPI input into Hackney Devolution Pilot. More about this later at tonight‟s event. Please visit the question wall to ask questions and post comments. 8
OUR MONEY 2015/16 £368m for commissioning services Management cost limit £6.3m (but expect to spend only £4.3m) Chart below shows value in millions and a %age of total Other £33m 9% Primary Care and Prescribing £48m 13% Acute and Community £231m Mental Health (Homerton, £56m £150m) 15% 63% 9
FUTURE FINANCES Headline, • Extra money for NHS through the Government‟s Comprehensive Spending Review However, • Most NHS Hospitals now in deficit, new funding will need to pay for this • Bail out funds conditional on local delivery of nationally set challenging productivity targets and agreement to meet other expectations Locally, • City & Hackney CCG received 3-5 year allocation with below average growth as „over‟ target on funding formula • In 2016/17, headline increase of 2.4% nets to 0% after national challenges met eg increase in costs for national insurance payments will return funds to Treasury in 2016/17 • Allocations will mean the CCG will struggle to commission recurrent services beyond 2016/17 without finding significant efficiencies or containing demand • But, still have money to spend non-recurrently c£14m pa and access 10 granted to historic surplus of £30m over next 3 years.
NON-RECURRENT INVESTMENT • Opportunity to invest in additional services • 21 services received funding through latest cycle • Patients involved in selection process • Criteria included • Health gain • Patient benefit • Reducing inequalities • Sustainability • Impact on outcomes and performance • Savings as a result of the investment 11
PROFILE OF NR SPENDING PLANS 2016/17 Non- 0% recurrent 5% 6% £14.3m 9% 4% 13% Community Mental Health Primary Care Acute 20% Strategic System Wide Patient Experience 43% Voluntary Sector Many schemes within primary care, will support the prevention of admissions, support prevention and self management, and move services into the community. Many schemes are intended to work across acute, community and primary care .
OUR PLANS As part of delivering the NHS Forward View we need to develop • Five Year Sustainability and Transformation Plan • Operational Plan for 2016/17 13
OUR FIVE YEAR PLAN • Sustainable Transformation Plan (STP) is a plan for Hackney and its people. • Making the best of the resources that are available to us • Some of the headline local issues that we will focus on include Cardiovascular mortality for under 75s high for the least 20 years, but now declining Obesity rates still high High A&E attendances Emergency admissions for over 75s still high High levels of mental health need One year survival for cancer is improving although overall mortality still not good 14
OUR PLAN FOR 2016/17 There are nine „must dos‟ for 2016/17 for every local system: • Develop a high quality Sustainability and Transformation Plan • Return to financial balance • local plan to address sustainability and quality of general practice • Improve access standards to A&E and ambulance waits • Improvement against 18 week referral to treatment standard for non- emergency pathways • Reduce waiting times for mental health • Improve community care for people with learning disabilities • Develop affordable plans for improvement in quality and publish Trust specific avoidable mortality rates 15
EQUALITY AND SUSTAINABILITY .
Adaptation Eliminate Waste ££Stability Reduce CO 2 Resilience Equality & Diversity Social Value Economic Growth Companionship Resilience Inclusion Mobilisation Fairness Giving time Access to services Supporting communities Volunteering Social Diet & Exercise People‟s time Creativity & Potential Access to Green Spaces Health & Training & Education Wellbeing Active Travel Well workforce Biodiversity Living Wage Environment Economic Responsible employer Growing Food Buying social, ethical Improve Air Quality Innovation & Technology Reduce congestion Efficient services / operations ££C&H Quality & Compliance Buying local
OVERVIEW OF OUR PLANS • Our Programme Boards will tell you the work we‟re doing to form our five year plan. • You can get more information on how our individual programme boards plan to continue to do this in the coming year during this evening‟s round table discussions. 18
IMPROVING HEALTH Our GPs amongst best in country for treating and supporting people with long term conditions. First, second or third in country against 45% of measures All City and Hackney practices who have been CQC inspected so far this year have received a „ Good ‟ rating Majority of practices outperforming London CCGs against targets Testament to working with high quality local providers 19
Joint Commissioning Intentions Event
Introduction Councillor Jonathan McShane Cabinet Member for Health, Social Care and Culture London Borough of Hackney
Overview Our focus in recent years has been on promoting independence and enabling people to remain living in the community with appropriate support if possible. • Meet the person, not just the need - make sure the person's needs are recognised so that services are designed around them • Promote health and wellbeing - help people to be safe and live healthily; tackle health inequalities to improve the wellbeing of our communities • Provide wider choice - give people a choice of, and control over, good- quality services • Improve access to services - enable people to access services which meet and respond to their individual and diverse needs • Join up and innovate - working in partnership to develop the capacity to achieve change and deliver our priorities
Our spend 2015/16 Public Health Budget: £31,413 Adult Social Care Budget: £ 93,697 (mandated and non mandated services) Commissioni [CATEGORY [CATEGORY ng NAME] Advice, NAME] Housing 3% [PERCENTAGE [PERCENTAGE] Prevention and 0 – 5 Services Related ] Promotion 13% Provided Support 7% Services Programme 13% Adult’s PH 14% Services 14% Sexual Health Services 21% [CATEGORY NAME] Preventative [PERCENTAGE] Services Overheads 22% 3% Staffing [CATEGORY 9% Substance NAME] [CATEGORY Misuse (Adults) [PERCENTAGE NAME] 16% ] Health Checks Mental [PERCENTAGE] [CATEGORY [CATEGORY 1% Health S75 NAME] NAME] 9% [PERCENTAGE] [PERCENTAGE]
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