CLINICAL COMMISSIONING GOVERNANCE BOARD EXECUTIVE SUMMARY SHEET

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1 Agenda Item 9.3 CLINICAL COMMISSIONING GOVERNANCE BOARD EXECUTIVE SUMMARY SHEET DATE: January 2015 TITLE OF PAPER: EXECUTIVE RESPONSIBLE: National Planning Guidance and Telford and Wrekin CCG Commissioning Intentions 2015/16 Fran Beck Executive Lead for Commissioning Contact Details: Ext: AUTHOR (if different from Nicky Wilde above) Deputy Executive Lead for Commissioning and Quality (Interim) In-hospital Services Contact Details: Ext: CCG OBJECTIVE: 1) To improve commissioning of effective, safe and sustainable services, which deliver the best possible outcomes, based upon best available evidence 2) To increase life expectancy and reduce health inequalities 3) To encourage healthier lifestyles 4) To support vulnerable people 5) In meeting the objectives above, to exercise CCG functions effectively, efficiently and economically, and in accordance with generally accepted principles of good governance and as an employer of choice. For Information X For decision X For performance monitoring EXECUTIVE SUMMARY The attached paper provides the proposals for the Telford and Wrekin CCG Commissioning Intentions for 2015/16, the link with the Quality Innovation Prevention and Productivity Programme and the National Planning Guidance for 2015/16 published in December The Broad intentions remain unchanged from previous years and are in relation to the CCG objectives outlined above and the Telford and Wrekin CCG plan on a page. FINANCIAL IMPLICATIONS: The Commissioning intentions are an indication of how the CCG proposes to spend its allocation to ensure our population is serviced by high quality, safe and productive health services. They are also linked with the CCG Quality, Innovation, Productivity and 1

2 Prevention (QiPP) programme. EQUALITY & DIVERSITY PATIENT & PUBLIC ENGAGEMENT: One of the key objectives for Telford and Wrekin CCG is to reduce health inequalities and improve life chances for all our population. All projects have either undertaken an equality impact assessment or will be undertaking one as part of this process. These assessments are reported through the QiPP sub-committee. Outline discussions have been held with patient representations regarding the overall process for commissioning intentions. Two workshops have taken place with a group of patients to enable an understanding of the processes. Individual projects will include their own detailed engagement plans which will be reported through QiPP sub-committee. A copy of this Board Paper will be presented to the CCG Health Roundtable at January / February meetings. LEGAL IMPACT: RECOMMENDATIONS: The CCG will need to ensure that all contractual processes are completed in line with the NHS Standard Contracts in terms of any contract changes. The CCG Board is asked to:- Agree the CCG commissioning intentions for 2015/16. Is there a need to consider inclusion in the Corporate Risk Register? No 2

3 National Planning Guidance and Telford and Wrekin CCG Commissioning Intentions 2015/ Introduction This paper provides details of the Telford and Wrekin CCG Commissioning Intentions for 2015/16, the link with the Quality Innovation Prevention and Productivity (QiPP) Programme and the National Planning Guidance for 2015/16 (published in December 2014). The broad intentions remain unchanged from previous years and are in relation to the CCG objectives outlined in the Telford and Wrekin CCG 2014/15 plan on a page (see appendix 1). The 5 objectives of the CCG are all addressed in varying forms and they also relate to many of the priorities detailed in section 4 of the recently published guidance from the Department of Health The Forward View into action: NHS England s Planning Requirements for Commissioners, 2015/16. A summary of how the high level objectives of the CCG and the priories in the new planning guidance are detailed below: CCG Objective To improve commissioning of effective, safe and sustainable services, which deliver the best possible outcomes, based upon best available evidence High level National Priorities for operational delivery in 2015/16* Improving patient safety Improving quality and outcomes To increase life expectancy and reduce health inequalities Improving quality and outcomes To encourage healthier lifestyles Improving quality and outcomes To support vulnerable people In meeting the objectives above, to exercise CCG functions effectively, efficiently and economically, and in accordance with generally accepted principles of good governance and as an employer of choice. Transforming care of people with learning disabilities Achieving parity for mental health Meeting NHS Constitution standards *Full details of the Priorities for operational delivery can be found at Appendix 2 The National planning guidance is published in several parts:- The Forward View into action: NHS England s Planning Requirements for Commissioners, 2015/16 overview document Activity and Financial Planning Templates 2015/16 Guidance for CCGs Planning timetable Technical guidance details the technical definitions of the overview document. 3

4 The Planning timetable at Appendix 3 details a number of key dates indicating when documents will be published, data is to be submitted and for contracts to be signed. The first date for submission of data to Unify.is 13 th January. This is a challenging timescale, given that our Commissioning Intentions have not yet been formally agreed, however commissioners are working with Informatics and Finance to put this initial Headline plan together. From 29 th January there are weekly contract trackers to be submitted to ensure progress is made. Submission of full draft plans is 27 th February with assurance from NHS England between 27 th February and 30 th March The indicated date for submission of full and final plans is 10 th April Key Issues - The Forward View into action: NHS England s Planning Requirements for Commissioners, 2015/16. This document describes the approach for national and local organisations to make a start in 2015/16 towards fulfilling the vision set out in the NHS Five Year Forward View, whilst at the same time delivering the high quality, timely care that the people of England expect today. The pace and scale of transformation over the next five years will partly depend on the scale of additional investment in, and uptake of prototyping 4 different types of care models which are described in the paper as being:- Multispecialty community providers (MCPs), which may include a number of variants; Integrated primary and acute care systems (PACS); Additional approaches to creating viable smaller hospitals. This may include implementing new organisational forms advocated by the Dalton Review, such as specialist franchises and management chains; and Models of enhanced health in care homes The paper talks of the importance of planning together with confidence and how in local communities Patient groups, clinicians, frontline NHS leaders and national organisations need to work together to sustain and improve NHS services. These requirements are largely being met by the Futurefit programme, for example the development of Urgent Care Centres will provide integrated primary and acute care. The guidance also refers to the achievement of Core Standards such as the NHS Constitutional rights not being relaxed. In order to achieve both the forward planning and the delivery of the NHS Constitutional rights CCGs are asked to refresh their operational plans for 2015/16. Other areas mentioned are: Getting serious about prevention and close working with local government partners. Specifically mentioned are lifestyle risks and evidenced based diabetes prevention. The role of employers in improving the health of the population Patient empowerment in terms of choice, improvement in access to information and personal health budgets. Achieving parity for mental health Improvements in choice for maternity services Better working with Carers and voluntary organisations A full list of the Priorities can be found at Appendix Key Issues - Activity and Financial Planning Templates 2015/16 The future financial gap is challenging. Planning templates have been constructed to provide sufficient granularity for NHS England to assess CCG plans for the 2015/16 financial year. The template is similar in format to that used in 2014/ /19 template. The major changes are: 4

5 Inclusion of information on activity on the contract tab; Further information on impact of the Better Care Fund; and Inclusion of information on the ad-hoc returns made in 2014/15 e.g. mental health parity of esteem. The financial information included in the templates needs to reflect the assumptions set out in the wider plans for CCGs. The Commissioning intentions are an indication of how the CCG proposes to spend its allocation to ensure the population is serviced by high quality, sage and productive health services. They are also linked with the CCG Quality, Innovation, Productivity and Prevention (QiPP) programme. There is special reference in the documentation to reviewing the Better Care Fund Plans, taking into account: Actual performance in the year to date, particularly through the winter; The likely outturn for 2014/15; Progress with contract negotiations with providers. Other key areas to note is the requirement for CCGs to set aside 1% non-recurrent spend in 2015/16 and the use of commissioning for quality and innovation payment framework (CQUIN) in the NHS Contracts allowing the opportunity to earn up to 2.5% of its annual contract value (excluding drugs, devices and other items funded on a pass through basis). The 2015/16 CQUIN scheme will feature four national indicators, with an even balance between physical and mental health: Two of the current national indicators will remain in place, with limited updating; these cover improving dementia and delirium care and improving the physical health care of patients with mental health conditions; Two new indicators will be introduced, one on the care of patients with acute kidney injury, the other on the identification and early treatment of sepsis; There will also be a new national CQUIN theme on improving urgent and emergency care across local health communities, commissioners will select indicators locally from a menu of options; The other national CQUIN indicators in 2014/15 covering the safety thermometer and the friends and family test will instead be covered from 2015/16 by new requirements within the NHS Standard Contract. NHS England will publish separate guidance on the 2015/16 CQUIN framework and the Quality Premium in January 4.0 Submission and assurance of 2015/16 plans All health and social care organisations must work together to develop locally owned and agreed plans. To support mutual working between commissioners and providers, there is an expectation that local organisations will share their own assumptions with each other in line with their duties of partnership. For the CCG as Commissioners, this will mean ensuring that plans reflect the local Joint Health and Wellbeing Strategy and that local providers and the local communities have been fully engaged in this process. Plans developed by commissioners, NHS Trusts, and NHS Foundation Trusts will be assured by NHS England, the TDA and Monitor respectively. 5.0 Telford and Wrekin CCG Commissioning Intentions 2014/15 5

6 Appendix 4 provides the draft CCG Commissioning intentions for 2014/15. This document has been populated by Commissioning Leads and is in draft form awaiting comments from Board. It should be noted that these Commissioning Intentions were developed prior to the national guidance being released and will need to be revisited to ensure that all required elements are included. There is also a need to expand on the urgent care element and reducing variation. The latter will be linked to our Co-commissioning / delegated Primary Care application which has just been submitted for approval. The reduced variation will be delivered by enhanced payments and collaborative commissioning to further improve the quality of our Primary Care Services. Appendix 4 shows the Commissioning Intentions for the following areas: To strengthen self-care and prevention Planned Care Cancer / End of Life Mental Health Better Care Fund / Rehabilitation Urgent Care General (e.g. 7 day working and co-commissioning) 6.0 Relationship with QiPP and Planning submissions In order to ensure connectivity between the Commissioning Intentions, the QiPP programme and the Planning submissions, the Interim Deputy Executive Lead for Commissioning and Quality (Inhospital services), the CCG Finance Manager and the CCG Senior Information Analyst are meeting with all the Commissioners weekly during January. This will ensure that the granularity required for the planning assumptions is in sufficient detail to be clearly monitored and measured. This will also ensure that all the required planning information in available, approved and ready for submission. It is intended that the additional information will include areas such as: Increase in Activity by HRG or ID code Decrease in Activity by HRG or ID code Gross Increase Decrease in Finance Investments Required Nett Savings/costs 7.0 Next Steps The next steps include:- Approval of draft commissioning intentions Gap analysis between the current Commissioning Intentions and the contents of the recently released planning guidance Meetings with lead Commissioners, Information and Finance Data submission in line with the national timeline Further communication and engagements with patients 8.0 Recommendation The CCG Board is asked to:- Agree the CCG commissioning intentions for 2015/16. 6