NHS Rushcliffe CCG Governing Body Meeting. CCG Improvement and Assurance Framework. 15 March 2018

Transcription

1 RCCG/GB/18/039 NHS Rushcliffe CCG Governing Body Meeting 15 March 2018 Introduction 1. This paper provides the Governing Body with an update on the progress being made by the Greater Nottingham CCGs in respect to the performance metrics specified in NHS England s Improvement & Accountability Framework. Background 2. This paper provides the Governing Body with an update on the progress being made by the Greater Nottingham CCGs in respect to the performance metrics specified in NHS England s Improvement & Accountability Framework. 3. NHS England introduced the first Improvement & Accountability Framework in 2016/17 in order to align the key objectives and priorities of CCGs whilst providing a mechanism to manage the relationships with commissions. 4. The framework consists of a range of metrics, in the main being published from nationally collected data from both providers and commissioners. This is supplemented by more qualitative information collected through stakeholder surveys and intelligence captured from NHS England team locally. 5. NHS England typically reported progress against the IAF on a quarterly basis with a formal letter reporting their annual assessment of the CCGs. Members will recall a summary of the annual letter being report as part of the Accountable Officers report towards the end of 16/17. Since then NHSE have not published further updates, most probably as the shift to considering STPfootprint performance is increasingly the norm. 6. However, the importance of maintaining service standards for patients remains alongside the requirement for the CCGs, internally, to confirm the progression of strategic objectives. Consequently, this report provides a local update on the progress being made and provides members with assurance of continued focus. Progress during 2017/18 7. The 51 indicators are categories into four domains: a. Better Health b. Better Care c. Sustainability d. Leadership Governing Body Page 1 March 2018

2 8. Locally each metric is assessed in three ways: whether the performance has achieved any relevant national standard (not applicable to all metrics); whether the trend is for an improving position; and how the performance of the CCG compares to all other CCGs across England. 9. For the purposes of the IAF, NHS England only consider the latter aspect, and specifically whether CCGs are in the Worst Quartile performance. Where this is the case the CCGs are required to provide assurances to the DCO that plans exist to improve performance. 10. A high-level summary of the most recent published data shows: CCG Number of Indicators Worst Best Improving Deteriorating Quartile Quartile Nottingham City Nottingham North & East Nottingham West Rushcliffe A detailed assessment of all indicators is shown in Appendix A (NHS Nottingham City) through to Appendix D (NHS Rushcliffe CCG), with a summary comparison for all four CCGs shown in Appendix E. 12. For Rushcliffe CCG The 3 indicators featuring in the worst quartile are: a. LD - reliance on specialist IP care: Rather than individual CCGs being measured, the performance of the Nottinghamshire STP is assessed as a whole. The footprint of Nottinghamshire Healthcare NHS Trust encompasses 7 CCGs, 2 Local Authorities, and NHS England Specialised Commissioning. Performance across the cluster has improved further with 77 people with a learning disability and/or autism (per 1 million population) relying on specialist inpatient care. Trajectories have been agreed with the area team to improve performance. Actions are being taken to ensure this trajectory is met. These include: Commissioners continuing to liaise regularly with inpatient units and other members of the multi-disciplinary team to expedite discharges where this is clinically indicated. Commissioners continuing to carry out blue light reviews as necessary with the aim of avoiding admissions where possible or expediting discharge. A new City and County wide Care and Treatment Review service with new enhanced specification has been commissioned. This started on the 2nd of January. Meetings are taking place to monitor the Intensive Community Assessment and Treatment Team service. b. IAPT Access: Members will be aware of the change in prevalence (for patients who are estimated to suffer from depression or anxiety) which occurred at the beginning of 2017/18. A series of discussions with NHS England have not resolved this issue for 2017/18 resulting in an artificially poor performance reported throughout the year. The Draft 2018/19 Operational Plan submitted on 7 March 2018 has provided Regulators with a more accurate, locally-derived, denominator for this indicator. This will significantly improve the reported performance against this indicator. Governing Body Page 2 March 2018

3 c. Cancer Patient Experience: Linked with the improving performance of the 62-day Cancer standard, there are a range of changes taking place in Cancer services for patients. These include: Improving the waiting times for first appointment. Modifying pathways to allow GPs to access straight-to-test diagnostics for patients. Working with peripheral providers to improve timescales for tertiary referrals. Implementing decision support tools to promote earlier diagnosis. Recommendations 13. The Governing Body is asked to: a. Note that NHS England no longer publish CCGs individual dashboards for the Improvement & Assessment Framework; b. Note the continued need to improve services for patients which will result in the required improvements for subsequent years; c. Note the plans discussed as part of the Operational Plan, STP, Contracts and performance management processes to improve this position; and d. Note future updates will be provided as appropriate. Andy Hall Director of Performance & Information 08 March 2018 Governing Body Page 3 March 2018

4 Appendix A NHS Nottingham City CCG IAF Published November 2017 Governing Body Page 4 March 2018

5 Key R Worst quartile in England Best quartile in England Interquartile range Data refreshed since last report Governing Body Page 5 March 2018

6 Appendix B NHS Nottingham North & East CCG IAF Published November 2017 Governing Body Page 6 March 2018

7 Key R Worst quartile in England Best quartile in England Interquartile range Data refreshed since last report Governing Body Page 7 March 2018

8 Appendix C NHS Nottingham West CCG IAF Published November 2017 Governing Body Page 8 March 2018

9 Key R Worst quartile in England Best quartile in England Interquartile range Data refreshed since last report Governing Body Page 9 March 2018

10 Appendix D NHS Rushcliffe CCG IAF Published November 2017 Governing Body Page 10 March 2018

11 Key R Worst quartile in England Best quartile in England Interquartile range Data refreshed since last report Governing Body Page 11 March 2018

12 Leadership Better Care Better Health Rushcliffe CCG Appendix E Greater Nottingham CCGs IAF Summary Sustainability Indicator Latest period Standard NHS Nottingham City CCG NHS Nottingham North and East CCG NHS Nottingham West CCG NHS Rushcliffe CCG 102a % classified overweight /obese 2013/ 14 t o 2015/ % 31.2% 30.7% 21.7% 103a Diabetes patients who achieved NICE targets % 37.4% 39.5% 38.7% 103b Attendance of structured education course % 12.0% 10.4% 6.3% 104a Injuries from falls in people 65yrs Q4 1,440 1,281 1,504 1, b Personal health budgets Q a Inequality Chronic - ACS & UCSCs Q4 2,813 1,853 1,463 1, a AMR: appropriate prescribing b AMR: Broad spectrum prescribing % 7.7% 9.6% 7.9% 7.7% 121a High quality care - acute Q b High quality care - primary care Q c High quality care - adult social care Q a Cancers diagnosed at early stage % 53.5% 52.7% 52.8% 122b Cancer 62 days of referral to treatment Q4 85.0% 76.6% 77.5% 75.9% 84.3% 122c One-year survival from all cancers % 70.6% 70.7% 71.5% 122d Cancer patient experience a IAPT recovery rate % 51.8% 59.3% 57.9% 60.9% 123b IAPT Access % 2.2% 2.9% 2.0% 123c EIP 2 week referral % 62.1% 69.4% 65.0% 88.9% 124a LD - reliance on specialist IP care Q b LD - annual health check % 33.9% 41.6% 35.0% 125d Maternal smoking at delivery Q1 16.7% 15.1% 12.4% 5.6% 125a Neonatal mortality and stillbirths b Experience of maternity services c Choices in maternity services a Dementia diagnosis rate % 84.3% 70.5% 87.3% 74.0% 126b Dementia post diagnostic support % 81.5% 80.3% 80.8% 127b Emergency admissions for UCS conditions Q4 2,682 2,186 2,138 1, c A&E admission, transfer, discharge within 4 hours % 86.6% 87.5% 86.8% 86.5% 127e Delayed transfers of care per 100,000 population f Hospital bed use following emerg admission Q b Patient experience of GP services % 83.6% 91.1% 91.9% 128d Primary care workforce a 18 week RTT % 94.9% 95.4% 94.4% 94.4% 131a % NHS CHC assesments taking place in acute hospital sett16-17 Q4 54.8% 64.1% 51.7% 64.6% 141b In-year financial performance Q1 Green Green Green Green 144a Utilisation of the NHS e-referral service % 95.6% 97.3% 101.8% 162a Probity and corporate governance Q1 Green Green Green Green 163a Staff engagement index b Progress against WRES a Working relationship effectiveness a Quality of CCG leadership Q1 Green Amber Amber Amber In Worst Quartile In Best Quartile Governing Body Page 12 March 2018