Chief Officer s Report December 2013/January 2014

Transcription

1 Chief Officer s Report December 2013/January 2014 Purpose This paper provides a summary of the key areas of business as led by the Chief Officer for this and the other four Clinical Commissioning Groups (CCGs) in the collaborative. It includes a brief summary of the main areas of work during June. The CWHHE collaborative comprises NHS Central London, West London, Hammersmith and Fulham, Hounslow, and Ealing CCGs. It has been written as a standard report across all five CCGs. Editing note: a number of items in the paper were reported to Hounslow CCG governing body at the meeting in December. The areas covered are: Health Service Journal BME Pioneers Ealing Clinical Commissioning Group Clinical visits Call to Action Winter Planning Contracting with our providers Better Care Fund Assurance and performance management Wholesystems Planning for next year and beyond Financial allocations Health Service Journal Black and Minority Ethnic (BME) Pioneers The Health Service Journal (HSJ) published its inaugural edition of BME Pioneers in December, supported by the British Medical Association (BMA), NHS Employers, and the NHS Leadership Academy. Hundreds of people were nominated and a panel of judges reviewed the nominations and developed the final list. Alastair McLellan, editor of the HSJ wrote, The result is a wide range of individuals in a diverse range of roles The judges were clear that they wanted individuals who not only achieve excellence beyond their immediate job roles but who also champion inclusion in its broadest sense and act as brilliant mentors to the next generation of leaders. I am delighted to report that Samira Ben Omar, our Assistant Director of Patient Experience and Equalities who works across the collaborative, has been included in the judges list. Samira has 1

2 been working in NW London championing patient engagement and health improvement for the past six years. The judges said, She s very good at her job. She s a passionate advocate about equality and diversity and leads in the whole public health agenda. Ealing Clinical Commissioning Group On 1 st December Ealing CCG joined the collaborative along with Central London, West London, Hammersmith and Fulham, and Hounslow CCGs. This concluded a process of assuring NHS England that all risks associated with the move had been identified and mitigated. We are all looking forward to working together more closely as a collaborative of five CCGs to make further collective improvements to the services we commission on behalf of our residents. Work will continue across the eight CCGs in NW London on our shared agendas of Shaping a Healthier Future and Out of Hospital strategies. Clinical Visits Jonathan Webster and his team have conducted clinical visits to Jubilee Ward (West London Mental Health Trust, in Ealing), West Middlesex Hospital, and Charing Cross Hospital. The purpose of these visits is to gather greater assurance with regards to the quality of services received by our patients including infection prevention and control, clinical leadership, and to seek opportunities for greater collaborative working and quality improvement. The outcome of the visits was identification of good practice and innovation in patient care and areas requiring improvement. Instant feedback is given as part of the visits and issues are followed up at the Clinical Quality Group meetings. Call to Action On 28 th November, NHS England (London Region) published Transforming Primary Care in London: General Practice - A Call to Action. It sets out the challenges facing general practice in London, and the priorities that doctors and patients have told us are important to improve. Much of the arguments rehearsed within the document echo those we have had in developing the Shaping a Healthier Future programme and the CCGs commissioning intentions and out of hospital strategies. Subsequently, the Pharmacy Call to Action was published, Improving care through community pharmacy a call to action. The main purpose of this Community Pharmacy Call to Action is to stimulate debate in local communities, with everyone who works with community pharmacy, to find out the best way to develop our integral service. NHS England s aim is to enable community pharmacy to play an even stronger role at the heart of more integrated out-of-hospital services that support better health outcomes for patients, provide more personalised care, deliver excellent patient experience, optimise the use of medicines and secure the most efficient possible use of NHS resources. The Call to Action seeks feedback from all healthcare professionals and users of services including GPs, pharmacists, patients and other stakeholders to develop a set of proposals describing the type of service people would like to see. 2

3 Winter Planning In early December, a tripartite event at which the CCGs presented our plans for managing demand for services this coming winter took place. The event was with NHS England, Monitor and the Trust Development Agency. The purpose of the event was for us to present our plans to manage the winter period, particularly the escalation of issues during periods of surge activity and how we work together across organisations in NWL to ensure that our residents are able to access care when they need it over the winter period. Part of the primary care response is seven day a week opening of selected practices across each CCG. A communications exercise has been carried out to promote these options to patients with a specific focus in Central London with adverts placed on telephone boxes. Contracting with our providers The contract with Imperial College Healthcare NHS Trust was signed on 19 th December. The only contracts that have not yet been signed are with West Middlesex University Hospital NHS Trust and Ealing Hospital NHS Trust. The outstanding issues are with specific areas for improvement under the Commissioning for Quality and Innovation (CQUIN) payment framework. We hope that these will be finalised shortly. Better Care Fund We are working with the tri-borough (i.e. the three local authorities of Westminster, Kensington and Chelsea, and Hammersmith and Fulham) to develop a plan for the Integration Transformation Fund. By working together across health and social care we aim to: transform the quality of care for individuals, carers and families; empower and support people to maintain their independence; lead full lives as active participants in their community; and shift resources to where they will make the biggest positive difference. Drafts have been considered at seminars and our draft plan is being used nationally as an early example of an approach. The learning from developing the tri-borough document is being used to develop those for Ealing and Hounslow CCGs. The proposal is a separate item on the governing body agenda for Central London, West London, and Hammersmith and Fulham CCGs. Assurance and Performance Management On Friday 29 th November we met with NHS England s Local Area Team as part of the quarterly assurance to check that CCGs are delivering on their agreed duties and responsibilities. We met as four CCGs and I am proud to report that NHS England was complimentary of our achievements to date. Furthermore, we will no longer need to have formal monthly meetings to review progress with delivering our Quality, Innovation, Productivity and Prevention (QIPP) plans as they are comfortable that we have made good progress in the previous 3

4 quarter and are on track to achieving improvements and efficiencies. NHS England has published their guidance on the year-end assurance process which includes the provision of evidence that we are delivering under the six domains within the authorisation framework. The intention is that we will be able to provide evidence such as governing body papers and audit reports that already exist, rather than having to produce new documentation. Whole Systems Integrated Care The co-design phase continues with over 100 people from across the health and social care system engaged in developing a range of tools and options to support the implementation of integrated care in NWL. It is anticipated that a draft toolkit will be available for review by early Each CCG is currently developing an integration plan which draws together national and local integration initiatives, including Better Care Funding, the move towards 7-day working, further development of networks of primary care and the implementation of an integrated plan for mental health. In addition we are looking for areas to consider testing some of the outputs from the codesign phase (including the pooling of health and social care funding and trialling a shadow capitation payment model) as early adopter sites. The learning from these sites will be used to support the roll out of integrated care across NWL. A national launch event was held on 3 rd December for the integrated care pioneer sites. We are currently shaping the support we would like to request from our national partners however this is likely to focus on: The development of capitated payment models; the potential for new provider organisational forms; information governance Planning for next year and beyond NHS England published their detailed planning guidance in December. This sets out the financial allocations to CCGs (see below) along with guidance on the preparation of our 2- year commissioning plans, and 5-year strategies. Our plans need to include the Better Care Fund work that we will be doing with the local authorities. As part of these planning activities, we are setting out, in broad terms, our annual business planning cycle so that the right things are considered in the right places at the right time. Two workshops have been planned in January to bring together the outputs of planning activities already completed as we developed our commissioning intentions. We have to submit the first draft of our 2-year plans to NHS England by 14 th February. The development of these plans will be shared with governing bodies through seminars with a further update at the March governing body meeting. Financial allocations NHS England has responsibility for determining funding allocations to commissioners within the NHS system. At their Board meeting on 17 December they considered a paper that set out the proposed funding allocations for 2014/15 and 2015/16. The paper outlined 7 different ways in which the CCG element of funding growth could be shared 4

5 between CCGs. These had differing approaches to the pace of change, i.e. how quickly historical allocations move towards the target allocations. The Board was asked to consider and make a decision between options 3 and 4. Both options had 3 elements: an element relating to population growth, an element relating to a basic uplift for all CCGs and an element relating to pace of change, i.e. how quickly allocations move from their historical basis to the target capitation funding level for each CCG. Option 4 included a floor, so that no CCG received a real terms reduction in funding, while option 3 didn t. The Board approved option 4. The impact of this by CCG is shown in table 3. The table also shows the funding that will transfer from CCG baselines into the Better Care Fund (previously the Integrated Transformation Fund) in 2015/16. 13/14 baseline 14/15 uplift uplift 15/16 uplift uplift BCF cost 15/16 Central 243, ,999 5, % 253,232 4, % 9,099 West London 328, ,133 7, % 340,830 5, % 12,246 H&F 239, ,607 5, % 248,765 4, % 8,939 Hounslow 274, ,628 12, % 298,008 11, % 10,708 Ealing 409, ,700 15, % 439,339 14, % 15,786 Harrow 224, ,162 9, % 243,174 9, % 8,738 Hillingdon 278, ,919 12, % 302,518 11, % 10,871 This is a good outcome for North West London. All CCGs receive an uplift to at least offset inflation, including those that are currently significantly over their target capitation budgets. At the same time, the CCGs that are more financial challenged also receive much larger uplifts than in recent years, giving them a greater opportunity to address those challenges. A more detailed paper on allocations is shown elsewhere on the agenda. Daniel Elkeles Chief Officer, CWHHE CCGs 23 rd December