2015/16 Annual General Meeting

Transcription

1 2015/16 Annual General Meeting Welcome Dr Hari Pathmanathan tweet #ENHCCGAGM follow

2 Financially Healthy? 2015/16 Finance Report Alan Pond Chief Finance Officer

3 Statutory financial duties To keep spending within resource limit To keep spending within running cost allowance Not to spend more cash than allocated To achieve value for money in use of resources To produce annual accounts and annual report To keep appropriate accounting records

4 Financial challenge facing CCGs Nationally 0.1% real terms growth in funding Increasing and ageing population = increased demand Improving quality and outcomes = cost pressures Pay and prices cost pressure NHSE requirement for 1% underspend on budget NHSE requirement 1% to be spent non-recurrently on transformation NHSE requirement to hold 0.5% contingency reserve EFFICIENCY SAVINGS NEEDED

5 ENHCCG s 2015/16 financial challenge 12m Efficiency Savings (QIPP) 1% underspend Increased demand Inflation Investment in quality/outcomes Funding growth Tariff reductions Underspend brought forward

6 How did we do on Statutory Duties? Expenditure does not exceed sums allotted to the CCG plus other income received [223H(1)] Capital resource does not exceed the amount specified in Directions [223I(2)] Revenue resource use does not exceed the amount specified in Directions [223I(3)] Capital resource on specified matter(s) does not exceed the amount specified in Directions [223J(1)] Revenue resource on specified matter(s) does not exceed the amount specified in Directions [223J(2)] Revenue administration resource use does not exceed the amount specified in Directions [223J(3)] Not to spend more cash than allocated To achieve value for money in use of resources [14Q] To produce annual accounts and annual report [14Z15] To keep appropriate accounting records ACHIEVED 7,775,000 underspent ACHIEVED 32,000 underspent ACHIEVED 7,743,000 underspent not applicable; no specified matters in 2015/16 not applicable; no specified matters in 2015/16 ACHIEVED 2,494,000 underspent ACHIEVED Cash underspent by 0.4% ACHIEVED unqualified audit opinion ACHIEVED draft delivered on time ACHIEVED unqualified audit opinion

7 By budget heading? Description Annual budget 000 YTD Actual 000 YTD Variance 000 Allocation 683, ,077 0 Acute Commissioning 374, ,452 (6,453) Non Acute Commissioning 176, ,302 (3,242) GP Prescribed Drugs 76,901 78,396 (1,495) Other Primary Care 18,764 15,894 2,870 Running Costs 12,334 11,196 1,138 Transformation reserve 6,311 5, Recurrent investment fund 2,546-2,546 Resilience funding 4,061 3, Contingency reserve 3,358-3,358 Expenditure 675, ,334 (0) TOTAL UNDER / (OVER) SPEND 7,743 7,743 0

8 How did localities do? Description Budget 000 Actual 000 Variance 000 Variance % Allocation 683, , North Herts 127, , % Lower Lea Valley 85,887 85, % Stevenage 103, ,664 (1,071) (1.0%) Welhat 121, ,283 1, % Upper Lea Valley 124, , % Stort Valley & Villages 60,105 60, % Reserves & Unattributable 51,935 53,039 (1,104) (2.1%) Expenditure 675, , TOTAL UNDER / (OVER) SPEND 7,743 7,

9 Where did we spend our money?

10 Changes in spending

11 Future cost drivers Increasing population Ageing population Reduced social care funding Reduced staff availability Increasing deficits in Providers New technology and treatments Patient expectations Drive for continuous improvement

12 Funding gap 2016/17 to 2020/21 92m

13 Financial plan headlines for 2016/17 Plan meets NHS England s requirements and carries forward the 7.8m underspend Plan rolls over 2015/16 funding for primary care services Plan has QIPP requirement of 18m compared to 12m in 2015/16 Plan has a Transformation Reserve of 8m, but this has been frozen by NHS England Must work with Providers to eliminate deficits

14 Thank you

15 Beverley Flowers Chief Executive s overview

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17 Care at home the rapid response service

18 Early intervention vehicles launched. With 1 vehicle in operation - Between 26 April to 5 August 186 visit s 75% of patients were able to stay in their homes

19 Improving stroke services Recognise and act on symptoms immediately Get to a specialist stroke centre quickly Have rapid access to specialist stroke assessments and treatment Ensure a joined-up approach to patientcentred rehabilitation Review patients progress to identify any needs which haven t been met

20 What does this mean for patients? the ambulance rings ahead to the hospital for all suspected strokes stroke specialist nurses at Lister Hospital meet the patients as they arrive, 24/7 when in an acute hospital, patients spend the majority of their time on the stroke unit and get there more quickly patients who don t need to be in hospital can quickly receive early intensive rehabilitation at home more people are able to get stroke specialist inpatient rehabilitation in the community and receive a specialist review 6 months after their stroke.

21 What our patients say About our hyper acute stroke services on a Sunday in February my world upside down in a second. I had had an acute and severe stroke. I received fantastic and state-of-the art treatment very rapidly which is what saved me from permanent paralysis. About our community stroke services He left in a taxi, no ambulance,no wheelchair, a walking stick and dignity..the reason she can walk again is due to the dedication and expert treatment every day.

22 What next? improve public awareness that the risk of stroke can be reduced increase the detection and treatment of people at risk of stroke ensure we act on the emotional wellbeing needs of people who have a stroke and their families increase the uptake of 6 month reviews and self management opportunities better understand and meet the needs of families and carers of people who have had strokes

23 Transforming care for adults with learning disabilities Our plan continues to focus on: Piloting community based, preventative services, to reduce avoidable admissions Improving the wellbeing and successful discharge from hospital of people who need inpatient beds or secure health services Services that support social inclusion Developing an all-age care pathway Training the wider workforce in Hertfordshire to meet changing needs

24 Kooth: Online counselling for young people Free online support for children and young people aged years Counsellors online until 10pm, 365 days a year Top presenting issues: anxiety/stress; family relationships; friendships; and depression More than 700 users signed up already What young people are saying: Hi, the advice that some of your team have given me is amazing. It has helped a lot. Thank you so much I love this site, it s really helpful, one of my teachers recommended it to me I m really glad my teacher showed me this.

25 Youth Mental Health First Aid Training 12 Hertfordshire professionals qualified as instructors to train others in Youth Mental Health First Aid Instructors now training staff in schools, Public Health, Youth Connexions, Herts for Learning, colleges, the School Nursing Service Mental health first aiders can support 8 to 18 year olds showing signs of mental or emotional distress

26 Time period April September 14 October 14 May 15 Type of service A&E at the former QEII Urgent Care Centre based at the former QEII Monthly average patient numbers June 2015 Nov 15 Dec 2015 April 16 Urgent Care Centre based in New QEII Hospital Urgent Care Centre in New QEII

27 Peter was there a few months ago and he was in and out, X- dddddd ray etc. in less than half an hour. Great service QEII keep it up. up. Went in with my stepson was seen in less then 20 minutes. X-rays etc. all done and out in less then 1 hour. Great Service;)

28 Workforce - our most valuable asset We are promoting General Practice as a career through: Creating fellowship schemes for GPs Investing in practice nurse training and 12 practice nurse mentors Appointed GP leads and nurse tutors to lead on developing the workforce across the area Next steps: Host careers events for all clinical specialisms Offer general practice apprenticeships Offer general practice taster sessions for student nurses & foundation doctors Focus on training of practice staff

29 Your questions and feedback?

30 Hertfordshire and West Essex Towards a healthier future Jacqui Bunce Associate Director

31 Who we are: The Hertfordshire and West Essex health and care planning footprint has a population of 1.5 million people. There are over 160 GP Practices, 2 county councils, 2 Health & Wellbeing Boards, 2 Healthwatch, 13 district and borough councils, 3 acute hospitals, 2 mental health providers, 2 community providers, 1 ambulance trust and a significant number of other partners. Patients travel for a range of services outside of the footprint.

32 The challenge Our population is changing: Birth rates are increasing, and people are living for longer Public demand for specialist treatments is increasing and expectations of services are high Patients with complex conditions are supported to live on into old age We currently spend 4.5m per day on health care alone. By 2021 we would have to spend 5.8m per day to keep up with demand, and if we continue to provide services in the same way In addition: There will not be enough skilled health and social care staff Our acute hospitals will not be able to meet demand Deaths from preventable illness will increase

33 Our Ambition By 2021 we will have integrated primary and community and social care services wrapped around local communities, alongside sustainable acute hospital services, which deliver the right care at the right time and at the right place within the financial resources available.

34 What do we want our plan to deliver? Our plan puts the patient at the heart of a high quality, sustainable health and social care system, which emphasises the importance of personal responsibility, preventative care and partnership working. I have the expert advice and tools I need to manage my long term condition I will be cared for at home, or close to home, whenever possible I know that the care I receive follows best practice advice and guidance I am empowered and motivated to look after my health and the health of my family When I need expert help, I can go to a specialist centre with skilled staff Simple treatments, procedures and consultations are available in my local area I know where to go for health and care advice and support

35 How will we get there? Prevention and self-care Working with people & communities to keep as healthy and as well as possible More patients are supported to live well with their conditions:» personal health budgets» use of voluntary sector» supporting carers Improving the health of NHS staff nationally could reduce sickness rates by a third, the equivalent of adding almost 15,000 staff to the national workforce, saving 3.3 million working days a year. Source: NHS Five Year Forward View Starting Well Living and Working Well Developing Well Ageing Well

36 How will we get there? Community and primary care Continue to bringing care closer to home physical and mental health and social care support provided in the community, by multi-speciality teams. Work with our localities and GP Practices to support primary care services Making better use of community pharmacists Continue to work with the voluntary sector to deliver joined up community based services

37 How will we get there? Acute services We have already made significant changes in our area but we can do more: Standardised pathways of care Going to hospital for specialist opinions only when required Looking after people in the community will reduce the demand for hospital care Closer working between hospitals Improve our cancer care

38 How will we get there? Bridging the financial challenge Right staff, right skills, right places Improving prevention and supporting self care Standardised pathways of care Coordinating care and supporting people to avoid crisis Going to hospital for specialist services only Reducing demand on hospitals with effective local services Efficiencies in how we do things including administration

39 Making the best use of medicines Pauline Walton, Associate Director Pharmacy & Medicines Optimisation

40 Medicines what s the problem? around 7% of hospital admissions are attributed to or associated with adverse drug reactions two thirds of these admissions are preventable up to 50% of patients take medicines incorrectly inappropriate use of antibiotics is a significant and growing problem

41 What are the costs? Medicines are the NHS most frequent health care intervention In 2015/16: we spent 77.7M on primary care prescribing - 12% of total budget GPs prescribed 5.5% more items and costs grew by 3.5% hospital prescribing increased by 15%.

42 Medicines optimisation Emphasises: patient engagement safety professional collaboration governance So that patients get the maximum benefits from their medicines.

43 The aim: right patients get the right choice of medicine, at the right time. The goal is for patients to: improve their outcomes improve medicines safety take their medicines correctly avoid taking unnecessary medicines reduce medicines waste Medicines optimisation can help encourage patients to take ownership of their treatment.

44 Medicines in Care Homes A dedicated CCG pharmacy team work in care homes: reviewing individual residents medication working with GPs and staff to make changes to improve residents health & wellbeing reducing avoidable hospital attendances reducing the risk of falls making medicines safer, reducing waste

45 Antibiotics vital life-savers Antibiotics treat infections caused by bacteria Routine and life-saving treatments rely on antibiotics. For example caesarean sections, hip replacements or treatment for cancer. Antibiotics cannot kill other microscopic organisms that may also cause infections e.g. viruses and fungi Antibiotic resistance is a growing problem

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49 Common Misconceptions Many people believe they are resistant to the antibiotic, whereas it is the bacteria that are resistant I m not feeling any better after 3 days so I must need an antibiotic Getting antibiotics is proof you re ill Parents want the best for their children and think gold standard treatment means antibiotics

50 What is the CCG doing to tackle antibiotic resistant infections? Guidance for treating common infections Educational sessions to GPs and patient groups Review and monitor GP prescribing Issuing prescribing targets Promoting the Antibiotic Guardian campaign

51 Reduction in total antibiotic GP prescribing Items per oral antibiotic* Antibiotic consumption 2015/16 Nationally total oral antibiotic consumption* stable between 2011 and 2014 G.P. prescribing of antibiotics in our CCG reduced by 4% between March 2015 and June 2016

52 What can you do? Don't ask your GP for antibiotics for cold and flu Take antibiotics exactly as prescribed. Always finish the course Encourage family and friends to sign up to the Antibiotic Guardian Campaign and tell them about antibiotic resistant infections Take the pledge! Become an Antibiotic Guardian. antibioticguardian.com

53 Repeat medicines In Hertfordshire we estimate around 3.5M is wasted on unused or unnecessary medicines This could be used on other valuable treatments such as expensive cancer drugs, hip replacements or more nurses Returned medicines cannot be recycled or reused

54 Ordering repeat medicines Only tick the items you really need Remember to tell your GP or pharmacist if you do not need a medicine at that time Open the bag! Check when you collect your medicines that you still need them. Only take those that you will use Don t stockpile medicines Be clear about how you can avoid wasting medicines and save money save NHS money.

55 Thank you Questions? Pauline Walton Associate Director Pharmacy & Medicines Optimisation

56 Time for a break followed by your workshop sessions

57 Welcome back? Any questions or feedback?

58 Thank you have a safe journey home Please complete and return your feedback form