Fylde Coast Health Event and Annual Meetings Thursday, 5 July 2018 Welcome Roy Fisher, Chair NHS Blackpool Clinical Commissioning Group 1
NHS Blackpool CCG Annual General Meeting 2017/18 Apologies for absence 2
Minutes of the previous meeting held on 21 September 2017 Annual report and accounts 2017/18 Andrew Harrison Chief Finance Officer 3
Key statutory financial targets Revenue control total Each CCG is empowered to spend the resources allocated to it based on population need in an effective and efficient manner, but no more. Additionally included in this target NHS England sets Business Rules to determine levels of surplus (unspent resource) for each CCG. Cash limit Each CCG is required to ensure that it manages the cash associated with the above control total effectively. Better payment practice code (BPCC) A CCG is required to pay its suppliers within 30 days of being invoiced (or receipt of goods and services where invoices are in advance). Revenue control total 13/14 14/15 15/16 16/17 16/17 Target 16/17 Actual 17/18 17/18 Target 17/18 Actual Blackpool CCG 286.2m 3.9m surplus 286.2m 3.9m surplus 300.9m 5.87m surplus 300.9m 5.87m surplus Fylde & Wyre CCG 239m 239m 5m Surplus 5m Surplus 246.5m 6m Surplus 246.5m 6m Surplus 4
Cash limit and BPPC Cash limit 13/14 14/15 15/16 16/17 16/17 Target 16/17 Actual 17/18 17/18 Target 17/18 Actual Blackpool CCG 286.2m 285.6m 302.0m 296.9m Fylde & Wyre CCG 238.5m 237.9m 250.2m 250.2m BPPC Blackpool CCG 95% 99.50% 95% 99.70% Fylde & Wyre CCG 95% 99.70% 95% 98.70% NHS Fylde and Wyre CCG Annual General Meeting 2017/18 5
Apologies for absence Minutes of the previous meeting held on 21 September 2017 6
Annual report and accounts 2017/18 Andrew Harrison Chief Finance Officer Key statutory financial targets Revenue control total Each CCG is empowered to spend the resources allocated to it based on population need in an effective and efficient manner, but no more. Additionally included in this target NHS England sets Business Rules to determine levels of surplus (unspent resource) for each CCG. Cash limit Each CCG is required to ensure that it manages the cash associated with the above control total effectively. Better payment practice code (BPCC) A CCG is required to pay its suppliers within 30 days of being invoiced (or receipt of goods and services where invoices are in advance). 7
Revenue control total 13/14 14/15 15/16 16/17 16/17 Target 16/17 Actual 17/18 17/18 Target 17/18 Actual Blackpool CCG 286.2m 3.9m surplus 286.2m 3.9m surplus 300.9m 5.87m surplus 300.9m 5.87m surplus Fylde & Wyre CCG 239m 239m 5m Surplus 5m Surplus 246.5m 6m Surplus 246.5m 6m Surplus Cash limit and BPPC Cash limit 13/14 14/15 15/16 16/17 16/17 Target 16/17 Actual 17/18 17/18 Target 17/18 Actual Blackpool CCG 286.2m 285.6m 302.0m 296.9m Fylde & Wyre CCG 238.5m 237.9m 250.2m 250.2m BPPC Blackpool CCG 95% 99.50% 95% 99.70% Fylde & Wyre CCG 95% 99.70% 95% 98.70% 8
Blackpool Teaching Hospitals NHS Foundation Trust Annual Members Meeting 2017/18 Apologies for absence 9
Minutes of the previous meeting held on 21 September 2017 Annual report and accounts 2017/18 Tim Bennett Deputy Chief Executive / Director of Finance 10
2017/18 Financial headlines Trust delivered an operating surplus of 5.7m including Sustainability and Transformation Fund (STF) Incentive of 4.6m ( 5.2m surplus after exceptional items). Surplus excluding STF Incentive of 1.2m. The operating surplus equates to 0.8% of turnover. The exceptional item relates to a revaluation of the estate which is a non cash item. Cash position 3.3m positive balance. Full details in the group accounts. Efficiencies Cost savings of 21.2m. Highest level we have ever achieved. Equivalent to 5% of our cost base. m 25.0 20.0 15.0 Delivered through: Transformational schemes. 10.0 Transactional schemes and increased 5.0 expenditure controls. 0.0 CIP Recurrent Non- Recurrent 11
Investments Improvements in clinical quality and safety including: Implementation of primary care streaming. Investments in medical staff. Haematology collaboration with LTH. Enhancement to the Diabetic Foot Service. Investment in Radiology out of hours service. Investments Major capital investments totalling 8.7m including: A&E Primary Care Streaming - 1.0m. Medical equipment - 2.0m. Electronic information projects - 4.7m. Women s & Children s Building Improvements - 0.5m. 12
Outlook for 2018/19 Continued financial pressure Increases in costs due to activity increases and pay pressures. Provider Sustainability fund of 6.6m dependent upon improvements in finances and A&E performance. CIP target of 17.4m NHSI control total 4.0m deficit Cash position by year end negative balance 3.3m with plans being developed on liquidity improvements Outlook for 2019/20 onwards Impact of recent funding announcement by Prime Minister not yet clear Significant savings will still be required Trust - Refresh of 2019-20 plan: Expected to be completed December 2018. Continued Fylde Coast health economy approach (Integrated Care Partnership). 13
Membership Report 2017/18 Pearse Butler Chairman Membership update In January 2018, the Council of Governors approved the following changes to the Trust Constitution in relation to the composition of the Council of Governors:- o Alignment to the Healthier Lancashire & South Cumbria STP, Cheshire & Merseyside STP and Greater Manchester STP. o Renaming of the Lancashire and Cumbria Public Constituency to North West Counties Public Constituency. o Removal of three Appointed Partnership Organisations. o Inclusion of University of Liverpool and University of Buckingham as Appointed Partnership Organisations, who receive information from the Council of Governors. o Removal of one Public Governor vacancy in Lancashire and Cumbria Constituency. o Revised quoracy for formal Council of Governors meetings. o Amendments to paragraphs 105, 114, 139, 164, 212, 219, 222, 223 and 224 in relation to voting. Slight decrease in public membership and slight decrease in staff membership. 14
Membership committee achievements 2017/18 Continued to implement the Membership Strategy and monitor the Key Performance Indicator targets relating to communications, young people, volunteering, diversity and engagement. the 2019 target number of schools to become involved in the Youth Health Leaders Project (10) and continue to develop links with other local schools and colleges. Continued to hold seminars for members covering a range of health issues, such as Patient Activation Measures, Why Social Inclusion Matters to Our Mental Health and Epilepsy Awareness Day. Further information relating to membership can be found at: www.bfwh.nhs.uk Looking forward 2018/19 To review the Membership Strategy To increase engagement with diverse communities To increase young people s membership To review the presentations from clinical speciality groups for Membership Seminars 15
Council of Governors and Board of Directors Pearse Butler Chairman There have been no elections to the Council of Governors during 2018 elections take place two out of every three years, therefore the next elections will be held in May 2019. There has been one Governor resignation during 2017/18 from Philip Hargreaves, Appointed Governor for the Institute of Directors, (and, since the end of the financial year, from Steve Winterson, Appointed Governor for Lancashire Care NHS Foundation Trust). Thank you to Peter Askew for his contribution as Lead Governor until the end of his term of office in September 2017. Welcome to Sue Crouch and George Holden who were elected Lead Governor and Deputy Lead Governor respectively in November 2017. 16
Special thanks to the following Directors who have either resigned or their term of office has ended during 2017/18: Doug Garrett, Dr Malcolm McIllmurray and Nicky Ingham (and, since the end of the financial year, Ian Johnson and Karen Crowshaw). Thank you to Pat Oliver (Director of Operations) who will be retiring at the end of July after 12 years service at the Trust. Welcome to the following Directors who have joined the Board during the year: Keith Case and Steve Finnigan, Non-Executive Directors (and, since the end of the financial year, myself as Chairman). Introduction Roy Fisher, Chair NHS Blackpool Clinical Commissioning Group 17
Then, now and beyond 70 years of the NHS What does the future hold? Wendy Swift, Chief Executive, Blackpool Teaching Hospitals NHS FT Dr Tony Naughton, Clinical Chief Officer, Fylde and Wyre CCG Amanda Doyle, ICS Chief Officer and Chief Clinical Officer for Blackpool CCG The early NHS 18
Over the years 1890 Decision made to build a hospital in Blackpool. Prior to this patients had to be transported by train to Preston Royal Infirmary or go to a cottage hospital in Lytham. 1894 On 25 August the first patient was admitted to Blackpool Infirmary on Whitegate Drive. A little girl aged four who had fallen from a hobby horse. 1897 Queen Victoria s Diamond Jubilee and Blackpool Infirmary renamed The Victoria Hospital. 1936 Blackpool Victoria Hospital moved to a new site on Whinney Heys Road. 19
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The treatment journey Blackpool Victoria Hospital 1936-1948 Beds 182 Wards 10 Building Cost 165,000 2018 Beds 820 Wards 42 Current Value 133M 23
Fylde Coast Hospitals over the years Blackpool Victoria South Shore St Annes Devonshire Road Moss Side Fleetwood Lytham Rossall Whitegate Drive (Original) Bispham Wesham Clifton Glenroyd Maternity Unit Milton Lodge Maternity Unit 1948 Introduction of the NHS 1947 1974 Lancashire NHS services managed by the Manchester Regional Hospital Board. 1967 Accident and Emergency Unit built at Blackpool Victoria Hospital along with the opening of a new outpatients department and day case theatre. 1974 Manchester Regional Hospital Board abolished and replaced by Regional Health Authorities. 1975 Maternity Unit opened at Blackpool Victoria Hospital. 1981 Gastroenterology Unit and Intensive Care Unit opened at Blackpool Victoria Hospital. 24
1993 Blackpool, Wyre and Fylde Community Services Trust formed. 1997 Blackpool Victoria Hospital Trust formed 2001 Primary Care Trusts (PCTs) formed for commissioning and provision of community services. 2007 Blackpool, Fylde and Wyre Hospitals NHS Foundation Trust formed. 2010 Blackpool Teaching Hospitals NHS Foundation Trust formed. 2012 New 2012 Health and Social Care Act meant PCTs were abolished and replaced by CCGs. Community Services transferred to Blackpool Teaching Hospitals NHS Foundation Trust. Changes in healthcare provision over the years Demography Life Expectancy Multiple Health Problems New Technology and Improved Diagnostic Equipment e.g. CT Scans; MRI Scans; Endoscopy New Drugs and Treatments:- Leaches Thrombolysis for Stroke Heart attacks Bed Rest Clot retrieval/stents/bypass Reduced Length of Stay Peptic ulcers operations obsolete now Knee Replacements No procedure - 1 week plus stay Day Case Cataract operations 1 week stay now done as an outpatient procedure 25
Move to Community Developments Increase in numbers of GPs and treatments at home and in new community primary care facilities:- Whitegate Drive South Shore Ashton Ansdell Newton Drive St Annes Moor Park Cleveleys Dock Street Heysham Caton Lytham Freckleton Thornton Broadway Morecambe Garstang Medical Centre Whitegate Drive Health Centre, Whitegate Drive, Blackpool 26
Moor Park Health and Leisure Centre, Bispham South Shore Primary Care Centre, Lytham Road, Blackpool 27
Lytham Primary Care Centre, Lytham Fleetwood health centre, Dock Street, Fleetwood 28
Urgent Care Centre, Blackpool Victoria Hospital, Blackpool New Main Entrance, Blackpool Victoria Hospital, Blackpool 29
Our staff A big THANK YOU to the many thousands of staff who work for the NHS now and have done over the past 70 years. It is their hard work and dedication which makes the NHS what it is today Where are we now? 30
Ageing population. Our challenges Blackpool most deprived town in England. Highest number of antidepressants prescribed. Staff shortages. More people living with multiple long term conditions. Our successes New care home models. Excellent Care Quality Commission ratings for GP practices. Improved channels of communications and engagement within our communities. Good financial position. 31
So, what next? Neighbourhoods Geographical areas across which GP practices and other health and care services work together to ensure joined-up care tailored to the needs of their local populations (typically between 30,000 50,000 people). 32
Integrated Neighbourhood Team Triage Assess Signpost Regulated Care Children & families Integrated Neighbourhood Hubs / Care coordination Voluntary & third sector Health & Wellbeing support Community consultants Primary care Rehabilitation Therapy Community Matrons / Nurses Social worker Mental health Empowering People & Communities Integrated Care Pathways End of life care Intermediate Care Falls Other Developments Chronic Disease Management reviews - COPD Self referral Hospital discharge Processes Blackpool Carers Centre Empowering people & Communities Linked services - drug and alcohol; mental health; Governance Multi Disciplinary Team meetings Neighbourhood, Operational and Strategic meetings Fylde Coast Integrated Care Partnership (ICP) Healthier Fylde Coast NHS and local authorities formally working together to improve the health and care of the whole Fylde Coast population. 33
Lancashire and South Cumbria Integrated Care System (ICS) Healthier Lancashire and South Cumbria 34
What people will see Neighbourhoods District General Hospitals Lancashire and South Cumbria Nationwide Questions and answers Pearse Butler, Chair Blackpool Teaching Hospitals NHS Foundation Trust 35
Closing remarks Mary Dowling, Chair NHS Fylde and Wyre Clinical Commissioning Group 36