ANNUAL GENERAL MEETING 26TH SEPTEMBER 2018 #BwDCCGAGM
Welcome to our Annual General Meeting 2017/18 Mr Graham Burgess - Chair
NHS Blackburn with Darwen CCG Annual General Meeting 2017/18 Programme Chair s Welcome Questions from Members of the Public Ratified Minutes of the 2017 AGM Review of the Year 2017/18 Financial Review Any Other Business Closing Remarks Speaker Mr Graham Burgess (Chair) Mr Graham Burgess (Chair) Mr Graham Burgess (Chair) Dr Penny Morris (Clinical Chief Officer) Mr Roger Parr (Chief Finance Officer) All Mr Graham Burgess (Chair)
NHS Blackburn with Darwen CCG Annual General Meeting 2017/18 Questions from the Members of the Public
Highlights of the Annual Report 2017/18 Dr Penny Morris Clinical Chief Officer
NHS Blackburn with Darwen CCG Population: 175,101 Budget: 252,849,000 Membership: 25 member practices Vision: To deliver effective, high quality, safe integrated care to improve health and wellbeing outcomes in Blackburn with Darwen
NHS Blackburn with Darwen CCG 26th most deprived CCG in the country Unprecedented demands on our primary care workforce Underfunding for our population (in 2017/18 our allocation was 2.08% below target or 4.6m less)
Mental Health Extended access to assessments and treatment for Improving Access to Psychological Therapies Supported the integration of mental health and primary care services Additional emotional support for people with long terms conditions such as Chronic Obstructive Pulmonary Disease
Mental Health Other areas of work include: Development of services to support women and families during the perinatal period Reducing the number of people in specialist mental health beds outside of Lancashire (out of area placements) Suicide prevention and intensive home treatment as an alternative
Learning Disabilities Work with partners to reduce reliance on in-patient care Worked with other CCGs in Lancashire to develop a Specialist Support Team service Worked with community teams to ensure specialist providers are able to provide safe, sustainable services with the least restrictive provision
Primary Care Placed Based approach to delivering services established 4 neighbourhood delivery model of care Health and social care working as integrated neighbourhood teams Improved 7 day extended access for patients for routine GP appointments at evenings and weekends
Primary Care Promoted prevention and early identification to improve flu vaccination uptake rates and cervical screening Joint working with local authority, councillors and community third sector to address issues with vaccinations in Muslim communities: Increase in uptake of nasal spray vaccine across all schools Reduction in paediatric emergency admissions related to respiratory conditions measured over a specific period
Integrated Care Reduce amount of time people spend avoidably in hospital, reducing delays in transfers of care and also inappropriate admissions Intensive Home Support Service has helped patients who were at risk of a hospital admission to stay and be cared for in their own home Embedded the Trusted Assessment process to reduce duplication, review service provision and support earlier discharge
Integrated Care Supported providers of health care to work together to provide the Home First Service. So they can: Go home with no additional care/minimal support needs e.g. take home and settle Go home with some support from rehabilitation teams Leave hospital into a community bed with intense nursing and/or social care.
Cancer Local GP and GP Cancer Lead for BwD and East Lancashire CCG Dr Neil Smith awarded GP of the Year Award 2017 by the Royal College of General Practitioners in the North West This is for his work in transforming cancer services in Pennine Lancashire through redesigning patient care In 2017 the cancer team were finalists in the National Transforming Care Awards for improving cancer outcomes.
Medicines Management Following public consultation, a Prescribing for Clinical Need policy has been adopted Continued to tackle prescription waste In association with the local authority, medicines awareness training has been provided to managers and carers working in residential, domicillary and children s services across the borough
Children and Adolescent Mental Health Re-design of services across Lancashire and South Cumbria has started This will help children and young people access the right care and treatment as soon as they need it BwD has a dedicated Primary Mental Health Worker to support children and young people with early intervention and clinical assessments
Children and Adolescent Mental Health The CCG has used the research undertaken by Healthwatch who sought the views and experiences of young people in Pennine Lancashire to help inform service re-design The findings, which included issues such as self-harm, mental health, LGBT issues, substance misuse, family problems and bullying will help the CCG in developing plans to help meet the needs of children and young people
Paediatrics Continued to monitor progress in implementing the reforms required through the Special Educational Needs and Disabilities work plans 0-25 Joint Commissioning Group established jointly with the Local Authority to support this A holistic asthma pathway has been developed for professionals which involves increased support for children in school Asthma Friendly School programme
Maternity Local maternity system plan is being developed to support the national ambition described in the Safer Maternity Care strategy The CCG is engaging with key partners to influence and share decision making around maternity and new born care
BwD CCG Impacts in 2017/18 Bucked national trends: Reduced GP referrals Reduced urgent demands on the acute system (particularly A&E attendances) Reduced paediatric emergency admissions relating to respiratory conditions Reduced prescribing costs by 1m despite significant in-year pressures
NHS Blackburn with Darwen CCG Improved our NHS England assurance rating from requires improvement to good due to achieving financial recovery Shortlisted for the Flu Fighters Award 2018 for the successful flu campaign Held a number of successful engagement events which were promoted widely on social media with posts reaching over 62,000 people and generating 107,000 responses
Annual Review of the CCG Constitution Review 2017/18 Included: Practice membership list updated References to BwD performers lists updated to reflect national performers list arrangements Amended the eligibility requirements of locum GPs for voting in and standing for election Requested removal of certain committee terms of reference from CCG Constitution and uploaded them to the CCG website
Any Questions?
Annual Accounts 2017/18 Mr Roger Parr Deputy Chief Executive/ Chief Finance Officer
BwD CCG Achieved each of its key Financial Duties in 2017-18 Statutory Duties Target Performance Achieved CCG to remain within 252,849k 249,217k Yes its revenue allocation CCG to remain within its running cost allocation 3,518k 3,385k Yes Better Payment Practice Code Target Number NHS Payables 95% 99.6% Non NHS Payables 95% 99.5%
Analysis of Income and Expenditure Funding 252,849k Commissioning Costs Staff Costs 848k Other Costs 245,446k Income ( 462k) Running Costs Staff Costs 1,605k Other Costs 1,780k Net Expenditure 249,217k Surplus 2017/18 (target 3,632k) 3,632k
Investments and Developments during 2017/18 Quality Improvement in Primary Care Better Care Fund Mental Health CAMHS Transformation Resilience
Expenditure per Head 249m equates to: 1,452 per head Acute Care 755 (52%) Primary Care 319 (22%) Community Based Care 102 (7%) Mental Health 116 (8%) Continuing Health Care 44(3%) Other 116 (8%)
QIPP - Past and Present QIPP Target Actual Gap % Delivered 2015 16 4,310,000 4,310,000 0 100.0% 2016 17 6,962,000 6,962,000 0 100.0% 2017 18 8,644,000 8,644,000 0 100.0% 2018 19 6,000,000 5,695,000 305,000 BwD CCG : QIPP Actual Gap 10,000,000 9,000,000 8,000,000 7,000,000 6,000,000 5,000,000 4,000,000 3,000,000 2,000,000 1,000,000 0 2015 16 2016 17 2017 18 2018 19
Financial achievement year on year 2013-14 2014-15 2015-16 2016-17 2017-18 Target Actual Variance 1,922,000 1,924,000 2,000 2,307,000 2,311,000 4,000 2,184,000 1,589,000-595,000 2,232,000 823,000-1,409,000 3,632,000 3,632,000 0
BwD CCG : GP Referrals Movement in 2017 18 BwD CCG : 5.2% England : 1.6%
BwD CCG : GP Referrals 4000 3000 2000 1000 0 1000 2000 3000 138 136 134 132 130 128 126 124 122 120 118 116 201304 201306 201308 201310 201312 201402 201404 201406 201408 201410 201412 201502 201504 201506 201508 201510 201512 201602 201604 201606 201608 201610 201612 201702 201704 201706 201708 GP Referrals 201710 201712 201802 GP Referrals per WDIM (Rolling 12) GP Referrals : BwD CCG Cumulative Variance to Previous GP Referrals Rolling 12 mongth GP refs per WDIM Movement in 2017 18 BwD CCG : 5.2% England : 1.6%
BwD CCG:Extended Primary Care Access 1800 91.3% 1600 76.6% 1400 1200 1000 800 600 400 200 0 100.0% 90.0% 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% Apr 16 May 16 Jun 16 Jul 16 Aug 16 Sep 16 Oct 16 Nov 16 Dec 16 Jan 17 Feb 17 Mar 17 Apr 17 May 17 Jun 17 Jul 17 Aug 17 Sep 17 Slots Oct 17 Nov 17 Dec 17 Jan 18 Feb 18 Mar 18 % Utilisation / % DNA BwD CCG : Primary Care Spokes Booked Unused Slot Utilisation (booked)
BwD CCG : CCG:Accident and Emergency Attendances Movement in 2017 18 BwD CCG : 2.5% England : +2.4% Reductions in A&E Attendances
BwD CCG:Non-Elective (Emergency) Admissions Movement in 2017 18 : BwD CCG : +7.4% England : +7.4% Movement in 2017 18: BwD CCG : +0.4% England : +1.8%
BwD CCG : Non-Elective Bed Days Movement in 2017 18 BwD CCG : 1.6% England : +0.6% Reductions in Bed Days
ELHT : Delayed Transfers of Care 2500 2000 1500 1000 500 0 201304 201306 201308 201310 201312 201402 201404 201406 201408 201410 201412 201502 201504 201506 201508 201510 201512 201602 201604 201606 201608 201610 201612 201702 201704 201706 201708 201710 201712 DTOC Bed Days 201802 201804 Delayed Transfers of Care (DTOC) Bed Days [ EAST LANCASHIRE HOSPITALS NHS TRUST (All) ] NHS Bed Days Social Care Bed Days Both Bed Days Reductions in Delayed Transfers of Care (DTOC) Bed Days
BwD CCG : Prescribing Cost Trends 3000000 2500000 2000000 1500000 1000000 500000 0 500000 1000000 1500000 201404 201406 201408 201410 201412 201502 201504 201506 201508 201510 201512 201602 201604 201606 201608 201610 201612 201702 201704 201706 201708 201710 201712 201802 201804 201806 201808 201810 201812 201902 Blackburn with Darwen CCG Prescribing Cumulative variance to previous Year Actual Cost Budget Profile -Key decisions Medicines Waste scheme started Reductions in overall prescribing costs Over The Counter Gluten Free Policy -> 1m Saving in 2017-18
8.0% 6.0% 4.0% 2.0% 0.0% 2.0% 4.0% 6.0% 8.0% 2013/2014 1st Quarter 2013/2014 2nd Quarter 2013/2014 3rd Quarter 2013/2014 4th Quarter 2014/2015 1st Quarter 2014/2015 2nd Quarter 2014/2015 3rd Quarter 2014/2015 4th Quarter 2015/2016 1st Quarter 2015/2016 2nd Quarter 2015/2016 3rd Quarter 2015/2016 4th Quarter 2016/2017 1st Quarter 2016/2017 2nd Quarter 2016/2017 3rd Quarter 2016/2017 4th Quarter 2017/2018 1st Quarter 2017/2018 2nd Quarter 2017/2018 3rd Quarter 2017/2018 4th Quarter BwD CCG: Prescribing Cost Trends Compared to National Average % Cost Variance to Previous Year (Cumulative) Local position bucking national trends England BwD CCG BwD CCG Continues to show greater proportional reductions in prescribing costs than the national average. 1718 vs 1617 BwD = 3.9% National = 0.9% Gap compared to National
What we will spend in 2018/19 Programme Allocation Running Cost Allocation Primary Care Cocommissioning Total Allocation 2018/19 229,790k 3,507k 24,176k 257,473k In 2018/19 BWD CCG received an allocation increase of 2.84% but remains 2.86% away from its target allocation. ( 6,539k)
Investments and Developments 2018/19 Primary Care Mental Health Five Year Forward View Continuing Health Care and Learning Disabilities CAMHS Transformation Better Care Fund End of Life training for clinical staff
Any Questions?
Close Mr Graham Burgess - Chair