Welcome to The Swindon Clinical Commissioning Group Annual General Meeting Agenda 09.30 Welcome 09.35 Presentation of the Annual Report 2016/17 Highlights of 2016/17 Presentation of the CCG Final Accounts Questions from Members of the Public 10.00 Accountable Care Organisation Presentation of the Swindon vision for an Accountable Care System Opportunity for discussion
Who we are Swindon CCG 25 GP practices Serving a population of over 230,000 residents in Swindon and Shrivenham The services we are responsible for include: Urgent and emergency care Planned hospital care Mental health services Community health services Rehabilitation for those recovering from illness and operations Maternity and newborn services Continuing healthcare for people with ongong health needs Primary Care GP Services
Challenges throughout 2016/17 Death of our previous Clinical Chair, Dr Peter Crouch Retirement of a Senior Director Closure of Community Services Provider, SEQOL GP shortages Challenging financial position Four hour waits in A&E Delayed discharges of care Achieving a maximum wait of 18 weeks for planned treatment Dr Peter Crouch
Highlights of 2016/17 Transfer of community services to Great Western Hospitals NHS Foundation Trust Launch of the Prescription Ordering Direct Service Continuing Health Care Completion of Swindon NHS Health Centre Children s Services review Diabetes Transformation Programme
Quality We put quality at the heart of everything we do and we want to ensure that we commission safe, effective services which provide our patients with the best possible experience of the NHS We work with our providers of care to ensure that patients, their families and carers are treated with compassion, respect and dignity, in a safe environment and protected from harm Effective Service Safe Service High Quality Services Good experience of our services
Patient Safety Continued reduction in usage of high risk antibiotics Clostridium difficile 48 reported Pressure ulcers 13 reported 44 serious incidents reported in 2016/17 compared to 96 in 2015/16 MRSA 2 reported Diagnostics / Treatment 9 reported Self inflicted harm/ unexpected death 9 reported Swindon CCG Serious Incident Panel ensures quality improvements are implemented to prevent reoccurence
Public and Patient Involvement We are committed to ensuring we involve patients, carers and the public in everything we do to improve healthcare in Swindon and Shrivenham In 2016/17 we undertook several pieces of work which resulted in direct and indirect improvements to work programmes including Changes to IVF policy Stay Well This Winter campaign Swindon Wound Improvement Project Falls and Bones Health Collaborative
NHS Five Year Plan Sustainability and Transformation Footprints Regions across England have come together to form footprints 44 footprints in total Includes all health and social care organisations Wiltshire, Bath and North East Somerset and Swindon
Sustainability Transformation Partnership Why the need to change? Increasing pressures on health and care systems Proportion of older people continues to rise More people living with complex long term conditions No increase in funding and resources so gap between forecast cost and forecast resources is growing Some of the issues are bigger than individual organisations can solve on their own
B&NES, Swindon & Wiltshire STP - Priority Areas Primary Care Supporting transformation of Primary Care Delivery of GPFV Urgent Care Integrated Urgent Care Service Increasing use of ambulatory care Planned Care Reducing Variation Managing growth Community based services Preventative Care Diabetes Care Staff Health & Wellbeing Flu Vaccinations
Priority Areas Workforce - Address skills gaps - Encourage diverse career pathways across organisations - Shared training / passport Digital - Improve interoperability between different IT systems - Share our learning on paperless systems Estates - Mapping of all estate across the footprint - Review of utilisation - Assess options to share space
How we spent your money Prescribing GWH NHS FT AWP Oxford Health SBC Oxford UH NHS FT SWASFT We spent a total of 265m Our largest spend of 137m is with Great Western Hospitals NHS Foundation Trust GWH NHS FT Glos NHS FT Private The CCGs running costs were 5m SBC AWP Hospices Other acute Transport Prescribing There is a full breakdown of costs in our Annual Report and Accounts 2016/17 (available on our website)
Financial performance targets We planned to achieve a surplus of 5,244k. The actual surplus achieved for the year was 5,227k. CCGs have a number of financial duties under the NHS Act 2006 (as amended). Performance against those duties were: We kept within our revenue resource limit of 265,168k by drawing down 260,015k. We kept within our capital resource limit of 57k by making acquisitions totalling 57k. We underspent on our running costs allocation of 4,999k by spending 4,925k.
Quality, Innovation, Productivity and Prevention (QIPP) Priorities QIPP stands for quality, innovation, productivity and prevention. Final reporting position 81% 10.7m against a target of 12.9m It is a large scale programme implemented to transform the NHS through quality care improvement. In short, it aims to deliver better value for money from the services we commission Key programmes were focussed around: Development of Prescription Ordering Direct (POD) service Focus on Continuing Health to strengthen policies and address backlog of reviews Delivering efficiencies from back office functions and use of discretionary spend Reviewing out of county mental health placements
Presentation of the Annual Report and Account The Annual Report and Accounts for 2016/17 are hereby presented and were approved by our Governing Body on 22 June 2017 Full copies are available on our website or the Summary Annual Report is available for you to take away
Developing Accountable Care in Swindon
What is Accountable Care? The end goal is to create a health and social care system that works in unity to support people of all ages and from all backgrounds to live healthy, independent lives. Each organisation providing care to the local community will pool resources to support the joint commissioning and delivery of health and social care for everyone.
Context in Swindon Rising demand for Same Day / Urgent care services Demand for inpatient care exceeding supply Care Homes feel unsupported- easier to dial 999/ request admission Social care demand exceeding budgets Difficulty in recruiting GPs- impact on sustainability and resilience of practices Limited clinical linkages between primary and secondary care Population and demand rising faster than resources Significant areas of new housing developments within the town and the New Eastern Villages
Overseeing implementation through an Alliance Board Alliance Board is formed comprising membership from across the local health and social care system, including the CCG, GWH and SBC. Membership covers a range of disciplines clinical, quality, finance, workforce, IT, governance, public health, social care, mental health. Feeding through to the Alliance Board will be a number of smaller project groups tasked with delivering specific aspects of the overall project. A shared narrative for all system leaders which focusses on the Team Swindon concept rather than the theory of accountable care will be important moving forward.
Agreed work streams High Intensive: Long Term Conditions Health and Wellbeing Same Day Urgent Care Three Key Priorities: Define when patients would move from Chronic Disease Management to High Intensive Care Pilot outreach clinics for disease area Develop multi-disciplinary hubs to manage some chronic disease management patients Three Key Priorities: Prevention of diabetes Establish Wellbeing hubs Joint working with GWH and Making Every Contact Count Prevention of falls roll out of Falls Strategy Three Key Priorities: Review of Home to Assess Model Urgent Treatment Centres same day access, self care 7 day access to primary care direct access, care home ward rounds, retain GP/Pt relationships
Benefits to patients Closer working means patients won t have to repeat their story Improved access to same day services Hospitals freed up for those that really need its services Increased amount of care for chronic disease delivered locally, with increased continuity of practitioner Doctors and nurses will have more time for patients, to fully understand their care needs Support for local communities to help them selves and get involved in priority setting and service development A sustainable way of providing care More systematic and structured approach to Chronic Disease Management Better coordinated transfers of care ie. hospital to community or home
What s in it for staff? An improved work/life balance The are no organisational boundaries - organisations talk / not them and us Coordinated systems and IT - sharing medical records Focus on outcomes not who has the funding putting the power and funding together Workforce addressing where cultural barriers exist and boosting consistency in decision making i.e. where patients are directed There is a single point of contact for patients staff feel this is reducing confusion and is easier to navigate people round the system One care plan for patients Trusted to do their job and trust others to do theirs Making every contact count is embedded into everything staff do
Our discussions with you today We will work with patients and the public to identify innovative, effective and efficient ways of designing, delivering and joining up services. We want to know what is important to you as we begin to re-shape healthcare in Swindon.
Tell us what you think High Intensive: Long Term Conditions Health and Wellbeing Same Day Urgent Care The Person : What is important to you?
Contact Us 01793 683700 communications@swindonccg.nhs.uk @swindonccg NHS Swindon CCG