2015/16 Annual General Meeting Welcome – Dr Hari Pathmanathan tweet #ENHCCGAGM follow us @enhertsccg
Financially Healthy? 2015/16 Finance Report Alan Pond Chief Finance Officer
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
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
ENHCCG’s 2015/16 financial challenge £12m Efficiency Savings (QIPP) • Funding growth • Tariff reductions • Underspend brought forward • 1% underspend • Increased demand • Inflation • Investment in quality/outcomes
How did we do on Statutory Duties? Expenditure does not exceed sums allotted to the CCG ACHIEVED £7,775,000 underspent plus other income received [223H(1)] Capital resource does not exceed the amount specified ACHIEVED in Directions [223I(2)] £32,000 underspent Revenue resource use does not exceed the amount ACHIEVED specified in Directions [223I(3)] £7,743,000 underspent not applicable; no specified Capital resource on specified matter(s) does not exceed the amount specified in Directions [223J(1)] matters in 2015/16 not applicable; no specified Revenue resource on specified matter(s) does not exceed the amount specified in Directions [223J(2)] matters in 2015/16 Revenue administration resource use does not exceed ACHIEVED the amount specified in Directions [223J(3)] £2,494,000 underspent Not to spend more cash than allocated ACHIEVED Cash underspent by 0.4% To achieve value for money in use of resources [14Q] ACHIEVED unqualified audit opinion To produce annual accounts and annual report [14Z15] ACHIEVED draft delivered on time To keep appropriate accounting records ACHIEVED unqualified audit opinion
By budget heading? Annual YTD YTD Description budget Actual Variance £000 £000 £000 Allocation 683,077 683,077 0 Acute Commissioning 374,999 381,452 (6,453) Non Acute Commissioning 176,060 179,302 (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 5,458 853 Recurrent investment fund 2,546 - 2,546 Resilience funding 4,061 3,637 424 Contingency reserve 3,358 - 3,358 675,334 675,334 (0) Expenditure TOTAL UNDER / (OVER) SPEND 7,743 7,743 0
How did localities do? Budget Actual Variance Variance Description £000 £000 £000 % Allocation 683,077 683,077 - - North Herts 127,228 126,892 336 0.3 % Lower Lea Valley 85,887 85,868 20 0.0 % Stevenage 103,593 104,664 (1,071) (1.0%) Welhat 121,601 120,283 1,317 1.1 % Upper Lea Valley 124,985 124,543 442 0.4 % Stort Valley & Villages 60,105 60,044 60 0.1 % Reserves & Unattributable 51,935 53,039 (1,104) (2.1%) 675,334 675,334 - - Expenditure TOTAL UNDER / (OVER) SPEND - - 7,743 7,743
Where did we spend our money?
Changes in spending
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
Funding gap 2016/17 to 2020/21 £92m
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
Thank you
Beverley Flowers Chief Executive’s overview
Care at home – the rapid response service
‘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
Improving stroke services Recognise Get to a Have rapid Ensure a Review patients’ and act on specialist access to joined-up progress to symptoms stroke specialist approach to identify any needs immediately centre stroke patient- which haven’t quickly assessments centred been met and treatment rehabilitation
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.
What our patients say … About our hyper acute stroke services – on a Sunday in February 2016. “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.”
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 r eviews and self management opportunities • better understand and meet the needs of families and carers of people who have had strokes
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
Kooth: Online counselling for young people • Free online support for children and young people aged 10-25 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.”
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
Monthly Type of average Time period service patient numbers April – A&E at the 1837 September former QEII 14 Urgent Care 1482 Centre based October 14 – at the former May 15 QEII Urgent Care 3176 June 2015 – Centre based Nov 15 in New QEII Hospital Urgent Care 3360 Dec 2015 – Centre in New QEII April 16
“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;)
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
Your questions and feedback ?
Hertfordshire and West Essex Towards a healthier future Jacqui Bunce – Associate Director
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