AGENDA ITEM NO: 024/18 GOVERNING BODY MEETING: Governing Body - - PDF document

AGENDA ITEM NO: 024/18

Performance Report NHS Warrington CCG Governing Body Meeting 9th May 2018 GOVERNING BODY MEETING: Governing Body Meeting DATE OF MEETING: 9th May 2018 REPORT AUTHOR AND JOB TITLE: Pam Broadhead Chief Performance Officer REPORT TITLE: 2017/18 summary presentation regarding the Improvement and Assessment Framework STRATEGIC OBJECTIVES: Please tick which strategic objectives the paper relates to Improve quality of services  Sustained financial balance Build an effective and motivated whole system workforce Sound governance arrangements  Ensure integration and joint working arrangements OUTCOME REQUIRED (tick) Approval Assurance  Discussion  Information  EXECUTIVE SUMMARY This presentation provides an overview of the key successes and challenges related to the Improvement and Assessment Framework (IAF) for NHS Warrington CCG. This was presented to NHS England to summarise the 2017/18 year-end position, approach to improvement and plans for the future. RECOMMENDATIONS Report for information and assurance only Outline any engagement – staff, clinical, stakeholder and patient / public Not applicable Are there any conflicts of interest which may be associated with this paper? None known Does this paper address any existing risks which are included on the A1 - Failure to performance manage to ensure continuous improvement

AGENDA ITEM NO: 024/18

Performance Report NHS Warrington CCG Governing Body Meeting 9th May 2018 Assurance Framework or Risk Register? A2- Failure to agree and measure outcomes Have the following areas been considered whilst producing this report? Yes N/A Equality Impact Assessment (if yes, attach to paper)  Quality Impact Assessment (if yes, attach to paper)  Regulation, legal, governance and assurance implications (reference in the report if applicable)  Procurement process (reference in the report if applicable)  Document development Has this document been presented to any other Committee or Forum? If yes, please list which meeting, date and outcome of presentation Yes – NHS England Year End, Improvement & Assessment Framework Meeting, Thursday 3rd May 2018.

AGENDA ITEM NO: 024/18

Performance Report NHS Warrington CCG Governing Body Meeting 9th May 2018 Strategic Objectives and Risks 2018/19 A1 Failure to performance manage to ensure continuous improvement A2 Failure to agree and measure outcomes A3 Failure to ensure clear arrangements are in place for quality management of non- commissioned providers in the independent sector B1 Failure to implement the financial strategy B2 Failure to ensure sound business practices are at the heart of running the CCG B3 Failure to secure best value B4 Failure to adequately provide for external factors, which impact on financial sustainability C1 Failure to continuously develop the organisational culture that meets the needs of the changing needs of the workforce C2 Failure of delivery by outsourced critical business functions C3 Failure to establish primary care capacity D1 Failure to ensure that we are compliant with our statutory duties D2 Failure to demonstrate patient and public engagement E1 Failure to provide appropriate reporting, for joint working arrangements E2 Failure to describe benefit of integration and joint working arrangements to local people

Improvement & Assessment Framework

2017/2018 Year End Review

Approach to Improvement

Governance (Committees & Governing Body) Monitoring & Contractual Mechanisms Actions & Risks Ownership

• Personal Health Budgets – 200 in place at end

17/18 against a plan of 130

• Continuing Health Care – consistently less than 15%
• f full CHC assessments taking place in acute setting
• One-year cancer survival – one of the 20 CCGs with

most improved survival rates

• Primary Care – overall experience of primary care

increased from 82% to 86% from 2016 to 2017

• surveys. 100% of registered population offered full

extended access

• IAPT Recovery and Access – annualised position

from quarter four local data shows both recovery and access above national standards

• Prescribing – antibiotic prescribing consistently below

requirement and also dropped below England median in 2017/18.

• Cancer 62 day – performance consistently below

85% from July 2016 to Sept 2017. Subsequent to this, four out of five months have been achieved.

Key Successes

• Cancer patient experience - 8.6 / 10

(decreased from 8.7 in 2016)

• Early cancer diagnosis – 47.8% in 2016

(decreased from 51% in 2015)

• Dementia care planning and post-

diagnostic support - 77% (decreased from 78% in 2015/16)

• A&E admission, transfer or discharge

within 4 hours - February 2018 80.5% v 90% STP trajectory

• Population use of hospital beds following

emergency admission - National rate 571.8 in Q2 17/18 (decrease from the 2 preceding quarters but remains in the lowest quartile)

Challenges – Better Care

• Diabetes education attendance - 0.5% of

patients diagnosed in 2015 were recorded as attending a structured education programme

• Injuries from falls in people aged 65+ -

National rate of admissions for falls per 100,000 Q2 17/18 = 2,967 (decrease from 3,059 in Q1)

• Inequality in emergency admission for

ACS and UCS conditions (links also to Better Care admissions for UCS) - Ranked 189/207 for the inequality measure. Data suggests that the UCS conditions are the main challenge. The ranking of emergency admissions for UCS is 191/207.

Challenges – Better Health

• 2017/18 Year-end Position - £0.4 million above

break-even

• 2018/19 Finance Plans, Key Risks and Issues
• Plan for in-year break-even
• Key risks & issues:
• Activity based performance
• Growth above planned levels
• In-year national risks

Sustainability

• Leadership capability & capacity
• Organisational Development Programme
• Interim integrated Management Team
• Quality
• Quality Surveillance Group member
• Contractual levers utilised
• Patient voice
• Governance
• Statutory Duties and Powers reviewed
• Assurance Framework in place
• Conflict of Interest managed in line with national

guidance

• Leadership through transformation
• CCG Clinical Chief Officer is the Place Based Lead

and a member of the Integrated Care System Partnership Board (Warrington Together)

• CCG is an active member of the Warrington

Together Senior Change Team and the Enabler Group work streams

• CCG engages and leads on work across Cheshire

& Mersey Health Partnership

Leadership

Overall engagement Clear leadership Confidence in leadership to deliver plans and priorities Involving the right individuals and

• rganisations when

commissioning/ decommissioning services Effectiveness as system leader Confidence in leadership to deliver outcomes Confidence that CCG will act on feedback Have opportunity to have a say / influence plans and priorities Effective communication of plans 360° Survey - Comparisons

2018/19 Actions for Improvement

Focus on Engagement Support Evaluation Ownership

360° Survey

• Working with our partners ensuring services are of the

highest quality

• Continued Improvement in performance indicators

from CCG Summary Dashboard

• Specified requirements for a hospital of the future at

the heart of an integrated care system in Warrington

• Maintaining NHS England Business Rules and

breaking out of an Annual Recovery Cycle

• Commissioning services from Warrington Together

progressing towards Alliance Contracting

• Improved relationships with Member Practices

Where we want to be…