ANNUAL GENERAL MEETING 26TH SEPTEMBER 2018 #BwDCCGAGM Welcome to - - PowerPoint PPT Presentation

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 Speaker Chair’s Welcome Mr Graham Burgess (Chair) Questions from Members of the Public Mr Graham Burgess (Chair) Ratified Minutes of the 2017 AGM Mr Graham Burgess (Chair) Review of the Year 2017/18 Dr Penny Morris (Clinical Chief Officer) Financial Review Mr Roger Parr (Chief Finance Officer) Any Other Business All Closing Remarks 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

• n
• ur

primary care workforce

• Underfunding

for

• ur

population (in 2017/18

• ur

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
• f

services to support women and families during the perinatal period

• Reducing the number of people in specialist mental

health beds

• utside
• f

Lancashire (out

• f

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

• 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

Primary 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 .

Integrated 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

• Re-design
• f

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

Children and Adolescent Mental Health

• 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

Paediatrics

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

• ver 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

Statutory Duties Target Performance Achieved CCG to remain within its revenue allocation £252,849k £249,217k Yes CCG to remain within its running cost allocation £3,518k £3,385k Yes

BwD CCG Achieved each of its key Financial Duties in 2017-18

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 £1,452 per head

Acute Care £755 (52%) Primary Care £319 (22%) Community Based Care £102 (7%) Mental Health £116 (8%) Other £116 (8%) Continuing Health Care £44(3%)

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

£0 £1,000,000 £2,000,000 £3,000,000 £4,000,000 £5,000,000 £6,000,000 £7,000,000 £8,000,000 £9,000,000 £10,000,000 2015‐16 2016‐17 2017‐18 2018‐19

BwD CCG : QIPP

Actual Gap

Financial achievement year

• n year

Target Actual Variance 2013-14 £1,922,000 £1,924,000 £2,000 2014-15 £2,307,000 £2,311,000 £4,000 2015-16 £2,184,000 £1,589,000

• £595,000

2016-17 £2,232,000 £823,000

• £1,409,000

2017-18 £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

116 118 120 122 124 126 128 130 132 134 136 138 ‐3000 ‐2000 ‐1000 1000 2000 3000 4000 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 201802 GP Referrals per WDIM (Rolling 12) GP Referrals

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

76.6% 91.3% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0% 100.0% 200 400 600 800 1000 1200 1400 1600 1800 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 Oct‐17 Nov‐17 Dec‐17 Jan‐18 Feb‐18 Mar‐18 % Utilisation / % DNA Slots

BwD CCG : Primary Care Spokes

Booked Unused Slot Utilisation (booked)

BwD CCG : CCG:Accident and Emergency Attendances

Reductions in A&E Attendances

Movement in 2017‐18 BwD CCG : ‐2.5% England : +2.4%

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

Reductions in Bed Days

Movement in 2017‐18 BwD CCG : ‐1.6% England : +0.6%

ELHT : Delayed Transfers of Care

500 1000 1500 2000 2500 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 201802 201804 DTOC Bed Days

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

‐1500000 ‐1000000 ‐500000 500000 1000000 1500000 2000000 2500000 3000000 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

Medicines Waste scheme started Gluten Free Policy Over The Counter

• Key decisions

Reductions in overall prescribing costs

• >£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

% Cost Variance to Previous Year (Cumulative)

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

Local position bucking national trends

BwD CCG: Prescribing Cost Trends Compared to National Average

What we will spend in 2018/19

In 2018/19 BWD CCG received an allocation increase of 2.84% but remains 2.86% away from its target allocation. (£6,539k) 2018/19 Programme Allocation £229,790k Running Cost Allocation £3,507k Primary Care Co- commissioning £24,176k Total Allocation £257,473k

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