Annual General Meeting 11 September 2018 Welcome Dr Naz Jivani - - PowerPoint PPT Presentation

Annual General Meeting

11 September 2018

Dr Naz Jivani Chair, Kingston CCG Welcome

Housekeeping

Agenda

1pm Introductions and Kingston background Dr Naz Jivani, Chair, Kingston CCG 1.05pm – 1.15pm Finances and annual accounts for 2017/18 Yarlini Roberts, Director of Finance, Kingston and Richmond CCGs 1.15pm – 1.40pm Review of the year and future plans Dr Naz Jivani, Chair, Kingston CCG and Sarah Blow, Accountable Officer, Kingston CCG (part of the NHS South West London Alliance) 1.40pm – 1.50pm Children in Care Council Vicky Fraser, Designated Nurse for Children Looked After, Kingston and Richmond CCGs 1.50pm – 2pm Kingston’s Health and Care Plan Tonia Michaelides, Managing Director, Kingston and Richmond CCGs 2pm – 2.30pm Question & answer session 2.30pm Close

Dr Naz Jivani Chair, Kingston CCG Panel introductions

Our community – Kingston

Population

21 £255m 209,500 31% 176,000

The Kingston story

The population of Kingston is healthy with the life expectancy for both females and males above the national average (81.7years for men / 84.9 years for women) People living in more deprived areas of Kingston have a lower life expectancy. Ageing population - and with this comes the challenge of caring for increased numbers of people with ill-health and multiple long-term conditions. We are also seeing growth in the number of children and young people who live and study in the borough.

Finance and annual accounts 2017/18 Yarlini Roberts Director of Finance Richmond and Kingston CCGs

Financial targets

Maintain financial stability through not exceeding our budget Use the CCG’s resources wisely to meet the health needs of Kingston and to ensure value for money and fair and effective use

• f resources

Stay within running cost allocation of £21.90/ head of population (£4.286m)

  

Kingston CCG’s accounts and report were submitted on time with an unqualified audit opinion.

How much do we spend and what do we spend it on?

£255m in 2017/18 for a population of just over 200,000 people registered with GPs in Kingston.

52% 9% 7% 8% 8% 12% 2% 2%

Kingston CCG Expenditure in 2017/18

Acute Hospitals Mental Health and Learning Disabilities Continuing Healthcare Community Services Prescribing Primary Care Other, including Social Care funding

Running costs – the cost of running the CCG

• Running costs target for the CCG in 2017/18 was £21.90 per head of

population which equates to £4.286m for Kingston CCG.

• Expenditure for the year was £4.266m representing an underspend of £20k.

This was primarily met by controls on expenditure on project and agency workers.

• Realignment of budgets has been implemented following the new working

arrangements with Richmond CCG.

Running Costs Allocation Actual Variance Running costs allocation (£000's) £4,286 £4,266 £20 ONS* resident population (000s) 195.5 195.5

• Running costs per head of population £

£21.9 £21.8 £0.1

Finance summary

As a CCG we faced many challenges in 2017/18. Large increases in demand for hospital services and children’s placements led to substantial financial pressures on the CCG. The CCG has managed these cost pressures and met all key financial targets during 2017/18. 2018/19 is a very challenging year and the CCG has submitted a financial plan which achieves the required surplus of 0.4%. Despite these challenges, the CCG has delivered a strong financial performance. Robust financial governance will be crucial going forward

Dr Naz Jivani Chair, Kingston CCG Performance summary 2017-18

Performance

• Kingston CCG was rated as ‘good’ in NHS England’s end of year

Improvement and Assessment Framework.

• For 2017/18, Kingston CCG achieved these ratings against the following

clinical priorities: Cancer Outstanding Maternity Outstanding Mental Health Good Dementia Requires improvement Diabetes Requires improvement

Performance against other NHS targets

• Cancer waiting time targets were met with the exception of the 62 day 1st treatment target for those

referred through a screening service, and the 31 day subsequent treatment target for radiotherapy.

• Referral to treatment – the national 18 weeks waiting time target was met. In addition, 99.1% of

people were seen within 6 weeks for diagnostic tests against the 99% standard.

• Accident & emergency performance at Kingston Hospital - just over 90% of patients were seen

against the national standard (target is 95%)

• Improving access to phycological therapies (IAPT). The access and recovery targets

were achieved for quarter 4 of the year, and the IAPT waiting times targets for access to psychological therapies were met for the whole of 2017-18.

• The Friends and Family Test surveys show excellent outcomes reported for inpatient,
• utpatient, community care, A&E and maternity services.

Key areas for improvement

Kingston CCG will continue to work with Kingston Hospital and around the whole health and social care system to recover the A&E 95% target of arrival to admission, transfer or discharge. The proportion of people diagnosed with dementia is not at expected levels, despite a great deal of work with clinical reviewers and practices. The CCG has seconded a dementia nurse specialist from South West London and St George’s Mental Health Trust to support practices in identifying people requiring referral to the memory assessment service. We will support the mental health provider to increase the proportions of people with long term health conditions, older people and people from black and minority ethnic communities accessing psychological therapies in line with best practice. We will work to increase the numbers of people with newly diagnosed diabetes who receive support through structured education services – to help them manage their condition.

Summary of achievements 2017-18

Sarah Blow, Accountable Officer for Kingston CCG (part of the NHS South West London Alliance)

Primary care and social prescribing

Primary care

• Extended access to GP appointments 8am to 8pm
• New referral management processes giving GPs quick access to expert advice
• 1,349 improved referral outcomes
• NHS switch over to paperless referrals from 1 October 2018

Social prescribing

• Connected Kingston - social prescribing project
• Trained ‘connected Kingston champions’ and introduced an online

referral tool

Changes to prescriptions

Engaged with our local communities on prescription items including gluten free foods, baby milk and IVF treatment In September 2017, we recommended no longer supporting routine prescriptions of gluten-free foods, vitamin D for maintenance and medicines readily available over the counter

Natural sources of vitamin D

Children and young people’s mental health and wellbeing

Guided by the views of children and young people Our plans were jointly agreed with the Health and Wellbeing Board Increased access to services, reduced waiting times for treatment and access to crisis counselling in child and adolescent mental health services. Priorities for 2018-20:

• access to face to face and online counselling
• shortening waiting times for a specialist neurodevelopmental assessment

for ADHD and / or ASD through developing a local pathway

Adult mental health services

• Working to introduce a single point of access
• Re-modelled the service for adults with attention deficit hyperactivity disorder
• Commissioned a new primary care based personality disorder service
• Reviewed the Retreat crisis house

Police: “The Retreat process was great. I made an initial phone call at the scene to see if they had space. On arrival at the Retreat they invited us in and after a quick handover staff were happy for us to leave.”

Improving care for people with musculoskeletal conditions

Reviewed the current provision of care for MSK conditions which account for up to 30% of GP consultations Expanded a single point of triage for patients to improve the overall quality of care Triage through e-referral by a team of MSK specialist practitioners and physiotherapists All routine GP referrals are assessed within 48 hours

South West London Health and Care Partnership

In November 2017, we published The South West London Health and Care Partnership: One year on for discussion Commitment to champion children and young people’s mental health and wellbeing Developing Kingston’s Health and Care Plan to be published in March 2019 NHS, local councils and the voluntary sector in south west London strengthening our commitment to work together to deliver better care for local people

South West London CCGs

Committees in Common agreeing collective decisions including funding for the transformation of primary care for 2018/19 £4.58 million NHS England funding for this implementation providing 18,000 extra appointments each month Cancer care to improve cancer care for local people by focusing on: Early and timely diagnosis and treatment Improving uptake of bowel screening Increasing screening uptake for people with learning disabilities Collective approach to staying well this winter to increase flu vaccine uptake and reduce pressure on A&E across south west London as a whole

Future plans

1. Integrate health and social care 2. Improve mental health support for people to remain independent 3. Improve access for children and young people to mental health services 4. Transform outpatient hospital services 5. Support extended GP services for local people 6. Continue to develop closer working with Richmond CCG and south west London CCGs

• 7. Focus on clinical quality and clinical leadership

Children in Care Council

Vicky Fraser Designated Nurse for Children Looked After Kingston and Richmond CCGs

Health needs of children in care

CCGs work with Achieving for Children to support the Children in Care Council Specific health needs Most children become looked after as a result of abuse and neglect. Although they have many of the same health issues as their peers, the extent of these is often greater because

• f their past experiences.

Almost half of children in care have a diagnosable mental health disorder and two-thirds have special educational needs. Delays in identifying and meeting emotional wellbeing and mental health needs can have far reaching effects on all aspects of their lives, including their chances of reaching their potential and leading happy and healthy lives.

• Children in Care Council: weekly meetings / action plan / residential

activities / member of corporate parenting group

• Last year the young people decided that they wanted to do a project to

increase their understanding of mental health – to support their peers with their mental health needs Young Health Champions

• This award recognises outstanding achievement in terms of raising

awareness of a health issue amongst their peers and making an impact on their community’s health and wellbeing.

Young health champions

Art project

Mental health improvement project The young people wanted to create a piece of art work to use as a prompt to

• pen up the conversation around mental health with their peers

For use at meetings and events across the borough – display at local gallery

A Health and Care Plan for Kingston

Tonia Michaelides Managing Director, Kingston and Richmond CCGs

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• The Health and Care Plan for Kingston will focus on where

working together with partners across health, social care and the voluntary sector will have maximum impact for local people

• It will be a two year plan for 2019/20 and 2020/21
• It will be informed by the joint strategic needs assessment

(JSNA), health and wellbeing board priorities and current plans & programmes of work

• It will also be informed by insight from engagement across

Kingston and south west London over the last two years

Kingston’s Health and Care Plan

• The partners involved are seeking to agree a few priority

ambitions/actions in each of the areas of: Start Well, Live Well and Age Well

• The plan will be jointly owned by the local NHS, Kingston Council,

Healthwatch and the local voluntary sector

• The plan will be overseen by Kingston’s Health and Wellbeing Board

Milestones 2018-19

Discussions & engagement June – September 2018 Case for Improvement and priority setting with stakeholders September – November 2018

Publication March 2019

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Implementation planning and outcome measures December 18 – March 2019

Questions and answers

Panel members

• Dr Naz Jivani, Chair, Kingston CCG
• Yarlini Roberts, Director of Finance, Kingston and

Richmond CCGs

• Sarah Blow, Accountable Officer for Kingston CCG

(part of the NHS South West London Alliance)

• Tonia Michaelides, Managing Director of Kingston and

Richmond CCGs