Hounslow CCG Annual General Meeting 2019/20 Thank you for joining us. The meeting will begin at 12.30pm . 1
Welcome to Hounslow CCG AGM TIPS: Questions can be posted in the MS Teams question and answer section and will be responded to towards the end of the presentation. 2
Welcome to Hounslow CCGs AGM Today’s agenda: Jo Ohlson, Accountable Officer Welcome and AGM Annabel Crowe, CCG Chair NW London plan 2019/20: Jo Ohlson - Changing the way we work a single CCG for NW London - Our five year plan - Covid19 Jenny Greenshields, Chief Finance Officer – Finance NWL CCGs Diane Jones, Chief nurse/Director of Quality Quality NWL CCGs Jo Ohlson, Jenny Greenshields, Diane Jones Questions Annabel Crowe Achievements 2019/20 Local Covid-19 update Dilo Lalande/Judith George, CCG Engagement Patient Engagement Annabel Crowe Questions Annabel Crowe AOB 3
NW London plans 19/20 Jo Ohlson Accountable Officer North West London Collaboration of CCG’s
In 19/20 we started working towards our vision for NW London: Our vision for NW London Integrated Care System (ICS) is to reduce inequalities and achieve health outcomes on a par with the best global cities. Care will be integrated within a single system, focused on the needs of the individual and unhindered by organisational boundaries. We will combine our collective resources, clinical expertise and local knowledge to build a fair, effective and accessible health service for all. This meant that key focuses for the year were: • The development of our five year (Long Term Plan) • Working towards a single CCG and building relationships as part of our Integrated Care Partnership and local borough partnerships • The Covid19 pandemic changed accelerated our focus and joint working. 5
Our five year plan • In 19/20 we developed a five year strategic plan with our partners, public and stakeholders. • This plan was developed to meet the new national requirements set out in the NHS Long T erm Plan, to improve the quality of patient care and health outcomes, while focusing on building an NHS fit for the future. • It also focuses on reducing local health inequalities and variation in services across NW London. • T o deliver our ambitions set out in the plan, throughout 19/20, we have focussed on seven interconnected areas: 6
Clinical and care strategy In conjunction with our five year plan we have also developed our clinical and care strategy. Setting out our expectations of care – as professionals, as stakeholder organisations accountable to our communities, and as patients, carers and residents in our local areas. The clinical strategy has nine clear priorities for delivery in 2020/21: • Access to specialist opinion • Frailty/last phase of life • Care planning • Long term conditions • Early detection of cancer • Social isolation • Safer care – maternity • Proactive urgent care • High intensity users 7
A single CCG for NW London As part of merging the eight CCGs we are making the following six commitments: 1. Move resources across NW London and within boroughs to reduce inequalities over the next four years In September 2019, the CCG agreed that a single CCG for 2. Increase our proportion of investment in out of hospital NW London was the right services, as a first step we will level up investment in direction of travel. It was also primary care services outside the core contracts agreed that 20/21 would be a transitional year focused on financial recovery, developing 3. Ensure consistency in services across NW London a single CCG operating model and working through financial 4. Ensure equity of access to services, to enable our implications. providers to improve outcomes for patients and reduce health inequalities 5. Patients and GP member practices will continue to be involved in the single CCG and at local level 6. We will devolve decision making on delivery and integration of services to neighbourhood and borough level as our integrated care partnerships develop. 8
Covid-19 pandemic • February and March 2020, saw the focus of the organisation shift to support and react to the Covid19 pandemic. • The CCG worked as part of the NW London health and care partnership to change ways of working and staff were redeployed to support the emerging situation. • A lot of work happened in a short space of time and the development of our NW London system ensured that we had a united response in terms of implementing national guidance, sharing resources and ensuring that as a system we provided the best possible outcomes for all patients through the crisis. 9
An overview of the 19/20 response February • Community testing centres and services were set up - the Heathrow isolation hotel was also opened. March onwards • Rapid expansion of intensive care capacity • Hospital and community services were changed to reduce the spread of the virus • Outpatient appointments were provided virtually • Across London, emergency powers were put in place to maintain urgent cancer and cardiac care in hubs and the private sector were brought in to resume elective surgery • In our GP practices video and telephone appointments were set-up and hot clinics were then launched to provide dedicated sites to see patients with symptoms of Covid19 • A dedicated programme of support for care homes, including greater GP support, infection control guidance and dedicated point of contact with the CCG. The NHS is now working on the recovery, and ensuring services can be safely maintained in the event of a second wave this winter 10
Our system’s financial challenge Jenny Greenshields Chief Finance Officer NWL CCG’s
Financial position 2019/20 2020/21 • • Accounts have been closed and A new financial regime was put in show a deficit of £50.9m in line with place for 2020/21 following the Covid our plan. pandemic. • • Five CCGs reported a deficit (Brent, For the first six months of the year Central, Ealing, Hammersmith & we are expecting to receive an Fulham and Harrow). resource allocation that matches • The major pressure in 19/20 was both our Covid and non-Covid spend. • acute spend. NHS providers receive a block • Achievement of the 19/20 plan was payment to meet their costs and the opportunity to claim for a ‘top - up’ if largely through non-recurrent measures, therefore our underlying this block payment is insufficient to deficit has not improved cover their costs. • significantly. We are waiting guidance on what the funding arrangements will be for the second half of the year. 12
What have we achieved since last year? Reduction of the deficit System alignment • Whilst we achieved the planned deficit target, • Five year plan is a combined plan for the underlying position remains broadly the providers and commissioners same at the end of the year at just under • Introduction of new payment regime moving £100m • from purely costs and volume for acute We have continued to reduce our management costs, under-spending by £6m contracts to agreed contract values with against budget marginal rates for over and under • Towards the end of the financial year we did performance begin to see a reduction in acute activity growth, which should impact on future costs Controls established System recovery • • Vacancy freeze and review of interim staff System recovery linked to five year plan and continued through 19/20 key programmes of work • • Investment Scrutiny Panel embedded to review Development of ICS (Integrated Care System) every proposed contract change or new Recovery Work Streams • business case Focus on schemes that will deliver system wide savings 13
Returning to financial balance as a system Covid-19 has significantly changed the way NWL are currently operating as a health system, with many of the normal activity of providers and commissioners being refocused on the Coivd-19 response. Therefore our original 20/21 Commissioner and Provider cost recovery plans have not started to deliver or be monitored in the normal way. However there are areas where transformation across the system has been accelerated beyond our plan and areas that are currently on hold that may or may not restart after Covid-19 activities have been normalised. The focus for the immediate future in order to return the system to financial balance will be to: • Reset 20/21 Commissioner and Provider Cost Recovery Plans; • Alignment with ICS Recovery work streams; • Determine gap to financial balance; and • Determine further ICS Recovery work stream opportunities. 14
Financial Position 2019/20 – Hounslow CCG The below table shows that the CCG achieved breakeven in 19/20. The CCG also achieved its financial duties with regards to Running Costs. 15
How we spent your money – £425m in 2019/20 The pie chart below shows a breakdown of CCG expenditure by programme area: 16
Quality Diane Jones Chief nurse/Director of Quality North West London Collaboration of CCG’s
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