NHS Mansfield and Ashfield CCG Annual Public Meeting 17 September - - PowerPoint PPT Presentation

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NHS Mansfield and Ashfield CCG Annual Public Meeting 17 September 2018 Civic Quarter, Civic Centre Mansfield

Welcome and Introductions

Dr Gavin Lunn Clinical Chair

Annual Review 2017/18

Amanda Sullivan Chief Officer

2017/18 – Making an impact

• Continued progress as a national Vanguard, leading the

development of better ways to meet local health needs

• Keeping people at home where possible and working in local

communities

• Intensive home support
• Care home enhanced services
• Joined up care for people with high intensity needs
• Urgent and emergency care – a whole system approach
• Best use of precious NHS resource – 5.7% savings (£27.7m), with

significant level of financial challenge

FILM

7 System Objective 2 – 11.6% Reduction in Emergency Admissions – Mid-Nottinghamshire

2,344 fewer stays in hospital

1,000 1,500 2,000 2,500 3,000 3,500 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 16/17 Actuals 17/18 Actuals Monthly Target

System Objective 1 – 17.3% Reduction in A&E Attendances – Mid-Nottinghamshire

1,000 3,000 5,000 7,000 9,000 11,000 13,000 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 16/17 Actuals 17/18 Actuals Monthly Target

3,961 fewer A&E attendances

8 System Objective 6 - Reduction in Paediatric Emergency Admissions – Mid-Nottinghamshire

100 200 300 400 500 600 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 16/17 17/18

137 fewer stays in hospital for children

System Objective 3 - Reduction in Non-Elective Bed Days – Sherwood Forest Hospitals for Mid-Notts

7,941 fewer days spent in SFH

10,000 11,000 12,000 13,000 14,000 15,000 16,000 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 16/17 Actuals 17/18 Actuals

FIT FOR PURPOSE FIT FOR TODAY FIT FOR THE FUTURE Financial turnaround Business cycle and processes Staff restructuring to maximise delivery impact and triangulation across business functions Governing Body and staff development Financial strategy, position and delivery of savings requirements Service performance and constitutional standards Service quality and safeguarding Stakeholder relationships and engagement Improve NHSE rating Alliance development moving towards population approach and population health management Integration of services Vanguard delivery – new model

• f care development

Staff views of working at the CCGs; Top 5 key achievements

Question 2016 result 2018 result

My work contributes to organisational performance 64% 91% My appraisal met my expectations 55% 84% My manager helps me celebrate my successes 48% 85% My manager recognises my efforts in the team 55% 90% My manager values my contributions 55% 90%

2017/18 Annual Ratings

NHS Mansfield & Ashfield CCG NHS Newark & Sherwood CCG

Overall 2016/17 Assessment Inadequate Inadequate Overall 2017/18 Assessment Requires improvement Requires improvement Cancer 2017-18 CCG IAF Assessment - Cancer Inadequate Good Dementia Q4 2017-18 CCG IAF Assessment - Dementia Outstanding Outstanding Elective Access Patients waiting 18 weeks or less from referral to hospital treatment 89.5% 89.6% Maternity Requires improvement Requires improvement Mental Health Q4 2017-18 CCG IAF Assessment - Mental Health Good Good Patient Safety Evidence sepsis awareness raising amongst healthcare professionals has been prioritised by the CCG Green + Green + Primary Medical Care Patient experience of GP services 84.8% 85.1% Urgent and Emergency Care Percentage of patients admitted, transfer Inadequate or discharged from A&E within 4 hours Diabetes Initial Assessment - Diabetes Inadequate Requires improvement Health Inequalities Quality of life of carers

This CCG is similar to the average for other CCGs This CCG is similar to the average for other CCGs

NHS Mansfield & Ashfield CCG NHS Newark & Sherwood CCG Sustainability Financial plan - assessment of whether the CCG is likely to meet the plan Inadequate Inadequate Utilisation of the NHS e-Referrals Service to enable choice at first routine elective referral 96.2% above target of 80% 90.8% above target of 80% Well-led Probity and corporate governance Fully compliant Fully compliant Staff engagement index (engagement index on a 1 to 5 scale (5 good) 3.8 3.8 Progress against workforce and race equality standard (higher scores indicate higher differences, 0 indicates equality) 0.05 0.062 Effectiveness of working relationships in the local system 67.2 66.2 Quality of CCG leadership Requires improvement Requires improvement Compliance with statutory guidance on patient and public participation in commissioning health care Requires improvement (7 out of 15) Requires improvement (8 out of 15)

Quality of our local healthcare services

Elaine Moss Chief Nurse and Director of Quality & Governance

Mansfield and Ashfield CCG monitor, challenge and support providers around a range of quality measures for example;

• CQC Inspections
• Healthcare associated infections
• Sepsis
• Mortality rates

Mansfield and Ashfield April 2017 (90 Homes) 67% Good or Outstanding March 2018 (105 Homes) 69% Good or Outstanding 2017 = 67% Good

• r Outstanding

2018 = 69% Good

• r Outstanding

Inadequate 1 (circa 1%) 1 (circa 1%) Requires Improvement 17 (circa 19%) 16 (circa 15%) Good 59 (circa 66%) 68 (circa 65%) Outstanding 1 ( circa 1%) 4 (circa 4%) Awaiting inspection 12 (circa 13%) 16 (circa 15%)

Care Homes – increase in care homes during year

GP Practices

April 2017 Rating March 2018 Inadequate 5 Requires improvement 3 15 Good 20 3 Outstanding 3 4 Awaiting inspection 1

Sherwood Forest Hospitals

April 2017 April 2018 Concerns from CQC Good response to quality, risk and assurance processes All areas inspected by CQC good Strong staff focus and good patient experience Stable leadership team

Reducing Healthcare Associated Infections (HCAI)

Improving rates Clostridium difficile infections (CDI)

Organisation Total CCG assigned MRSA cases

April 2015 - March 16

Total CCG assigned MRSA cases

April 2016 - March 17

Total CCG assigned MRSA cases

April 2017- March 18

National Target MRSA cases Target Achieved 2017-18 NHS Newark & Sherwood CCG 1 NHS Mansfield & Ashfield CCG

Improving rates MRSA bloodstream infection

Organisation Total CDI cases April 2015 - March 16 Total CDI cases April 2016 - March 17 Total CDI cases April 2017 - March 2018 Objective Set Total CDI cases 2017/18 Target Achieved 2017-18 NHS Newark & Sherwood

37 44 37 39

NHS Mansfield & Ashfield

107 51 78 94

Sherwood Forest Hospital Trust

45 39 28 48

Target

During 2017/8 we have seen significant improvements in:

• Management of sepsis – training, reporting mechanisms.
• Reduction in mortality rates (the rate of deaths in a

particular health care related grouping ) – case review, staff training, incident reviews.

• Supported through the CQC assessment findings.

Sherwood Forest Hospitals

2017/18 Finance Review

Michael Cawley Chief Finance Officer

2017/18: Performance on Key Duties

Financial Duty Achieved Details Fully utilise allocated funds



£301.7 million spent on healthcare services. Met revised financial target



Agreed £9.1m in year deficit. Represents an improvement of £0.1m compared to forecast of £9.2m in the financial recovery plan. Remain within running cost allowance



Spent £3.9 million on running costs £21.60 per head of population against a limit of £22.03. Remain within maximum cash drawdown



Cash balance of £47,419 at 31st March 2018. Pay suppliers within 30 days



96.6% of invoices paid within 30 days.

2017/18: How the CCG spent the allocation.

The CCGs key providers were (as a % of total CCG budget):

• Sherwood Forest Hospitals 42%
• Nottinghamshire Healthcare 7%
• County Health Partnerships 6%
• Nottingham University Hospitals 4%
• East Midlands Ambulance Service 2%

What services were delivered for patients?

Primary Care & Prescribing

Prescribing: 4.7 m items issued (Statins =0.3 m) Diabetes and Prostate Cancer checks Anticoagulation & rheumatology monitoring Minor injury clinics Home visits for complex patients with acute illness

Acute Services: hospital based services

649 hip/knee replacements 1,109 cataract treatments 58,004 seen in Outpatients First Attendances 22,200 Non Elective admissions (including pneumonia, COPD, heart conditions, urinary tract infections) 77,400 diagnostic tests including 8,563 endoscopic tests

Ambulance Services

42,759 calls to the service 22,026 were transported to hospital 13,162 patients were provided telephone advice or received treatment at location

Looking Ahead: 2018-19 and beyond

Challenge/ Risk In response to those challenges.. Sustainability

• Turnaround Board and Financial Recovery Plan in place.
• A significant savings plan to keep within our financial allocation developed and

being delivered in 2018-19 and beyond.

• 2018 -19 Productivity and efficiency requirement of 6.7% (£19.8 m).
• Continued partnership working with the Nottinghamshire-wide Integrated Care

System (ICS). The whole health system to work together to deliver financial sustainability for the population of Nottinghamshire. Fragmented Services

• Increased partnership working across all sectors, to reduce service

fragmentation. High cost individual packages of care.

• Risk pool arrangements for high cost healthcare cases.

2018-19 and beyond

• Our population - changing and growing.
• Expectations on healthcare – ever increasing.
• Growth in demand anticipated to be greater than CCG growth in funding.

[18/19: 2.8% (£7.8m)]

Question Time Panel Hosted by Phil Lyons, MBE

Celebrating Success in General Practice Awards presented by Peter Clay Chair of Audit and Governance Committee

Partnership Working Award

This award reflects collaborative team work between the practice and the PPG

Partnership Working Award

Winner

Huthwaite Involving People

Going the Extra Mile Award

This award recognises a team or individual who have gone that extra mile to make a positive difference within their working environment, to a patient or colleague

Going the Extra Mile Award Winner

• Dr. Dean Temple

Outstanding Contribution Award

This award recognises a truly inspirational group or individual who have had a positive impact on the health and wellbeing of people living in Mansfield and Ashfield

Highly Commended

Vickie Hardwick & Katie Barson Millview Surgery

Outstanding Contribution Award

Outstanding Contribution Award

Winner

Roundwood Nursing Team

Outstanding Clinical Leader Award

This award celebrates a clinical leader within General Practice who has gone over and above what is expected of them in their role and has had a positive impact on delivery of one or more of the CCGs vision and values

Outstanding Clinical Leader Award

Winner

Dr Carter Singh

Innovation Award

This award celebrates an individual or a team who have an excellent example of an innovative approach to design and delivery of better patient care and can provide evidence of change or outcomes

Innovation Award

Winner

Katie Barson Millview Surgery

Kindness Award

This award recognises a staff member who is working in Mansfield and Ashfield who has shown exceptional kindness towards patients and carers in the last year

Kindness Award

Winner

Tracey Stent

Excellence in Engagement Award

This award celebrates the contribution of a volunteer or representative of a group of people who have gone above and beyond in their position helping the CCG

Excellence in Engagement Award

Winner Julie McIntyre

CCG Staff Awards

Emerging Leader Donna Nussey

CCG Staff Awards

Team award for

• utstanding contribution

Infection Control Team

CCG Staff Awards

Individual award for

• utstanding contribution

Highly Commended Caren Rice & Mark Yates

CCG Staff Awards

Individual award for

• utstanding contribution

Julie Andrews

CCG Staff Awards

Innovation Annie Tasker

CCG Staff Awards

Going the extra mile/unsung hero Andrea Rowan

Congratulations to all nominees and winners