Older People Joint Management Group Finance, Performance and Activity Report For Period April to June 2015/16
Pooled Budgets Older People & Equipment 1. Vision 2. Priorities 3. Spending & activity to meet those priorities 4. Performance 5. Issues
Pooled Budgets Older People - Vision We celebrate our ageing population in Oxfordshire; however we acknowledge that the natural effect of ageing means that the likelihood of ill health increases with age. We want all people as they age to lead lives that are healthy and personally and socially fulfilling. Our goal for older people in Oxfordshire is to enable people to live independent and successful lives
Pooled Budgets Older People - Priorities Priority 1: I can take part in a range of activities and services that help me stay well and be part of a supportive community. Priority 2: I get the care and support I need in the most appropriate way and at the right time. Priority 3: When I am in hospital or longer term care it is because I need to be there. While I am there, I receive high quality care and am discharged home when I am ready. Priority 4: As a carer, I am supported in my caring role. Priority 5: Living with dementia, I and my carers, receive good advice and support early on and I get the right help at the right time to live well. Priority 6: I see health and social care services working well together.
Pooled Budgets OP & Equipment Purchasing Summary
Pooled Budgets OP & Equipment – Finance Summary #��"����� ������� ��������� $���� ������������ ��������� ������� �"����"��� ������ ��������� ���%"���� ��������������������� ������� #��"��"�� ������ �$�)��%�� ������� � !���"���� &���'(�� ���� ���� ���� ���� �������� ���� ������������ ������� ������ ������� ��� Overspend ����� Worse ��������� ����� ���� ����� �� *%���!��� ���� Improved )�����$���+"�,��'�������*������ �--.��/ �/.010 �--.0�� �0/ Overspend 2�- Worse +"�,��'��� ������������ ����!� ���"�� ��#��$ ��������������� %� ��� Worse Overspend ������������ ����"&�� �����������'�(���� ��#��$ ������������� ��� ��� Worse Overspend )���� ���3��4 �0/ 2�- Emerging Risks The County Council anticipates increased spend within the Older People’s pool in order to build and maintain system resilience through summer into winter. However, it is anticipated that this can be met by underspends within other areas of the pool. A virement will be processed to reduce budgets where there is an underspend and to increase the budgets where pressures have been identified.
Pooled Budgets OP & Equipment – Finance Summary Emerging Risks continued. A pressure of £0.389m is reported for the non-emergency patient transport service on an annual budget of £3.3m. This is mainly due to the savings anticipated from changing eligibility criteria proving lower than originally planned. Changes to eligibility criteria for the patient transport service were introduced towards the end of 2014, and it was anticipated that this would result in the annual number of journeys reducing by around 28,000 in 2015/16 (total number of journeys 110,000 in 2013/14), saving £603k annually. Whilst a reduction in the number of journeys has been achieved, the reduction has not been as steep as anticipated, and there have been increases in the number of high cost bariatric journeys and wheelchair journeys. Revised savings of £248k per year are now forecast, creating a pressure of £355k. The remaining pressure of £34k is due to a small increase in expenditure on smaller (mainly out-of-county) providers. Action is underway between OCCG, South Central Ambulance Service (the main provider of PTS) and OUH to review the increases in higher acuity transport (e.g. wheelchair) and in the smaller reduction in seated transport than anticipated, to ensure that hospital staff are not classifying patients as higher need than required in order to arrange transport for them. The CCG is keeping the expenditure under review and if savings cannot be delivered to offset the pressure during the remaining months of the year, this will be a call on the contingency reserve. This pressure will be met in full by the Clinical Commissioning Group and is excluded from the risk share.
Pooled Budgets Older People – care homes activity £50.500m annual forecast (compared to 14/15 outturn of £55.129m). Outturn underspend of -£0.004m FNC payments are over 100 more than the same time last year but are decreasing in year. Currently average 12.6 care home admissions per week compared to 11.5 last year. Main growth is in admissions from hospital pathway Average spot price (£597) 4.8% higher than 12 months ago 42 care homes inspected by CQC ) 20 (48%) good – 60% nationally ) 20 (48%) require improvement – 34% nationally ) 2 (5%) inadequate compared t- 7% nationally Budget Forecast Variance Outturn Social Care (net of £30.466m £30.609m £0.143m income) Continuing Health £8.239m £8.520m £0.281m Care Funded Nursing £11.799m £11.371m -£0.428m Care )���� £50.504m £50.500m -0.004m
Pooled Budgets Older People – care at home activity £28.483m annual forecast (compared to 14/15 outturn of £25.642m). Outturn overspend of £0.369m Small drop in client numbers compared to this time last year. Continuing problems with sourcing care Average cost of a package has stabilised in the last 3 months, but is 6% higher than 12 months ago Budget Forecast Variance Outturn Social Care £24.773m £24.871m £0.098m Continuing £3.341m £3.612m £0.271m Health Care Total £28.114m £28.483m £0.369m
Pooled Budgets Older People – early help 590 618 5,542 ) attending A wide range of receiving Items of health & services are in place to Reablement to equipment wellbeing June 191 provide early help April to June centres 154 receiving receiving hospital Crisis Response at home ) Significantly more (to June) in April people receive these services than receive 477 4,100 attending long term services receiving EMU in April Alert service Budget February Variance Outturn ) We are currently not Expenditure £27.240m £26.940m -£0.300m 83 people able to identify who 25,561 attending uses more than one seen by Diabetics community service Course in information April Network 1784 641 Contracts with Nutrition & the care home Dietetics Support service contacts in 2881 in April 1727 April Attending people minor funded for day injury units opportunities (April)
Pooled Budgets Older People – support activities 3,822 social care client assessments 2,189 social care client reviews 731 safeguarding alerts April - June 20,331 district nurse visits in April
Priority 1: I can take part in a range of activities and services that help me stay well and be part of a supportive community 3 key indicators in the better care fund 1. Reduce emergency admissions to hospital - currently 3% more admissions than target 2. Increasing the proportion of people with long term support who are supported at home - currently better than target 1. Reduce the number of permanent admissions to care homes – more admissions than planned, but better than last year 2. Increase the number of people supported by social care through home care in Extra Care Housing Admissions – 107 people currently supported 3. Increase access to reablement from the community – currently half the rate of that expected
Priority 2: I get the care and support I need in the most appropriate way and at the right time. ������"��!�� 7�!��%����� *�������"�� 1. Quality of care 7����6���� +�6�"���� ���%"��� 5��� *��&� 8��� New CQC ratings are showing issues about the ��� ��!� quality of care &��� ��� �%� � �� �� � +���� ��� ��� ����"� � � � � 2. Growing number of people waiting for home care due �������!� � � � � �� �� to market pressures ,��-�"�� 1����2��&���'�����2� ��� .������� .�"����/(� �%� ��� � � � � � +�����&�� � � � � �� �� 0���&�� �% �� � � � � +�&��� ,��-�"������ � � � � ��% ��� !��������
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