Oxfordshire Clinical Commissioning Group: Annual Public meeting Dr - PowerPoint PPT Presentation

Oxfordshire Clinical Commissioning Group Oxfordshire Clinical Commissioning Group: Annual Public meeting Dr Joe McManners Clinical Chair 28 September 2017

Agenda Oxfordshire Clinical Commissioning Group Review of the year: 2016 / 2017 Financial Accounts Bicester Healthy New Town Questions?

Oxfordshire Clinical Commissioning Group Review of the year: 2016 / 2017 David Smith Chief Executive

Strategic plan Oxfordshire Clinical Commissioning Group  New and better ways of delivering good value services  Consult on Oxfordshire Transformation Plan proposals  Meet constitutional targets and reduce DToC and A&E attendance

How did we do? Oxfordshire Clinical Commissioning Group  Introduction of new ‘ambulatory’ model of care to reduce acute hospital admissions Ambulatory Assessment Units at the JR and Horton o General in Banbury Rapid Access Care Unit at Townlands in Henley o  Increasing access to primary care services Care navigators coordinating support for patients in o their own home, liaising with GPs and carers Email consultations o Neighbourhood access hubs – for urgent care o appointments in the evening and weekend

How did we do? Oxfordshire Clinical Commissioning Group  Taking over commissioning of specialist learning disabilities services for adults from County Council and transferring services from Southern Health to Oxford Health  A New Child and Adolescent Mental Health Services Contract to reduce waiting times  Securing funding for Diabetes prevention and education

How did we do? Oxfordshire Clinical Commissioning Group  Oxfordshire Transformation Programme phase 1 - why? To ensure:  high quality and safest care  equality of access to best care  care closer to home or at home

How did we do? Oxfordshire Clinical Commissioning Group  Oxfordshire Transformation Programme - the agreed changes:  all acute stroke patients get best available treatment at JR’s Hyper Acute Stroke Unit  sickest patients all go to intensive care unit at JR  all obstetrics services centred at JR  closure of some acute beds to reinvest funds in care closer to home  more outpatients and planned care services at Horton General

How did we do? Oxfordshire Clinical Commissioning Group  Oxfordshire Transformation Programme - but:  Current legal challenges to the consultation process and some of the changes approved may delay implementation and could impact on the next phase of Transformation.

How did we do? Oxfordshire Clinical Commissioning Group  We must do better:  Delayed Transfer of Care remains stubbornly high despite several joint initiatives with health and social care partners  Work and joint investment continues to boost home care and nursing home providers and create extra capacity to manage more complex people outside of hospital

How did we do? Oxfordshire Clinical Commissioning Group  We must do better:  A&E attendance increased by 6.7% in 2016/17  Ambulance response times  Some cancer targets  Work to improve access to primary care through extended and weekend hours  More support for GP practices to offer more services

The Future Oxfordshire Clinical Commissioning Group  Meeting constitutional targets: A&E wait times – what is being done?  More consultants working in A&E  Plans for streaming of patients arriving at A&E Ambulance response times – what is being done?  National Ambulance Response Programme: new clinical coding system for effective prioritisation based on patient clinical need  Revised Ambulance Response targets to measure median time to patients rather percentage of achievement which will lead to long wait reduction . Cancer waits/ diagnosis – what is being done?  Increasing awareness of screening for the public  Straight to test/one stop shop diagnostics across a number of specialities

The Future Oxfordshire Clinical Commissioning Group  The need to successfully implement changes agreed in phase 1 Transformation Programme  Transformation phase 2 – the challenges:  growing demand for services  workforce shortages  financial pressures  unsuitable buildings  health inequalities

Oxfordshire Clinical Commissioning Group Annual Accounts 2016/17 Gareth Kenworthy Director of Finance

Context of 2016/17 Oxfordshire Clinical Commissioning Group  Fourth year of operation of CCG and Commissioning Support Unit  First year of being fully responsible for GP Primary Care Commissioning from NHS England (received a transfer of allocation of £91m in order to achieve this)  Management of in-year financial risks – FNC price increase and development of new contracting arrangements with main providers

Financial highlights Oxfordshire Clinical Commissioning Group  Financial accounts produced to national deadlines  Surplus of £21.1m achieved – significantly higher than planned due to funds released by NHS England. This additional surplus will be carried forward for drawdown in future years.  All financial duties achieved  Unqualified audit opinion on the financial statements, regularity and value for money

Financial Performance targets Oxfordshire Clinical Commissioning Group Target Position Achieved Position Revenue spend not to exceed allocation Actual revenue surplus £21,131,000 of £845,960,000 Revenue administration spend not to Actual administration spend of exceed allocation of £14,642,000 £14,207,000 95% of all NHS invoices paid within 30 98% of total value of invoices paid within days 30 days Remain within cash funding We have achieved our cash target

How was the money spent? Oxfordshire Clinical Commissioning Group In 2016/17 we spent £825million That’s . . . £1,146 per person per year £2.26m per day £1,570 per minute Plus £21.1m ‘surplus’ carried forwards to 2017/18

How was the money spent? Oxfordshire Clinical Commissioning Group Annual Actual Variance Budget Month 12 Month 12 £'000 £'000 £'000 Acute 400,607 403,386 2,779 Community Health 70,637 70,999 362 Continuing Care 57,934 64,851 6,917 Mental Health and Learning Disability 68,439 68,922 483 Delegated Co ‐ Commissioning 89,546 89,012 (534) Primary care 100,516 97,659 (2,857) Other Programme 16,355 15,793 (562) Sub Total Programme costs 804,034 810,622 6,588 Running costs 14,642 14,207 (435) Sub Total 818,676 824,829 6,153 Transformation/risk management 0 0 0 Non recurrent reserve 8,198 0 (8,198) Contingency 6,161 0 (6,161) 1% Surplus 12,924 0 (12,924) Total 845,960 824,829 (21,131)

And what did it buy? Oxfordshire Clinical Commissioning Group  Acute Healthcare Services:  166,220 attendances at A&E & MIU, 455 per day  79,667 emergency inpatient admissions, 218 per day  61,078 planned inpatient admissions and day cases  661,128 outpatient appointments  87,832 ambulance incidents  Community Health:  1,750 community hospital episodes  350,187 contacts with community services  88,577 podiatry appointments  105,251 contacts with out of hours GP services

And what did it buy? Oxfordshire Clinical Commissioning Group  Mental Health Services:  50,330 in-patient bed days  127,598 appointments  Other:  198,725 calls to NHS 111  13,506 appointments in primary care neighbourhood access hubs (approx 6 months)  Total drug items prescribed – 11,085,290  1,751 referrals for NHS Continuing Care

External Audit Opinion Oxfordshire Clinical Commissioning Group  Financial statements – an unqualified opinion that the accounts reported fairly on the CCGs finances  Regularity of income and expenditure – an unqualified opinion that financial transactions were conducted within the CCG legal framework  Value for money – no matters to report

Present and future Oxfordshire Clinical Commissioning Group  For the financial year 2017/18 OCCG has a £16m increase to our funding compared to £50m in 2016/17. The CCG will remain at 4.8% below target funding.  OCCG has submitted a plan for 2017/18 that was compliant with financial planning targets including a surplus of £19.989m  Key risk for OCCG moving forward into 2017/18 remains the same as it is for all NHS organisations across the country, which is to address the increasing demand for NHS services within the resources available

Bicester Healthy New Town Programme Dr Rosie Rowe, Bicester HNT Programme Director

In Oxfordshire our health needs are changing... INCREASING INCREASING INCREASING INCREASING BIRTHS FROM CHRONIC POPULATION GROWING DISEASE AGE POPULATIONS

The Healthy New Towns programme has three key objectives • To shape new towns , neighbourhoods and communities to promote health and wellbeing, prevent illness and keep people independent; Potential additional • To radically rethink delivery of health and impact Health and wellbeing care services , supporting learning about new models of deeply integrated care benefits • To spread learning and good practice to other local areas and other national programmes Current good practice Time (Years)