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NHS Croydon CCG
Annual General Meeting
Tuesday 25 September 2018
A very warm welcome to our
Annual General Meeting 2018
Dr Agnelo Fernandes
Clinical Chair
In memory of
Bosco Saldanha
1943 to 2018
Photo here
Welcome Tudor Academy Choir
Governing Body
Governing Body
Croydon in numbers…Key facts about Croydon
Andrew Eyres
Accountable Officer
www.croydonccg.nhs.uk
Longer, healthier lives for the people of Croydon
Our strategic approach:
• ambition
• innovation
• working with our partners
• using resources wisely
• transforming healthcare
• high-quality services
Delivered through five clinically-led programmes
Our vision
A nice picture here
Highlights of the year
How are we performing?
Clinical Priority Areas 2017/18
Cancer
Maternity
Outstanding
Good
Annual CCG overall rating:Requires Improvement
Leadership Finance
This is an improvement from Inadequate last year
London CCGS
NHS 70
NHS 70
Croydon NHS70
Stars
Dr Kamran KahnGP
Stovell House Surgery
Susan McCarthyHead of Family Learning
and DevelopmentTudor Academy School
Elsie SutherlandVolunteer
Croydon CCG and Croydon Health
Services
Sally InnisDesignated Nurse for
SafeguardingCroydon CCG
Memuna SoweMidwife of the Year
Croydon Health Service
Sean CrillyProgramme Lead
Croydon CCG
Rachel CarseSocial Inclusion Co-
OrdinatorDementia Action Alliance
Sylvarani NairTeam Leader
Age UK
Kerry StarrettSex and Relationship Education
and Training SpecialistCroydon Health Services
Brian DickensPractice Manager
Parchmore Medical Centre
Staff Awards 2018
Staff Awards 2018
Edward Odoiand
Ros Spinks
Local people influencing commissioning
Looking ahead
Thank you to patients, public
and colleagues involved in
improving health and
providing care in Croydon
Financial Performance
Mike Sexton
Chief Finance Officer
In 20017/18, we spent £559m on healthcare:
We are funded £1,199 per person (£490m)We spent £1,365 per person in Croydon. Our key providers of healthcare are:• Croydon Health Services NHS Trust• South London & Maudsley NHS
Foundation Trust (FT)• St George’s University Hospitals
NHS FT• Kings College Hospital NHS FT• Epsom & St Helier NHS Trust• London Ambulance Service
In 2017/18, we performed as follows:Description Source Target Actual Achieved
Target Expenditure Deficit:- CCG Original Plan - NHS Set Target (In Year)- NHS Set Target (Cumulative)- Statutory Duty (In Year)
NHSENHSENHSEStat.
£15.0m£6.9m
£61.4mBreakeven
£13.9m£13.9m£68.3m£13.9m
QIPP Savings Target- Identified Programme Savings- Unidentified Programme Savings
NHSE £21.2m (4%)£8.1m (2%)
£21.2m (4%)Nil (0%)
Capital Resource Limit Stat. £0.4m £0.4m
Administration Costs Stat. £8.4m £8.3m
Stay within Cash Forecast NHSE £562.7m £555.7m
Cash Balance - % of initial drawings held at 31/03/18
NHSE 1.25% 0.9%
Public Sector Payment Policy DH 95% 96.9%-97.2%
External Audit AssuranceType of Opinion Description Opinion Achieved
Financial Statements Opinion
“True and Fair View” Unqualified
Regularity Opinion“expenditure incurred as intended by parliament”
Qualified:Expenditure exceeded resource limit
Value for Money Assessment
Securing economy, efficiency and effectiveness
Qualified: Did not meet NHSE target deficit
GovernanceThe Council of Members approved the Annual Report / Annual Accounts on 24 May 2018.
In the future, we plan meet our financial targets:
In 2018/19, Croydon CCG received £17.0m (3.59%) allocation growth
Target performance is £1.2m surplus (18/19) and £5.2m/1% (19/20)
The QIPP challenge for 18/19 is £27.6m.
Note: Above average growth funding is only available if more than 5% below target. At 4% below target the expectation is that the CCG must simply live within its allocation.
Source: Financial Improvement and Recovery Plan June 2018
Financial Improvement and Recovery
26
• Long journey from 2013 when CCG was established with a significant underlying
deficit (£30m) and underfunding position (£40m/10%)
• Our Financial Improvement Plan (June 2018) builds on the success since 2013 of
clinically led quality improvements and we continue to spearhead more efficient use
of our limited resources.
• On the back of recent improvements, the CCG is no longer in Financial Special
Measures.
• CCG is planning to meet full business planning rules from 2019/20 (ie 1% surplus).
• The backbone of this success is joint working across local clinicians, senior
leadership, and alliance partners, to continue to drive the delivery of these quality
improvements for Croydon citizens.
Creating a Dementia Friendly CroydonRachel Carse
Dementia Action Alliance & Social Inclusion Coordinator
September 2018
Why Dementia?
• Costs UK economy £26.3 billion per year
£11.6 billion in unpaid care
• Two thirds of people with dementia live in
the community
Dementia figures for Croydon
• In 2017 there were an estimated 3,611 people aged 65+ living with
dementia
• In 2016/17, only 2,322 were formally diagnosed with dementia
• They, their family and carers are customers of many businesses,
shops and services across the borough
• 51% of people caring for someone with dementia are still in work
and might need support from their employers. Some of your
existing employees may also develop dementia
We want Croydon to be dementia friendly
What is the Croydon Dementia Action Alliance?
The CCG’s commitments
1. All staff to receive training in dementia awareness
2. Develop a dementia roadmap with other members of
the Croydon Dementia Action Alliance for local carers
and health and care professionals
3. Work with care homes to review approach to falls
with dementia care in mind
Memory as a bookcase
EmotionsFacts
Dementia friendly community - people
Raise awareness of dementia by getting everyone to
The more understanding and awareness of dementia, the more
understanding the community
Dementia friendly community - place
Mat or black hole?
Dementia friendly community - process
• Remind carer of appointments made for person living with dementia
• Send a reminder text or a member of staff could ring about the
appointment
• Where possible allow person living with dementia to see the same
advisor
• Allow plenty of time for appointments
Dementia friendly community - process
• Shops – designated worker to support vulnerable shoppers and
help maintain their independence
• Banks – support people by being alert to requests for unusually
large withdrawals - in Croydon, people have been prevented
from being victims of fraud
If you want to find out more, join the Croydon Dementia Action Alliance, please contact me:
Social Prescribing
Brian Dickensand
Les Persaud
Croydon Social Prescribing Community
Engagement Team
Where are we: The Journey
July 2017 – 1 Practice
July 2018 – 42 Practices
Why? How? Impact?
Community Engagement
Why
• Practices have increasing and unmanageable patient lists
• Increasing complexity of medical care provided by GPs
• 20% of GP consultations do not require clinical intervention
• Currently practices have a few patients taking up 90% of practice time
• Those who need to engage do not attend or manage their own health
• Shortage of GPs fuelled in part by pressures of workload
• Reducing available NHS Budget
• Need to change patient and community behaviour around health self
management for more effective use of resources
Community Engagement
Why• We are in the thick of it
• Majority of our area and some patients are in either from 5% to 10% most
deprived in the country of 10% to 20%
• We deal with a cohort that includes health issues such as 2 in 3 adults,
roughly 181,000 Croydon are obese / overweight
• Half the number of women giving birth are overweight / obese / morbidly
obese and 5% of these are diabetic
• 23% of children live in poverty
• 58% of females and 43% males are not physically active
• Life expectancy is 9.1 years lower for men and 7.7 for women than the
national average
Social Prescribing
Community Engagement
LOCAL SOCIAL ISSUES
• Social Isolation• Financial / Debt advice• Health and Exercise / Health management• Diet• Mental Health issues• Community Safety / Mentoring• Unemployment Rate – Highest in London• Community Cohesion / integration
Social Prescribing
Community Engagement
• Need to look at long-term behavioural change• Change Patient Dependency
• Capacity Build the local provider
• Develop patient self referral to more community structures
• Develop more holistic community interventions
• Multi Agency- Multi disciplinary Approach
• Community Hubs / led by the community / for the community / owned
by the community / SUSTAINABLE
• One stop shops for community development / health interventions
Social Prescribing
Community Engagement
How
• All of this has been achieved• Small Dedicated community based team• A Partnership approach• Development of relationships with GP practice’s• Small Localized Funding – and Community Support• No NHS Support or Funding• Because• No Barriers • No Delays• No Red Tape• This was always about Doing! Not Waiting!
Partnerships - Opportunities• Croydon Council
• Local MP
• Local Councillors
• Croydon Commissioning Group
• GP Practices
• Christians Against Poverty
• Nike / Brand Jordan: Practical
partners in positive change
• Apple
• NHS – National Team
• Best Start
• Crystal Palace Foundation
• Croydon Voluntary Action
• Croydon BME Forum
• Various Local Churches and
Community organisations
• We have delivered partnerships
that includes support from
• Statutory Sector / Public Sector /
Third Sector and the Commercial
Sector
• This is the route to sustainability
and long term impact
Social Prescribing
Community Engagement
Key partners
• Palace for Life Foundation
• Nike Community Ambassadors
• Croydon Best Start
• Apple
• St Paul’s Church
• NHS Croydon CCG
Community Engagement
ImpactStrategic Developments
• Partnership and strategic support from NHS England at a National level
• Winner of the NHS Parliamentary Award for excellence in Primary Care
Programme Development
• Access to and partnerships with 60 interventions: from health classes- choirs---to
counselling
Partnership Development
• Over 60 partnerships- covering, corporate-public- third sector- local community
Community Hubs
• 21 community hubs signed up to be part of the programme
Participation
• Over 28,000 attendances in six months
Independent Research
• Resourced and underway
Community Engagement
Next Steps / Opportunities
• Food Stop Project – Partnership with Fairshare / All major food retailers around
overall support for Thornton Heath Community
• New Addington & Selsdon network
• Group Consultations – Tremendous feedback already
• Development of Local Voluntary Partnerships : - Alliance
• GPs in the community
• Barbershop project
• Physical Activity Young people
• Community Gyms / Well Being Centres
• Health help Now App
• Meeting with Simon Stevens: CEO NHS
• Formalisation of the social prescribing community engagement team
Any questions?
Find the right service
• GP hubs
• Health Help Now
• NHS 111
• Croydon Talking
Therapies
