6 February 20141.30pm-4pm
Catterick Leisure Centre
Henry CroninLay Chairman
Jane RitchieHEN representative for Richmondshire
CCG news update
Dr Mark Hodgson GP and CCG Governing Body Member
Ambulance times GP Urgent Pathway GP Urgent patients to travel on non-emergency ambulance transport allowing more A&E vehicles to respond to 999 callsGP In Hours Triage Pathway Ambulance staff send patients to the GP practice from the scene, or the GP visits them at home as an alternative to sending to A&E, retaining ambulances in the local communityParamedic Practitioners working in GP practices in Sleights/Sandsend and Harewood they see and treat in the community and respond to emergency calls in the local areaNew Ambulance Stand By points are now working at locations in Catterick (GP Practice) and Richmond (Co-Op) with an additional point in Bedale (Health Centre) due to go live early in 2014Additional Static Defibrillator Points (e.g. Northallerton Civic Centre and Osmotherley) and a new C-Pad scheme (community defibrillator) scheme in Borrowby
Ambulance Response Times across the area
Month Red 1 Response Red 1 Response Month YTD
*April55.2% 55.2% *May50.0% 52.5%
September79.0% 68.7% October84.0% 71.0%
November62.9% 70.2%* Pre new initiatives
Out of Hospital Contract
Plans for the future Introduce more community initiatives to improve ambulance response timesMore investment in nurses and therapists in the community to keep care closer to home and achieve maximum potentialCloser working with the Voluntary sector and community support groups to reduce social isolation and give greater support to carersBetter identification of patients at high risk of repeat hospital admissions and targeting the right careSpeed up access to intensive support towards the end of lifeBased on what you tell us, to redevelop services in the community to deliver care closer to homeNew treatments and services in the community, e.g. IV antibiotics
Alison LevinHead of Finance, Governance & Support Services
Review of 2013/14 Good News !
CCGs overall delegated budget for commissioning services in 2013/14 is 169m.
Repaid our share of the PCT brought forward deficit 1.8m
We are still planning to deliver a 0.45% surplus (752k) at the 31st March 2014(Note: below the 1% identified in the national planning guidance).
This has given us a platform to have a balanced financial position to start 2014/15 with.
Where do we spend the money?
Delivering our Financial StrategyWhat we have to do in 2014/15:Planning Guidance states:Buy safe and sustainable services
Plan for Non Recurrent Spend 1.5% - 2.6m
Create a Transformation Fund 1% - 1.7m
Plan for a contingency of 0.5% - 0.9m
End the year with a 1% surplus - 1.7m
In 2015/16 Create the Better Care Fund 5.2m
How much money have we got?2013/142014/15 2015/16 000 000 000
CCG Programme Budget165,573169,381 173,028
Uplift for growth 3,808 3,647 2,941
Amount available to spend 169,381 173,028 175,969
Growth 2.30% 2.15% 1.70%
How do we agree the budgets?
000What we spent in 2013/14 (recurrent)165,603Efficiencies on provider contracts (-4.0%)-6,182Inflation on provider contracts (+2.8%)5,673Demographic Growth (+1.4%)2,315Other growth and cost pressures1,975QIPP-2,529TOTAL EXPENDITURE FORECAST FOR 2014/15166,855
What does the bottom line look like?
2014/1500020/15/16000How much money have we got173,028175,969How much are we spending166,855168,110What have we got left6,1737,859
What will we use this for?Receive CCG 2013/14 Surplus7521,730Non recurrent Spend 1.5%/1.0%-2,595-1,760Transformation Fund 1% -1,7300Better Care Fund-5,1710.5% contingency-865-880Balance 1.0% surplus1,7301,778
Risks to the financial planDemographic growth increases more than expected
Providers cannot meet their efficiency targets
QIPP programme is not fully delivered
Unexpected pressures emerge throughout the year
Investing the Non Recurrent Spend or Transformation Fund does not reduce the number of people being admitted to hospital as an emergency, which we need to do to help us create the Better Care Fund in 2015/16
Delivering our Financial StrategyWith the application of growth the CCGs overall delegated budget for commissioning services in 2014/15 is 173m.
This equates to 1,211 per head of population to spend on commissioning services for its population.
Deliver the QIPP
Implement the service change needed to help create the Better Care Fund in 2015/16.
The CCG is planning to deliver its full 1.0% surplus (1.7m) at the 31st March 2015.
CCG planning 2014/15 National and local contextA Call to Action Fit 4 the FutureOur prioritiesGroup discussion
Recent reforms to the health and care system and the Health and Social Care Act of 2012 focus on a drive towards integration to ensure the kind of care and support that best meets patients' needs.A range of current national policies have given renewed emphasis on the promotion of wellbeing, the prevention of ill health and early intervention.A personal health budgets policy is being implemented across the NHS, which is an amount of money to support a patient with identified healthcare and wellbeing needs and is planned and agreed between the patient and their local NHS/social care team.
Vulnerable and older people require homes and opportunities that meet their particular needs, foster self determination and support a good quality of life.
The NHS is facing large and complex changes in the way it delivers care. This means that the way we provide care must be radically transformed if we are to meet the challenge of caring for our patients, particularly olderpeople.National Context
Changes to the NHS
Need for better quality and transparency
Integrated health and social care
Prioritise prevention and early intervention
Providing more personalised care
Beds, clinic rooms, diagnostic rooms are not used to their full. The current hospital provision is out-dated and does not meet current healthcare standards. Much of the footprint is under-utilised and the design of the current building does not lend itself to developing integrated workforce. Technology is under-utilised. The Existing Whitby Hospital site is freehold and currently under York Teaching Hospital NHS FT control. Occupies a 4.25 acres (1.72HA) and is developed with 10,800 square metres of buildings, largely built around 1979, with 128 car parking spaces and green space. From previous studies, it is considered the existing facilities are unlikely to have a future economic use for health purposes in current condition and therefore redevelopment of the site is recommended with H&SC.The current spend for Whitby Community Services contract has not changed. The contract has made a 4% annual efficiency in line with national requirements and their has been no increase in overheads or staff costs.Additional investment has come from health and social care monies (reablement). Trust overheads have increased significantly and we are working with the trust to benchmark and understand cost pressures in more detail.Mobile diagnostics needs to be considered in bringing more services closer to patients homes.The future challenge will be how we transfer specialist knowledge to the community and this may not necessarily require traditional outpatients appointments. We will look to use telemedicine, telehealth and telecare and make the most of the electronic health record integration programme to provide advice and guidance remotely.
Planned outcomes as part of the Fit 4 future transforming community services programme is to deliver an appropriate distribution of care moving out of high cost acute trusts into more low cost settings and provide as much care in a persons own home as is clinically safe. Community services and community hospitals will therefore need investment and redesign to meet this challenge.
Our Local Context Ageing population
Resources are under-utilised and acute care focussed
Community hospital estate needs investment
GPs want greater input in local care and services available 7 days a week
Innovation in healthcare e.g. telemedicine
Health economy is changing
National impact A Call to Action
Every day the NHS saves lives and helps people stay well. However, the UK still lags behind internationally in some important areas, such as cancer survival rates.There is still too much unwarranted variation in care across the country, increasing health inequalities.But improving the current system will not be enough. Future trends threaten the sustainability of our health and care system: an ageing population, an epidemic of long-t