1. health and fitness

NHS Airedale Wharfedale and Craven
Clinical Commissioning Group
Dr Colin Renwick
CCG Clinical Chair
Why are we here
• Looking back - To share our Annual Report and
Accounts for 2013/14
• Looking forward - To discuss with you what we
would like the future to look like
• Your views - To ask your views on how we can do
things differently and what is important to you
What is in our annual report and accounts?
• Introduction from the
representative of our member GP
practices – Dr Bruce Woodhouse.
• Strategic report.
• A report from our member
practices.
• Remuneration report.
• Statement of Accountable Officer
Responsibilities – Dr Phil Pue.
• Governance statement.
• Annual accounts.
Who are we
•
We have a 156,000 population and 17 member practices.
We buy
What health services do we commission?
• Last year we spent £186million on health
services – equivalent of £1,192 per
patient.
• We have a 156,000 population
This includes: hospital services, mental health services,
ambulance and patient transport services, out of hours
GPs, community health services and medicines.
Our strategic priorities in 13/14:
•
•
•
•
Transform urgent care
Transform planned care
Transform mental health services
Reduce health inequalities and increase health
promotion
• Achieve excellence in prescribing and medicines
management
• Maintain safe, high quality and effective care
• Develop a sustainable CCG
Annual Report and Accounts 2013/14
Dr Phil Pue
CCG Chief Clinical Officer
Some facts…..
Levels
diabetes
are day
Threeofpeople
every
higher
than
the England
in the
Bradford
District
average.
experience a stroke
12.6% households in
Bradford and Airedale
and 25.1% in Craven live
in fuel poverty
We have higher levels of
depression compared to
the rest of the Bradford
district.
have more
£7We
in every
£10 ofpeople
health
aged
over 75
years
oldisin
and social
care
spend
areawho
thanhave
the a
forour
people
national
long
termaverage.
health
problem
1 in 4 patients in
hospital has dementia
Levels of chronic
obstructive pulmonary
disease and asthma in our
area are above the
England average.
1 in 10 people locally
provide some level of
unpaid care – the UK is
More people binge drink
third in Europe for the
in our area than the
number of informal carers
England average.
Some facts…..
What progress have we made? £7 in every £10 of health
Three people every day
in the Bradford District
experience a stroke
1 in 4 patients in
hospital has dementia
Home oxygen service
set up in Craven
12.6% households in
Bradford and Airedale
and 25.1% in Craven live
in fuel poverty
Community health
navigators and health
promotion managers
“Gold Line” service for
patients at the end of life.
and social care spend is
for people who have a
long term health
problem
Alcohol workers in A&E
and GP practices
1 in 10 people locally
provide some level of
unpaid care – the UK is
third in Europe for the
number of informal
carers
Communications
campaign
to help people choose the
Specialist dementia beds in
right health service for their
Holmewood Care Home.
needs
What progress have we made?
More mental
health talking
therapy
services.
Increased
psychiatric
liaison service
in A&E
Specialist
tissue viability
nurses in care
homes.
Village agent
scheme in Craven
to help people get
involved in
activities
More
telemedicine
in homes and
care homes.
We were involved
in the planning of
Tour de France so
health services
were available.
How we engage with patients and the public
Grassroots
Complaints
Health
questionnaires
Have your say
events
PPERG
AWC Hub
You said, we did
Attendance at groups
• Keighley College
• South Skipton project
• Roshni Ghar
• South Craven Over
50s forum
• Clarke Foley Centre
Informs our commissioning
strategies
Engagement last year
Child
Development
Centre review
Have Your Say
Events in Ilkley
and Keighley
Diabetes service
review
Community
nursing service
review
Community
midwifery
patient feedback
We spoke to many groups and people about their views on the national NHS debate ‘A Call to Action’,
including: Keighley Association Women and Children's Centre; Bangladeshi
Commmunity Centre; Keighley Healthy Living Network; Skipton and Craven
Action for Disability; Keighley and Ilkley Voluntary and Community Action;
Highfield Community Centre; Roshni Ghar; Skipton Older Peoples Reference
Group; Age UK; luncheon clubs in Settle; Craven Area Carers’ Group; South
Craven Over 50s Forum; Skipton Islamic Society; Temple Row Centre in
Keighley; Sue Belcher Community Centre; i centre in Ingleton; Medina Mosque in Keighley; Patient
Participation Group Network; Health and Wellbeing Hub; Carers’ Resource in Skipton; Sangat Centre;
Clarke Foley Centre in Ilkley.
Equality and diversity
Workforce
policies
We have a range
of policies to
make sure that
our staff so not
experience
discrimination,
harassment or
victimisation.
Training
All our staff have
equality and
diversity training.
Our Governing
Body and senior
managers receive
extra training.
Equality Delivery
System
Equalities
information
We use a national
computer system
to monitor our
services to make
sure they are
personal, fair and
diverse for staff
and our
population.
We publish
information about
the inequalities
experienced by
local people on
our website. We
also publish our
equality
objectives.
Safeguarding
• Safeguarding is keeping adults and children
safe from abuse.
• We work in partnership with the two local CCGs
– NHS Bradford City and NHS Bradford Districts.
• We make sure staff have the knowledge and
skills to recognise, report and respond to
safeguarding issues.
• We are members of the local safeguarding
boards for Bradford and North Yorkshire.
• We monitor the performance of our providers
regularly to ensure safeguarding systems are in
place.
Remuneration Report - our staff
Our full annual report contains details of:
• Who sits on our committees.
• A profile on each of our senior managers.
• Our register of conflicts of interest.
• Pay and pension liabilities of senior managers in the CCG.
Governance statement - how the CCG is run
Risk – We keep track of risks through our risk register and assurance
framework.
Information Governance – We have been working to meet the
standards set out in the NHS information governance toolkit. This
ensures we can keep information safe and secure.
Reporting incidents – We log and investigate “serious incidents” to
make sure we learn and make changes, if needed, to stop them
happening again.
Audit – We receive independent scrutiny from our auditors who
have audited our processes and our annual report and accounts.
Council of Members
CCG senior
managers
Exec
GPs
Member Practice
GPs
managers
Governing Body
Executive Group
CCG senior Exec
managers GPs
Exec
Nurse
Patient and Public
Engagement Reference
Group
CCG
VCS
senior
managers
Patient Other Exec
Lay
groups public Nurse member
sector
Public
Health
Practice
manager rep
Lay
Exec
members GPs
Hospital CCG senior
consultant managers
Clinical Quality and
Governance Committee
Lay
Registered Hospital
Exec
CCG
member and Exec consultant
GP
senior
Nurses
managers
Finance, Performance and
Governance Committee
CCG
senior
managers
Registered
nurse
Exec
Lay
Hospital Practice
GP member consultant manager
rep
Remuneration
Committee
Registered
Nurse
Lay
members
Audit Committee
Hospital
Lay
consultant Auditors members
Chief
finance
officer
Decision
making
Council of Members
Assurance
(chaired by Member practice representative)
Executive Group
Governing Body
GP
Executive
Secondary
Care
Consultant
GP Executive
GP Executive
GP
Executive
Clinical
Chair
Chief
Finance
Officer
Chief
Clinical
Officer
Chief
Operating
Officer
Lay Member
(engagement)
Member
practice
representative
(GP)
Registered
Nurse
Executive
Nurse
Director of
Public Health
Lay member
(governance)
These four roles above sit on both the
Executive Group and Governing Body
Our finances
Our target
expenditure
for 2013/14
was £190
million and
our actual
spend was
£187 million.
Financial performance
Target
Actual
£3.65
£3.65
Commit 2% budget non recurrently (one-off
funding)
£3.75
Manage within running cost* allocation
Achieve quality, innovation, productivity and
prevention (QIPP) plan to make efficiency
savings
Achieve surplus of 1%
£3.31
£1.5
£1.5
£1.8
£2.8
Spend in millions
*The running cost is the amount the CCG regularly spends so it can function, like salaries and rent.
Our performance last year
Targets met
Underperformance
 A&E four hour waits
 Ambulance response times
 MRSA and C. Difficile
 Ambulance handovers
 18 week wait for treatment
 Aspects of stroke care
 Mixed sex accommodation
 Hospital admissions due to alcohol
 Cancer waiting times
 People improving after talking therapy
Our ‘Annual Review’, a summarised review of 2013/14, is
available today.
Our annual report and accounts for 2013/14 is on our
website.
We received a number of questions prior to the event
that were about wider issues than the annual report. A
printed copy of these Q&A is available today.
Do you have any questions about the 2013/14 annual
report and accounts?
Looking to the future
Our five year forward view
Five year forward view
A district wide plan that was written in partnership with the two Bradford CCGs,
and health and care providers in the district.
The future…..
There is a
significant
funding gap
What does £1000 buy you in the NHS?
Approx. ten
A&E
attendances
One fifth of a hip
replacement
Approx.
four
ambulance
responses
Treating an insulin
dependent diabetic
for eight months
31 GP
appointments
One eye cataract
removal
We want to go from this
Community
mental health
teams
GP
Warden
Vol &
Community
sector
Outpatients
Home
care
Memory
assessmen
t
Community
Local
health services Authority
Podiatrist
Social
worker
services
LA OT
Discharge
team
Community
Matron
Physiotherapy
Equipment
General
practice
District
nurse
Housing
grants
Vol &
comm
sector
Housing
services
Falls
service
Telecare
Housing agencies
Heart
doc
Secondary
care
Practice
nurse
Health
OT
Diabete
s
service
Voluntary &
Community
sector
Primary
care
To this – our vision
Graphic courtesy of Airedale FT
We hope to achieve our vision with the following
new models of care:
Enhanced Primary Care
• Care plan
Accountable
GP
Care
Coordinator
• Reviews in
between visits
• Set personal
goals
• First point of
contact for help,
support & advice
• Monitor & review
each patient
Before visit
• Referrals and
coaching to
enable self-care
• Accountable
• Diagnose & treat
At GP, after
appointment
Patient
At GP,
before
appointment
• Develop action
plan
• Oversight of
referral
During
appointment
What will help us achieve this?
Coordinated approach to
staffing, estates and
support functions.
Electronic assistive
technology
Engaging and involving
service users and staff
The right workforce
More effective use of
medications.
Commissioning across a
broader footprint and
new payment models
What next
• We want to share these draft plans with
patients, the public and carers to get your
thoughts and feedback.
• We will be engaging more on our plans over the
coming months, including holding more events.
• If you have any comments from today, please
share them with us using the contact details on
the following slide.
Email: engage@awcccg.nhs.uk
Address: NHS Airedale, Wharfedale and
Craven Clinical Commissioning Group
Millennium Business Park, Station Road,
Steeton, Keighley, BD20 6RB
Phone: 01274 237 324