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: [email protected] Address: NHS Airedale, Wharfedale and Craven Clinical Commissioning Group Millennium Business Park, Station Road, Steeton, Keighley, BD20 6RB Phone: 01274 237 324
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