agm 2014 commissioning healthcare – moving forward together a year in review naz jivani – chair
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AGM 2014Commissioning Healthcare – Moving Forward Together
A Year in Review
Naz Jivani – Chair
Kingston CCG Annual General Meeting
Welcome, Lunch, KCCG Market Place
2013-14 – A Year in ReviewNaz Jivani – ChairYour Questions
Spotlight on flagship projectsSurbiton Health Centre – Dr Phil MooreA Patient’s story – Dominic D’Souza
Financial ReportHardev Virdee – Interim Finance OfficerYour Questions
Looking to the FutureTonia Michaelides – Interim Chief Officer
AGENDA
A Year In Review
April 2013 - Kingston CCG was one of a small number of CCGs in the country to be fully authorised without conditions
Highlights from our first year as a statutory body
Commissioning
Performance
Engagement
Partnership Working
Naz Jivani – Chair, Kingston CCG
A Year In Review
Commissioning Highlights for 2013-14Kingston CCG made an excellent start in our first year
• Opened Surbiton Health Centre – offering modern GP and other high quality services in the heart of the community
• Launched Kingston At Home – supporting local residents to avoid unnecessary hospital admission and stay at home for as long as they want with rehabilitation and ‘re-ablement’
• Spearheaded improved self-management initiatives for patients with long term conditions e.g. Expert Patients Programme, Angina Management Clinic, Diabetes Prevention
• Progressed Integrated Care working with Kingston Council
Commissioning Intentions 2013-14 are available at www.kingstonccg.nhs.uk
Naz Jivani – Chair, Kingston CCG
A Year In Review
Performance Highlights for 2013-14Kingston CCG laid a robust foundation for on-going improvements
By April 2014, Kingston CCG and its partners had fully met 73.4% of its national and local targets including key targets such as the 4 hour A&E waiting time and 18 weeks planned referral to treatment targets
We also discharged our statutory obligations and are committed to continuous improvements in all areas of our operation (including governance, quality and patient engagement)
We met all our financial targets Kingston CCG won a finalist award for the NHS Governing Body of the Year Award by the NHS Leadership Academy
Our Commissioning Intentions 2013-14 available at www.kingstonccg.nhs.uk
Naz Jivani – Chair, Kingston CCG
A Year In Review
Engagements Highlights 2013-14
We can only commission responsive, high quality local health services by involving the local residents who use these services.
In 2013-14, we engaged local people through Patient Group meetings, our work with Health Watch and Kingston Council and communications
Patient feedback helped us design and develop services including: Cardiology Community Services (April 2013) Unscheduled and Urgent Care; End of Life Care (July 2013) Personal Health Budgets (January 2014) Better Care Fund (March 2014)
• A Year Book summarising Kingston CCG’s Engagement activities is available on our website www.kingstonccg.nhs.uk
Naz Jivani – Chair, Kingston CCG
A Year In Review
Partnership Highlights 2013-14
Kingston CCG along with others faces major challenges including increasing demand, an aging population and need for 7 day health service provision
To meet these challenges Kingston CCG has continued to work with the other South West London CCGs under the name – South West London Collaborative Commissioning
Together, we have developed a comprehensive, five year strategy for the local NHS including primary care, community and mental health and hospital care
Kingston CCG also worked with Royal Borough of Kingston to integrate health and social care
Naz Jivani – Chair, Kingston CCG
AGM 2014Commissioning Healthcare – Moving Forward Together
Phil Moore
Kingston CCG
I know who is in charge of coordinating my care
I am treated as a person and helped to stay well, and so is my carerI am supported through
difficult times
I manage my conditions myself and am in control of decisions about my care
I live safely and well where I want to be
I feel part of a community
I know where I can get help and support
The care I receive is built around me
My independence is respected
Better care for service usersPart of the vision …
Surbiton Health Centre
• Drivers– Co-location of a wide variety of services at the heart of the community– Quality and accessibility – Available to residents of the south of the borough and also the rest of
Kingston– Innovative approach to services in the community
• Enablers– Using half the site for a new school– The concept of polyclinics– LIFT (Local Improvement Finance Trust)– The push to integration of services
17 years in the making …
Surbiton Health Centre17 years in the making …
Surbiton Health Centre provides …
4 General Practices – Central Surgery,
Langley Medical Practice, Brunswick Surgery,
Berrylands Surgery
Diagnostics – X-ray, ultrasound, retinal
screening, mammography, audiology
Community services – nursing, health
visitors, physiotherapy, speech & language
therapy, podiatry, etc.
Outpatients clinics – from GPs with special
training and consultants
Minor surgery – fully equipped theatre for
procedures under local anaesthetic
100 hours a week community pharmacy –
open 7 days a week and late each evening
Urgent Care Centre – with assessment bays
to avoid hospital attendance – awaiting final
go ahead to open
Community Corner – access to a wide range
of community information from RBK
Mental health services – space for
consultations for counselling and
psychology
All under one roof …
Surbiton Health Centre
• Easy– To access a variety of services in one place– Diagnostics on site– Space to increase the provision of care close to home– Ability to increasingly innovate
• Future– Improve the provision of 8am to 8pm services, 7 days a week– Increasing range of services in the community (e.g. cardiology
from October)– Closer working between primary community and secondary
services – integration
Making a difference now and in the future …
Annual General Meeting 2014Commissioning Healthcare – Moving Forward Together
Finance ReportHardev Virdee – Interim Chief Finance Officer
Financial Targets
Maintain financial stability through not exceeding resource targets
Use the CCG’s resources wisely to meet the health needs of Kingston and to ensure value for money and fair and effective use of resources
Stay within Running Cost Allocation of £25/head of population (£4.6m)
Kingston CCG’s first set of accounts were submitted on time with an unqualified audit opinion.
Month 12 – Income and Expenditure
Budget Actual Variance£000's £000's £000's
RESOURCESRevenue Resource Limit 199,694 199,694 0
APPLICATION OF FUNDSAcute Commissioning 109,908 110,547 (639)Non Acute Commissioning 54,819 56,117 (1,299)Primary Care & Prescribing 22,870 23,108 (238)Corporate and Reserves 10,086 7,880 2,206
Total Applications 197,682 197,652 30
In Year Surplus/(Deficit) 2,012 2,042 30
Year To Date
How did we spend our money?
Income from DoH
Acute Services
Mental Health
Services
Community Services
Continuing Care
Other Non Acute
Primary Care Prescribing
Primary Care Other
CCG Running Costs
Other Costs Surplus
£199.7m £110.5m
£19.3m
£17.0m
£14.5m
£6.8m£19.6m
£3.6m £4.2m £2.3m £2.0m
Running Costs – the cost of running the CCG
TARGET ACTUALRunning Costs £'000s £'000s
Resource Limit (£25/head) 4,610 4,185 Weighted Population 184,313 184,313
Running cost per head of weighted population (£) 25 23
Running costs target for the CCG in 2013/14 was £25 per head of population or £4.61m in total.
Our expenditure for the year was £4.185m representing an underspend of £425k, which was spent instead on patient care. This was primarily met by not spending our contingency reserve.
We are planning for a 10% reduction in running costs going forward
Summary
As a CCG we faced many challenges in our first year some
of which were beyond our control:
• New organisations with new responsibilities
• New national finance ledger system
• New boundaries on use of patient data
• Changing criteria on how to manage the money
Given the challenges the CCG has delivered a strong
financial performance which will be crucial going
forward
AGM 2014Commissioning Healthcare – Moving Forward Together
Looking to the Future
Tonia Michaelides – Interim Chief Officer
Looking to the Future
Context
• Kingston CCG’s looks to the future against a national backdrop to deliver ever better services within tighter budgets and increasing population with complex health needs
• In developing our plans for the future, we will continue to work our partners, patients and the public.
Tonia Michaelides – Interim Chief Officer
Looking to the future
Working with the five other South West London CCGs under the umbrella name – South West London Collaborative Commissioning – we have developed the South West London five year strategy (to 2018) to address the following challenges:
• The quality of care• The workforce gap• Financial sustainability• Rising demand for healthcare
The south west London five year strategy is available at www.kingstonccg.nhs.uk
Tonia Michaelides – Interim Chief Officer
Looking to the future
Key outcomes the SW London five year strategy is working to achieve:
1. Securing additional years of life for people with treatable mental and physical health conditions
2. Improving the health-related quality of life of people with one or more long-term conditions, including mental health conditions
3. Reducing the time people spend in hospital through better and more integrated care in the community, outside of hospital
4. Increasing the proportion of older people living independently at home following discharge from hospital
5. Increasing the number of people with mental and physical health conditions having a positive experience of care in hospital, in community services and in general practice
6. Making significant progress towards eliminating avoidable deaths in our hospitals caused by problems in care
Tonia Michaelides – Interim Chief Officer
Looking to the future
Working with RBK (Adult Social care and Public Health), Kingston CCG has developed an Operating Plan up to March 2016
Highlights from our Operating Plan include: Integrated Services for Adults – with a strong focus on increasing proactive
and preventive activities, early intervention, enabling better coordinated health and social care
Urgent and Emergency Care alternatives to A&E: moving to 7 day working
Children and Young People including safeguarding arrangements, mental health services and implementation of the Children and Families Bill.
Improving Quality, Patient Safety and involving Patients and local people in our work.
Tonia Michaelides – Interim Chief Officer
Looking to the future
Kingston CCG’s plans also include:
Children – ensure robust safeguarding in place; implement the Children and
Families Bill; improve mental health services; commission integrated disabled
children’s services esp. from ‘Achieving for Children’
Adults and Older People – focus on self-care, prevention, early intervention
including targeted support for those at risk; rapid response for admission
avoidance; further expand Kingston at Home (esp. rehabilitation and reablement)
including 7 day working; progress ‘Discharge to Assess’ to improve discharge from
hospital and subsequent decisions about care
Mental Health – improve adult and older people’s community mental health
services; implement a new model of dementia care built around GP and community
services; continue expansion of community wellbeing services; consolidation of
dual diagnosis services
Urgent Care – ensure whole-system 7 day working; re-specify and procure new
GP out of hours and NHS111 services; progress alternatives to A&E attendance
Tonia Michaelides – Interim Chief Officer
We are committed to working with You, our residents and
stakeholders to develop solutions that will deliver safe,
high quality care for everyone.
We welcome Your ideasContact Kingston CCG
Thank You