NHS Darlington CCG Annual General Meeting 201617 Annual

NHS Darlington CCG Annual General Meeting 2016/17

Annual General Meeting 2017 2

About Darlington CCG • 11 Family GP practices • Population of 107, 318 • Higher than average deprivation • 20. 6% of children living in poverty • Lower than average life expectancy 3

Our vision and aims “To commission healthcare that will improve health outcomes, reduce health inequalities and ensure fair and equitable access to high quality, safe, patient centered services. ” Our strategic aims are to: • improve the health status of the people of Darlington; • secure the right services in the right place for the people of Darlington; • invest in primary care and services; • secure meaningful engagement with people. 4

Our financial challenges and delivery Target Outcome Delivered Deliver surplus on revenue budgets of at least 1% plus uncommitted funding on 1% Surplus of £ 3. 4 m on revenue allocation of £ 164. 5 m Maintain running costs within allowance Running cost spend of £ 2. 3 m against allowance of £ 2. 3 m Maintain capital spending within capital resource limit No capital resources allocated to the CCG and no spend incurred Ensure cash spending is within the cash limit set Cash managed within available resources Target Achieved 5

Our financial challenge and delivery 6

Our commissioning challenges and delivery Our ambitions are to; • Transform the way health is provided • Change the way we care for older people with a joint approach to health and social care • Improve urgent care services • Improve access to GPs • Strengthen care delivered outside of hospital • Provide a patient centred approach to providing care in the community or at home • Prevent unnecessary admissions to hospital • Present a vision for the CCGs plans for new models of care, what health services in Darlington will look like in the future 7

CCG Population – Our challenge 8

Our commissioning successes to b experience The CCG was a crucial partner in the successful application for Darlington to become a ‘Healthy New Town’, one of 10 demonstrator sites in England. We have developed ambitious plans to strengthen services delivered in primary care, attracting more GPs to the area and improving integration with social care. We will increase the number of services that are delivered outside of hospital settings and develop health and social care hubs as part of the Sustainable Transformation Plans (STP) vision for 2020. We are a key stakeholder in the Better Health Programme about how the NHS in Darlington, Durham and Tees can improve outcomes and for patients when they need care, especially in an emergency. 9

Our commissioning successes To improve urgent care we have moved the urgent care (walk-in) service from Doctor Piper House in Darlington town centre to Darlington Memorial Hospital, alongside the Emergency Department We have improved access to GPs with pre-bookable GP and nurse appointments available during evening and weekends at Doctor Piper House The CCG has developed a two year operational plan as part of our response to the Five Year Forward View. The Better Care Fund creates a single pooled budget to incentivise the NHS and local government to work more closely together. This has seen the CCG and Darlington Borough Council work together to transform the way we care for older people, reducing unnecessary hospital stays. 10

Our commissioning successes We have ambitious plans to strengthen services delivered in primary care, attracting more GPs to the area. Emergency admissions to hospital continue largely at similar levels to previous years, but we can see the impact of targeted activity in relation to older people’s admissions to hospital from care homes, which continue to fall. We are continuing a pilot programme that involves GP practices becoming aligned to nursing and residential care homes with 8 practices providing additional support to 21 care homes across Darlington. 11

Our commissioning successes We are part of the North East Urgent and Emergency Care Network. In 2016/17 the network received £ 2. 9 m from NHS England to implement various schemes, including; An under 5 s health app which provides easy to understand guidance on childhood illnesses as well as advice on when and where to seek treatment. Great North Care Record which is bringing the region up to a common standard of information-sharing, saving time and improving patient safety, enables real-time access to patient information at the point of care in emergency departments, GP out of hours services, mental health trusts, NHS 111 and the ambulance service. 12

Our commissioning successes We continue to commission community step-down beds where patients are transferred to from an acute bed when they are medically fit but may not yet be capable of returning home. We have developed a new Integrated Diabetes Model which will see care being delivered to all but the most complex diabetes patients within a GP practice setting with skilled diabetes GP’s and Practice Nurses. We continue to achieve high standards with regard to meeting cancer waiting time targets. These are performance figures we are proud of and we are continuing to improve the outcomes of those affected by cancer. 13

Our performance challenges and delivery Sustainability and Transformation Plans Challenge - The Five Year Forward View, NHS Planning Guidance, and the Sustainability and Transformation Plans (STPs) for each area, are all driven by the pursuit of the “triple aim”: (i) improving the health and wellbeing of the whole population; (ii) better quality for all patients, through care redesign; and (iii) better value for taxpayers in a financially sustainable system. Delivery - We have developed ambitious plans to strengthen services delivered in primary care, attracting more GPs to the area and improving integration with social care. 14

Our performance challenges and delivery Finance Challenge – CCGs are set resource limits on an annual basis and must contain their expenditure within these limits. Financial targets and performance for the year in accordance with NHS England financial planning guidance, the CCG is required to deliver a surplus of at least 1% (£ 1. 77 million) of available resources. Delivery - Due to prudent financial planning and management, the CCG’s financial performance in 2016/17 has delivered the planned surplus as was the case for 2015/16. 15

Our performance challenges and delivery Primary care Challenge – improve GP workforce and extend and improve access Delivery – We have ambitious plans to attract and retain GPs in Darlington and we have funded evening and weekend GP and nurse appointments at Doctor Piper House which are pre-bookable and available to all patients in Darlington 16

Our performance challenges and delivery Urgent and emergency care Challenge • A&E four hour waits - 95% of patients should wait no longer than four hours for treatment in an emergency department • Ambulance Response times - All ambulance trusts are expected to respond to 75% of immediately life threatening calls within eight minutes • Where onward transport is required, 95% of life-threatening calls will receive an ambulance capable of transporting the patient safely within 19 minutes of the request for transport being made. Delivery • A&E four hour waits - unfortunately this was an area where performance against the target was not achieved. This will be an area of continued focus for 2017/18. • Ambulance response to life threatening calls - performance of the North East Ambulance Service against both indicators was below target. The CCG is working closely with the provider to achieve a sustainable improvement in performance 17

Our performance challenges and delivery Referral to treatment times and elective care Challenge - Patients have the legal right to start their NHS consultant-led treatment within a maximum of 18 weeks from referral. No patients should be waiting more than 52 weeks for treatment Delivery – Performance for referral to treatment incomplete pathways treated within 18 weeks was above target for the year and Darlington CCG reported no patients waiting for treatment for over 52 weeks, an improved position compared to the previous year, where two cases were recorded. 18

Our performance challenges and delivery Cancer Challenge – Meet all 9 categories for cancer waiting times Delivery - Darlington CCG met targets for six out of the nine categories for cancer waiting times. Performance against the 2 week wait, 2 week wait breast symptomatic and Cancer 62 day wait for urgent GP referral are the 3 areas that were under target. 19

Our performance challenges and delivery Mental Health 20

Our performance challenges and delivery Learning disabilities 21

Our future challenges • Local plans focussing on the bottom two tiers of the STP vision • Development of local GP practice services and integrated community hubs 22

Local model of care 2017/18 building on 2016/17 delivery • Community hubs • Care co-ordination • Discharge management • Care planning • Using technology • Community and voluntary support 23

Integration 24