NHS North West Surrey Clinical Commissioning Group Annual

NHS North West Surrey Clinical Commissioning Group Annual General Meeting 18 July 2018 12. 30 – 3. 00 pm

Programme Introduction, performance overview and highlights from the year Dr Charlotte Canniff Clinical Chair

Performance Overview Successes £ MSK – Exemplar Service Care home help line e-Referral Service Cancer care Joint Commissioning Intentions Delayed transfer of care Locality Hubs GP Extended Access Funding to improve local diabetes services Out of Hospital

Electronic Referrals e-RS is a key element in the move to a paperless NHS. In 2017/18 all GP Practices were supported to transition over to e-RS, enabling GPs to send referral letters quickly and safely to the NWS Referral Support Service (RSS). Patients contacted within 24 to 48 hours to book a routine first hospital appointment with a choice of place, date and time. For suspected cancer referrals the patient is initially contacted within four hours of the referral being received by the RSS. All GP Practices have been trained on e-RS and have proactively supported the paper switch off project, which went live 9 July, three months ahead of the national obligation in October 2018.

Locality Hubs Update Bedser • • Caseload of 2, 800 patients Community transport 4 ASPH consultant sessions a week – respiratory, care of the elderly and cardiology Pilot Reactive Service continuing Ashford • • • Opened February 2018 Community Transport Community Matrons and Social Workers CSH heart failure nurses Home visiting Virtual Ward caseload. Walton • Opened May 2018 • Community Transport • GP, Community Matron • Wellbeing Coordinators, • Adult social care and District and Boroughs. • Access to Reactive Service • Pharmacist recruited

Diabetes – new integrated diabetes specialist nurses now supporting patients at Ashford & St Peter’s, Royal Surrey County and Epsom hospitals and in the community. According to Diabetes UK these specialist nurses help reduce length of stay in hospital, improve patient satisfaction and are cost effective.

Care Home Help Line • Rapid access clinical advice line available to health care professionals and non-professional staff across North West Surrey’s Care Homes • 27 Care Homes across NWS have fully utilised the opportunity to dial in and have a GP return their call • Significant decreases in both A&E attendances and admission following the implementation of Care UK’s care home advice line • Supported a reduction in A&E attendances and ambulance transfers involving care and nursing home patients

Delayed Transfer Of Care

Extended Access – Primary Care Winter and Easter joint working with partners to plan, fund and deploy a range of initiatives to support access, resilience and responsiveness during these periods of high demand Significant and material focus on extending access and capacity in primary care £ 417 k invested in local practices to secure additional appointments and support additional GP services in Walk in Centres CCG worked closely with North West Surrey’s GP federation NICS, to deliver 3441 additional GP appointments between January and end of March.

Handi – App Handi App is an innovative new mobile app that gives parents instant and up-to date advice about common childhood illnesses, and how to treat them. The app takes parents through a series of questions about the symptoms their child is experiencing and then advises on the best course of action. The app gives simple and straight forward advice on what to do and who to contact when a child is unwell. North West Surrey commissioned the Handi. App in November 2017, it has now been adopted across Surrey Heartlands. Number of times used Parent Pathways HCP Pathways Hospital Pathways Android IOS 1048 3533 262 1357 204 896 This is the most recent up to date analysis and relates to every time the HANDi Paediatric App for Ashford and St Peters has been accessed from the time it was launched in October 2017 to July 2018. This demonstrates that Handi App has been used 7300 times since launch – This is the highest usage since the App was launched in the South West of England.

Financial review of the year 2017/18 Karen Mc. Dowell Chief Finance Officer

A Year in View – Financial Review Financial Performance Target £’ 000 Performance £’ 000 Variance £’ 000 Expenditure 485, 246 482, 693 (2, 553) Resource 484, 246 0 1, 000 (1, 553) (2, 553) (Surplus) / Deficit

A Year in View – Financial Review Services we spend our money on £ 483 m Total expenditure in 2017/18 £ 259 m (54%) Largest area of spend was for acute services

A Year in View – Financial Review What we spend our money on The chart illustrates what the CCG spent its allocation on in 2017/18 The largest area of spend was on services from NHS bodies – Commissioning of healthcare

A Year in View – Financial Review Where we spend our money The chart illustrates the organisations with whom the CCG spent its resource in 2017/18 The largest area of spend was with Ashford and St Peter’s Hospital as the CCG’s main acute provider

2018/19 Financial Position • CCG has a challenging financial plan for 2018/19 – Surplus of £ 2. 6 m. • Growth in CCG allocation (2%) is offset by growth in expenditure budgets and increase in acute tariff costs resulting in a “planning gap”. • QIPP target of £ 12. 5 m (2. 6% of the CCG resource limit) which underpins the delivery of the plan. • National planning guidance has been followed in preparing the financial plan including setting the budget for 0. 5% contingency and tariff and growth assumptions. • CCG reports risk outside of the plan position of £ 12. 4 m mitigated by the release of contingency and other mitigations to a net risk position of £ 8. 5 m.

Our plans for the future Karen Thorburn Managing Director

Looking Ahead Challenges Action Continued rise in demand for healthcare Greater focus on prevention, community hubs, pro-active support for people with long-term conditions Health inequalities and variation in outcomes Work underway to address this through Surrey Heartlands, including focus on first 1, 000 days Financially challenged system Focus on integration and transformation to achieve longerterm sustainability and new shared system control total Integration of planning and delivery of care Rebuilding in Weybridge NWS Health and Care Partnership development Out of Hospital Strategy Model of Care development Engagement and co-design of services and building

An evolving system Working with Partners in health and care including NICS, the GP federation, on the creation of North West Surrey Health and Care Partnership Providing joint leadership, planning and delivery of local care for local populations, based on local needs Integration is central to this new way of working Local partnerships will work together with key organisations to join up and integrate care pathways, putting patients at the centre

Supported by the wider Surrey Heartlands Partnership Where there are opportunities to work across a wider geography, this will be done through the Surrey Heartlands Health and Care Partnership Surrey Heartlands will work with clinicians and citizens to agree clinical standards and care pathways, drawing on the latest clinical evidence Integrated Care Partnerships will then work together to deliver these standards locally in a way that works for them and for their patients

Get involved You can get involved to help make a difference Patient Quality reps Patient and Public Engagement (PPE) Consultations Sub Committee membership Patient Participation Groups (PPG)

Contact us 01372 232400 www. nwsurreyccg. nhs. uk @NHSNWSurrey. CCG

Surrey Heartlands Health and Care Partnership and Devolution Dr Charlotte Canniff Clinical Chair Karen Thorburn Managing Director

Surrey Heartlands 1 County 3 CCGs Council 4 Acute 684 GPs 95 GP Practices 8 GP-led 1 Community localities Service Providers Hospitals 7 District / 1 Mental Health 11 Community Borough Councils Provider Hospitals Surrey Heartlands Health and Care Partnership

Celebrating our progress so far

Surrey Heartlands National Priorities and clinical workstreams Mental Health Urgent and Emergency Care Cancer Out of Hospital Care Women and Children Musculoskeletal Public Estate Prevention Clinical Academy Cardiovascular Benefits Value for money Prevention and selfcare Work as one team Accessible care Reduce health inequalities Sustainable financial balance Quality health &social care outcomes Shared decision making

Looking Ahead - Devolution Health and Social Care Devolution for Surrey Heartlands Local control over commissioning decisions Focus on place and people, not organisations Devolution Flexibility to integrate and transform Alignment between health and local government Raised national profile of Surrey Heartlands

Questions ? ?