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East and North Hertfordshire Clinical Commissioning Group AGM 2014 Welcome.

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Presentation on theme: "East and North Hertfordshire Clinical Commissioning Group AGM 2014 Welcome."— Presentation transcript:

1 East and North Hertfordshire Clinical Commissioning Group AGM 2014 Welcome

2 Kate Harding Creative Practitioner Health Liaison Team

3 Lesley Watts Chief Executive






9 2013/14 ANNUAL ACCOUNTS Alan Pond Chief Finance Officer

10 Housekeeping Draft Accounts submitted within 15 working days of the year end – before the 23 rd April deadline Annual Report and Accounts were agreed by Board, audited and submitted to NHS England before the 6 th June deadline Unqualified opinions on the Accounts and Value for Money statement received from the Auditor Full Annual Accounts published with the Annual Report

11 A challenging first year Complete reorganisation of commissioning landscape and funding Increase in CCG baseline funding of only 2.3% – no more than inflation CCG remains underfunded by over £30m Activity growing faster than population growth and the growth in funding NHS England requirement for CCGs to underspend on their budgets by 1% Providers under financial stress

12 £38m £20m Balancing the funding Population growth Increased demand 1% underspend 2.3% funding uplift Tariff reductions Underspend carried forward

13 2013/14 “A good first year” Achieved strong performance across the majority of key performance indicators with c75% delivered (e.g. hospital waiting times, long term conditions, cancer services and end-of-life care) Achieved national requirement for additional efficiency savings Achieved the required 1% underspend of £6m

14 Performance on statutory financial targets Expenditure does not exceed sums allotted to the CCG plus other income received [223H(1)] ACHIEVED £6,020,000 underspent Revenue resource use does not exceed the amount specified in Directions [223I(3)] ACHIEVED £6,020,000 underspent Revenue administration resource use does not exceed the amount specified in Directions [223J(3)] ACHIEVED £3,204,000 underspent

15 Performance across the CCG

16 Where the money was spent Acute services61% Prescribing12% Mental health & learning disability services12% Community services7% Continuing care services4% Other primary care2% CCG running costs2% Acute Prescribing Community Cont. care MH and LD Other primary care Running costs

17 Future cost drivers Increasing population Ageing population Reduced Social Care funding New technology and treatments Patient expectations Drive for continuous improvement So expenditure rises ever faster

18 The financial challenge ahead Continued low growth in funding:  3.38% in 2014/15  2.52% in 2015/16  Estimate 2.6% for each of 2016/17 to 2018/19 10% reduction in running cost allocation Gap between cost of demand and CCG funding – £80m by 2018/19 CCG savings of at least £80m needed over the next 5 years


20 The good news There are excellent and committed clinicians and managers in East and North Hertfordshire to make this work for local people Relationships with Social Care Partners are good and we share the same objectives Relationships with Providers are good and we challenge them to improve their services further We have already identified the efficiencies needed in 2014/15 We have delivered on tough challenges in the past and will do so again

21 Future proofing our strategy Develop the market and improve providers Improve productivity and reduce waste Joint and clinically led commissioning Assess our priorities

22 Dr Hari Pathmanathan CCG Chair

23 A clinically-led organisation Most of the Governing Body members are clinicians – doctors, midwives, nurses. Every ‘locality’ group of GP practices is represented on the board – diverse health needs inform commissioning decisions We are the only CCG in the region to delegate £5 per head funding for over 75 year olds to practices.

24 Clinically-driven improvements Home visits for acutely ill patients commissioned, GPs can focus on complex patients. Better continuity of care for patients and staff in nursing homes Additional winter capacity in the community, avoiding unnecessary hospital admissions

25 Challenges Demand management – demographic, prescribing, staffing and infrastructure pressures New QEII Ongoing issues at Chase Farm Hospital Need to scale up successful schemes across the whole CCG area, such as HomeFirst Political uncertainty

26 Opportunities New best-practice treatment ‘pathways’ for common conditions in development Active and committed patient participation groups Diverse opportunities for clinicians to get involved in new models of care Ongoing learning from pilot projects is improving the services offered to patients

27 Thank you

28 The New QEII Hospital John Webster Director of Commissioning Dr Nicky Williams Vice Chair

29 Introduction Highest priority for the CCG History Phases of the development Services to be provided Clinical perspective Integration Timescales for completion

30 A reminder DQHH - Delivering Quality Healthcare for Hertfordshire Public consultation across Hertfordshire concluded in 2007 Key recommendations:  Centralise acute inpatient services at Lister  Provide a local general hospital in Welwyn Garden City

31 DQHH objectives Centralise specialist services, skills and staff in one place Improve clinical outcomes Improve the patient experience and environment To meet growing demand To recruit the best staff

32 Timeline The new hospital completes in..…. 30 weeks

33 Timeline The next significant milestone is in…. 3 weeks Remaining wards, theatres and Emergency Department transfer to the Lister Hospital on 1 st October

34 Lister QEII October 2014 April 2015 £30 million investment in new hospital New services, new buildings Urgent Care Centre Outpatient appointments, ante-natal care and diagnostic tests Therapy areas and children’s zone Remaining wards and theatres move to the Lister £150 million investment Inpatient maternity care Outpatient appointments and diagnostic tests All surgery All inpatient wards Full emergency department and urgent care centre What’s happening and when? New services, existing buildings

35 What is an Urgent Care Centre? From October 2014, there will no longer be an A&E at the QEII Open 24/7 to treat patients of all ages, including babies Urgent Care Centres treat everything except the most serious injuries or illnesses – when people should call 999. There will also be an Urgent Care Centre integrated within the new Lister emergency department to stream patients appropriately Public understanding of the new way of working is crucial

36 New QEIIListerHertford County Summary of services after October 2014 Local general hospitalCentre for specialist careLocal general hospital 24 /7 Urgent Care Centre for minor injuries and illnesses Full emergency departmentNo emergency care Outpatients appointmentsOutpatients appointments and specialist clinics (e.g. sleep disorders, urgent eye clinic, etc.) Outpatients appointments Medical and surgical inpatient services Specialty services – renal dialysis, heart attack centre, stroke unit, etc. Blood testsFull range of diagnostic servicesBlood tests Scanning: x-ray, ultrasound, MRI, CT scansScanning: full range of scanning services including CT, Dexa, MRI, nuclear medicine, ultrasound Scanning: ultrasound, x-ray Endoscopy Breast unitBreast surgery PharmacyPharmacy – hospital pharmacy only Children’s ZoneChildren’s inpatient and outpatient servicesSpecialist children’s centre Physiotherapy and other therapies Rapid assessment for ill patientsCritical care Out-of-hours GPs Ante-natal careMaternity including births, ante-natal and post-natal Neonatal care Routine blood treatmentsRoutine blood treatments (e.g. anti-coagulants) Planned & emergency surgery (inpatient & day)

37 Every year, the New QEII will deliver: 105,000 outpatient appointments 35,000 Urgent Care Centre attendances 17,000 ultrasounds 13,500 CT and MRI scans 110,000 phlebotomy tests 30,000 x-rays

38 The New QEII


40 June 2014 Progress so far


42 Care home on the New QEII site History ENHT marketing site CCG & HCC specification for bed based care service we want to commission Joint bid evaluation Links to Hospice and services within the New QEII


44 Nicky Photo No 2

45 Nicky Photo No 3

46 HomeFirst Community Hub Discharge to assess Early Supported Discharge NHS 111 Acute in-hours visiting service Doing things differently in the community

47 Mental health services Hertfordshire Partnership University NHS Foundation Trust currently provide some adult mental health services at the QEII Welwyn and Mymms inpatient wards will close in September and move to a purpose built facility at Kingfisher Court in Kingsley Green, near St Albans and Radlett Community mental health outpatient clinics at the QEII will be run from Roseanne House in Welwyn Garden City. Appointments are also held in a range of other locations Kingsley Green: Kingfisher Court is easily accessible via the M25, the M1 and the A1M. Public transport to the site is to be confirmed, but meanwhile HPFT will provide a free transport service from QEII & Hemel Hempstead Hospital and from Radlett, Potters Bar, St Albans City and Watford Junction train stations.

48 Thumbswood mother and baby unit will move to Kingsley Green The Acute Day Treatment Unit will move in due course. It is likely to move to the Glaxo Day Hospital at the rear of the Lister Hospital in Stevenage Community outpatient clinics run from Roseanne House in Welwyn Garden City and other community settings, so these patients will not need to visit an acute hospital site Mental health services

49 New theatres blockThe Treatment Centre Car parking New wards block Investing £150 million

50 Critical care unit Neonatal unit Environmental Infrastructure Refurbished wards Investing £150 million

51 We’re delivering an extensive communications and engagement campaign to ensure everyone understands what’s happening and what’s available at the New QEII and Lister Hospitals NHS 111 will advise anyone with an urgent medical enquiry that is not an emergency, and people should always call 999 when there is a medical emergency Sharing information

52 Summary Draws to a conclusion a significant planning exercise Strong partnership working and staff commitment The new QEII will be central to our future commissioning plans Will result in a fantastic new facility that the local community can feel proud of

53 Questions?

54 Workshop groups

55 Questions?

56 Thank you

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