1. Croydon Clinical Commissioning Group An introduction

2. The CCG is responsible for overseeing the local NHS budget of, approximately £415 million for hospital, community and mental health services. Our job is to make sure it is spent on the right services to meet the health needs of people in Croydon.

3. The CCG is an autonomous statutory body accountable to NHS England nationally We commission a wide range of services across primary, community and secondary care: Planned Hospital Care Urgent & Emergency Care Medicines Rehabilitation and Continuing Care Community Health Services Mental Health Services and Learning Disability Services We are responsible for planning, designing and commissioning healthcare services for the people of Croydon.

4. We are an organisation led by GPs We understand the needs of our patients because we see them every day and we are committed to working with our local partners in health, public health, and social care to improve the way in which we deliver services. We know that our partnerships have become even more important: With providers, for example in our whole system Transformation Board With Croydon Council, through our Integrated Commissioning Unit, the Health & Wellbeing Board, and Public Health With Patients, the public and other stakeholders With other CCGs in South West London (the South West London Commissioning Collaborative) We are a “membership” organisation made up of all 61 GP practices in the borough of Croydon The clinical influence of our membership and clinical leadership means that we have been able to focus on quality and clinical effectiveness this year.

5. Our team (Governing Body)

6. This means that there is more demand than ever on our health services, and this demand is continuing to increase and we know that the funds available to spend on health services will not be able to keep pace with this rise in demand. To continue to provide a high quality health service, we will have to make significant changes over the next few years - our plans must meet the health and financial challenges and also improve the quality of local services for the people of Croydon. From our inception as a CCG, we commenced an ambitious programme of change. In our first year as an organisation, we have been bold in developing our plans for a sustainable health service for the future – pushing organisational, professional, contractual and service redesign boundaries so that we can achieve the best possible care for the people in Croydon. The population of our borough is increasing. We also know that people are now living longer, and often with one or more long-term medical conditions. It has been an important year for the NHS nationally and locally.

7. Limited resources 10% increase in the number of young people under 20 in next five years Number of over 85s to increase by over 60% by 2029 A third of our ten year olds are overweight. This is higher than the national average. Hospital admission rates attributable to smoking are 16% higher than London average A tenth of all children in Croydon experience mental health problems A fifth of men in their 50s have at least one long-term condition Heart disease, lung disease and cancer are top 3 causes of death Health inequalities are rising

8. This funding gap has existed for a number of years, and has left the CCG with significant financial challenges. This means that we have had to work particularly hard to improve services in ways which improve efficiency, effectiveness, and a reduction in costs. Against this backdrop we are proud of our achievements this year. We have improved the quality of services for people in Croydon, introduced the rigorous financial control, and challenging transformational plans necessary to deliver and achieve financial balance over five years. NHS England recognises that the CCG is underfunded each year by approximately £46m for the needs of its local population. The CCG is underfunded by about £46m a year

9. The delivery of £14m (3.5%) efficiency savings has been a great success in the first year of operation. The financial benefits are the product of a clinically led initiative to improve services for patients. The CCG is exploring new approaches to commissioning services locally, in particular we are developing an innovative outcomes and capitation based approach to commissioning health and social care services for older people in Croydon, in collaboration with Croydon Council. Given the indicative five year funding settlement, local health economy forecasts, and the benchmarked efficiency opportunities, the CCG will not be in a position to repay the predicted accumulated deficit. Considering the inherited underfunding position, Croydon has successfully delivered ahead of expectations this year, by recording an £18.2m deficit against the £19.9 deficit plan. We are succeeding in turning around our financial position

10. In particular, over the past year we have: Invested in Multi-Disciplinary Teams, Rapid Response and Single Point of access for older people in the community Developed plans which will transform the way patients receive cardiology services in Croydon. Developed a new integrated model of care for people with diabetes based in the community and supported by a consultant-led diabetes service. Delivered our ambitious quality improvement and efficiency programme and kept within our challenging financial deficit plan Developed, expanded and engaged our clinical leaders and membership to drive significant change Established our patient and public forums to get a better understanding of local people’s concerns It has been a challenging year but we made significant progress toward achieving our vision of “longer healthier lives for all the people in Croydon”. We have achieved a great deal in our first year

11. In summary, we are facing up to the challenge Inherited significant challenges Strong Leadership (Clinical & Managerial) Team Robust financial plans for a financial recovery that is clinically and quality lead Committed to holding our providers to account to improve services Hugely ambitious plans are being delivered to secure better care & improved outcomes for the people of Croydon