Annual General Meeting Transforming your local NHS Our year in review

Our role as a CCG We are responsible for developing, planning and purchasing health services in Fareham and Gosport. We want these to be the best possible services for people and we work with many different organisations to try and make that happen – listening to the views of patients, groups and members of the public as we develop them. We have a budget of around £254m to buy services from local providers including Portsmouth Hospitals NHS Trust, Southern Health NHS Foundation Trust and local GPs.

Our priorities for people in Fareham and Gosport Everyone should have the support they need to live the life they want, take control of their health and be as independent as possible throughout their lives... Our priorities focus on: Staying healthy and preventing ill health Integrated care away from hospital Urgent and emergency care Improving elective care Improving quality and reducing variation

So, what progress have we made? Better Local Care: we are at the forefront of developing a multi-specialty community provider and creating new models of care Same day access to GP in Gosport Surgery Signposters Working more closely with GP practices through new commissioning responsibilities. Improving access to care: 94% of outpatients received treatment within 18 weeks of initial referral, and 98% of people had a diagnostic test within six weeks Meeting mental health access targets Primary care opening hours extended Low waiting times for cancer care.

Financial context The two previous years, the CCG broke even, despite ongoing pressures The CCG entered 2015/16 with little reserve or contingency The annual savings target was tough: £9.9m, about 4% of the budget By September, it was clear that the CCG faced a deficit. Main pressures: the PHT contract, and Continuing Healthcare. Almost all of the savings plan was delivered - £8.2m out of £9.9m. This limited the deficit to £4m The 2015/16 deficit must be repaid in 2016/17 - extremely challenging.

Financial performance 2015/16 The CCG loss of £4,012,000 (against a Revenue Resource Limit of £253.6m) was below the £677,000 target surplus, below the 1% of expenditure set out in the NHS England planning guidance, and below the CCG’s original plan of a 0.3% surplus. The deficit triggered a ‘Section 30’ report to the Secretary of State from the CCG’s external auditors. Cash was managed within available resource limits. The CCG running costs were £18.20 per head, well within £24.80 target.

Analysis of spend 2015/16 Annual budget 2015/16 £m % of budget Over / (under) spend Portsmouth Hospitals NHS Trust 100.2 39.5 3.2 Other acute contracts 22.9 9 1.5 Mental Health 16.5 6.5 (0.2) Community Services 26.5 10.4 (0.1) Primary Care Commissioning 60.1 23.7 (0.9) Continuing Healthcare 17.7 7 2.6 Other Commissioning 3.9 0.1 Running Costs 5.1 2 (1.4) Reserves and Contingencies 0.7 0.3 (0.8) 253.6 4.0

Urgent care improvements ‘a priority’ We know things have to improve quickly for patients needing emergency care. CQC report demands immediate action from Portsmouth Hospitals NHS Trust. All NHS organisations and local authorities are working together to ensure that patients are cared for appropriately from admission to discharge…and follow up care. New schemes in the pipeline – eg Discharge to Assess. Range of alternative urgent care services in place including same day GP services, minor injuries units, greater role for pharmacies and the urgent care centre at QA Hospital.

Where else do we need to do more? Demand for primary care services (eg. getting an appointment with a GP) continues to be an issue that concerns people locally. GP recruitment/retention is becoming more difficult, which may lead to different ways of providing services. Need to keep scrutiny on waiting times – particularly our 18-week targets. Financial pressures will be significant for us in the year(s) ahead; we are still amongst the lowest-funded CCGs nationally – but also have some of the lowest running costs.

What you have told us Your feedback helps us plan more effective services. In the past year: People in Gosport told us their views on primary care services which helped us plan the same day access service at GWMH. We also worked with South Eastern Hampshire CCG to seek the views of local people about how care could best be organised in the community to support more patients being cared for at home. Several focus groups helped us hear about priorities, challenges and worries for people with long term conditions.

How will we face up to the challenges ahead? Ensuring financial stability is critical. Increasing the emphasis on early intervention, prevention and provision of care away from hospital and closer to patients’ homes. Plans to ensure that assets like Gosport War Memorial Hospital and Fareham Community Hospital are used to full capacity. Working closely with GPs/primary care – GP Forward View. Better Local Care – building on the progress made to date in Gosport with expansion into Fareham.

Implementing ‘Better Local Care’ Programme has now extended from Gosport into Fareham - positive launch event in May. Working groups to start looking at initial priorities, including care for frail elderly. GPs will be at the heart of making this work effectively with primary, community and social care colleagues and voluntary sector. Next steps in Gosport include an ‘out of hospital team’ that delivers care in a truly different way, where clinical teams are developed across organisations to focus directly on patient outcomes. 

Annual General Meeting Questions