NHS Airedale Wharfedale and Craven Clinical Commissioning Group

Dr Colin RenwickCCG Clinical Chair

Why are we here

• Looking back - To share our Annual Report and Accounts for 2013/14

• Looking forward - To discuss with you what we would like the future to look like

• Your views - To ask your views on how we can do things differently and what is important to you

What is in our annual report and accounts?• Introduction from the

representative of our member GP practices – Dr Bruce Woodhouse.

• Strategic report.• A report from our member

practices.• Remuneration report.• Statement of Accountable Officer

Responsibilities – Dr Phil Pue.• Governance statement.• Annual accounts.

Who are we• We have a 156,000 population and 17 member practices.

What health services do we commission?

• Last year we spent £186million on health services – equivalent of £1,192 per patient.

• We have a 156,000 population

This includes: hospital services, mental health services, ambulance and patient transport services, out of hours GPs, community health services and medicines.

We buy

Our strategic priorities in 13/14:• Transform urgent care• Transform planned care• Transform mental health services• Reduce health inequalities and increase health

promotion• Achieve excellence in prescribing and medicines

management• Maintain safe, high quality and effective care• Develop a sustainable CCG

Annual Report and Accounts 2013/14

Dr Phil PueCCG Chief Clinical Officer

Three people every day in the Bradford District

experience a stroke

12.6% households in Bradford and Airedale and 25.1% in Craven live in fuel poverty

1 in 4 patients in hospital has dementia

£7 in every £10 of health and social care spend is for people who have a

long term health problem

1 in 10 people locally provide some level of

unpaid care – the UK is third in Europe for the

number of informal carers

Some facts…..

Levels of diabetes are higher than the England average.

We have more people aged over 75 years old

in our area than the national average.

More people binge drink in our area than the England average.

Levels of chronic obstructive pulmonary disease and asthma in our area are above the England average.

Some facts…..

We have higher levels of depression compared to the rest of the Bradford

district.

Three people every day in the Bradford District

experience a stroke

12.6% households in Bradford and Airedale and 25.1% in Craven live in fuel poverty

1 in 4 patients in hospital has dementia

£7 in every £10 of health and social care spend is for people who have a

long term health problem

1 in 10 people locally provide some level of

unpaid care – the UK is third in Europe for the

number of informal carers

Some facts…..What progress have we made?

Home oxygen service set up in Craven

“Gold Line” service for patients at the end of life.

Community health navigators and health promotion managers

Specialist dementia beds in Holmewood Care Home.

Alcohol workers in A&E and GP practices

Communications campaign to help people choose the

right health service for their needs

What progress have we made?

More mental health talking therapy services.

Village agent scheme in Craven to help people get involved in activities

Specialist tissue viability nurses in care homes.

More telemedicine in homes and care homes.

Increased psychiatric liaison service in A&E

We were involved in the planning of Tour de France so health services were available.

How we engage with patients and the public

Engagement last year

We spoke to many groups and people about their views on the national NHS debate ‘A Call to Action’, including: Keighley Association Women and Children's Centre; Bangladeshi Commmunity Centre; Keighley Healthy Living Network; Skipton and Craven Action for Disability; Keighley and Ilkley Voluntary and Community Action; Highfield Community Centre; Roshni Ghar; Skipton Older Peoples Reference Group; Age UK; luncheon clubs in Settle; Craven Area Carers’ Group; South Craven Over 50s Forum; Skipton Islamic Society; Temple Row Centre in

Keighley; Sue Belcher Community Centre; i centre in Ingleton; Medina Mosque in Keighley; Patient Participation Group Network; Health and Wellbeing Hub; Carers’ Resource in Skipton; Sangat Centre; Clarke Foley Centre in Ilkley.

Equality and diversity

Safeguarding• Safeguarding is keeping adults and children safe from abuse.

• We work in partnership with the two local CCGs – NHS Bradford City and NHS Bradford Districts.

• We make sure staff have the knowledge and skills to recognise, report and respond to safeguarding issues.

• We are members of the local safeguarding boards for Bradford and North Yorkshire.

• We monitor the performance of our providers regularly to ensure safeguarding systems are in place.

Remuneration Report - our staffOur full annual report contains details of:

• Who sits on our committees.• A profile on each of our senior managers.• Our register of conflicts of interest.• Pay and pension liabilities of senior managers in the CCG.

Governance statement - how the CCG is runRisk – We keep track of risks through our risk register and assurance framework. Information Governance – We have been working to meet the standards set out in the NHS information governance toolkit. This ensures we can keep information safe and secure.

Reporting incidents – We log and investigate “serious incidents” to make sure we learn and make changes, if needed, to stop them happening again.

Audit – We receive independent scrutiny from our auditors who have audited our processes and our annual report and accounts.

Finance, Performance and Governance Committee

Hospital consultant

Practice manager

rep

Exec GP

Lay member

CCG senior

managers

Patient and Public Engagement Reference

Group

VCS Lay member

Exec Nurse

CCG senior

managers

Other public sector

Patient groups

Audit Committee

AuditorsLay

members

Hospital consultant

Chief finance officer

Clinical Quality and Governance Committee

Hospital consultant

Exec GP

Lay memberCCG

senior managers

Registered and Exec Nurses

Remuneration Committee

Lay members

Registered Nurse

Executive Group

CCG senior managers

Exec GPs

Practice manager rep

Public Health

Exec Nurse

Governing Body

Lay members

Registered nurse CCG senior

managersExec GPs

Hospital consultant

Council of Members

CCG senior managers

Practice managers

Exec GPs

Member GPs

Council of Members(chaired by Member practice representative)

Governing BodyExecutive Group

Lay member (governance)

Secondary Care

Consultant

Registered Nurse

Lay Member (engagement)

Member practice

representative (GP)

GP Executive

GP Executive

GP Executive

GP Executive

Chief Clinical Officer

Clinical Chair

Chief Operating

Officer

Executive Nurse

Chief Finance Officer

These four roles above sit on both the Executive Group and Governing Body

Decision making

Assurance

Director of Public Health

Our finances

Our target expenditure for 2013/14 was £190 million and our actual spend was £187 million.

Financial performance

*The running cost is the amount the CCG regularly spends so it can function, like salaries and rent.

Our performance last year

Targets met Underperformance

A&E four hour waits Ambulance response times

MRSA and C. Difficile Ambulance handovers

18 week wait for treatment Aspects of stroke care

Mixed sex accommodation Hospital admissions due to alcohol

Cancer waiting times

People improving after talking therapy

Our ‘Annual Review’, a summarised review of 2013/14, is available today.

Our annual report and accounts for 2013/14 is on our website.

We received a number of questions prior to the event that were about wider issues than the annual report. A printed copy of these Q&A is available today.

Do you have any questions about the 2013/14 annual report and accounts?

Looking to the future

Our five year forward view

Five year forward viewA district wide plan that was written in partnership with the two Bradford CCGs, and health and care providers in the district.

The future…..

There is a significant funding gap

What does £1000 buy you in the NHS?

31 GP appointments

One fifth of a hip replacement

Approx. ten A&E attendances

One eye cataract removal

Approx. four ambulance responses

Treating an insulin dependent diabetic for eight months

District nurse

General practice

Podiatrist

LA OT

Physio-therapy

Practice nurse

Heart doc Diabetes

service

Warden

Community health services

Local Authority

Housing agencies Voluntary & Community sector

Secondary care

Primary care

Discharge team

Equipment services

Community mental

health teams

Housinggrants

Memory assessment

Community Matron

Out-patients

Home care

Social worker

Telecare

Vol & comm sector

Vol &Community

sector

Falls service

Health OT

Housing services

GP

We want to go from this

To this – our vision

Graphic courtesy of Airedale FT

We hope to achieve our vision with the following new models of care:

Enhanced Primary Care

Accountable GP

Care Coordinator

• Care plan

• Reviews in between visits

• Referrals and coaching to enable self-care

• Set personal goals

• First point of contact for help, support & advice

• Accountable

• Monitor & review each patient

• Diagnose & treat

• Develop action plan

• Oversight of referral

What will help us achieve this?

What next

• We want to share these draft plans with patients, the public and carers to get your thoughts and feedback.

• We will be engaging more on our plans over the coming months, including holding more events.

• If you have any comments from today, please share them with us using the contact details on the following slide.

Email: engage@awcccg.nhs.uk

Address: NHS Airedale, Wharfedale and Craven Clinical Commissioning GroupMillennium Business Park, Station Road, Steeton, Keighley, BD20 6RB

Phone: 01274 237 324