NHS Hambleton, Richmondshire
and Whitby Clinical
Commissioning Group
Annual Operating Plan 2013/14
28th March 2013
Debbie Newton
Chief Operating & Finance Officer
Our Strategic Plan
Strategic aims
• We will involve people in their care and
we will encourage self-care
• We will buy quality services
• We will change services for the better
and in doing so we will provide care as
close to home as possible that is easily
accessible
• We will use the money we have in the
best possible way
How did we develop our plan?
Our Strategic plan is based on:
•Our current performance
•What we know about the range and extent of services in our area
•Knowledge of local health and social issues through the
Joint Strategic Needs Assessment (JSNA)
•Knowledge of patient and stakeholder views through JSNA
•Department of Health priorities within “Everyone counts”
How do our initiatives link to the JSNA?
How do our initiatives link to the JSNA?
National Commissioning
Requirements
Everyone Counts
• Provides planning guidance, incentives and tools which are intended
to improve services from April 2013.
• Used by the CCG to ensure delivery of the priorities and
requirements which encompasses four key areas:
1.
2.
3.
4.
New approaches to planning.
Improving outcomes, reducing inequalities.
Commissioning support; tools and levers.
Planning and assurance.
• Two challenges are highlighted below:
1.
2.
A guarantee around the reduction of inequality; and ensuring
patients’ interests are placed front and centre in delivery of care.
Five offers to NHS commissioners, providing guidance and
evidence needed to produce better local health outcomes.
Everyone Counts:
The five offers from the NHS
Commissioning Board to CCGs
1.
2.
3.
4.
5.
NHS services, seven days a week.
More transparency, more choice.
Listening to patients and increasing their
participation.
Better data, informed commissioning,
driving improved outcomes.
Higher standards, safer care.
CQUINS (Commissioning for Quality and Innovation)
• CQUIN for 2013/14 is set at a level of 2.5% value for all healthcare
services commissioned through the NHS Standard Contract.
• Trusts are only eligible to obtain CQUIN payments if they satisfy
50% of the pre-qualifying requirements.
• One fifth of the total CQUIN value (0.5% of overall contract value) is
to be linked to the national CQUIN goals.
• 0.5% of the value for all healthcare services commissioned through
the NHS Standard Contract is to be linked to the national CQUIN
goals.
National CQUIN
Friends and Family Test – “How likely are you to recommend our ward / A&E to friends and family”
Improvement against the NHS Safety Thermometer (excluding VTE), particularly pressure sores
Improving dementia care, including sustained improvement in Finding people with dementia, Assessing and Investigating
their symptoms and Referring for support (FAIR)
Venous thromboembolism (VTE) – 95 per cent of patients being risk assessed and achievement of a locally agreed goal for
the number of VTE admissions that are reviewed through root cause analysis
Performance
• Contractual levers as set out in the 13/14 standard contract.
• National performance measures are in performance indicators
delegated to the CCG.
• Detailed work to review performance and action plans will take place
through our monthly Contract Management Board.
• Additional focussed work will continue with providers and patients to
ensure the delivery of all ambulance and cancer indicators.
The key risks around non-delivery
of the Annual Integrated Plan 2013/14
• Capacity and capability.
• Demand management.
• Impact of Payment By Results Tariff change, specialist
commissioning and unbundling of diagnostics.
• System wide accountability.
• Clarity and credibility of strategic plans.
• Finance.
• Volume of work transferring to primary care.
• Continued patient and public involvement and support.
Any significant risk will be added to the CCG Risk Register and
therefore result in formal tracking and management.
Delivering our Financial Strategy
Planning Guidance – what we have to do:
Buy safe and sustainable services
End the year with a 1% surplus - £1.6m
Plan for a contingency of 0.5% - £0.8m
Repay share of PCT legacy debt - £1.8m
How much money have we got?
CCG share of PCT budget
Uplift for growth
Amount available to spend
£’000
165,573
3,808
169,381
How do we agree the budgets?
£’000
What we spent in 2013/14
162,563
Efficiencies on provider contracts (-4%)
-5,986
Inflation on provider contracts (+2.9%)
4,813
Demographic Growth (+0.72%)
1,105
Other growth and cost pressures
2,581
QIPP
Payment to providers for Quality (CQUIN +2.5%)
TOTAL EXPENDITURE
-2,048
2,977
166,005
Where do we spend the money?
What does the bottom line look like?
£’000
How much money have we got
How much are we spending
What have we got left
169,381
-166,005
3,376
What will we use this for?
Repay share of PCT legacy debt
0.5% contingency
Balance 0.45% surplus
-1796
-828
752
Risks to the financial plan
• The split of the PCT budgets to numerous organisations – 6 CCG’s,
the NHS Commissioning Board and Local Authorities
• Demographic growth increases more than expected
• Providers cannot meet their efficiency targets
• QIPP programme is not fully delivered
• Unexpected pressures emerge throughout the year
Management Costs
£’000
How much can we spend (£25 per head of population)
3,556
Where are we spending it
CCG internal costs
1,582
Services bought from Commissioning Support Unit
1,249
Services bought from other support organisations
725
Delivering our Financial Strategy
• With the application of growth the CCG’s overall delegated budget
for commissioning services in 2013/14 is £169m.
• This equates to £1,195 per head of population to spend on
commissioning services for its population (Average £1,145).
• The full QIPP programme is £2.0m.
• After repaying its current share of the PCT brought forward deficit,
the CCG is planning to deliver a 0.45% surplus (£752k) at the 31st
March 2014, which is below the 1% identified in the national
planning guidance.
• Gives us a platform to have a balanced financial position next year
but this is dependent on mitigating our financial risks.
Questions