Transcript North Norfolk Clinical Commissioning Group

Annual General Meeting 2014
NHS North Norfolk CCG
One Year On
North Norfolk CCG is:
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A clinically led membership organisation
comprising 20 GP Practices, situated
across North Norfolk and parts of rural
Broadland.
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Licenced from 1 April 2013 under
provisions enacted in the Health and
Social Care Act 2012.
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Patient focused approach to
commissioning healthcare for residents
who largely live in rural areas and at
some distance from the major acute
hospitals.
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Demographic and socio-economic
profile comprising the oldest population
of any CCG in England.
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Local GPs with long and deeply
embedded roots in our practices and
communities will ultimately judge the
success of the CCG simply by what is
achieved for patients.
The CCG is accountable for exercising the
statutory functions of the Group, but has granted authority to act on its
behalf to:
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Any of its members
The Governing Body
Its Executive Team
Senior Management Team
Its Committee and/or SubCommittees
This is demonstrated in the following Scheme of Reservation and Delegation:
Council of Members
Governing Body
Audit Committee
Remuneration and Terms of
Service Committee
Conflict of Interest
Governance Committee
Clinical Quality and Patient
Safety Committee
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The Council of Members meets on a
monthly basis. Attendance at
meetings is very good, with member
practice representation delegated to
a Practice Manager if required.
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The Governing Body meets on a
monthly basis. Meetings are held in
the presence of the general public on
a bi-monthly basis.
Key Issues / Successes
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111 Service - addressed significant
issues with performance through a
close working relationship with EEAST
and weekly clinically led performance
reviews.
Ambulance Response Times –
highlighted serious shortcomings in
EEAST’s ability to meet acceptable
response times, resulting in an
increase in capacity and remodelling
of resources across North Norfolk.
Mental Health Services – on-going
quality reviews and engagement of
clinicians to highlight concerns with
waiting times and the impact of the
Trust’s strategy to reshape services in
Norfolk.
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Significant progress in the
development of fully integrated
primary, community and care teams
across North Norfolk.
Urgent Care Performance, impact on
A+E waits and winter pressure
2013/14
Re-commissioning of Referral
Management Service and Nonemergency Patient Transport
Services to secure value for money ,
and services which meet the needs of
patients in a rural location.
Commissioning of ‘closer to home’
Audiology services under the Any
Qualified Provider scheme.
Engagement
Patients and carers are central to planning health and care services and their insight as
service users informed the CCG’s thinking. The following variety of mechanisms have
been used to consult and engage with patients and stakeholders throughout 2013/14:
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Annual Stakeholder Events which reviewed North Norfolk’s health priorities,
discussed how the CCG should support local voluntary and third sector organisation
and gathered insight to inform a new volunteer service;
Biannual Patient Conferences, attended by local Patient Participation Groups (PPGs),
which focused on dementia support and community services in 2013/14;
Patient Surveys conducted by the Referral Management Service to gather patients’
views on the referral process and the service they received in relation to audiology
and Lower Urinary Tract Symptoms (LUTS) service;
Online consultations via ‘Your Voice’, recruiting people across the county with an
interest in informing how services our are shaped in the local area;
Patient Stories presented at each public meeting of the Governing Body, which gives
local people the opportunity to tell their story ; and
Partnership News, launched in the summer of 2013 and issued on a quarterly basis,
with the aim of keeping patients and stakeholders appraised of the work of the CCG.
Collaborative Commissioning Arrangements
The CCG has entered into the following
formal joint arrangements with other
CCGs in Norfolk and Waveney;
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Acute Care;
Integrated Services (community, out
of hours and 111);
Mental Health Services (including
elements of Learning Difficulties);
and
Children’s Services
In addition the Acute Commissioning
Board established an ‘Urgent Care Board’
to specifically manage aspects of the
unplanned and acute emergency care
system.
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The CCG’s Chair, is a member of the
joint Health and Wellbeing Board
(HWB) in conjunction with Norfolk
County Council and other strategic
partners. The Board leads the
development of the Joint Health and
Wellbeing Strategy.
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The HWB has linked with a
Safeguarding Adults Board, including
membership from the police, social
services, the NHS and local charitable
organisations. The CCG’s Nurse
Member of the Governing Body is a
member of this Board, which is de to
become statutory in 2014/15.
2013/14 Annual Accounts -Context
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Financial Envelope
Programme and Running Costs
Planned Surplus
Financial Challenges in 2013/14
Mitigations
Final Reported Position
Impact on 2014/15
How do we spend your money?
2013/14 Annual Accounts
• Statutory Financial Duties
- To not overspend against allocated resources
- To ensure value for money
- Audit opinion
• Primary Financial Statements
- Statement of Comprehensive Net Expenditure
- Statement of Financial Position
- Statement of Changes in Taxpayers’ Equity
- Statement of Cash Flows
Statement of Comprehensive Net Expenditure
for the Year Ended 31st March 2014
Note
Commissioning
Gross employee benefits
Other costs
Other operating revenue
Net Operating Costs before Financing
4
5
2
2013-14
£000
1,049
210,926
(1,053)
210,922
Other operating revenue
Other (gains)/losses
Finance costs
Net Operating Costs for the Financial Year
210,922
Net (gain)/loss on transfers by absorption
Retained Net Operating Costs for the Financial Year
210,922
Other comprehensive net expenditure
Total Comprehensive Net Expenditure for the Financial Year
210,922
Statement of Financial Position as at 31st March
2014
31 March 2014
Non-current assets:
Property, plant and equipment
Total non-current assets
Current assets:
Trade and other receivables
Cash and cash equivalents
Total current assets
Total assets
Current liabilities
Trade and other payables
Provisions
Total current liabilities
Total Assets less Current Liabilities
Non-current liabilities
Total non-current liabilities
Note
£000
13
176
176
17
20
1,787
73
1,860
2,036
23
30
(14,710)
(1,200)
(15,910)
(13,874)
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Total Assets Employed
(13,874)
Financed by Taxpayers’ Equity
General fund
Revaluation reserve
Other reserves
Total taxpayers' equity:
(13,874)
(13,874)
Statement of Changes in Taxpayers’ Equity for
the Year Ended 31st March 2014
2013-14
General Fund
Note
Changes in taxpayers’ equity for 2013-14
Balance at 1 April 2013
Transfer of assets and liabilities from closed NHS Bodies as a result of the 1 April 2013
transition
Adjusted CCG balance at 1 April 2013
Changes in CCG taxpayers’ equity for 2013-14
Net operating costs for the financial year
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Total revaluations against revaluation reserve
Net Recognised CCG Expenditure for the Financial Year
Net funding
Balance at 31 March 2014
£000
13
SoCNE
£000
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197
197
197
197
(210,922)
(210,922)
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SoCF
2013-14
Total Reserves
(210,725)
196,851
(13,874)
(210,725)
196,851
(13,874)
Statement of Cash Flows for the Year Ended 31st
March 2014
2013-14
Note
£000
Cash Flows from Operating Activities
Net operating costs for the financial year
Depreciation and amortisation
(Increase)/decrease in trade & other receivables
Increase/(decrease) in trade & other payables
Increase/(decrease) in provisions
Net Cash Inflow (Outflow) from Operating Activities
SoCNE
13
17
23
30
Cash Flows from Financing Activities
Net funding received
Net Cash Inflow (Outflow) from Financing Activities
a
196,851
196,851
Net Increase/(Decrease) in Cash & Cash Equivalents
20
73
Cash & Cash Equivalents (including bank overdrafts) at the End of the
Financial Year
(210,922)
21
(1,787)
14,710
1,200
(196,778)
73
NNCCG will look to build on its successes throughout 2013/14 by adopting the
‘Commissioning for Prevention’ approach to:
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Build on the capacity and skills of the Integrated Care Teams, to identify people
with complex and long term care needs and design proactive services which will
reduce incidences of acute crises;
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Implement a fully integrated service between 111, out of hours primary care and
999, available 7 days a week;
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Develop a robust and locally sensitive Directory of Service to enable 111 call
handlers to direct people to the right care, at the right time;
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Ensure people in North Norfolk are supported by a high quality 999 emergency
ambulance service, that delivers the best possible response times in a dispersed
population;
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Deliver responsive Mental Health assessments and services, with better
stratification between low level conditions and more complex mental health
disorders.
Any Questions?
Patient’s view
Case Study: Mary and John Tuck