Agenda item - Clinical Commissioning Group (CCG) Operating Plan 2016/17

Agenda item

Clinical Commissioning Group (CCG) Operating Plan 2016/17

To receive a report on the Clinical Commissioning Group Operating Plan 2016/17. 

Minutes:

The Board received a report on the Clinical Commissioning Group Operating Plan 2016/17. 

 

Graham McDougall (Director of Strategy and Partnerships- Enfield Clinical Commissioning Group) introduced the report to the Board highlighting the following: 

 

·         This was the fourth year of the CCG’s NHS Operating Plan (2016/17), produced as part of the NHS annual planning cycle, and has been reported to HWBB.

·         The plan covered acute activity, performance and finance.

·         Acute activity from acute providers includes accident and emergency, outpatients, day case surgery and emergency admissions. 

·         The NHS expects performance to be improved in 2016/17 in 4 key areas: accident and emergency, referral to treatment, cancer 62 day treatments and access to diagnostics.

·         The NHS expects accident and emergency performance to be at 95% during the fourth quarter of 2016/17 and for treatment to take place within 18 weeks of referral. 

·         The other focus for 16/17 is to reduce acute providers who are in deficit Acute providers have access to the national Sustainability  Transformation Fund which is designed to improve performance as well as financial position.

·         CCgs have access to financial incentives via the Quality premium which is set out in the table included in the papers.  There were five national measures and three locally determined measures to meet.

·         The three local measures involved cancer treatment, dementia reporting and Improving Access to Psychological Therapies.

·         The CCG has been given an additional savings target of £7.2m to achieve during 2016/17 which was expected to be a significant challenge. This would mean an overall saving on nearly £17m for 2016/17.

 

Questions/Comments   

 

1.            Meeting the additional savings target would mean that difficult decisions would need to be made.  The CCG were currently looking at all expenditure to assess what could be done.  A high level list would be provided to NHS England by the end of April.

 

2.            Enfield suffers in comparison with other authorities as they were 4.8% underfunded.  Underfunding within 5% was deemed acceptable putting Enfield in a difficult position. 

 

3.            A plea was made that local people be involved in deciding what cuts would be made. 

 

4.            The multi system (North Central London wide) sustainability and transformation plan was a new requirement for delivering the Five Year Forward View.  This meant partners including commissioners, providers and local authorities working together to improve the quality, and reduce the inequality and financial gap across services.  In order to obtain the transformation money, the goals in the plan would need to be met.  All parts of Health and Social Care were working together to develop a sustainable plan.  This will have to be submitted towards the end of June 2016.  Governance structures would need to be agreed to enable quick decision making and to make sure that everyone is aligned and all deliverables and key milestones can be met. 

 

5.            Schemes to work on include urgent and emergency care, mental health and primary care.  The system enablers were estates and workforce.  However these proposals were outside the funding deficit and were not designed to close the existing financial gap.

 

6.            The next steps were to provide a high level indication, to be bought together into a high level plan by June 2016.  By November 2016 the plan should be complete.  Some areas were already being delivered across the five CCGs such as the recently commissioned integrated NHS111 and Out of Hours Service, commissioned for all five North Central London CCGs.

 

7.            There had not been much time to involve the public in the sustainability and transformation plan proposals, but there were plans to develop a communication and engagement strategy.  Some engagement strategies were already in place within the workstreams, but it was acknowledged that more could be done. A Healthwatch representative does sit on the Transformation Board.  Each workstream will need to develop an engagement plan.

Post meeting note: A Healthwatch representative attends the Transformation Board as an observer and not a full member of the Board.

 

8.            Ray James advised that he was the Director of Adult Social Services lead for the five boroughs for the North Central London Sustainability and Transformation Plan.

 

9.            There were issues of democratic deficit and engagement which did still need to be addressed.  Some alignment was planned to take place in the near future with full integration in 2017 for delivery in 2020. 

 

10.         Developments were welcomed and there was a view that where there have been co-operations in the past they have been successful but there were concerns that changes should make sense to patients and the local population.  There would be fears that services were moving away from people. 

 

11.         Plans were being developed, looking at population projections and disease profiles.  It is currently planned that specialist commissioning would be done at a pan London strategic level. 

 

12.         Some concern was expressed that the structure was too much focussed on Camden.  It was suggested that this may have been because Camden was better funded than other boroughs and so had more capacity to take on the extra work.  The Health and Wellbeing Board was concerned to feel confidence and receive reassurance that the more peripheral areas were being understood.  Ray James agreed to feed the board’s concerns back to the North London Strategic Planning Group.

 

Supporting documents: