NHS South Norfolk CCG – Financial context and QIPP Programme James Leeming Interim Turnaround Director

Local challenges: Populations are living longer Living with long term conditions Demands on access to care across health and social care is increasing The rate of lifestyle-related health conditions continues to increase NHS faces frontline recruitment issues, particularly in Primary Care

Financial context: 2016-17 budget – total budget £272.6m Of which: £139m is spent on acute (hospital-based) services £33m is spent on community-based services £23m is spent on mental health services and services for people with learning disabilities £42m is spent on Primary Care (primarily prescribing) £20m is spent on Continuing Health Care £5m is allocated towards the running of the CCG

‘QIPP’ – Quality, Innovation, Productivity and Prevention Transformation initiative introduced in 2010 Identify efficiencies within commissioning to reinvest in frontline care ‘Thinking differently’ about commissioning, and putting local patients at the forefront of commissioning decisions All CCGs are tasked with developing QIPP Programmes to drive efficiency locally

QIPP (2): NHS England requires CCGs to achieve a 1% surplus Since the its inception in 2013-14, the CCG has set ambitious QIPP plans to achieve financial balance, as well as the required 1% surplus The CCG has delivered its QIPP plans each year, but has not always delivered a 1% surplus This has created an underlying deficit in the CCG’s budget of £8m The CCG’s 2016-17 QIPP programme is £13.9m to reduce this deficit to £2.8m

QIPP (3): Methods of delivering QIPP plans: Transactional: Financial, contractual and performance-related details Transformational: Strategic, pathway changes, and changes in national policy Relational: Historic relationships, communication, local knowledge and experience