NHS Hartlepool and Stockton-On-Tees CCG Annual General Meeting 2017/18

Our Vision and principles Our vision for the population of Hartlepool and Stockton-on-Tees is “to develop outstanding, innovative and equitable health and social care services, ensuring excellence and value in delivery of person centred working across health and social care including: Health services which are safe and of the highest quality Best possible health outcomes Joined up services which benefit patients and the public and give best value for money

Key aims Work with our patients to promote and support healthy living and self-care Involve service users, carers, staff, providers, partners and the public to develop services and reduce health inequalities Work in partnership to transform services and ensure transparency through inclusion of all stakeholders to meet patient needs Make use of and contribute to the evidence base that drives service transformation, embracing opportunities to innovate Commission sustainable services as close to the patient’s home as possible Ensure services are safe, high quality and cost effective Plan and respond to the identified needs at a locality level for the residents of Hartlepool and Stockton-on-Tees

CCG Population – Our challenge

CCG Population – Our challenge

Our Commissioning Challenge & Delivery Ambition 1: Reduce unwarranted variation across a range of services to ensure patients receive equitable access to high quality services in the right place at the right time Ambition 2: Design and implement plans to transform a range of service in line with national, regional and local initiatives to improve access, sustainability and achieve the best possible outcomes Ambition 3: Strengthen care outside hospital to ensure that individuals and their carers are able to take more control of their health and maintain independence for longer through early intervention and prevention Ambition 4: Implement plans to deliver a sustainable primary care offer fit for the 21st century, delivering access to high quality, cost effective, patient centered care through a motivated, diverse and appropriately skilled workforce

AMBITION 1: Reduce unwarranted variation across a range of services to ensure patients receive equitable access to high quality services in the right place at the right time

Ambition 1: You said, we did Urgent Care You said you wanted new integrated urgent care service providing 24/7 access to Urgent Care in the right place at the right time We have Implemented a new Integrated Urgent Care service across the locality which brings together three separate services into two centres at The University Hospital of Hartlepool and North Tees Hospital

AMBITION 2: Design and implement plans to transform a range of service in line with national, regional and local initiatives to improve access, sustainability and achieve the best possible outcomes

Ambition 2: We said, we did Diabetes Prevention We said we would work towards implementation of national diabetes prevention programme to support patients with an increased risk of diabetes to live healthier lives to reduce this risk We have worked with local GP practices to enable them to identify patients suitable to be referred into the programme to benefit from behavioural interventions to reduce their risk of developing diabetes

AMBITION 3: Strengthen care outside hospital to ensure that individuals and their carers are able to take more control of their health and maintain independence for longer through early intervention and prevention

Ambition 1: You said, we did Care Homes You said you wanted us to improve the health, wellbeing and safety of people living in care homes We have worked with care homes, GPs and Social Care to: Realign community matron service to prevent unnecessary hospital admissions Deliver education and training to care home staff Have pharmacists working with care homes to manage medication

AMBITION 4: Implement plans to deliver a sustainable primary care offer fit for the 21st century, delivering access to high quality, cost effective, patient centred care through a motivated, diverse and appropriately skilled workforce

Ambition 1: You said, we did Improving Access to GPs You said you wanted 7 day access to pre-bookable and same day GP services We commissioned our local GP Federation to pilot a service which is delivered from 3 hubs which provides access to appointments 7 days a week

Our Performance

Sustainability and Transformation Partnership The 5 Year Forward View highlighted 3 areas where there is a gap between where we are now and where we need to be by 2020/1 in terms of Health and wellbeing of the population, Quality of care provided and Finance and efficiency of NHS services An Integrated Care System (ICS) is evolving across Cumbria and the North East which will lead and plan care for the population The ICS will comprise Integrated Care Partnerships (ICP) that bring together CCGs and providers across a smaller footprint ICPs will focus initially on bringing together enough critical mass to sustain vulnerable acute services within their geography - clinicians will work together to build consensus on the right model to deliver medical care CCGs within the ICP geographies will continue to develop place-based arrangements for the planning and provision of primary and community care and health and social care integration 1. Sustainability and Transformation Plans Challenge - The Five Year Forward View, NHS Planning Guidance, and the Sustainability and Transformation Plans (STPs) for each area, are all driven by the pursuit of the “triple aim”: (i) improving the health and wellbeing of the whole population; (ii) better quality for all patients, through care redesign; and (iii) better value for taxpayers in a financially sustainable system. Delivery – NHS Hartlepool and Stockton-on-Tees CCG a part of the Durham, Darlington, Tees, Hambleton, Richmondshire and Whitby plan This plan describes our shared local vision for 2021 regarding care both inside and outside our hospitals underpinned by better integration with local authority services in respect of prevention, early intervention and social care: We now need to work together with partners to design the next steps such as:  How we can better collaborate on prioritising prevention despite many financial cuts and other challenges  Enabling the out of hospital sector to be stabilised and strengthened as demand grows  Optimising the acute hospital sector to get the best quality within the resources it has Going forward we will develop health and social care hubs that will be responsible for the health and care of their local population to reduce the number of people who require admission to hospital, and to be safely discharged more quickly if they do have to stay in hospital. We will also strengthen links between health and social care and encourage the development of the voluntary sector to they can support patient care in the community. This applies to physical and mental health service users and those with a learning disability.

CCG Governance Good governance is central to the running of the CCG as it helps us to meet our legislative responsibilities and provides assurance that we are conducting the duties required of a public body. The CCGs governance processes ensure that we are an accountable, transparent, ethical and well-led organisation The CCGs Constitution was reviewed during 2017/18 in order to ensure it remained legally compliant Throughout 2017/18 the CCG has continued to operate with a governance structure that reflects guidance and best practice The overall opinion from the CCGs Internal Auditors was as follows: From my review of your systems of internal control, I am providing good assurance that the system of internal control has been designed to meet the organisation’s objectives, and that controls are generally being consistently applied.

Our Financial Challenge & Delivery

Our Financial Challenge & Delivery Target Outcome   Met? Maintain expenditure within ‘in-year’ funding allocation plus 0.5% uncommitted In-year surplus of £2.571 million against an in-year funding allocation of £452.298 million P Maintain running costs within separate running cost allowance Surplus of £0.831 million delivered on running cost budgets Maintain capital spending within capital resource limit No capital resource required and no capital spend in year N/A Ensure cash spending is within the cash limit set Cash managed within available resources During the year we have worked hard to secure high quality services, making every effort to ensure we use the resources allocated to Hartlepool and Stockton-on-Tees CCG economically and with effectiveness and efficiency. Robust systems of financial governance and financial management processes monitored by the CCG’s Finance Committee have allowed all financial risks to be appropriately identified and managed during the year enabling the delivery of financial targets. The CCG’s financial position has been maintained in the current year and it is pleasing to report that we have again been successful in achieving our key statutory and administrative financial duties during the financial year ended 31 March 2018. This continues to be a challenging time for the NHS with significant financial pressures and the financial performance outlined in the CCG’s annual accounts is pleasing to see, reflecting the strong financial management within the organisation.

Some of Our Key Priorities for 2018/9 Partnership Working Further strengthening of our partnership working with all providers and other CCGs across our Strategic Transformation Partnership (STP) Continued development of an Integrated Care Partnership for Mental Health and Learning Disability Services New Models of Care In collaboration with the GP Federation, primary care colleagues and health and social care stakeholders, develop a vision for New Models of Care for Hartlepool and Stockton on Tees. Acute Services Reconfiguration Continue with programme of work regarding pathway reviews to improve patient pathways and create efficiencies in service provision Autism Spectrum Disorder Implement agreed action plan to improve wait times for ASD diagnosis and put in place a new model of service delivery RightCare Improve quality and outcomes for patients whilst reducing cost by reducing variation within the pathways for MSK, Respiratory, GI, Trauma and Injuries, CVD and Maternity and Early Years

Thank You