Finance Update October 2018/19

Planning – 2018/19 Initial Plan submitted in April – Board declared would not achieve the NHSI target ‘control total’ NHSI revised the ‘control total’ to be more in line with our forecast deficit Board signed off revised plan to achieve the control total in June STF opportunity if hit CT = £2.96million

Month 5 – 2018/19 Continued positive position – at month 5: Plan to date = £7.29m deficit Actual to date = £6.37m deficit so better by £919k Cost Improvement Plan (CIP) = £11.4m for the year Plan to date = £3.64m savings Actual to date = £3.72m savings Ahead of plan by £79k Achieved ‘Provider Sustainability Fund’ (PSF) conditions (finance & A&E target) = £837k Cash = £12.5million (£2.7m more than plan)

Looking Forward National: Impacts of £20bn national funding – still to be confirmed: eg PSF into 2019/20 unknown Consultation around tariff changes starting Local: Development of a system wide Financial Recovery Plan (FRP) – South Tyneside & Sunderland health partners (Trusts & CCGs)

Financial Recovery Plan Aim across the 4 partners: To develop a South Tyneside & Sunderland integrated health and care system over a 3 - 5 year period that improves health outcomes and is financially sustainable

Outcomes Challenge South Tyneside Sunderland Using multiple measures of health outcomes, the North East, and Sunderland and South Tyneside within it have poor outcomes. The analysis for alcohol (above) is similar for obesity, cancer and smoking related illnesses. There is recognition that even with the financial challenges, we are also not delivering improving health outcomes for our populations. The focus therefore is to relook at everything that we do and target our limited resources at those interventions that make the biggest impact which includes stopping some services, enhancing others and (where needed) seeing people once rather than multiple times across our system.

Financial Recovery Plan High level system wide Financial Recovery Plan (FRP) developed Considered: Scale of system financial challenge – until 2021 Options & opportunities to address the challenge Reviewed by Boards & Governing Bodies of the organisations Looking to demonstrate how we can jointly bring our finances to more sustainable levels For further discussion with regulators on 17th October

Questions?

Alison King, Director of Performance Performance Update Alison King, Director of Performance

A&E 4 hour target Q2 performance 95.8% PSF funding secured - £177K Trust remains in the top 25% nationally May expect some deterioration in performance over winter linked to operational pressures

NHSI Single Oversight Framework/Ntl Indicators Target Latest month perf (Aug) *Jul RTT 92% 95.97% Diagnostics <1% 0% Cancer 2ww 93% 91.63%* Cancer 31d 96% 100%* Cancer 62d 85% 90.32%* IAPT recovery 50% 53.64% IAPT access 6 weeks 75% 99.47% IAPT access 18 weeks 95% 99.82% RTT in top 25% nationally Diagnostics – no patients waiting over 6 weeks Cancer 2 week wait performance affected by capacity issues in gastro – remains a risk Continue to meet all IAPT indicators (Improving Access to Psychological Therapies)

IAPT - comparison 6 weeks – from referral to entering a course of treatment 18 weeks – as above Recovery – people who complete treatment and are moving to recovery Target Q1 STFT Q1 National Waiting less than 6 weeks >75% 99.4% 89.5% Waiting less than 18 weeks >95% 99.94% 99% Moving to recovery >50% 56.92% 52.4%

Winter – Long stay patients 25% reduction nationally to free up bed capacity over winter Target by December to reduce occupied beds for patients with a length of stay +21 days – actions underway including process for review and discharge of patients

National quality requirements 1 MRSA case YTD – 0 trajectory C Diff YTD 5 – 7 trajectory No trolley waits in A&E No urgent operations cancelled for a second time VTE risk assessment 94.02% for Q2 – below target and validation ongoing Work ongoing to reduce ambulance handover delays – limited by estate and staffing, not an outlier regionally

Summary Strong performance continues against most national indicators Winter – A&E performance and bed capacity Ten year plan for the NHS – may influence future priorities from an operational performance perspective