AGM 2015 Working together for better health Naz Jivani – Chair Review of 2014/15

Kingston CCG Annual General Meeting 13:00 – 13:45Welcome, Lunch, KCCG Market Place 13:45 – 14: – A Year in Review Naz Jivani – Chair 14:00 – 14:05Your Questions 14:05 – 14:15Spotlight on self-management Expert Patients Programme 14:15 – 14:25Financial Report Yarlini Roberts – Chief Finance Officer 14:25 – 14:30Your Questions 14:30 – 14:40Looking to the Future Tonia Michaelides – Chief Officer 14:40 – 14:45Final Questions and Close AGENDA

A Year In Review During 2014/15, we made progress in a number of key areas outlined in our Integrated Operating Plan:  Children and Young People  Integrated Health and Care Services for Adults  Mental Health  Primary Care  Urgent and Emergency Care  Cancer  Quality  Patient Engagement Naz Jivani – Chair, Kingston CCG

Children and Young People June 2014 – CQC visit noted good safeguarding practices and progress in improving outcomes for Looked After Children. We’ve worked with providers to deliver the requirements of the Children and Families Act. We established a single point of access for referrals to CAMHS, with more children and young people accessing suitable services earlier.

Integrated Health and Care Services for Adults The CCG played a pivotal role in developing a Better Care Fund (BCF) plan for Kingston, with several multi-agency workstreams. We consolidated our Kingston At Home initiative, to support elderly residents to remain independent and in their own homes as long as possible. The CCG co-sponsored the ‘Voice of the Customer’ project with RBK to find out from service users, carers and frontline staff how care services could be improved. We established a multi-disciplinary team to identify vulnerable patients who would benefit from co-ordinated care provision at an earlier stage. We’ll be further developing integrated services throughout 2015/16.

Mental Health We worked with other CCGs across south west London, NHS England and South West London and St. George’s Mental Health NHS Trust to deliver a public consultation on the future provision of services. The Kingston Community Wellbeing Service met its targets for waiting times, the number of patients seen, and recovery rates. 19 GPs began working towards the Advanced Diploma in Primary Care Mental Health to increase mental health provision in primary care. We worked with the council to provide more independent living opportunities for residents locally. We reviewed mental health provision for older residents.

Primary Care The CCG worked with GP Practices on a national programme – Transforming Primary Care – to further improve standards locally. All patients over 75 years now have a named GP in Kingston. All ‘high-risk’ adult patients have a named Care Co-ordinator and agreed Care Plan. All GP Practices are part of Kingston GP Chambers – a provider body supporting the expansion of primary care outside of hospital in the future. We agreed to joint commissioning of primary care with NHS England from 1 April 2015.

Urgent and Emergency Care A&E departments have been facing a significant challenges nationally over the past year, particularly during winter 2014/15. The Kingston System Resilience Group oversees planning and addresses pressures on urgent and emergency care across Kingston. The CCG piloted a number of initiatives in 2014/15 to address pressures on the urgent care system: Enhancements to an acute care physician role at Kingston Hospital. Placement of psychiatric liaison services at Kingston Hospital. GP weekend locality-based clinics to relieve pressure on A&E departments.

Cancer In 2014/15, we commissioned a full range of cancer prevention and treatment services, working with NHS England. We reviewed current provision across Kingston and agreed a Cancer Implementation Plan for the borough. We worked with Macmillan Cancer Support to recruit a local Macmillian GP to support engagement with clinicians. We supported NHS England’s ‘Be Clear on Cancer’ campaign throughout the year to raise public awareness.

Quality We’ve worked with RBK and the Care Quality Commission to develop a quality assurance framework for care and nursing homes in the borough. We recruited a lead nurse for adult safeguarding to support improvement in systems and processes in this area. Themes and recommendations from the Francis Enquiry are at the heart of commissioning decisions, including: Provision of clinical chairs for Clinical Quality Review Groups, ensuring that clinical and patient perspectives are taken into consideration. Publication of a Quality Strategy for

Thank you Your Questions welcome To contact Kingston CCG E:

AGM 2015 Working together for better health Spotlight on self-management Expert Patients Programme

The Expert Patients Programme

Annual General Meeting 2015 Working together for better health Finance Report Yarlini Roberts - Chief Finance Officer

Financial Targets Maintain financial stability through not exceeding resource targets Use the CCG’s resources wisely to meet the health needs of Kingston and to ensure value for money and fair and effective use of resources Stay within Running Cost Allocation of £25/head of population (£5.0m)    Kingston CCG’s accounts and report were submitted on time with an unqualified audit opinion.

2014/15 – Income and Expenditure Statement Kingston CCG delivered a surplus of £2,550k, which is 1.2% of the resource limit The surplus is £513k higher than the planned surplus, in line with direction from NHS England to increase our surplus. The CCG spent more than planned on acute and non acute commissioning and less than plan on corporate costs and reserves

How did we spend our money?

Running Costs – the cost of running the CCG Running costs target for the CCG in 2014/15 was £25 per head of population or £5.041m in total. Our expenditure for the year was £4.763m representing an underspend of £278k, which was spent instead on patient care. This was primarily met by not spending the reserve that was held for non-recurrent project work. Plans have been implemented for the 10% reduction in running costs in 2015/16

Summary As a CCG we faced many challenges in our second year. Large increases in demand for hospital services and continuing care services led to substantial financial pressures on the CCG. The CCG has managed these cost pressures and has met all key financial targets during 2014/15. Despite these challenges, the CCG has delivered a strong financial performance. Robust financial governance will be crucial going forward

Your Questions Contact Kingston CCG

AGM 2015 Working together for better health Looking to the Future Tonia Michaelides – Chief Officer

Our challenge for the future The delivery of improved services against a backdrop of static NHS budgets An increasing and ageing population with complex health needs Improving early intervention to prevent emergency admissions to hospital Increasing access to GP appointments Encouraging self-management to enable patients to have more control over their own health Working more closely with our partners, patients and the public

Commissioning Intentions 2015/16 Focus on improving primary care and community services and delivering locally- led, integrated care programmes. Working with NHS England to co-commission primary care services in Kingston. Increased collaborative working with other CCGs in SWL, as well as providers. Transforming mental health services across south west London to provide state- of-the art facilities and modernise support in the community. Kingston’s 2015/16 commissioning intentions are available at

SWL Collaborative Commissioning Working with the five other South West London CCGs under the umbrella name – South West London Collaborative Commissioning – we have developed the South West London five year strategy (to 2018) to address the following challenges: The quality of care The workforce gap Financial sustainability Rising demand for healthcare The south west London five year strategy is available at

SWL Five Year Strategy Key outcomes the SWL five year strategy is working to achieve: Securing additional years of life for people with treatable mental and physical health conditions. Improving the health-related quality of life of people with one or more long-term conditions, including mental health conditions. Reducing the time people spend in hospital through better and more integrated care in the community, outside of hospital. Increasing the proportion of older people living independently at home following discharge from hospital. Increasing the number of people with mental and physical health conditions having a positive experience of care in hospital, in community services and in general practice. Making significant progress towards eliminating avoidable deaths in our hospitals caused by problems in care.

Operating Plan Children – ensure robust safeguarding in place; implement the Children and Families Bill; improve mental health services; commission integrated disabled children’s services esp. from ‘Achieving for Children’. Adults and Older People – focus on self-care, prevention, early intervention including targeted support for those at risk; rapid response for admission avoidance; further expand Kingston at Home, including 7 day working; progress ‘Discharge to Assess’ to improve discharge from hospital and subsequent decisions about care. Mental Health – improve adult and older people’s community mental health services; implement a new model of dementia care built around GP and community services; continue expansion of community wellbeing services; consolidation of dual diagnosis services. Urgent Care – ensure whole-system 7 day working; re-specify and procure new GP out of hours and NHS111 services; progress alternatives to A&E attendance.

Kingston Co-ordinated Care Programme (KCC) Launched by the CCG and Kingston Council in June Developed with insight from the Voice of the Customer project. Vision - to help people stay healthy, well and independent, and to support them when they have health and care needs. People with complex needs supported by one team of staff with a ‘can do’ culture, working together to support you in leading the life you choose. Focus on prevention and proactive care, helping people remain independent by providing more community support. 3 key aspects of the programme: building active and supportive communities, caring for people with complex needs and strengthening joint commissioning.

We are committed to working with You, our residents and stakeholders to develop solutions that will deliver safe, high quality care for everyone. We welcome Your ideas Contact Kingston CCG Thank You