1. Governance and Performance
Cathy Kennedy
Deputy Chief Executive/Chief Financial Officer

2. Performance Outcomes

3. Performance Outcomes Notable successes Challenging targets
Increasing availability community based preventative support (ASC)
Reducing Delayed Transfers of Care (Patients)
Delayed Transfers of Care attributable to Adult Social Care
Reduction in number of antibiotics & broad spectrum antibiotics prescribed
Cancer: 2 week and 31 day waits (from GP referral to treatment)
IAPT (Psychological Therapies) 6 and 18 week waiting times
Challenging targets
A&E 4 hour waits for 95% of attenders
IAPT Recovery target of 50%
Ambulance response times
Cancer: 62 day waits (from GP referral to treatment)
18 week waiting time for 92% of patients

4. Governance
Assessed as good in 4 out of the 5 “NHS England assurance process” component areas
Well lead organisation
Delegated functions
Finance
Performance
But one element within ‘Planning’ required improvement
Met our legal duties as set out in statute and the Partnership Agreement with NEL council
Very positive External Audit annual governance report

5. Financial Performance

6. Quality in the CCG - the last 12 months.
Jan Haxby
RGN, RSCN,
BSc (Hons) SCPHN, MSc.

7. Quality in health & care.
A national agenda in both health and social care. CCG’s are bound by statutory duties to improve the quality of services.
The CCG agreed its model of quality in 2014 based on:
clinical effectiveness
safety
patient experience
.. and put systems and processes in place to provide quality assurance.

8. Key challenges in health and care
Quality issues across the health and care sector
Excessive waiting times
Not achieving performance targets
Workforce pressures
Challenges of meeting the needs of care home residents
Low levels of reporting of incidents in primary care
The challenges behind improving unexpected mortality - SHMI
Lack of clear processes to fully support the quality agenda with all providers.

9. What have we done in last 12 months
CCG committees receive & monitor data about the quality of services and provide challenge.
Appointed a “quality team” – Director, Nursing Lead for Quality, Clinical Nurse for Quality, and Clinical Support Officer.
Developed the quality dashboard for health services
Work with the Community Forum to understand what quality in services means.
Targets and measures - CQUINS, quality contract measures, performance data.
site visits – announced and un-announced

10. What have we done in last 12 months.
Reviewed our own internal processes for managing concerns
Developed new processes for focusing on concerns or Noise in the System (NITS, PIG, MIFS) which triangulates all information.
Commenced Quality Committee workshops to undertake deep-dives into specific issues
Reviewed the health and care support to care homes and commenced the Care Homes project
Developed closer working with the CCG Service Leads and contracts team to focus on quality

11. What’s changed, what difference did we make.
Improved what and how we monitor as a reflection of quality.
Increased the reporting of clinical incidents in primary care by 100% using a new incident reporting App.
Supported providers to improve their quality standards.
Projects in respiratory care, cardiology care, cancer care have made improvements for patients.

12. Whats changed, what difference did we make.
Achieved NHSE targets for PUPOC (continuing healthcare assessment).
Established new process for receiving and reviewing national clinical guidance
Unexpected mortality – whilst SHMI remains higher than the target, it is reducing and agencies are working closer together
Increased the support and input to the CCG Clinical Leads –primary care quality scheme, cardiology project, etc.

13. Looking forward - in 16/17.
1. Continue to work with providers on the quality challenges.
2. re-shape & develop the way we manage Clinical Governance.
3.Continue to address key areas like mortality.
4. Further develop our focus on Effectiveness and Experience .
5. Improve our focus on quality within smaller providers.

14. Looking forward - in 16/17
6. Work with service leads for Care Homes to align our systems and processes that test quality and safety of services. 7. Continue to build in evidence-base quality standards to service specifications and contracts. 8. Develop a clear & robust programme for proactively testing the quality of services e.g. Quality Profiles.