1. Council of Members 27 June 2018
Chief Clinical Officer’s Update
Dr Stewart Findlay

2. Incentive for over-spending but improving practices? Urgent Care
FAIR FUNDING SCHEME
Nursing home patients
Deprivation
Incentive for over-spending but improving practices?
Urgent Care
TAPs pooled budgets
Smoothing effect?
High Cost Patients. Top slice
Penalties reinvested in PC

3. slow IT systems NECS aware of the problem
Problem is so much is now done through the cloud
Computers are old
Band width inadequate
Solutions
New equipment for the slowest now
COIN procurement will increase bandwidth considerably
Considering closing down public access temporarily.

4. Election of Chair and Locality Leads
Dr Jonathan Smith
Clinical Chair term ends 31 July 2018
Dr Dilys Waller
Locality Lead term ended 30 April 2018
Dr Rushi Mudalagiri
Locality Term will end in November 2019
Dr Winny Jose

5. Election of Chair and Locality Leads
Jonathan Smith would like to run for a second term as Clinical Chair.
Dilys Waller, Winny Jose and Rushi Mudalagiri would like to work a second term as Locality Leads.
Could anyone who is interested themselves in these positions please express your interest directly to me?
Election process.
Please do so by Friday 13 July at the latest.
If no interest is received then the above candidates will be automatically re-elected.

6. Annual Report 2017/18

7. Annual Report Overview:
The annual report is a narrative report providing a summary of the year, including review of performance and achievements along with forward planning.
Requirements:
All CCGs are required to prepare an annual report and set of annual accounts for the year ended 31 March 2018.
Deadlines and timetables are set by NHS England with expected content of the annual report and accounts set out in the ‘CCG Annual Reporting Guidance’.
Final audited annual report and accounts were signed off by Audit Committee on 21 May 2018 using delegated authority from Governing Body in accordance with national deadlines.
These are required to be presented at an AGM and are published on the CCG website. This annual report provides further details of all items covered today.

8. Annual Report
The ‘CCG Annual Reporting Guidance’ is relatively prescriptive in terms of the required content of the annual report.
The Performance Report provides a summary of performance during the year, progress against targets, work to improve health outcomes and a financial review.
The Accountability Report provides an overview of the governance of the CCG, it includes the Statement of Accountable Officer’s Responsibilities, which is a standard statement signed by Dr Findlay to confirm that his responsibilities have been properly discharged.

9. Annual Report
Included within the Accountability Statement is the Governance Statement
This statement by the Accountable Officer is designed to be a standalone document which tells the governance story for the full year.
It includes details of the governance framework of the CCG, including information about the Governing Body and its committees, risks management arrangements, internal controls, information governance etc.
It is pleasing to note that there are no significant internal control issues to report within the statement.
In addition, the annual report includes details of staffing, remuneration, and the external auditors opinion. The financial statements/annual accounts are appended to the report.

10. Review of 2017/18

11. Key Successes Implemented new urgent care model Developed PCH
Developed new TAPs clinical leads
Full procurement of adult community services
Ongoing implementation of award winning diabetes pathway
Enhanced CYP Community Eating Disorder service
Dementia diagnosis rates significantly above national levels
Continuing GP Career start scheme
Support for vulnerable GP practices

12. Key Areas of Work during 2017/18
Integral role in development of the STP
Development of Integrated Community Services via Primary Care Homes (PCHs)
Implementing the commissioning plans including working with other CCGs
Developing estates strategy working with NHS Property Services
Exploring the development of an Accountable Care Partnership for mental health (and LD)
New Ways of working with NECS – customer controlled

13. Key Areas of Public Engagement in-year
Commissioning Priorities event – October 2017
Urgent Care, Cancer, Smoking/Respiratory, Elderly Care
Stroke services
Care Navigation
Mental Health Crisis and Home Treatment
Primary Care Services
Dementia Services
Ophthalmology
Community Services

14. PERFORMANCE

15. CCG Performance against key NHS Constitutional Targets 2017/18
Outcome
Met?
Referral to Treatment (18 weeks)
Performance for the year was 92.8%
(target delivered for 11 out of 12 months) P
Diagnostic Test waiting times
Achieved the target throughout the year
Accident & Emergency (4hr)
Main provider performance = 91.4%
(against a target of 95%) X
Cancer waiting times
Performance of 79.7% for 62 day target
(against a target of 85%)
Healthcare acquired infections
Zero cases of MRSA, and Cdiff cases within the target for the year
Please note that ambulance response times targets were suspended during the year.

16. CCG Performance 2017/18 – A&E by provider
Outcome – vs target of 95% of patients seen within 4 hours
Target
Met?
North Tees and Hartlepool NHS Foundation Trust
Performance = 97.2% P
County Durham and Darlington NHS Foundation Trust
Performance = 91.4% X
City Hospitals Sunderland NHS Foundation Trust
Performance of 91.2%

17. Performance Challenges
A&E target failed for year
Ambulance handover delays unacceptable
IAPT mental health target missed
62 day Cancer waits missed

18. Financial Performance Review 2017/18

19. Statutory financial duties 2017/18
Target
Outcome
Met?
Maintain expenditure within ‘in-year’ funding allocation plus 0.5% uncommitted as required by NHS England
Total in-year surplus of £2.827million against a total revenue resource limit of £ million P
Maintain running costs within running cost allowance
Surplus of £0.621million delivered on running cost budgets
Maintain capital spending within capital resource limit
Nil capital allocation and no capital spend in year
Ensure cash spending is within the cash limit set
Cash managed within available resources
All statutory financial duties and targets were achieved.

20. Other financial targets 2017/18
Compliance with better payment practice code
Target is to pay at least 95% of valid invoices within 30 days
For 2016/17, 99.6% (99.8% by value) of non-NHS invoices and
99.7% (99.9% by value) of NHS invoices were paid within 30 days
Quality, Innovation, Productivity and Prevention (QIPP):
Planned QIPP efficiencies delivered in full for 2017/18:
QIPP Plan 2017/18
Actual QIPP
2017/18
£'000
£’000
CCG (allocative) efficiencies
12,089
12,377

21. Independent auditors opinion
The annual accounts have been audited by
Ernst and Young LLP (External Auditors)
Audit Opinion
Opinion Issued
Truth and fairness of the financial statements
Unqualified opinion issued
Regularity of the financial statements
Proper arrangements for securing economy, efficiency and effectiveness in use of resources

22. Looking Forward….

23. Priorities for the coming year
Primary care
Primary Care Resilience
GP Recruitment
Primary Care Homes (PCHs)
Integrated Care – primary care led working (PCHs)
TAPs Budgets
Personal health budgets.
VAWAS and work with Federations
Estates – efficient and cost effective use of our estate.

24. Priorities for the coming year
Cancer – Ensuring timely treatment, improving uptake of screening, and supporting people living with and beyond cancer.
Commissioning Priorities in a new world
pathway reviews, children’s servicesservices,
Mental health
LD / Autism – increasing health checks, improving community support services.
SEND – improve the support offer by working in partnership with DCC, Healthwatch and families.
Commissioning Support – working collaboratively with NECS to deliver best possible health outcomes.

25. Priorities for the coming year
Supporting older people – increase independence and reduce dependence where possible.
Working in Partnership
ICS
ICP
5CCGs
The Durham Plan for integration
ACP for Mental Health
GP streaming/Enhanced access to Primary Care
A&E waits
Improved ambulance response times
Reduced Stranded Patients
Trusted Assessor and home to assess

26. Any Questions?
Any Questions?