1. Finance Update
October 2018/19

2. 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

3. 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)

4. 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)

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

6. 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.

7. 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

8. Questions?

9. Alison King, Director of Performance
Performance Update
Alison King, Director of Performance

10. 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

11. 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)

12. 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%

13. 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

14. 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

15. 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