1. Annual
General
Meeting

2. Welcome
Dr Elango Vijaykumar
Clinical Chair

3. What we do
We are responsible for planning and buying (“commissioning”) healthcare services for a population of 185,000 people living across the districts of Tandridge, Redhill, Reigate and Horley
We are a GP-led organisation, made up of a membership of 17 GP practices
This year we spent £249m and we have to ensure money is spent in the most effective way

4. Reflections on

5. Reflections on the year
We have made a number of positive improvements to health and care services for our local population. For example:
Innovative early supported discharge rehabilitation service for stroke patients
Bringing community hospital rehabilitation beds closer to our population
Launched of a new perinatal mental health service to support mums with severe mental health difficulties
We aim to maintain and build upon the progress
we have made in the year ahead

6. Reflections on the year
Also a challenging year for the CCG
Remained in special measures
Remained under legal directions
Continued to face a challenging financial situation
Largely due to the rising demand on health services across our local area.
The future of the CCG was uncertain for large periods of the year
Discussions with NHS England and partner organisations about best solution to commission the best possible services for our patients

7. Our Alliance

8. Our Alliance
Single Accountable Officer and Executive Team across the five CCGs
Teams are working closer together to streamline processes, avoid duplication, and share best practice and expertise
The commissioning work of the CCG is part of the Alliance “north” place, working closely with Crawley and Horsham and Mid Sussex CCGs
The Governing Body of each CCG remains accountable for the commissioning of health services for their populations

9. A year at East Surrey CCG
Adam Doyle
Accountable Officer

10. Our performance A&E waiting times
Target to achieve 95% of people seen in A&E within four hours
Performance was below this for much of the year and deteriorated over the winter.
We finished the year achieving around 90
Despite not meeting the national target, the performance is one of the best compared to other A&Es across Surrey and Sussex
We have been working closely with the clinicians and managers of the A&E department to improve the way patients are assessed then treated through the
We are measured against a number of national standards, which are important in ensuring we deliver the best possible care for our patients. These include:
A&E performance - Our local A&E department at Surrey and Sussex Healthcare NHS Trust (SASH) in Redhill treats thousands of patients each year. The target set in the operating plan for 2017/18 was to achieve 95% (as per the national target) by March Performance has been below the recovery trajectory by 1.8% for much of the year, and deteriorated over the winter. Despite the non-achievement of the national target however, overall this compares favourably with performance of other A&Es in Surrey and Sussex.

11. Our performance Waiting times for treatment
National target is 92% of patients waiting no longer than 18 weeks from a GP referral to treatment
We did not meet the target throughout the year
Largely due to increased demand on hospital beds, which means priority has to be given to those patients with urgent needs
The NHS Constitution states that 92% of patients should wait no longer than 18 weeks from a GP referral to treatment. This is known as the 18 week RTT standard and it has not been met for the past 12 months. The CCG has been working towards increasing the number of places where patients can receive treatment, wider patient choice and managing demand. This includes commissioning additional capacity with other NHS and independent sector organisations, in order to maximise the choices patients have about where and when they receive their healthcare.
The winter period has brought significant pressures with more resources being used to care for those people who have urgent needs. In addition, NHS England asked acute
Hospital Trusts to pause planned care work for the whole of January 2018 which meant that fewer patients waiting for routine care could be treated. Following January, acute hospital trusts have looked at ways to introduce additional capacity to catch up with cancelled treatments.
We have been working on increasing the number of places where patients can receive treatment, wider patient choice and managing demand.

12. Our performance Diagnostic waiting time
National standard states that no more than 1% of patients should wait longer than six weeks for a diagnostic test.
We consistently met this standard - great achievement as the demand for diagnostics (MRI, CT and Ultrasound scanning) increased
Cancer treatment
Achieved national targets in two areas
Did not meet standard for patients being seen within 62 days from an urgent referral to the first treatment
We are focussing on improving this and are working closely with our local hospital
The diagnostic waiting time standard states that no more than 1% of patients should wait longer than six weeks for a diagnostic test. During 2017/18, the CCG consistently met this standard, which is a great achievement as the demand for diagnostics (MRI, CT and Ultrasound scanning) increased due to the implementation of new national referral guidelines for the diagnostics of suspected cancer.
The CCG successfully achieved the national cancer targets for patients being seen by a specialist doctor within two weeks of GP referral for suspect cancer; and for patients being seen within 31 days from when the decision is made to treat. However, we have not met the standard where patients should be seen within 62 days from an urgent referral to the first definitive treatment for all cancers. This is something we are focussing on improving and we have been working with our local hospital on ensuring patients who are referred urgently by their doctor can be seen within seven days of that referral; and that diagnostic tests are done and reported in a timely way.

13. Our highlights
Mental health service for out-of-hours support for year olds recognised with national award
More patients benefit from pharmacists at GP Surgeries
More support to diabetes patients
High achieving eating disorder service
Mental health service for children and young people recognised with national award: Our out-of-hours mental health support service for year olds in Surrey won the Crisis Services award at the first ever Children and Young People’s Mental Health (CYPMH) Positive Practice Awards The service provides out-of-hours telephone support seven days a week for young people experiencing an emotional or mental health crisis, along with respite beds for short overnight stays. It also provides outreach to young people in hospitals and at home.
More patients benefit from pharmacists at GP Surgeries: More patients benefitted from expert advice from a clinical pharmacist when they visit their GP surgery. Clinical pharmacists working as part of the team in local GP surgeries can help with patients’ routine medication and treatment and provide expertise on day-to-day medicine issues and consultations with patients directly. The support includes extra help to manage patients’ long-term conditions; advice for patients on taking multiple medications; and better access to health checks.
More support to diabetes patients: We introduced a new way of caring for patients newly diagnosed with type 2 diabetes, giving them the opportunity to meet Health and Wellbeing Advisors at their GP practice to receive advice on lifestyle changes. This helps them avoid complications and gives them support with their mental health if needed.
High achieving eating disorder service: The community eating disorder service for children and young people was recognised as one of the highest achieving in the country against
national targets. The service helps young people to avoid going to hospital by providing care quickly in the community.

14. Our challenges Rising demand Increasing hospital admissions
Increasing number of patients with complex needs
Increasing demand on GPs
Increasing number of patients in hospital are fit to go home
Across the country, demand on services is increasing.
The health and care needs of these patients has become more complex, which has added further pressure of services.
Demand on our GPs and hospitals are at unprecedented levels.

15. Our challenges Finances
Nationally, funding cannot keeping up with the increasing demand
We have to find ways to work more efficiently and effectively
We cannot continue spending more money than we have and will have to make difficult decisions about services that are not cost effective
Finish with…on the subject of funding, here is our Strategic Finance Director Mark Baker to present the annual accounts. Full accounts are available in the Annual Report.

16. Strategic Finance Director
Annual Accounts
Mark Baker
Strategic Finance Director

17. Our finances

18. Our finances
The CCG incurred an in-year deficit of £24.9 million in , which resulted in a cumulative deficit of £66.9 million at March 2018.
This was a significant deterioration compared to the deficit control total of £6.1 million set by NHS England, and the planned deficit of £16 million that the CCG agreed with NHS England at the start of the year.
The CCG remains under legal directions and financial special measures imposed by NHS England in previous years.

19. Our finances
We have a duty to ensure local services are being commissioned in a sustainable and affordable way and that we do not carry on spending more money than is available.
We have developed a financial recovery plan for the CCG and have committed to saving £7.5m by the end of the financial year
This will be a challenge and we have to be open and honest that it will require difficult decisions to be made about some services that are not considered to be cost effective.

20. Looking ahead to
Dr Elango Vijaykumar
Clinical Chair

21. Our T.E.A.M priorities

22. Engaging with public Yvette Robbins Lay Member Patient and
Public Participation

23. Engaging with public
We are launching the “Big Health and Care Conversation”
Want to talk to as many people as possible about the issues we face in health and care and to listen to what matters most to them and their experiences of using services
We will use the feedback to influence and shape our decision-making and future plans for transforming local services

24. Engaging with public The areas we will be focusing on are: Finances
Developing a preventative approach to health and care
Improving children’s health and wellbeing
Promoting emotional wellbeing and mental health
Improving older adults’ health and wellbeing
Improving access to services
Sustainability and Transformation Partnership (STP)

25. Engaging with public
The first Big Health and Care Conversation will take place on:
31 August 2018, 1.30pm-4.30pm, at Nutfield Lodge, Nutfield Road, Redhill RH1 4ED
Everyone is welcome – just book a place by contacting Carol Rowley on or

26. Questions from the public?

27. Thank you