1. Annual Members Meeting 2018/19 Annual Report and Accounts

4. Insert image of the CCG team
E.g. mandy at the governing board session took when we were rated outstanding aprox 16th July)

5. CCG Improvement and Assessment Framework (IAF)

6. NGCCG Performance in 2018/19

7. Challenges Poor Health: % children overweight or obese
Consequences- Injuries from falls in older people
Antimicrobial resistance: prescribing in primary care (Improving)
Avoidable Emergency admissions
Population use of hospital beds following emergency admission
Services- Improving access to Psychological therapies – recovery
Reliance on specialist inpatient care for people with LD/autism(Improving)
Workforce
Waiting times- Cancer
Personal Helath budgets moved into highest performers
Inequalities emergency admissions – lowest to mid

8. Annual Accounts 2018/19

9. Statutory Financial duties of a CCG
CCG statutory financial duties:
Ensure expenditure does not exceed the aggregate of the allocations for the financial year (breakeven duty)
Take account of any directions issued by the NHS England in respect of specified types of resource use in a financial year, to ensure the amount specified by the NHS England is not exceeded
Publish an explanation of CCG expenditure on quality
Keep appropriate accounting records and publish annual accounts
CCG financial obligations:
To pay 95% of its creditors within 30 days
Control totals set by NHS England

10. 2018/19 Annual Accounts
The CCG annual accounts were issued with unqualified audit opinions
The annual accounts were formally approved by the Governing Body on 21st May, submitted to NHS England on 25th May and published on the CCG website on 14th June 2019

11. Meeting Financial Duties: breakeven
The CCG met its duty to breakeven
At the start of 2018/19, the CCG had an approved commissioning budget of £734.5m, a running costs allocation of £10.6m and a planned surplus of £10.2m.
In addition the CCG received its delegated Primary Care Commissioning Budget at £68.4m, giving an overall in year funding envelope of £813.4m.

12. Meeting Financial Duties: breakeven
At the year end, with additional allocations in-year, the CCG had a full resource allocation of £822.6m and a total expenditure of £822.4m, giving an in year surplus of £0.2m
Added to the previous year surplus the cumulative surplus is £14.8m

13. Meeting Financial Duties
Revenue resource limit
2018/19
£000
Total net operating cost for the financial year
822,392
Final revenue resource limit for year
822,606
Underspend against revenue resource limit
214

14. Meeting Financial Duties
Public Sector Payment Policy: 95% undisputed creditors to be paid within 30 days – the CCG met this duty
Better Payment Practice Code
2018/19
Number
£000
Non-NHS creditors
Total bills paid in the year
18,044
213,144
Total bills paid within target
17,605
211,021
Percentage of bills paid within target
97.57%
99.00%
NHS creditors
3,397
523,454
3,336
522,412
98.20%
99.80%

15. How the money was spent

16. How the money was spent – by provider

17. How the money was spent – by expenditure

18. Looking ahead - finances
2019/20 marks the first year of the new NHS funding settlement. This is part of NHS England’s five-year funding settlement; averaging growth of 3.4% a year in real terms and reaching £20.5bn extra a year by 2023/24.
Year one of the new settlement has produced an increase to the CCG’s core programme funding allocation of 5.28%, recognising the impact of national pay awards and significant changes to national tariff and funding flows for NHS providers.

19. Financial Risks & Challenges
Continuing Health Care and high cost packages of care
Pressures arising from demand for acute services
Drug Costs
Workforce and capacity
Moving investment upstream
Economics
SUSTAINABILITY AND TRANSFORMATION PLAN

20. Living within our budget

21. QIPP achievement 18/19
The CCG achieved £23.4m of savings in18/19 against a plan of £22.2m.

22. QIPP achievement 18/19 by area

23. Demand Management

24. Year on Year Activity Variance 17/18 – 18/19
Outpatient First Attendances 1,428 up (0.8%)
Outpatient Follow-up Attendances 13,240 down(3.0%)
Outpatient Procedures 1,891 up (2.1%)
Elective Inpatients down(6.1%)
Day Case Admissions 2,593 down (4.2%)
A&E Attendances 14,206 up (6.1%)
Non-Elective Admissions 1,898 up (2.9%)

25. Outstanding rating Top 15% of all CCGs A proactive approach to quality
Collaborative work.
Top 1/4 patient experience of Primary care access
High quality care in primary care and acute settings

26. System working

27. People

28. Patients

29. Networks

30. Place (Local Authority)

31. A Place-Based Approach to Health, Wealth and Wellbeing in Newcastle
The JEG focuses collectively on the challenges and opportunities within Newcastle and the requirement to deliver the Newcastle plan with supporting governance and capacity arrangements.
The group have agreed to include wider public sector stakeholders e.g. the two Universities in major strategic work on health for wealth, maximising social value and local investment with organisational spending power.
The Joint Executive Group (JEG) brings together CEOs of Newcastle City Council, Newcastle upon Tyne Hospitals NHS Foundation Trust, Northumberland Tyne and Wear NHS Foundation Trust and Newcastle Gateshead CCG. The JEG aims to:
Maintain high level dialogue on health and social care
Better align services and opportunities to coordinate or share resources
Realign the cycle of inequality into a cycle of opportunity and achievement to significantly improve the health, wealth and wellbeing of those who live and work in the city

32. Joint Delivery Group
A JDG work plan has been agreed, including nominated sponsors and leads aligned to the following areas:
Primary Care Networks
Integrated care provision
Integrated intermediate care service
Healthy start
Newcastle £ - including pooled budgets
Digital
Leadership development
Workforce
Secondary prevention
The Joint Delivery Group (JDG) has the following membership :
The Newcastle upon Tyne Hospitals
NHS FT (NuTH)
Northumberland Tyne and Wear (NTW)
Newcastle Gateshead CCG
Newcastle GP services
Newcastle City Council
West End Family Health
Bluestone Consortium
Newcastle CVS

33. Health Foundation Trust
Gateshead Health & Care System A Place based approach to Integrated Health & Care
Collective and best use of Gateshead £
Primacy of Gateshead Place
Planning as a System
Newcastle Gateshead CCG
Gateshead Local Authority
Public Health
Gateshead GP Federation/CBC/PC Networks
NUTH
NTW
Priority areas:
Children’s health & wellbeing
Multiple & complex needs
Frailty
Transformation Programme – 10 areas
The 3 priority areas plus:
Community services
Intermediate care
Falls
Deciding Together, DT (MH)
Community Model - LD
End of life care
Gateshead
Health Foundation Trust
Blue Stone Consortium

34. Gateshead Health & Care System A Place based approach to Integrated Health & Care
This Year, we……..
developed the ‘skeleton’ for the Gateshead System (agreed an MoU etc.)
are developing relationships with ICP (North) and ICS, advocating the ‘primacy of place’.
have developed an iterative Gateshead Plan and a ‘system lens’ focus on performance and quality.
progressed work on our priority and transformation areas.
are working on enablers to integration and the linking with work at bigger geographies – e.g. workforce, IT.
progressed a population health approach and a focus on prevention.
provided a ‘system’ response to various issues – budget proposals, emerging PC Networks, local consultation on air quality etc.
developed our profile as a system. We are recognised externally as a good emerging system.

35. North Integrated Care Partnership (ICP)
The North ICP is the largest of the four ICPs in the North East and North Cumbria ICS. The footprint covers a population of 1.025m with the following statutory organisations:
3 CCGs -NHS Northumberland CCG, NHS North Tyneside CCG and NHS Newcastle Gateshead CCG
3 NHS Foundation Trusts –Northumbria Healthcare NHS FT, The Newcastle upon Tyne Hospitals NHS FT and Gateshead Health NHS FT
4 Local Authorities –Northumberland County Council, North Tyneside Council, Newcastle County and Gateshead Council
1 Mental Health Trust –Northumberland Tyne and Wear NHS FT
1 Ambulance Trust -North East Ambulance Service NHS FT

36. North East and North Cumbria Integrated Care System (NENC ICS)
Working collaboratively with partners an ICS Vision for health and care services has been jointly developed:
To work with our communities and partners to tackle health inequalities and fundamentally shift health outcomes for the people of the North East and North Cumbria; and
To ensure the sustainability, quality and effectiveness of our services by working together as an integrated system with mutual accountability for our shared challenges.
For neighbourhood and place-based activity, CCGs, Primary Care Networks and Foundation Trusts will continue to work with Local Authority and Voluntary Sector partners, with a focus on delivering and enhancing integrated health and social care.

37. ICS priority work streams
Population Health and Prevention – using Prevention Health Management techniques, deliver a systematic approach to tackling the biggest causes of premature death in NENC: cardiovascular disease, respiratory disease and cancer.
Optimising Health Services – setting clinical standards, maintaining oversight on quality and coordinating initiatives across the ICS to find sustainability solutions for our health services under the greatest pressure.
Digital Care – improving how we use Information & Technology Services to meet the needs of care providers, patients and the public, helping clinicians to share information and our patients to manage their healthcare.

38. ICS priority work streams
Workforce Transformation – building a future workforce by getting supply and education right, becoming a great place to work and then valuing and supporting leadership at all levels.
Mental Health - improving outcomes for people who experience poor mental health and breaking down barriers between physical and mental health services.
Learning Disabilities – transforming care for people with learning disabilities and autism so that more people can live closer to home, or in the community, with the right support.

39. Looking Ahead

40. Looking ahead – challenges for the NHS
Ageing population with increasing needs
Health inequalities
Levels of smoking, alcohol consumption and obesity high
Over-reliance on hospital based services
Increasing high cost drugs and cost of new medical technologies
Limited growth in financial allocations in future

41. Patient challenges – cancer

42. Waiting List – All Providers
Total Waiters
March ,093
March ,693
Change Since March 2018
+23.7%
Change Excl.T&O
+10.1%

43. CCG Financial challenges