1. Annual General Meeting Thursday 27 th September 2007 Broadfield Stadium Crawley

2. Welcome & Introduction Barbara Wilkins Acting Chair

3. John Wilderspin Chief Executive Highlights for 2006/07

4.  What do PCTs do?  Creating the new PCT  Delivering on key objectives  Challenge of Fit for the Future

5. A Breath of Fresh Air Dr Andrew Foulkes Chairman, Professional Executive Committee

6. A breath of fresh air  Management of long term conditions  Improvements in end of life care  Care closer to home

7. Long term conditions COPD Practice registers Expert patients Better management Less exacerbations of illness 40% reduction in admissions to hospital

8. End of Life care 37% died at home : national stats for all causes 20% 20% died in the acute hospital: national stats 56% 46% patients had had no unplanned crisis admissions to hospital in the last six months 56% patients obtained their preferred place of death 72% cases had been offered bereavement support 73% patients included on the palliative or supportive care register 76%patients discussed at primary health team meetings at least monthly

9. Early Life

10. Finance West Sussex PCT 2006 / 07 Neil Ferrelly Director of Finance

11. Key financial targets In 2006/07 the PCT failed to achieve financial balance on the revenue account for the year, recording a deficit of £12.86m. It did however achieve the remaining targets: Full cost recovery for the services that the PCT provides out of its own resourcesFull cost recovery for the services that the PCT provides out of its own resources Full utilisation of the cash resources allocated to the PCTFull utilisation of the cash resources allocated to the PCT Keeping capital expenditure within the limit set by the Department of HealthKeeping capital expenditure within the limit set by the Department of Health

12. Note (from full Annual Accounts) 2.1 Revenue Resource Limit (RRL) Note (from full Annual Accounts) 2.1Revenue Resource Limit (RRL) The PCTs' performance for 2006/07 is as follows: 2006/07 2005/06 £000 Total net operating cost for the financial year 984,852 911,451 Less: Non-discretionary Expenditure 6,023 6,908 Operating Costs less non- discretionary expenditure 978,829 904,543 Final Revenue Resource Limit for year 965,967 902,270 Under/(over) spend against Revenue Resource Limit (12,862) (2,273)

13. Analysis of expenditure by service 2006/07 £million

14. Revenue resource expended by former organisations The amount of revenue resource expended byformerorganisations to 30 September 2006 as a percentage of the total anticipated RRL for West Sussex PCT is as follows: Netoperating costsfor the first six months of 2006/07 £000 Adur, Arun and Worthing PC 150,161 Crawley PCT 68,270 Horsham and Chanctonbury PCT 65,829 Mid Sussex PCT 82,897 Western Sussex PCT 118,262 Total 485,419 Anticipated RRL for West Sussex PCT for 2006-07 as 965,967 notified by the Department of Health on 16 April for 31.3.07 Percentage of RRL used to September 2006 50.25%

15. Value for Money The PCT actively sought Value for Money in its business activities and during the period 1 April 2006 to 31 March 2007. The PCT’s key approaches to ensuring value for money were:  Rigorous review of all contracts for purchasing goods and services.  Effective use of national purchasing contracts through the NHS  Purchasing and Supply Agency (PASA).  The Local Delivery Plan process  involvement of partners / prioritisation of investments.  Reconfiguration of the existing five PCTs to a single, leaner structure across West Sussex.  Refining the PCT’s performance monitoring process.  Continued close scrutiny of budgets and the identification of savings that can be made.

16. A new mind-set for improving health and well-being Annual Report of Director of Public Health for West Sussex, 2007

17. Securing Health of the Population “We are not tinkers who merely patch and mend what is broken. we must be watchmen, guardians of the life and the health of our generation, so that stronger and more able generations may come after.” Dr Elizabeth Blackwell (1821-1910) The first Woman Doctor

18. A celebration of good health

19. A celebration of Good Health in West Sussex  Life expectancy at birth is 78 years for men and 82 years for women  Between 1993 to 2005:  21% reduction in overall death rates  14% reduction in cancer death rates  42% reduction in deaths due to circulatory diseases  3.2 deaths under 1 year per 1000 live births compared to 5 per 1,000 nationally

20. Significant, Unacceptable, Unfair, widening variations in health  At electoral ward level life expectancy ranges from 70.1 years to 84.8 years (note impact of nursing homes)  ‘Healthy Life Expectancy’ (Life Expectancy without Limiting Long Term Illness), is 66.8 years.  On average in West Sussex the last 12.9 years of life are limited by long term illness  At electoral ward level a range of 8 years lived with a long-term illness to 17.9 years in more deprived wards.

21. Healthy life expectancy & deprivation

22. From Analysis to Action Cause of death SMRLLUL Circulatory disease 120.2114.8125.8 Respiratory disease 137.4127.8147.5 All cancers 111.2104.8118.0 Breast cancer 99.880.4122.4 Lung cancer 132.7116.2150.9 Standardized Mortality Ratios (SMR) for LNIAs by cause of death (West Sussex = 100)

23. Choosing health? Living and Planning Today with tomorrow in mind  Alcohol: Reducing harm, evaluating tradition  Working together to reduce Obesity  Reducing sexually transmitted diseases  Health and well-being in workplaces  Promoting mental health and well-being Role of three key players: Individuals, communities, institutions

24. Developing sustainable services Focus, Trust and Commitment on targeting  People and Places in most need  Primary Care  Prevention  Partnerships  Promoting full engagement of people and communities and Capacity building for health improvement Living today with tomorrow in mind

25. Securing Health of the Population “We are not tinkers who merely patch and mend what is broken. we must be watchmen, guardians of the life and the health of our generation, so that stronger and more able generations may come after.” Dr Elizabeth Blackwell (1821-1910) The first Woman Doctor

26. Thanks and Closing Remarks Margaret Bamford Acting Vice-Chair

27. Annual General Meeting Thursday 27 th September 2007 Broadfield Stadium Crawley