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Merton CCG Annual General Meeting

Merton CCG Annual General Meeting. 24 September 2015. Agenda. Welcome and Chair’s Introduction The Annual Report Our accounts The challenges ahead Questions Mental health in Merton Questions. Introduction Dr Andrew Murray, Chair. The Annual Report Adam Doyle, Chief Officer.

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Merton CCG Annual General Meeting

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  1. Merton CCGAnnual General Meeting 24 September 2015

  2. Agenda • Welcome and Chair’s Introduction • The Annual Report • Our accounts • The challenges ahead • Questions • Mental health in Merton • Questions AGM slides 24 September 2015

  3. IntroductionDr Andrew Murray,Chair

  4. The Annual ReportAdam Doyle,Chief Officer

  5. Who we are • We are: • a GP-led membership organisation responsible for planning, buying and monitoring local health services • Our GP practices work in partnership with hospitals, community services, mental health services, pharmacists and dentists, Merton Council and our local community AGM slides 24 September 2015

  6. Merton’s Health Need • Merton’s population expected to increase by over 21% by 2021 • We have an increasing and high birth rate and at the same time an aging population • Levels of deprivation are much higher in wards in East Merton than West Merton • Our population is increasingly diverse with BAME rising to 39% by 2017 AGM slides 24 September 2015

  7. Our aims in 2014-15 • To improve the health outcomes for the people of Merton by buying services tailored to their needs while addressing the diverse health needs of our population • Everyone in Merton should be able to receive the care they need, at the right time, in the right place and from the right health care professionals, bringing the right outcomes AGM slides 24 September 2015

  8. How we operate • We have strong clinical input via the work of our localities, our Practice Leads Forum, the Practice Nurse Forum and our Clinical Reference Group (CRG) • We have in place a strong executive leadership team • We work in partnership with Merton Council and Healthwatch AGM slides 24 September 2015

  9. Our structure AGM slides 24 September 2015

  10. Delivering Our Priorities • We agreed a set of priorities for 2014-15 which we believed would make a real difference to the quality of care in Merton • Many of these initiatives aimed to tackle the most common diseases which affect local people and their quality of life AGM slides 24 September 2015

  11. Older Adults • Expanded the community prevention of admission team (CPAT) • Developed a new tool to support homes in identifying the best service • Provided ‘in-reach’ nursing at St. George’s Hospital to support patient discharge • Launched the Dementia Hub • Developed a falls prevention pathway AGM slides 24 September 2015

  12. Children and Maternity • Target time achieved for the provision of initial health assessments for children looked after away from home • Review for children with complex health needs commissioned from the Royal College of Paediatrics and Child Health • Maternity Clinical Network created to review and improve maternity services AGM slides 24 September 2015

  13. Mental Health and Learning Disabilities • Mental Health Needs Assessment (HNA) commissioned • The Improving Access to Psychological Therapies (IAPT) programme re-procured • New complex depression and anxiety service launched to improve service provision AGM slides 24 September 2015

  14. Engagement • Established the Merton Better Healthcare Closer to Home group • Worked with Healthwatch, the public and patients to ensure local people have a voice in everything we do • Greater use of digital and social media • Ran Engage Merton and Mitcham Carnival ‘health hub’ AGM slides 24 September 2015

  15. Keeping Healthy and Well • Developed a joint weight management pathway and GP pilot in the more deprived areas of Merton • Merton CCG and East Merton GP locality group began to develop a Model of Care for East Merton AGM slides 24 September 2015

  16. Early Detection • Increased provision of cardiac rehabilitation - in particular targeting hard-to-reach groups • Clinical health coaching telephone service pilot launched for patients with chronic obstructive pulmonary disease • Macmillan GP recruited • Invested in enhanced musculoskeletal service AGM slides 24 September 2015

  17. Urgent Care • Urgent Care Centres incorporated into A&E departments at St. Helier and St. George’s Hospitals - ensured appropriate assessment and reduced pressure on A&E departments • ‘Not Always A&E’ communication campaign helped raise awareness of the range of services available to local residents in addition to A&E AGM slides 24 September 2015

  18. Planned Care • Opened the state of the art Nelson Centre on 1 April 2015, allowing patients to be diagnosed and treated closer to home

  19. The Nelson Health Centre • Community services well utilised • Diagnostics working well • Patient numbers are increasing steadily month on month • Waiting times for many services are very short • The pharmacy service opened this week AGM slides 24 September 2015

  20. New Health Centre for Mitcham • Wilson Hospital site agreed as the preferred location • Approval request submitted this month to NHS Property Committee to proceed • Engagement with local people and groups begins in November • Site and facility design to begin November/December AGM slides 24 September 2015

  21. Our performance 2014-15

  22. 2014-15 Performance • Merton achieved the following key performance targets helping to get people seen, diagnosed and treated – often more quickly: • Diagnostics • Cancer 2 weeks / Cancer 31 days • IAPT (Improving Access to Psychological Treatment) • Diagnosis rates for dementia AGM slides 24 September 2015

  23. 2014-15 Performance • Targets not achieved: • A&E 4hr waiting time (93.6%) - St Georges (92.4%) Kingston (94.4%). Lack of beds/staff • Cancer 62 day wait (83.8%) – still ranked 8th of 32 London CCGs • Ambulance red response times – not achieved across London, significant investment in 2015-16 from CCGs AGM slides 24 September 2015

  24. A&E AGM slides 24 September 2015

  25. Diagnostics AGM slides 24 September 2015

  26. Cancer – Two week wait

  27. Cancer – 31 days AGM slides 24 September 2015

  28. Cancer – 62 days AGM slides 24 September 2015

  29. Cancer – 62 days screening AGM slides 24 September 2015

  30. Improving Access to PsychologicalTherapies AGM slides 24 September 2015

  31. Dementia AGM slides 24 September 2015

  32. Our Accounts Cynthia Cardozo, Chief Finance Officer

  33. 2014/15 Financial allocation • We were given £208m (c.£940 per head of population) 4.92% increase from 13/14, 7.67% below target • A running cost allocation of £5m • In-year extra funding of £4.7m (incl. 13/14 carry forward surplus of £2.1m and £1.1m for winter resilience) • This created a total allocation of £218m AGM slides 24 September 2015

  34. 2014/15 Financial requirements • We achieved: • A surplus of £2.7m (1.2% of resource allocation) against the budget of £218m • Met our running cost target of £5m • Achieved the Better Payment Practice Code - 97% in terms of invoices and 99% in terms of invoice value (Target 95%) • Met the target for Capital expenditure (£0.8m) AGM slides 24 September 2015

  35. How we spent our money on NHS care AGM slides 24 September 2015

  36. Acute Activity Performance • Acute spend of £128m (59%) covers detailed activity • Overall activity has increased from 2013/14 • Large increases in emergency and GP referred activity AGM slides 24 September 2015

  37. External Audit Conclusions • The CCG fully met the relevant conditions and requirements on its 2014/15 annual accounts • Specifically: • Unqualified opinion on financial statements • Unqualified regularity opinion • Unqualified opinion on remuneration report • No issues on value for money review AGM slides 24 September 2015

  38. 2015-16 and beyond: the challenges aheadDr Andrew Murray Chair

  39. Allocations for 2015-16 • An 8% increase in programme cost allocation (£226m), to buy services for an estimated population of 226,559 • This gives us £997 per head of population, however still 4.77% below target for our population • A running cost allocation of £4.5m (reduction of £0.5m from 2014/15) AGM slides 24 September 2015

  40. Financial Plan for 2015-16 • To deliver 1% surplus (£2.3m) • Invest £11.3m in Better Care Fund • Invest 8% more in Mental Health services to deliver parity of esteem • Invest in capacity at St George’s Hospital FT deliver A&E four hours wait • Deliver QIPP plans of £4.9m (2.1%) to offset growth in demand for services AGM slides

  41. Priorities going forward • Whole Merton Model: • Engagement and communications • Culture and workforce • Technology • Partnerships AGM slides 24 September 2015

  42. Priorities going forward • Planned care – review of referrals • Taking forward the Mitcham development • Delegated commissioning • Working with other CCGs on the South West London Collaborative Commissioning (SWLCC) on our five-year plan AGM slides 24 September 2015

  43. SWLCC – ‘The Issues Paper’ • In June 2015, six south west London CCGs published an Issues Paper, summarising the challenges and emerging solutions set out in the strategy and putting forward questions for local people to respond to. • You can read and respond to the Issues Paper online http://www.swlccgs.nhs.uk/issues-paper/ AGM slides 24 September 2015

  44. Any questions? AGM slides 24 September 2015

  45. Mental health services in MertonDr Andrew Murray, Clinical Chair and Emma Gennard, Mental Health Commissioning

  46. Our population • Total CCG population in 14/15: 217,802 • No. of GP practices:26 (now 24) • One in four adults will experience mental health problems • One in six adults has a mental health problem at any given time AGM slides 24 September 2015

  47. Merton Community Mental Health Profile (2014) • The profile for Merton looks at 3 areas; Mental Health and Illness, Treatment and Outcomes and then compares us with the rest of England using 26 indicators • It helps us to understand better where we are doing well and if we need to review something AGM slides 24 September 2015

  48. Mental Health and Illness • There are five indicators • Merton has significantly lower figures than England across all five measures tested and compared to the rest of England • This could indicate that depression and anxiety may be lower than other places • Or could mean there is under-diagnosis and under-recording in general practice AGM slides 24 September 2015

  49. Recording people with depression Example: Depression Prevalence Merton = 4.7 National= 5.8 Category= Significantly Lower AGM slides 24 September 2015

  50. Key points on Mental Health and Illness • We need to understand better the variation between GP practices • This will help us make better decisions about what services are needed AGM slides 24 September 2015

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