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Performance and Financial Update on Integrated Care System and Partnerships

This panel update provides a comprehensive overview of the performance and financial status of the Integrated Care System and Integrated Care Partnerships in the region. It includes updates on NHS targets, infections, safety, and financial performance.

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Performance and Financial Update on Integrated Care System and Partnerships

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  1. Scrutiny panel updateSteven Mason, Director of Finance and Kevin Oxley, Director of Estates, ICT and Health Care Records 19 December 2018

  2. Update 1. Performance update including NHS targets, infections and safety 2. Financial performance 3. Update on the Integrated Care System and Integrated Care Partnership for the south of the region

  3. Performance Update

  4. Year to date Performance Deliver Excellence in Patient Outcome and Experience…. A&E 4hrTarget (Nov) Referral to Treat 18 Week Target (Oct) Cancer 62 Day Target (Oct) C. Difficile 89.23% 31 80.92% 95.65% 85.02%* Operating Surplus On plan

  5. Performance - A&E July 18Ranked 6th in the region

  6. Referral to Treat Oct 89.23% 92% TARGET Q2 : 89.48%

  7. Performance – 62 Day Cancer Standard

  8. Trust Apportioned Clostridium difficile

  9. Delivering Safe Care18/19 Trust attributed category 2 pressure ulcers Falls CHIEF EXECUTIVE REPORT 29th November2018 Rate 1.9 per 1000 bed days. Rate within normalvariation 4.0per 1000 bed days. Rate within normalvariation Continued Focus on Falls PreventionStrategies

  10. PatientExperience CHIEF EXECUTIVE REPORT 29th November2018

  11. Financial Performance

  12. 17/18 and 18/19 Plan Comparison Original Control Total £11.9m 17/18 Control Total Negotiated Revision £3.8m £7.4m £6.2m Actual Outturn £9.1m £35.6m P&E Plan Non-recurrent savings £10.2m Inflation £6.3m Service Pressures

  13. 18/19 Productivity and Efficiency Savings £35.6m 18/19 original P/E target } £ £33.9m Delivery Booked £1.7m Planned to Deliver }

  14. Financial Run Rate – National Picture 18/19 Number of providers in deficit Forecast CIP savings against plan £3.6BN CIP delivery target 163 / 230 Providers reporting a deficit (92% in acute sector) £136m Behind plan

  15. Integrated care system (ICS) and integrated partnership (ICP)

  16. 44 Sustainable Transformation Partnerships (STP) Footprints Into x? Integrated Care Systems (ICS) NHS 10 Year Plan Wave 1 ICS December 2017 South Yorkshire and Bassetlaw Frimley Health and Care Dorset Bedfordshire, Luton and Milton Keynes Nottinghamshire Blackpool and Fylde Coast West Berkshire Buckinghamshire Greater Manchester (devolution deal) Surrey Heartlands (devolution deal) £/ £ Gloucestershire West Yorkshire and Harrogate Suffolk and North East Essex North Cumbria Capitation Budgets Wave 2 ICS May 2018 Wave 3 ICS March 2019 Cumbria and North East South East London Devon Bristol Norfolk Oxford

  17. Current Clinical Footprint 2 Major Trauma Centres 4 Vascular; (NICU) Newborn intensive care unit; PPCI (coronary); Renal Northumberland Proposed pathology hubs 2+1 Tyne and Wear 7 Paediatric Inpatients 7 Hyper Acute Stroke Units Consultant led maternity 8 Stockton-on-Tees Hartlepool Durham Redcar & Cleveland Darlington Middlesbrough

  18. Four Integrated Care Partnerships Northumberland CCG Newcastle Gateshead CCG North Tyneside CCG South Tyneside CCG Sunderland CCG North Durham CCG Darlington CCG North Cumbria CCG Hartlepool & Stockton-on-Tees CCG Durham Dales, Easington and Sedgefield CCG South Tees CCG Hambleton, Richmondshire and Whitby CCG

  19. Four Integrated Care Partnerships • North Cumbria • Population 327k • ICP lead: Stephen Eames Northumberland CCG Newcastle Gateshead CCG North Tyneside CCG South Tyneside CCG Sunderland CCG North Durham CCG Darlington CCG North Cumbria CCG Hartlepool & Stockton-on-Tees CCG Durham Dales, Easington and Sedgefield CCG South Tees CCG Hambleton, Richmondshire and Whitby CCG

  20. Four Integrated Care Partnerships • North • Population 1.025M • ICP lead: Jim Mackey Northumberland CCG Newcastle Gateshead CCG North Tyneside CCG South Tyneside CCG Sunderland CCG North Durham CCG Darlington CCG North Cumbria CCG Hartlepool & Stockton-on-Tees CCG Durham Dales, Easington and Sedgefield CCG South Tees CCG Hambleton, Richmondshire and Whitby CCG

  21. Four Integrated Care Partnerships • Central • Population 675k • ICP lead: Ken Bremner Northumberland CCG Newcastle Gateshead CCG North Tyneside CCG South Tyneside CCG Sunderland CCG North Durham CCG Darlington CCG North Cumbria CCG Hartlepool & Stockton-on-Tees CCG Durham Dales, Easington and Sedgefield CCG South Tees CCG Hambleton, Richmondshire and Whitby CCG

  22. Four Integrated Care Partnerships • South • Population 1.1m • 5 CCG areas • 3 FTs • 7 Councils • ICP lead: Siobhan McArdle Northumberland CCG Newcastle Gateshead CCG North Tyneside CCG South Tyneside CCG Sunderland CCG North Durham CCG Darlington CCG North Cumbria CCG Hartlepool & Stockton-on-Tees CCG Durham Dales, Easington and Sedgefield CCG South Tees CCG Hambleton, Richmondshire and Whitby CCG

  23. ICP operating principles • The needs of people will have priority over organisational interests • We will work in clinical networks across hospital sites - sharing scarce resources to maintain local services • We will work collaboratively, urgently and with pace on system reform and transformation • Costs will only be reduced by improving co-ordinated care • Waste will be reduced, duplication avoided and activities stopped which have limited value or where benefit to our population is disproportionate to cost

  24. ICP – what we are doing now • Our clinicians are developing the Clinical Strategy • We will preserve each of our hospitals into the future by using them differently and in a more joined up way to benefit all patients • Some changes and improvements may be necessary to services currently provided from different hospital sites • We want to introduce new ways of working so that clinicians can work easily across multiple organisations and clinical sites, and expand our use of new roles and care models that will help us to manage demand and drive an improvement on outcome.

  25. ICP – clinical strategy Our Clinical Strategy will focus on how we deliver a number of key services: • Urgent & Emergency Care • Paediatric, Maternity (Gynaecology modelling interdependencies) • Elective care: Spinal Breast Urology • Frailty services • Stroke services We will finalise and agree our Clinical Strategy in early 2019 and will be sharing with Overview and Scrutiny panels.

  26. Questions

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