Delivering the Forward View: NHS planning guidance 2016/ /21

Transcription

1 Delivering the Forward View: NHS planning guidance 2016/ /21

2 Planning Guidance 2016/17 Published December 2015 Spending Review National Priorities 2 separate but connected plans CCG Operational plan for 2016/17 5 year sustainability plan (STP) on a wider planning footprint The 2016/17 Operational Plan should be regarded as year one of the five year STP, and we expect significant progress on transformation through the 2016/17 Operational Plan

3 The 9 must do s for 2016/17 for every local system 1. Develop a high quality and agreed STP 2. Return the system to aggregate financial balance and to deliver savings by tackling unwarranted variation in demand through implementing the Right Care programme. 3. Develop and implement plan to address the sustainability and quality of general practice, including workforce and workload issues 4. Access standards for A&E and ambulance waits 5. Improvement against and maintenance of the NHS Constitution standards 6. Deliver the NHS Constitution 62 day cancer waiting standard make progress in improving one-year survival rates 7. Achieve and maintain the two new mental health access standards 8. Transform care for people with learning disabilities 9. Develop and implement an affordable plan to make improvements in quality, providers participate in the annual publication of avoidable mortality rates

4 Planning outputs Operational Plan All plans will need to demonstrate: How they intend to reconcile finance with activity (and where a deficit exists, set out clear plans to return to balance) Planned contribution to the efficiency savings Plans to deliver the key must-dos How quality and safety will be maintained and improved for patients How risks across the local health economy plans have been jointly identified and mitigated through an agreed contingency plan How they link with and support with local emerging STPs.

5 Planning Outputs STP Five year Sustainability and Transformation Plan (STP) Health and social care systems - local blueprints - accelerating the implementation of the Five Year Forward View. Place based for local populations not organisational silo planning. System leadership local leaders develop a shared vision and interventions to realise the vision. Engage with clinicians, patients, carers, citizens and local partners. Umbrella plan with specific delivery plans over different footprints. Place based plans include all CCG and NHS commissioned activity (Specialist Commissioning, primary medical care etc). Include plans for integration with LA services.

6 Hull CCG Key Deliverables Avoidable deaths and seven-day services Patient experience Cancer Balancing the NHS budget Obesity and diabetes Dementia A&E, ambulances and Referral to Treatment (RTT) New models of care and general practice Health and social care integration Mental health, learning disabilities and autism Research and growth Technology Health and work

7 How we identify Hull Priorities Commissioning for value (Right Care) Health Needs Analysis including Demographic patterns Quality Indicators Patient Engagement and Feedback

8 Our Priorities Programme Primary Care Vulnerable People System Resilience Integration Children and Young People Wider determinants of health Cancer Integrated Care Centre Plans Blueprint, Long Term Conditions, care coordination, End of Life Care, Mental health, Learning Disability, Dementia, CAMHs, Autism, early intervention psychosis A&E, Ambulance, discharge to assess, assess to admit. Referral to treatment, diagnostics. BCF further integration, falls, reablement, MDTs rapid response, personal health budgets Maternity, Children's complex needs, Hull 2020, Healthier Hull, Public Health, Screening uptake, 62 day waits Recommissioning - Pathways and Protocols

9 Financial Planning 2016/17 and beyond Allocation Headlines So what for Hull Commissioning Business Rules Sustainability and Transformation Fund

10 Allocation Headlines: Allocations received 8 January 2016 Front loaded 3.8bn in 2016/17 moving to 8.4bn by 2020/21 Requirement for stabilisation leading to sustainability Included place based allocation for specialised and primary care services Revised allocation formulae (inequalities adjustment for specialised care, more sensitive adjustments for CCGs and Primary Care and adjustments for remote areas)

11 So what for Hull: CCG has become within 5% of target (1.94% in 2016/17) Primary Care is within 5% of target (1.52% in 2016/17) CCG Growth Primary Care Growth 2016/ % 3.56% 2017/18 2% 1.84% 2018/ % 1.93% 2019/ % 2.54% 2020/ % 3.69%

12 So what for Hull: The previously planned deflator for providers has become an inflation requirement for 2016/17 Tariff proposals for 2016/17 are: +3.1% -2% efficiency = 1.1% +0.7%+0.3% = 2.1% Significant risk if this continues in 2017/18 and beyond at current allocation growth levels Challenging Commissioning Business Rules e.g.1% risk reserve and lots in baseline Other pressures mean contract negotiations will be very challenging

13 Efficiency Assumptions Tariff proposals (3.1% inflation and 2% efficiency = 1.1%), plus 0.7% CNST HRG4+ being considered for 2017/18 onwards National procurement arrangements for specialised high cost excluded devices 2% efficiency predicated on forecast provider deficit of 1.8bn at end of 2015/16 13

14 Commissioning Business Rules For 2016/17, similar to last year CCG/DC cumulative surplus of 1% (excl. PH and Spec Comm) At very least, in-year break-even position CCGs in cumulative deficit expected to apply allocation growth to improve bottom-line (after national new policy requirements) CCGs asked to plan to draw-down cumulative surpluses over 1% over next three years 14

15 Commissioning Business Rules 1% non-recurrent reserve (uncommitted) for health economy risks change in emphasis Additional contingency of 0.5% Joint plans (CCGs and Councils) for BCF - further guidance expected Commissioners must continue to increase investment in mental health services each year to at least match their overall expenditure increase. CCGs eligible for benefits from service efficiency in relation to specialised commissioning 15

16 2016/17 Sustainability and Transformation Fund Transformation element of the Fund - 0.3bn Sustainability element of the Fund - 1.8bn A general element for sustainability of emergency services and achievement of agreed control totals; A targeted element to support additional efficiency gains. 16

17 Returning Provider Sector to Balance Draft values and control totals sent to providers Locally HEY and HFT are expected to receive a share Calculated by NHS Improvement and agreed with NHS England) Quarterly release dependent on achieve recovery milestones: Deficit reduction Access standards Progress on transformation Cost containment (Carter) Constrained capital DH guidance due in January

18 Quality Commissioning for Quality Strategy partnership working across health economy. 5 key objectives to be delivered over next 3 years reflective of 5YFW & Compassion in Practice (6C s) Nursing Strategy collaborative work across the health economy to facilitate development and sustainability of the nursing workforce Patient engagement and experience Serious Incident process Support/Challenge & monitoring of providers via CQF/CMB/Quality Risk Profile/engagement with NHS E

19 Quality cont Mortality Maternity Safeguarding CQUINS Increasing involvement with Local Authority & CQC with Care Home Contract development & monitoring of standards Research, Innovation & Growth

20 Planning timetable