Richmond Clinical Commissioning Group Report Summary

Transcription

1 Richmnd Clinical Cmmissining Grup Reprt Summary Meeting Title: Gverning Bdy Date: 16 September 2014 Reprt Title: Better Care Fund Plan Agenda Item: 8 Attachment: D Purpse: (please delete /N as apprpriate) Apprval/ Ratificatin Discussin/ Cmment Fr Infrmatin Other Authr: Presented by: Mary Palmer Head Jint Cmmissining Cllabrative Mary Palmer Head Jint Cmmissining Cllabrative Executive Leads (Clinical and Officer) Further Infrmatin cntact: Chief Officer Chair Mary.palmer@richmnd.g v.uk Executive Summary: Backgrund On 18th March 2014 the Gverning Bdy endrsed the jint Richmnd CCG and Cuncil Better Care Fund (BCF) plan prir t the plan being submitted t NHSE n 4 April. On 11 July Jn Ruse and Helen Edwards wrte t each HWB t ask all areas t submit revised plans. The new submissin date is 19 September. What s Changed? Ministerial interest in the BCF has increased dramatically ver the summer leading t a number f key plicy changes including: the target t reduced avidable emergency admissins has been revised t include all emergency admissins (except fr maternity and admissin t a mental health trust) the Pay fr Perfrmance element f the BCF nw nly applies t the target t reduce emergency admissins althugh areas are still required t set targets t achieve the remaining perfrmance measures (delayed transfers f care, admissins t care hmes, peple still hme 91 days after discharge fllwing rehabilitatin, patient satisfactin and ur lcal target, the prprtin f peple dying in their place f chice) if the reductin in emergency admissins target is achieved then all f the funding linked t perfrmance will be released t the HWB t Wrking tgether a healthier Richmnd fr everyne Page 1 f 6

2 spend n BCF activities. If the target is nt achieved, the CCG will retain the mney prprtinal t perfrmance and it will be spent by the CCG in cnsultatin with the HWB the natinal expected minimum target reductin in ttal emergency admissins is 3.5% fr all areas, unless there is a credible case fr it be lwer. Areas can set mre ambitius targets and the amunt f funding linked t perfrmance will increase accrdingly the lcal target and resulting funding linked t ttal emergency admissins will be based n the ttal figure fr the area nt just t the prtin resulting frm BCF schemes the requirement t ensure plans prtect scial care remains including that at least 135m natinally is identified fr implementatin f the Care Act HWBs are asked t sign ff and resubmit their plans by 19 September. A range f supprt and assurance has been prvided including hw t guides, seminars, webinars, and 1-1 supprt frm PA Cnsulting. Richmnd has taken advantage f all the different types f supprt available and has als been part f the SWL Cmmissining Cllabrative (SWLCC) wrk t supprt and align develpment f BCF plans in additin t the revised guidance arund the metrics (as set ut abve) all plans narratives are required t be strengthened in the fllwing areas: analysis, evidence base, detail and alignment f targets and initiatives including acrss health and scial care the delivery chain that will underpin the shift f activity away frm acute hspitals a much clearer fcus n risks, risk sharing arrangements and cntingency plans ensuring the ptential impact f prpsed schemes n prviders are understd and prviders are fully engaged further detail n the prtectin f scial care services, including the new duties resulting frm the Care Act in recgnitin that the Care Act will impact lcal authrities and the NHS and ther lcal partners. Prgress The CCG and Cuncil have cntinued t wrk jintly thrugh the Jint Cmmissining Cllabrative (JCC) t develp a revised plan and have cntinued t engage partners thrugh the Integratin Partnership Grup which brings tgether executive representatives frm the CCG, Cuncil, prviders (including acute, mental health, cmmunity health, scial care and primary care), RCVS, Healthwatch and Public Health (PH). Wrking tgether a healthier Richmnd fr everyne Page 2 f 6

3 Challenges Richmnd already perfrms well in reducing emergency admissins. We are: 3rd best in England 2nd best amng ur peer grup 1st in SWL A further 3.5% reductin (n tp f any anticipated grwth) is a challenge and NHSE recgnise the difficulty in attributing an avided admissin t any ne service r initiative. We aim t meet this challenge thrugh ur current investments in services such as the 7 day Richmnd Respnse and Rehabilitatin service and Falls service, and planned incremental investments in fr example a GP led mdel f care fr peple at risk f emergency admissin and psychiatric liaisn services at acute hspitals. Risks A risk register is included in the plan. The three mst significant risks are shwn in the fllwing table. Risk Mitigatin Lead Executive Failure t achieve targets impacts pay fr perfrmance CCG and Cuncil inadequately prepare fr impact f Care Act n health and scial care resurces Health and scial care services fail t secure apprpriate wrkfrce t deliver BCF plans CCG and Cuncil t share financial risk prprtinate t respective BCF investment in health and scial care initiatives 0.5m frm BCF fr Care Act implementatin All prviders members f IPG SWLCC undertaking wrkfrce enabler prgramme Head f JCC AD Care Cmmissining Services AD Care Cmmissining Services / HRCH Directr f Operatins Wrking tgether a healthier Richmnd fr everyne Page 3 f 6

4 Financial/Res urce Implicatins: Funding The CCG/Cuncil cntributins t the BCF remain at the same level as reprted in April: 14/15 Sectin 256 transfer Lcal Authrity m NHS 4.558m m TOTAL 4.558m m 15/16 Better Care Fu pled budget This can be further brken dwn int the fllwing areas: 14/15 15/16 Existing NHS Supprt fr Adult Scial Care 2.916m 3.029m Additinal CCG transfer frm cre funding 0.426m 6.444m Reablement 0.896m 0.896m Carers 0.32m 0.32m LA Capital Funding m TOTAL 4.558m m The transfer f funding frm the CCG t the BCF cntributes t the CCG s requirement t make QIPP savings f 3.8m in 14/15 and 4.3m in 15/16. Mst f this will cme frm acute activity, 2.9m (2.9%) in 14/15 and 3.2m (3.2%) in 15/16. A planned reductin f 3.5% in emergency admissins will lead t a Richmnd Pay fr Perfrmance element f 714k in 15/16. Initiatives The fllwing table sets ut current pled fund initiatives. Wrking tgether a healthier Richmnd fr everyne Page 4 f 6

5 Initiatives 14/15 15/16 Scial care preventative services 0.5m 0.8m Persnal Budgets 0.705m 1.034m Preventin services - vluntary sectr 0.714m 0.714m Carers 0.29m 0.446m 7 day Richmnd Respnse & Rehab 1.284m 2.315m Jint equipment service - 0.6m Falls service 0.19m 0.275m Early supprted discharge fr strke m Cmmunity ward in HRCH cntract 0.45m 0.75m COPD respiratry team m Diabetes intermediate care m Ttal 4.134m 7.794m The next table sets ut planned incremental pled fund investments. Initiatives 14/15 15/16 GP led mdel integrated care m Psychiatric liaisn service at WMUH and KHT m Cmmunity geriatrician m Step up / step dwn beds in cmmunity m Enhanced assistive technlgy services m Imprving Hme Supprt Services 0.424m 0.665m Care Act Implementatin - 0.5m Subttal 0.424m 2.895m BCF capital prjects 1.051m Pled Fund subttal 4.134m 7.794m TOTAL 4.558m m Cmmunicatin plan and stakehlder invlvement: The Integratin Partnership Grup (IPG) is the main stakehlder engagement frum fr the develpment (and delivery) f the BCF Plan. Cmmittees that have previusly discussed/agreed the reprt and utcmes: Health and Wellbeing Bard Gverning Bdy. Wrking tgether a healthier Richmnd fr everyne Page 5 f 6

6 Equality Impact Assessment: Equality Impact Assessments will be cnducted where plans prpse majr changes t services. Recmmendatin: The Gverning Bdy is asked t: nte and apprve the details set ut in this reprt delegate apprval f the final plan prir t submissin t NHSE t the Chief Office, CFO and Chair. Next Steps: Next Milestnes 19 September: Submit final plan t NHSE 13 Octber: Results f NHSE assurance prcess received. There are 4 categries, Apprved, Apprved with Actins (light tuch self/assurance thereafter), Apprved with Cnditins (further assurance required), Nt Apprved (NHSE interventin required). Which Strategic Objective(s) des the paper address? (please delete /N as apprpriate) 1. Clinical Leadership: Use the experience f GPs and ther healthcare prfessinals t cmmissin safe, efficient, sustainable secndary, tertiary and cmmunity health services 2. Cmmissining: Wrk clsely with ur lcal health prviders in primary, scial and cmmunity care, the lcal authrity, and cmmunity and vluntary sectrs t secure the best services delivered in the best setting fr lcal peple 3. Quality: Engage and invlve the lcal ppulatin in the decisins we make in the planning, design, prcurement and quality mnitring f services and ensure sustained fcus n imprving quality and safety f services 4. Gvernance: Ensure apprpriate cnstitutinal and gvernance arrangements are in place t enable the CCG t becme a highly effective membership rganisatin 5. Finance: Ensure the mst efficient use f resurces t get the best value fr patients Which Strategic Risk(s) des the paper help t mitigate? (please delete /N as apprpriate) 1. Failure t ensure patient safety 2. Failure t ensure cmmissined services are gd value, quality and are delivered 3. Failure t maintain r imprve health utcmes 4. Failure t develp and implement Out f Hspital Care Strategy 5. Failure t engage with and manage expectatins f key stakehlders 6. Failure t maintain an n-ging psitive financial psitin /N 7. Failure t recgnise and manage the requirements/challenges f a new rganisatin Wrking tgether a healthier Richmnd fr everyne Page 6 f 6