Annual General Meeting

Tuesday 10 September 2019

An introduction to the CCG

2

Fiona Barber

Deputy Chair and Lay Member (Public and Patient

Involvement)

ELR CCG

Our population and their health

needs

Our patch

Our vision, strategic aims and

values

Our vision

To improve health by meeting our patients’ needs with high quality and efficient

services, led by clinicians and delivered closer to home.

Our strategic aims

• Transform services and enhance quality of life for people with long term

conditions

• Improve the quality of care

• Reduce inequalities in access to healthcare

• Improve integration of local services

• Listening to our patients and public

• Living within our means

Our values

Local challenges and

opportunities in 2018/19 • We have continued to face significant financial pressures and

performance issues with some of our providers

• Closer partnership arrangements and collaborative

working has supported work to address those challenges

• In August 2018, we published the Next Steps for Better Care Together – our local health and care partnership programme – which set out an update on our long term aspirations to deliver improved health outcomes and care for local people

• We also continued to work to our long-term plans under Better Care Together to redesign primary care services in line with the GP Five Year Forward View, to deliver increased outpatient and diagnostic services in local communities and to develop proposals for a new community service model to deliver care at home or as close to home as possible

CCG assurance rating

In July 2019, ELR

CCG was given an

annual assurance

rating of ‘good’ by

NHS England for

the year 2018/19

Our finances

9

Colin Groom

Deputy Chief Finance Officer

Financial duties

• In 2018/19 ELR CCG was entrusted with an in-year allocation (our budget) of £434,032,000 with which to plan and buy the health services needed by people living in East Leicestershire and Rutland

• This year, the CCG continued to face significant financial pressures and performance issues with some of our providers

• Partnership arrangements and collaborative working both at local and health and social care system level has been the focus during the past year to enable the CCG to address the challenges

• We have achieved our key financial targets in the face of these major financial challenges, which was no easy task and is testament to the continued commitment of our staff, clinicians and collaborative commissioning and partnership arrangements.

Financial duties

Financial statements

Value for money

Manage within cash limit

Manage within capital limits

Manage within running costs

target

Statutory duties

How we spent our money

Budget Actual

Variance -

(Under)/

Overspend

£m £m £m

Total allocation 436.48 436.48 0.00

Total Acute Commissioning 219.33 217.57 -1.76

Total Non-acute Commissioning 107.91 108.31 0.40

Total Practice Prescribing 46.51 48.72 2.22

Total Primary Care Services 51.19 52.69 1.51

Miscellaneous (inc reserves) 2.23 0.00 -2.24

Total Running Costs 6.86 6.72 -0.14

Total Expenditure 434.03 434.02 -0.01

Surplus £m £m £m

Programme control total 2.45 2.32 -0.13

Running Costs control total 0.00 0.14 0.14

Total control total 2.45 2.46 0.01

East Leicestershire and Rutland

Clinical Commissioning Group

Summary Financial Performance

Selected Elements £m

Acute Commissioning

UHL (Including Alliance) 153.67

NHS Contracts outside of LLR 31.53

Non NHS Contracts 10.50

East Midlands Ambulance 8.77

Other 13.10

Total Acute Commissioning 217.57

Non-acute Commissioning

LPT 57.46

Continuing Healthcare and similar

personalised Commissioning32.03

Other 18.82

Total Non Acute Commissioning 108.31

Financial challenges – 2018/19

• The CCG set an opening financial plan for 2018/19 predicated on the following components:

– Opening allocation (our budget) of £425.79m analysed as follows

• Programme £374.25m

• Primary Care Co-commissioning £42.17m

• Running Costs (Admin) £6.91m

• Targeted surplus £2.45m

– QIPP (savings) requirement £19.6m (4.8%)

• By the end of the year, the CCG overall allocation had grown to £434.03m following the receipt of earmarked investment funding and transitional support

Financial outlook – 2019/20 • The CCG set an opening financial plan for 2019/20 predicated on the

following components:

– Opening allocation (our budget) of £447.36m analysed as follows:

• Programme £394.59m

• Primary Care Co-Commissioning £43.41m

• Running Costs (Admin) £6.91m

• Targeted surplus £2.45m

– Quality, Improvement, Productivity and Prevention (savings) requirement £26.65m (6%)

• The CCG is therefore facing another challenging year, financially, and continues to work collaboratively with partner NHS organisations to ensure the LLR system can achieve it’s financial duties in year

Services we commission

15

Tim Sacks

Chief Operating Officer

ELR CCG

Services we commission The services we are responsible for planning and buying include:

– hospital treatment

– rehabilitation services

– urgent and emergency care

– community health services

– personalised commissioning

e.g. continuing healthcare,

continuing care for children,

and funded nursing care

– primary medical services

– mental health

– learning disability services

New services in 2019

• New contract for extended primary care / urgent care healthcare services commenced on 1 April 2019

• These services are provided by Derbyshire Health United and

the East Leicestershire and Rutland GP Federation following

a procurement process

• Additional site opened in Blaby and extended weekend

access delivered in Lutterworth

• Additionally, we introduced longer opening hours for minor

injury services in Oakham, Market Harborough and Melton

Mowbray from June 2019.

New urgent care centre in Blaby

District • In April 2019 we opened a new urgent care centre inside the

existing Enderby Leisure Centre to serve patients in and around Blaby

• Conversations and engagement with residents in Blaby district in June 2018 had shown strong demand for a new site there

• Two thirds of residents responding

across the Blaby told the CCG that

Enderby was their preferred site

and provided strong reasoning for their

preference.

Urgent Care Centres in East

Leicestershire and Rutland

Listening and engaging

Fiona Barber

Deputy Chair and Lay Member (Public and Patient

Involvement)

ELR CCG

Engaging with our patients and the public

• We have a clear vision for the

delivery of healthcare in our area

• We aim to provide health by

meeting our patients’ needs with

high quality and efficient services,

led by clinicians and delivered

closer to home

• Involving and informing people is a

critical part of achieving this. We

aim to see our patients, partners

and stakeholders, staff and

clinicians, truly involved and

informed when it comes to local

healthcare

How we involve local people

Listening to our patients and public

Key engagement activities in 2018/19

• Changes to the prescribing of over the counter medicines

• Changes to urgent care services

• Engaging on our mental health services

• Community Services Redesign

Listening booth

• Our Listening Booth has been out across the ELR participating in patient engagement activities, mapping trends and themes. This led to 321 pieces of detailed feedback about the services patients receive.

Increasing our reach through social media

ELRCCG’s engagement rated ‘Good’ by NHS England

• The CCG was rated as ‘Good’ overall by NHS England for our

Patient and Community Engagement arrangements and activities

• We are keen to build on this and other feedback we’ve received to

continue to improve. This will include refreshing our Listening and

Engaging Strategy in 2019/20

Our priorities and achievements

Paul Gibara

Chief Strategy and Planning Officer

ELR CCG

Progress with our priorities in 2018/19

Mental Health

and Learning

Disabilities

Dementia

Urgent care Cancer

Donna Enoux

Deputy Managing Director and Chief Finance Officer

ELRCCG

Looking ahead

The NHS is moving to a new service model over the next

10 years to give patients more options, better support, and

joined-up care at the right time in the best care setting for

their needs

The NHS Long Term Plan

Best start in life

Ageing well

World class care for

major health problems

Prevention

What will this mean for patients?

Local response to the Long Term Plan

Long Term Plan published January 2019

Leicester, Leicestershire and Rutland Operational

Plan for 2019/20

published

Leicester, Leicestershire and Rutland

Five Year Plan to be

published in Autumn 2019

Under our local partnership, Better Care Together, we

need to develop and implement our strategy for the next

five years to reflect the requirements

of the Long Term Plan.

The LLR Five Year Plan will be published in Autumn 2019

and will be delivered through the development of an

Integrated Care System (ICS).

Components of an Integrated Care System

(ICS)

• Single strategic commissioner to commission health

services for LLR

• Setting system-wide outcomes

• Longer term provider contracts (5 to 10 years)

• Care alliances: hospitals, councils, public health and

primary care

• Complete understanding of local needs by local authority

area

• Design responsive care pathways

• Improve experience and outcomes.

• Focus on long term / multiple conditions

• Primary care networks

• Multi-disciplinary teams

• More services closer to home

• Community, voluntary, local authority and independent

sector

Primary care networks (PCNs)

Increased collaboration

• Increased collaboration is taking place between the three CCGs in

Leicester, Leicestershire and Rutland (LLR)

• A single accountable officer has been appointed and proposals are being

developed for a shared management team

• Key focus for the coming year will be the development of an Integrated

Care System (ICS) for Leicester, Leicestershire and Rutland

• We will keep you updated on

development of the ICS and

future involvement opportunities

Strengthening existing partnerships with our

patients and stakeholders

• We will continue to work in

partnership with our patients,

patient groups and

stakeholders through regular

meetings, engagement

events, feedback

opportunities and on local

and national initiatives to

ensure that patients receive

high quality health services

that meet their needs

• There will also be

opportunities to get involved

with LLR-wide health

programmes and initiatives.

Question and answers

Annual report

37

Our full annual report can be downloaded from our website

at www.eastleicestershireandrutlandccg.nhs.uk

Or speak to one of the team here today

if you’d prefer a paper copy

Finding out more and get involved

For details of our work, our finances and how you can get

involved please visit our website at:

eastleicestershireandrutlandccg.nhs.uk

OR

Call us on 0116 295 3405

AND

Remember to ‘like’ and ‘follow’ us on social media!

@NHSELRCCG