Annual

General Meeting2019/20

WelcomeDr Anand Rischie

Introductions

Dr Anand

RischieChair

Paul

MaubachAccountable

Officer

Manjit

JhootyLay Member for

Audit and

Governance

James

Green Chief Finance

Officer

Agenda

6.00pm Welcome Dr Anand Rischie,

Chair

6.05pm Accountable Officer’s Report Paul Maubach,

Accountable Officer

6.20pm Annual Accounts 2019/20 James Green, Chief

Finance Officer

6.30pm Formal receipt and Approval of

Annual Report and Accounts

2019/20

Manjit Jhooty, Lay

Member for Audit and

Governance

6.35pm Questions from the public Dr Anand Rischie,

Chair

6:45pm Closing remarks Dr Anand Rischie,

Chair

Chairs MessageDr Anand Rischie

Our year in brief

• Committed to improving the health and wellbeing of Walsall

people, through reviewing, redesigning and securing local health

services.

• Made plans to improve the areas that have challenged us this

year - more information about these plans can be found in our

Annual Report, along with the different ways local people have

shared their views and experiences with us.

• Local health and care organisations, including the CCG and its GP

members have continued to strengthen their partnership working as

part of the ‘Walsall Together Partnership’.

• Our local response to the Coronavirus Pandemic dominated the

end of 2019/20 and will remain a key focus during 2020/21.

Accountable

Officer’s

ReportPaul Maubach

Achievements

During 2019/20, we made improvements to the way health and care services support the people of Walsall. These include:

• A single point of access to co-ordinate rapid access to community services for patients who may otherwise have been admitted to hospital.

• Working with partners across the Black Country and West Birmingham to implement personalised care, including expanding the use of Personal Health Budgets and providing health coaching training to front line staff in primary care and maternity services.

• Opening a Mental Health Crisis Café and securing national funding to enhance the local crisis and home treatment service and establish a crisis helpline.

• The establishment of seven Primary Care Networks led by local GPs. Enabling greater provision of proactive, personalised, coordinated and more integrated health and social care.

Improved performance

Through our partnership with Walsall Council, we have been able to maintain significantly reduced levels of delayed transfers of care (DTOC) out of hospital, with 16.8% less patients being delayed in going home compared to 2018/19.

Where we performed well

• 99.5% of patients wait no more than a month for cancer drugs

• Our average time between the clock starting on an ambulance category 1 call and the ambulance arriving on scene is 12 minutes [target less than 15 minutes]

• 95.7% of patients receiving Care Programme Approach (CPA) support are followed up within 7 days of discharge from an inpatient mental health setting

• 85.7% of patients with Psychosis are treated with a NICE approved care package within two weeks of referral.

Areas of challenge

Cancer waiting times

• 57.5% of patients with breast symptoms (where cancer is not

suspected) wait up to 2 weeks to see a specialist (target is 93%)

• 73.9% of cancer patients wait up to 62 days for their first cancer

treatment (target is 85%)

• 85% of patients wait up to 2 weeks for an urgent cancer referral

(target is 93%)

Waiting times in A&E and ambulance handover delays

• 81.8% of patients wait up to four hours in A&E (target is 95%)

• 2,121 ambulances experienced handover delays of 30 minutes

(March 2019 - March 2020)

Reliance on specialist inpatient care for people with a learning

disability and/or autism.

Walsall Together

We continue to work with local health and care partners to develop an

integrated care model which:

• improves access to local services

• provides greater continuity of care for those with on-going conditions

• ensures more coordinated care for those with complex needs.

Progress during 2019/20

• The Partnership is now formally established through an alliance

agreement and monthly meetings of a Walsall Together Board.

• Integrated health and adult social care teams established in each of

our localities, working alongside the seven Primary Care Networks.

• Weekly GP-led multi-disciplinary team meetings in place across

Primary Care Networks, where professionals work together to co-

ordinate care for people in the community with the most complex health and care needs.

Public involvement

During 2019/20 we undertook a number of engagement activities with local communities to seek their views and experiences of health and care services.

• Listened to the views of adults with learning disabilities, their carers and family members, on the introduction of a new community services model.

• The views of patients, the public and healthcare professionals were used to develop a strategy for the future of primary care services.

• An interactive workshop was held with mums and their families, to understand and improve user experience for women experiencing any kind of mental, psychological or emotional ill health during or after pregnancy.

• Local people and healthcare staff were invited to share their views on the NHS Long Term Plan.

Public involvement

• Invited service users, families and carers, professionals, members of

the public and local community organisations to come and hear

about plans to change the way in which care is delivered for

children and young people living with Learning Disabilities

and/or Autism.

• Listened to the views of women who have accessed assisted

conception services in the last five years to inform what future

service should look like.

• Engaged with patients, the public and clinical colleagues on the

harmonisation of clinical treatment polices.

Listening exercise

Future form of the Black Country and West Birmingham CCGs

This year we held a listening exercise with our staff and stakeholders on

the future form of the Black Country and West Birmingham CCGs.

There were two phases of the exercise, the first focusing on the case for

change for moving to a ‘single commissioner voice’ (October 2019), and

the second looking at the proposed governance arrangements

(February 2020).

Feedback from stakeholders:

• Emphasis on local identity, including relationships, reputation,

organisational culture and intelligence.

• Knowing who to go to and a focus on the local population.

• Sense of pride in what has been achieved locally.

• A desire to keep things local.

Valuing our staff

During the last year our focus has been on staff development and

support:

• Embedding the staff values in everything we do. These were co-

designed with staff and were launched with a values and behaviour

charter

• Introduced an Employee Assistance Programme (EAP) for all staff

to access.

• Annual Staff Awards to recognise and celebrate our staff.

• We continue to recognise our “Star of the Month” award scheme

for staff that have gone the extra mile in demonstrating our staff

values

• Training for all staff on: ‘Resilience – coping with change’, ‘How to

become a more motivated and positive person’ and ‘Unconscious

bias training to address inequality’.

Formal Conversation on proposal

to merge the Black Country and

West Birmingham CCGs

In January 2019, the NHS Long Term Plan set out a number of

ambitions for CCGs:

• Every CCG should continue to evolve into strategic

commissioners and become part of an Integrated Care System

(ICS) on an STP level by April 2021.

• Each ICS area should typically have only one single CCG

commissioner, which would be achieved by existing CCGs merging

into one larger single CCG.

To achieve these ambitions and deliver on our collective commitments

to improve the health and wellbeing of the local people, the Black

Country and West Birmingham CCGs Governing Bodies in Common

approved the decision on 14 July 2020 to begin a process of

engagement to ask member GPs to vote on a proposal to merge

the Black Country and West Birmingham CCGs.

Formal Conversation on proposal

to merge the Black Country and

West Birmingham CCGs

We want to assure you that no decisions have been taken and all four

CCGs are keen to listen to the views of member practice GPs, partners,

patient representatives and other key stakeholders.

A formal conversation was launched on Monday 20 July 2020,

which includes a series of events and a survey to get your views on the

proposal. This conversation will continue until 7 September 2020.

How to get involved?

Visit the Walsall CCG website to download a copy of the

Conversation Document, take part in the online survey and book

your place on the Walsall stakeholder event on Thursday 13

August. Alternatively you can speak to the engagement team on 0121

612 1444 or by e-mail bcwb.communications@nhs.net.

Year ahead

• Continue to coordinate our system response to the coronavirus

pandemic

• Ensure that addressing inequalities is a central component of

our restoration and recovery from the coronavirus pandemic

• Improve performance and quality through local/system-wide

health and care partnerships

• Continue to develop our local Integrated Care Partnership

‘Walsall Together’

• Enhance collaborative working at CCG level across the Black

Country and West Birmingham

• Deliver ambitions set out in the NHS Long Term Plan

• Continue to support GP members with the development of Primary

Care Networks across Walsall.

Annual

AccountsJames Green

£78.4 billion

£475.7million

£140.4 billion

Parliament

Treasury

NHS England

Walsall CCG

Department of

Health

How the money flows in the NHS?

What were our financial performance targets in 2019/20?

2019/20 2018/19

Target

£000's

Actual

£000's

Difference

£000's Achieved

Actual

£000's

In Year

Expenditure not to exceed income 0 5 5 Yes 4

Cumulative

Expenditure not to exceed income 5,713 5,718 5 Yes 5,713

Revenue resource use does not exceed the

amount specified in directions 470,027 470,022 5 Yes 438,900

(Revenue Resource Limit)

Revenue Administration Resource does not

exceed the amount funded 6,275 5,985 290 Yes 5,816

(Running Cost Limit)

Better Practice Payment Code Non NHS 95.0% 98.9% Yes 98.4%

Number of invoices paid within 30 days NHS 95.0% 95.9% Yes 99.6%

Breakdown of

every pound spent2019-20

£1,634£470Million £1.29m

Breakdown of

every pound spent2019-20

Services

Net Operating

Costs

£000's

Healthcare from NHS Providers (Acute Community & Mental Health) 300,413.11£

Prescriptions & drugs 50,028.77£

Healthcare from Non NHS Bodies and Care Homes 64,150.39£

Healthcare from GP Practices 43,903.75£

Other Spend including Premises, NHS 111 and MCM support costs 5,541.43£

CCG Running Costs 5,984.97£

Net Operating Costs 470,022.42£

Revenue Resource Allocations 475,740.00£

Total Cumulative Surplus 5,718-£

Areas of investment

• GP Extended Hours at Weekends

• Online Consultations

• Dementia diagnosis

• Implementation of Repeat Prescribing

Hub

• GP Premises and IT improvements

• New Town Centre GP Premises (Set

Up Costs)

• Cancer Alliance

• Diabetes Infrastructure and training

• Children & Young Peoples Mental

Health - Easting Disorders

Areas of Savings

• Better Prescribing Practice and roll out of a repeat prescribing POD

• Improving Hospital Discharge

• Care Closer to Home (MSK)

• Reduction in Emergency Admissions

• Reduction in Urology Emergency Admissions

• Compliance with Procedures of Limited Clinical Value

• Latent TB Detection

• Psychological Therapies

• Crisis & Acute Care (Mental

Health)

• Early Intervention Psychosis

• Physical Health Intervention

(in Mental Health)

• GP Transformational Support

• GP online consultation

systems

• GP Training care Navigators

Looking Forward

Challenging:

• National funding pressures

• Financial pressures on provider sector (primary & secondary care)

• Increasing demand

• Financial Pressure of Partners e.g. Walsall Healthcare NHS Trust & Walsall MBC

• Ageing population

New Financial Regime

• Regional control total (commissioners and providers)

How will we approach this?:

• Implementation of New Models of Care

• Value from involvement in Sustainability Transformation Partnership (STP)

• Achieving best value from every pound we spend

£438.9m£475.7m*

£483.3m£502.1m

£520.8m£539.2m

4.7%2%4.1%

3.9% 3.7% 3.4%

Annual Report and Accounts Approval and Sign Off

Financial Performance Targets All achieved

Annual Governance Statement Approved with no significant internal

control issues identified during the

2019/20 financial year

Head of Internal Audit Opinion Significant assurance given

Independent Auditors Report on the Audit of the Financial Statements Extract

- In our opinion the financial statements Unqualified

• give a true and fair view of the financial position of the CCG as at 31 March 2020 and of its expenditure

and income for the year then ended; and

• have been properly prepared in accordance with International Financial Reporting Standards (IFRSs) as

adopted by the European Union, as interpreted and adapted by the Department of Health Group

Accounting Manual 2019/2020; and

• have been prepared in accordance with the requirements of the Health and Social Care Act 2012.

- In our opinion on regularity required by the Code of Audit Practice: Unqualifiedin all material respects the expenditure and income recorded in the financial statements have been applied to

the purposes intended by Parliament and the financial transactions in the financial statements conform to the

authorities which govern them.

Approval of

Annual Report

and Accounts

2019/20Manjit Jhooty

Questions from the

public

Thank you.