NHS Croydon CCG Annual General Meeting · In 2018/19, Croydon CCG received £17.0m (3.59%)...

NHS Croydon CCG

Annual General Meeting

Tuesday 25 September 2018

A very warm welcome to our

Annual General Meeting 2018

Dr Agnelo Fernandes

Clinical Chair

In memory of

Bosco Saldanha

1943 to 2018

Photo here

Welcome Tudor Academy Choir

Governing Body

Governing Body

Croydon in numbers…Key facts about Croydon

Andrew Eyres

Accountable Officer

www.croydonccg.nhs.uk

Longer, healthier lives for the people of Croydon

Our strategic approach:

• ambition

• innovation

• working with our partners

• using resources wisely

• transforming healthcare

• high-quality services

Delivered through five clinically-led programmes

Our vision

A nice picture here

Highlights of the year

How are we performing?

Clinical Priority Areas 2017/18

Cancer

Maternity

Outstanding

Good

Annual CCG overall rating:Requires Improvement

Leadership Finance

This is an improvement from Inadequate last year

London CCGS

NHS 70

NHS 70

Croydon NHS70

Stars

Dr Kamran KahnGP

Stovell House Surgery

Susan McCarthyHead of Family Learning

and DevelopmentTudor Academy School

Elsie SutherlandVolunteer

Croydon CCG and Croydon Health

Services

Sally InnisDesignated Nurse for

SafeguardingCroydon CCG

Memuna SoweMidwife of the Year

Croydon Health Service

Sean CrillyProgramme Lead

Croydon CCG

Rachel CarseSocial Inclusion Co-

OrdinatorDementia Action Alliance

Sylvarani NairTeam Leader

Age UK

Kerry StarrettSex and Relationship Education

and Training SpecialistCroydon Health Services

Brian DickensPractice Manager

Parchmore Medical Centre

Staff Awards 2018

Staff Awards 2018

Edward Odoiand

Ros Spinks

Local people influencing commissioning

Looking ahead

Thank you to patients, public

and colleagues involved in

improving health and

providing care in Croydon

Financial Performance

Mike Sexton

Chief Finance Officer

In 20017/18, we spent £559m on healthcare:

We are funded £1,199 per person (£490m)We spent £1,365 per person in Croydon. Our key providers of healthcare are:• Croydon Health Services NHS Trust• South London & Maudsley NHS

Foundation Trust (FT)• St George’s University Hospitals

NHS FT• Kings College Hospital NHS FT• Epsom & St Helier NHS Trust• London Ambulance Service

In 2017/18, we performed as follows:Description Source Target Actual Achieved

Target Expenditure Deficit:- CCG Original Plan - NHS Set Target (In Year)- NHS Set Target (Cumulative)- Statutory Duty (In Year)

NHSENHSENHSEStat.

£15.0m£6.9m

£61.4mBreakeven

£13.9m£13.9m£68.3m£13.9m

QIPP Savings Target- Identified Programme Savings- Unidentified Programme Savings

NHSE £21.2m (4%)£8.1m (2%)

£21.2m (4%)Nil (0%)

Capital Resource Limit Stat. £0.4m £0.4m

Administration Costs Stat. £8.4m £8.3m

Stay within Cash Forecast NHSE £562.7m £555.7m

Cash Balance - % of initial drawings held at 31/03/18

NHSE 1.25% 0.9%

Public Sector Payment Policy DH 95% 96.9%-97.2%

External Audit AssuranceType of Opinion Description Opinion Achieved

Financial Statements Opinion

“True and Fair View” Unqualified

Regularity Opinion“expenditure incurred as intended by parliament”

Qualified:Expenditure exceeded resource limit

Value for Money Assessment

Securing economy, efficiency and effectiveness

Qualified: Did not meet NHSE target deficit

GovernanceThe Council of Members approved the Annual Report / Annual Accounts on 24 May 2018.

In the future, we plan meet our financial targets:

In 2018/19, Croydon CCG received £17.0m (3.59%) allocation growth

Target performance is £1.2m surplus (18/19) and £5.2m/1% (19/20)

The QIPP challenge for 18/19 is £27.6m.

Note: Above average growth funding is only available if more than 5% below target. At 4% below target the expectation is that the CCG must simply live within its allocation.

Source: Financial Improvement and Recovery Plan June 2018

Financial Improvement and Recovery

26

• Long journey from 2013 when CCG was established with a significant underlying

deficit (£30m) and underfunding position (£40m/10%)

• Our Financial Improvement Plan (June 2018) builds on the success since 2013 of

clinically led quality improvements and we continue to spearhead more efficient use

of our limited resources.

• On the back of recent improvements, the CCG is no longer in Financial Special

Measures.

• CCG is planning to meet full business planning rules from 2019/20 (ie 1% surplus).

• The backbone of this success is joint working across local clinicians, senior

leadership, and alliance partners, to continue to drive the delivery of these quality

improvements for Croydon citizens.

Creating a Dementia Friendly CroydonRachel Carse

Dementia Action Alliance & Social Inclusion Coordinator

September 2018

Why Dementia?

• Costs UK economy £26.3 billion per year

£11.6 billion in unpaid care

• Two thirds of people with dementia live in

the community

Dementia figures for Croydon

• In 2017 there were an estimated 3,611 people aged 65+ living with

dementia

• In 2016/17, only 2,322 were formally diagnosed with dementia

• They, their family and carers are customers of many businesses,

shops and services across the borough

• 51% of people caring for someone with dementia are still in work

and might need support from their employers. Some of your

existing employees may also develop dementia

We want Croydon to be dementia friendly

What is the Croydon Dementia Action Alliance?

The CCG’s commitments

1. All staff to receive training in dementia awareness

2. Develop a dementia roadmap with other members of

the Croydon Dementia Action Alliance for local carers

and health and care professionals

3. Work with care homes to review approach to falls

with dementia care in mind

Memory as a bookcase

EmotionsFacts

Dementia friendly community - people

Raise awareness of dementia by getting everyone to

The more understanding and awareness of dementia, the more

understanding the community

Dementia friendly community - place

Mat or black hole?

Dementia friendly community - process

• Remind carer of appointments made for person living with dementia

• Send a reminder text or a member of staff could ring about the

appointment

• Where possible allow person living with dementia to see the same

advisor

• Allow plenty of time for appointments

Dementia friendly community - process

• Shops – designated worker to support vulnerable shoppers and

help maintain their independence

• Banks – support people by being alert to requests for unusually

large withdrawals - in Croydon, people have been prevented

from being victims of fraud

If you want to find out more, join the Croydon Dementia Action Alliance, please contact me:

rachel.carse@croydon.gov.uk

Social Prescribing

Brian Dickensand

Les Persaud

Croydon Social Prescribing Community

Engagement Team

Where are we: The Journey

July 2017 – 1 Practice

July 2018 – 42 Practices

Why? How? Impact?

Community Engagement

Why

• Practices have increasing and unmanageable patient lists

• Increasing complexity of medical care provided by GPs

• 20% of GP consultations do not require clinical intervention

• Currently practices have a few patients taking up 90% of practice time

• Those who need to engage do not attend or manage their own health

• Shortage of GPs fuelled in part by pressures of workload

• Reducing available NHS Budget

• Need to change patient and community behaviour around health self

management for more effective use of resources

Community Engagement

Why• We are in the thick of it

• Majority of our area and some patients are in either from 5% to 10% most

deprived in the country of 10% to 20%

• We deal with a cohort that includes health issues such as 2 in 3 adults,

roughly 181,000 Croydon are obese / overweight

• Half the number of women giving birth are overweight / obese / morbidly

obese and 5% of these are diabetic

• 23% of children live in poverty

• 58% of females and 43% males are not physically active

• Life expectancy is 9.1 years lower for men and 7.7 for women than the

national average

Social Prescribing

Community Engagement

LOCAL SOCIAL ISSUES

• Social Isolation• Financial / Debt advice• Health and Exercise / Health management• Diet• Mental Health issues• Community Safety / Mentoring• Unemployment Rate – Highest in London• Community Cohesion / integration

Social Prescribing

Community Engagement

• Need to look at long-term behavioural change• Change Patient Dependency

• Capacity Build the local provider

• Develop patient self referral to more community structures

• Develop more holistic community interventions

• Multi Agency- Multi disciplinary Approach

• Community Hubs / led by the community / for the community / owned

by the community / SUSTAINABLE

• One stop shops for community development / health interventions

Social Prescribing

Community Engagement

How

• All of this has been achieved• Small Dedicated community based team• A Partnership approach• Development of relationships with GP practice’s• Small Localized Funding – and Community Support• No NHS Support or Funding• Because• No Barriers • No Delays• No Red Tape• This was always about Doing! Not Waiting!

Partnerships - Opportunities• Croydon Council

• Local MP

• Local Councillors

• Croydon Commissioning Group

• GP Practices

• Christians Against Poverty

• Nike / Brand Jordan: Practical

partners in positive change

• Apple

• NHS – National Team

• Best Start

• Crystal Palace Foundation

• Croydon Voluntary Action

• Croydon BME Forum

• Various Local Churches and

Community organisations

• We have delivered partnerships

that includes support from

• Statutory Sector / Public Sector /

Third Sector and the Commercial

Sector

• This is the route to sustainability

and long term impact

Social Prescribing

Community Engagement

Key partners

• Palace for Life Foundation

• Nike Community Ambassadors

• Croydon Best Start

• Apple

• St Paul’s Church

• NHS Croydon CCG

Community Engagement

ImpactStrategic Developments

• Partnership and strategic support from NHS England at a National level

• Winner of the NHS Parliamentary Award for excellence in Primary Care

Programme Development

• Access to and partnerships with 60 interventions: from health classes- choirs---to

counselling

Partnership Development

• Over 60 partnerships- covering, corporate-public- third sector- local community

Community Hubs

• 21 community hubs signed up to be part of the programme

Participation

• Over 28,000 attendances in six months

Independent Research

• Resourced and underway

Community Engagement

Next Steps / Opportunities

• Food Stop Project – Partnership with Fairshare / All major food retailers around

overall support for Thornton Heath Community

• New Addington & Selsdon network

• Group Consultations – Tremendous feedback already

• Development of Local Voluntary Partnerships : - Alliance

• GPs in the community

• Barbershop project

• Physical Activity Young people

• Community Gyms / Well Being Centres

• Health help Now App

• Meeting with Simon Stevens: CEO NHS

• Formalisation of the social prescribing community engagement team

Any questions?

Find the right service

• GP hubs

• Health Help Now

• NHS 111

• Croydon Talking

Therapies

Thank you

@NHSCroydonCCG

www.croydonccg.nhs.uk