Welcome to our

Annual General Meeting

2017Dr Nicola Jones, Chair

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AgendaFinance report

2016/17 summary of the year

Making a difference to patients

Looking ahead - South West London Sustainability and

Transformation Partnership

Closing remarks and questions

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Finance Report

James Murray

Interim Chief Finance Officer

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How we were funded in 2016/17

• Funding given based on our weighted population of 318,504

(calculated by NHS England)

• Number of people actually registered with a GP closer

to 390,000

• Allocated £480.8 million (including new funding for primary care

delegated commissioning)

• This is equivalent to £1,510 per person

• We generated a surplus of £6.6 million (including the 1% non-

recurrent reserve of £4.6 million)

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Our financial targets

Maintain financial stability

Fair and effective use of resources

Investment made in mental health in line with

our growth allocation

Stay within running costs of £25 per

head of population

Our accounts were submitted on time and with an

unqualified opinion

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How we spent the money

Despite the challenges faced in 2016/17 we delivered our surplus position.

2016/17 Summary of the year

Sarah Blow, Accountable Officer

James Blythe, Managing Director

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Three strategic priorities that require us to do things differently:

1. Prevention – working with the voluntary sector and Wandsworth Council.

Exploring new ways to build resilient communities. Focusing on the

outcomes when we commission services.

2. Integration – breaking traditional barriers between services. Multi-specialty

Community Provider (MCP) is a first step in changing the way we contract

for services so that they deliver specified health outcomes for patient

populations.

3. Collaboration – working with partner organisations in south west London to

look at the wider health and care system. Lots of local engagement. Closer

working with Merton. Part of the South West London Alliance of CCGs.

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What we set out to do

Data and performance issues at St George’s

Working with the trust and monitoring its recovery plans

Ensuring GPs aware of waiting times for certain specialties so they

can refer accordingly

GP quality alert systems

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The main challenges we faced

How we did against some of our targets

95% of people treated within 18 weeks of referral to psychological therapies – 100% achieved ✔93% of suspected breast cancer referrals to be seen within 2 weeks of referral – 93.7% achieved ✔67% of people with dementia diagnosed – 74.8% ✔96% of patients waiting no more than 31 days from diagnosis to first definitive treatment for all cancers –

97.6% achieved✔95% of category A 999 calls result in an ambulance arriving in 8 minutes – 97.6% achieved ✔0 incidents of MRSA – 1 incidence ✘95% of patients seen in A&E admitted or discharged within 4 hours – 91.6% achieved ✘93% of suspected cancer referrals to be seen within 2 weeks of referral – 90.4% achieved ✘99% of patients have diagnostic tests within 6 weeks of referral – 98.6% achieved ✘

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How we performed

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How we performed

• Overall rating of “good” from NHS England

• In top 25% of CCGs nationally

• Strong performance on IAPT and dementia standards

– Dementia diagnosis rate: National standard is 66%. Our

operating plan target was 71.8%, which we met

throughout the year.

– IAPT waiting time standards: 75% receiving 1st treatment

within 6 weeks and 95% receiving treatment within 18

weeks.

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Looking forward

Strategic planning Operational performance

Continuing demand growth

Collaboration – across borough on MCP

and health and social care integration

- Across LTB with Merton

- Across SWL on Alliance/STP

QIPP delivery

Acute performance and quality

IAPT and wider mental health services

Governance Managing risks

Establishing joint ways of working with

alliance/LDU partners – committees

meeting together

Finance

Quality

Performance

System sustainability

Governance and reputational – ‘taking

everyone with us’

Making a difference to patients…

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…through preventing strokes Dr Nicola Jones

Making a difference to patients…

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…through mental health support for children Dr Tom Coffey

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Making a difference to patients…

…through Planning All Care Together and the Enhanced Care

PathwayDr Caroline Scott

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Making a difference to patients…

…through Move More Dr Owen Carter

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• 86% of participants who completed a three month assessment

increased their physical activity levels, 71% increased their quality

of life score and 71% improved their fatigue status.

• Cancer specific Move More Class has been a popular option for

participants and 50% of referrals have attended the class.

• Signposted and supported participants to take part in a range of

other activities including local leisure centres and community

classes.

• Delivered ‘Understanding Physical Activity and Cancer’ training to

practices nurses and GPs.

Positive feedback

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Positive feedback“Move More has arranged membership of a local gym for me, and given

me both a fitness assessment and a suggested programme of exercise

so that I can regain stamina, strength, and then confidence to sail a boat,

having had chemotherapy in 2016.”

“I feel that I have passed another milestone in that I have actually started

exercise based on professional advice, rather than just thought that I 'ought to

do so'. I have made some substantial physical gains, which has improved my

morale.”

“It encourages me to exercise. It encourage me to exercise bits that I

wouldn't normally think about exercising and it motivates me to do more.

It is helping me get my strength back in a controlled and structured

way.”

“It's a great service. It's also good to speak to others post treatment, to share

experiences and encourage each other.”

South West London Sustainability and Transformation Partnership

Sarah Blow, Wandsworth CCG AGM 20 September 2017

Start well, live well, age well

About our five year forward plan

• SW London STP plan – November 2016 Following publication the NHS Five Year Forward View by NHS England in 2014, all regions of the NHS in England were required to produce five year Sustainability and Transformation Plans (STP). A draft plan was submitted to NHS England in November 2016.

• Refresh and a local approachAfter talking to local people and communities, we believe a local approach, rather than a SW London-wide approach, works best. We have set up four local health and care partnerships in Croydon, Sutton, Merton/Wandsworth and Kingston/Richmond. The revised plan is expected to be published in November 2017.

• Bottom-up planning with Councils at borough level, based on local people’s needsThese local health and care partnerhips (LA and NHS) are are looking at what services should be provided in the community and what their local hospitals should provide. They are working together to provide more joined-up health and social care services, and how to make these local systems clincally and financially sustainable

Summary of current STP thinking

• A local approach works best for planning health and care

• The best bed is your own bed - Let’s keep people well and out of hospital

• Care is better when it is centred around a person, not an organisation -

Clinicians and care workers tell us this

• Likely to mean changes to services locally - We are not proposing to

close any hospitals. Evolution not revolution

• We need to show people how it works better with local examples

• Involving people at local level will remain critical.

Where we have delivered locally

Wandsworth Care for older people in the community and in their own homes (Wandsworth Enhanced Care Pathway)

• Vulnerable, frail older people at high risk of ill health in Wandsworth are being supported to stay well, out of hospital and

independent at home.

• Locality based, multidisciplinary teams of GPs, community health, social services, mental health and voluntary sector

staff work together on an agreed care plan to coordinate day to day care/support for these vulnerable people as well as

what to do in a crisis situation.

• For example: GPs provide home visits within two hours of receiving a request and home care packages can be agreed within four

hours of referral to the team. This helps to avoid hospital admissions.

• Each person has an identified professional leading on their care as well as a coordinator who is the main point of

contact for the person and their family.

• Since November 2016, 500 vulnerable people have been identified and 330 people have received care

• 29% reduction in hospital emergency admissions

• 26% reduction in days spent in hospital

• In 2017/18 up to 800 people will be supported at home as well as 1,000 residents in Wandsworth care homes.

23Start well, live well, age well

Keeping touch with local communities

• There have been local events this year for people to discuss the STP with clinicians, managers and local authorities in our six boroughs.

• We have written to over 1,000 local voluntary and community organisations at every key stage of STP development: May 2016, September 2016 and March 2017 – setting out our emerging ideas, inviting feedback and offering to attend local meetings to discuss the issues raised.

Grass roots engagement

• Working with local Healthwatch organisations, we have run an extensive grassroots engagement programme, which was shortlisted for a national award. This has led to representatives from the local NHS discussing the challenges and emerging ideas with groups and individuals the NHS does not always reach, at 88 separate events in 2017/17. The evaluation report from these events is available on our website and we have agreed to run the programme for a further year.

Patient and Public Engagement Steering Group

• Our Patient and Public Engagement Steering Group advises us on all communications and engagement activity.

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Involving local people

Start well, live well, age well

Closing remarks and questionsDr Nicola Jones, Chair

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