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NHS Halton Clinical Commissioning Group Annual Report 2018/2019

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NHS Halton Clinical Commissioning Group Annual Report 2018/2019 NHS Halton Clinical Commissioning Group Annual Report 2018/2019 1 CONTENT PERFORMANCE REPORT 3 Performance overview 4 Performance analysis 22 ACCOUNTABILITY REPORT 74 Corporate Governance Report 74 Members Report 75 Statement of Accountable Officer’s Responsibilities 82 Governance Statement 84 Remuneration and Staff Report 130 Remuneration Report 130 Staff Report 138 Parliamentary Accountability and Audit Report 147 EXTERNAL AUDITORS OPINION 148 ANNUAL ACCOUNTS 153 2 PERFORMANCE REPORT Andrew Davies Accountable Officer 28th May 2019 3 Performance overview The purpose of this overview is to give readers information about who we are, what we do, our achievements this financial year and how well we’ve performed as well as our key risks and how we manage them: Welcome to our Annual Report for the year 2018/2019. The purpose of this Annual Report is to share with stakeholders how the organisation has discharged its functions in the financial year 2018/2019. The report includes several key statements supporting the financial year-end reporting and the annual accounting requirements for the whole of the NHS and is subject to audit review. Our financial accounts, which form part of this submission, have been prepared in accordance with the going concern principle as part of International Financial Reporting Standards. The Governance Statement included in this report sets out how we identify, manage and control risks such as assuring business continuity. The past year has been incredibly busy, with several changes and challenges in addition to some significant things that we should be proud of and celebrate which we do so throughout this report. This year has also been one of change. We have formalised our working with NHS Warrington Clinical Commissioning Group by creating a joint Management Team across both organisations. Following undertaking the role of Interim Clinical Chief Officer, Dr Andrew Davies was made substantive Clinical Chief Officer across both NHS Halton CCG and NHS Warrington Clinical Commissioning Group in March 2019. In June 2018, Dr David Lyon, temporarily stepped away from the position of Chair due to a personal issue, which impacted on his ability to carry out the duties of Chair. We would like to formally record our thanks to Mr David Merrill, Vice Chair who took on the interim role of Chair in June 2018, taking responsibility for discharging the duties of Chair in the absence of Dr David Lyon. During the interim period Mrs Ingrid Fife, Vice Chair of the Audit Committee took over responsibility from Mr David Merrill as the Chair of the Audit Committee. Following the resignation of Dr Lyon in March 2019, we are now working with the CCG membership to appoint a new substantive Chair. 4 During 2018/19, it was identified that work needed to be undertaken with regards to improving and strengthening internal governance considering several issues and challenges with regards to governance structures and members. In order to progress this, work the CCG has engaged the services of an associate from Mersey Internal Audit Agency (MIAA) to take forward a programme of work including a full review of all committee terms of reference, membership and attendance of members. Where there is national guidance in place for specific committees, all terms of reference are being cross referenced to ensure they fully reflect what is required. This work will continue through 2019/20 to ensure robust governance arrangements are in place. Whilst this has been a challenging year, it has also been a year which has seen a number of key achievements which are highlighted in this report, including NHS Halton CCG being chosen by NHS England as one of only 14 CCGs nationally to run a new Targeted Lung Health Check programme. Another success to celebrate is Well Halton, which won the Partnerships in Innovation Award for the second year running at the North West Coast Research and Innovation Awards 2019. We lead Well Halton and we have adopted an approach of wide and inclusive partnership across multiple sectors. Our range of partners includes Widnes Vikings Rugby Team, The Science and Technology Facilities Council, Runcorn Shopping Centre, Runcorn Veterans Association and many others. A new Primary Care Dermatology Lesion Service was commissioned and has seen real benefits and improved outcomes for local people. The service, which was co-designed and launched by local GPs, in partnership with us is based in both Widnes and Runcorn and has created 120 additional appointments for routine queries every month. The service has resulted in a significant reduction in waiting times from around 16 – 18 weeks to just three weeks or less and only 3% of patients seen are then referred to secondary care. Patient experience has been radically improved with 100% patients telling us they would use service again and 100% of patients would recommend the service. Another major highlight of the year was the celebrations for the NHS’ 70th birthday in July. This signification milestone gave us a chance to reflect on our achievements of the health service nationally and locally. We are sure you’ll agree that despite its many challenges, we are very lucky to have a health service that 70 years on provides help to all, regardless of wealth or status. 5 Finally, enjoy reading the review of the year and a date for your diary – our Annual General Meeting on 5th September 2019. Dr Andrew Davies David Merrill Clinical Chief Officer Chair 6 Our performance against the NHS England Constitution The NHS Constitution establishes the principles and values of the NHS in England. It sets out rights to which patients, public and staff are entitled, and pledges which the NHS is committed to achieve, together with responsibilities, which the public, patients and staff owe to one another to ensure that the NHS operates fairly and effectively. Within Section 3a of the NHS Constitution there are certain rights and pledges regarding access to services and respect/confidentially. The actual performance against each individual indicator can be seen in the dashboard, which can be accessed here. In summary of the total 24 rights and pledges included within the NHS Constitution: • Both of the two NHS Constitution Rights were not achieved • 12 of the NHS Constitution Pledges were achieved • 8 of the NHS Constitution Pledges were not achieved • One of the cancer waiting times indicators does not have a specific target and the cancelled operations data reflects the number treated within 28 days not the number offered treatment within 28 day (which is the NHS Constitutional requirement). These are therefore not rated Our joint Management Team structure 7 Our objectives Objective one: To commission services which continually improve the health and wellbeing of Halton residents Objective Two: Continually improve the quality of the services we commission ensuring compliance with NHS constitutional requirements Objective Three: To deliver our statutory duties in respect of commissioning, quality, equality, safeguarding, engagement, consultation, and finance including QIPP Objective Four: To create a high performing organisation that seeks to create excellence in its skill base enabling the building of effective partnerships with our staff and key stakeholders. Our commissioning priorities 2018/2019 Our Commissioning Plan details our priorities, aligned to the requirements of the Five Year Forward View, and local challenges and opportunities. Building upon firm foundations of Primary Care and Community provision, the delivery of the five Change Programmes will bring about the positive impact needed in terms of use of elective, non-elective and specialised services: 8 Fulfilling our duties…real engagement We continue to fulfil our statutory duties and strive to make real differences in the way that the people of Halton access health and social care working, collaboratively with partners and providers. During 2018/2019, we have strengthened our engagement capabilities with increased focus on ensuring that our patients are at the heart of our decision making. We held eight public Health Forums throughout the year which attracted members of the public, provider organisations and other professionals and our Annual General Meeting was delivered in September 2018 at the Halton Stadium. We led the consultation events relating to the closure of the Hale Village Branch Surgery and, in December 2018, we launched the public engagement into the future development of the Urgent Treatment Centres. We have worked collaboratively with partners to develop our priorities for 2019/2020. More information can be found under the engaging people and communities’ section on page 59. Improving Primary Care During 2018/2019, we have continued to work with our fourteen GP practices, two GP Federations and two emerging Primary Care Networks in order to support the continuous improvement of Primary Care Services. The work undertaken supports our: • Statutory duty to improve the quality of services provided by local GP practices • Responsibilities contained with the delegation agreement, which allow us to commission General Practice services locally and; • Transformation agenda, as detailed within the national GP Five Year Forward View, which aims to improve the sustainability and resilience of general practice Specific developments to note include: Improving Patient Access Evening and weekend GP services continue to be available with a GP, Advanced Nurse Practitioner or Health Care Assistant. The service is available from 6.30pm to 9.00pm on weekday evenings and 9.00am to 3.30pm at the weekend. The service offers routine appointments that are booked via the patient’s own practice during the week. At the weekend, patients can phone the service for an appointment. Over 2018, the use of these appointments by patients has increased from 62% utilisation in April 2018 to 80% in December 2018. A comprehensive review of current practice telephone hardware and processes was undertaken 9 with the introduction of call recording software across nine practices.
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