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Annual Report and Accounts 2017/2018 Mid Essex CCG Annual Report and Accounts 2017/18

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Annual Report and Accounts 2017/2018 Mid Essex CCG Annual Report and Accounts 2017/18 Annual Report and Accounts 2017/2018 Mid Essex CCG Annual Report and Accounts 2017/18 Contents Contents........................................................................................................................................... 2 Chair’s foreword ............................................................................................................................... 3 1. Performance Report .................................................................................................................. 5 Accountable Officer’s introduction ............................................................................................. 5 1.1 Performance Overview ........................................................................................................... 6 1.1.1 What Mid Essex CCG does .............................................................................................. 6 1.1.2 Key issues and challenges ............................................................................................. 14 1.1.3 Performance Summary ................................................................................................... 17 1.1.4 Financial Overview ......................................................................................................... 20 1.2 Performance Analysis ........................................................................................................... 24 1.2.1 Improve quality ............................................................................................................... 24 1.2.2 Health and wellbeing strategy ........................................................................................ 28 1.2.3 Engaging people and communities................................................................................. 29 1.2.4 Reducing health inequality ............................................................................................. 33 1.2.5 Detailed review of the CCG’s development and performance ........................................ 35 1.2.6 Sustainable development ............................................................................................... 41 2. Accountability Report............................................................................................................... 43 2.1 Corporate Governance Report.............................................................................................. 44 2.1.1 Members Report – member practices ............................................................................ 44 2.1.2 Composition of Governing Body ..................................................................................... 45 2.1.3 Board Members and Other Elected GPs ........................................................................ 45 2.1.4 Personal-data-related incidents ...................................................................................... 50 2.1.5 Statement as to disclosure to auditors ............................................................................ 50 2.1.6 Donations to political parties and charitable organisations ............................................. 50 2.1.7 Modern Slavery Act ........................................................................................................ 50 2 Mid Essex CCG Annual Report and Accounts 2017/18 2.1.8 Statement of Accountable Officer’s Responsibilities....................................................... 51 2.2 Governance Statement ......................................................................................................... 54 2.2.1 Introduction and context ................................................................................................. 54 2.2.2 Governance arrangements and effectiveness ................................................................ 55 2.2.3 Risk management arrangements and effectiveness ....................................................... 62 2.2.4 Other sources of assurance ........................................................................................... 67 2.2.5 Control Issues................................................................................................................. 70 2.2.6 Review of economy, efficiency and effectiveness of the use of resources ..................... 70 2.2.7 Review of the effectiveness of governance, risk management and internal control ....... 73 2.3 Remuneration and Staff Report ............................................................................................ 75 2.3.1 Remuneration Committee Report ................................................................................... 75 2.3.2 CCG staff ........................................................................................................................ 85 2.3.3 Off-payroll engagements longer than six months ........................................................... 89 2.3.4 Expenditure on consultancy ........................................................................................... 90 2.3.5 Pension liabilities ............................................................................................................ 90 2.4 Parliamentary Accountability and Audit Report (subject to audit) ......................................... 91 3. Independent Auditor’s Report to the Members of the Governing Body ................................... 92 4. Annual Accounts ..................................................................................................................... 95 Appendix A: Glossary of non-financial terms ................................ ................................................. 96 Appendix B: Glossary of financial terms ................................ ........................................................ 98 Chair’s foreword I am coming to the end of my time as an elected GP and Chair of NHS Mid Essex Clinical Commissioning Group (CCG), since all GP Board members can serve only two terms of three years. I shall begin handing over to my successor next month, but I know they will be brilliantly supported by the very capable leadership of an organisation I have been proud to be part of. 3 Mid Essex CCG Annual Report and Accounts 2017/18 Mid Essex CCG has helped the people of our area to look after themselves and get the health and care services they need. We work against a background of local financial pressures you can read about in this report, as well as the national issues of rising demand and staffing difficulties – but we are determined to keep patients at the heart of what we do. I look back with particular pride at the dedication of the whole CCG team, at every level of the organisation, to improving care for patients. Our growing use of patient stories in driving our commitment to deliver improved care has helped all of us to realise that everything we do can help individuals, families and carers. As an organisation we can also see the bigger picture, including how our local Sustainability and Transformation Partnership (STP) can overcome some of the difficulties we as a single organisation cannot. We have fully engaged with the STP and supported the establishment of a CCG Joint Committee, as we discuss in this report. Now we are undertaking a new and exciting transformation programme as a CCG for out-of-hospital care. Those who know me well will realise how happy I am to see us take control of the mental health agenda. We have signed up to the Time to Change initiative, focused on reshaping attitudes to mental health, and have started to transform the way care is delivered. Our emotional wellbeing service for children has won national recognition, our perinatal health service is truly integrated with primary care and the Dementia Intensive Support Service, which you can read more about in the Performance Overview below, is off to a great start. All offer easier access to services, helping patients, their carers and the professionals around them. There are many examples of great practice in mid Essex, from Continuing Health Care and support for our residential and nursing homes to a new dementia-friendly primary school initiative and the palpable improvement in primary care morale. We even have a new medical school in our area! There are too many things I am proud of to list in full, but I do want to thank everyone at the CCG for their hard work and dedication. People in the CCG have time for each other, too, and, as Chair, I have been touched by instances of individuals helping others who are going through a rough patch. We also support other parts of the health and care system when they struggle. Improvement happens best when challenges are approached positively. The decisions the CCG has taken while I have been Chair have sometimes been very difficult, but they have all been informed by strong clinical knowledge, in-depth experience of health and care, robust evidence and as far as possible, input from the people affected and the wider community. This is the way I expect Mid Essex CCG to continue to operate and I wish it and the people it serves the very best for the future. I know they will be in safe hands as I return to my regular role in general practice. Dr Caroline Dollery Chair 25 May 2018 4 Mid Essex CCG Annual Report and Accounts 2017/18 1. Performance Report Accountable Officer’s introduction The past year has seen some major changes in the way NHS services are planned and how care is offered across the country, with the introduction of 44 new Sustainability
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