Brighton and Hove CCG 2020/21 Annual Report
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ANNUAL REPORT 2020/21 | NHS Brighton and Hove Clinical Commissioning Group 1 of 149 Making health and care information accessible We are committed to following the NHS Accessible Information Standard. This publication can be made available in alternative formats such as easy read or large print, Braille or audio and may be available in alternative languages, upon request. To find out more, please contact us: [email protected] ANNUAL REPORT 2020/21 | NHS Brighton and Hove Clinical Commissioning Group 2 of 149 Contents Section 1: Performance Report Performance Overview Section 2: Accountability Report Corporate Governance report Statement of Accountable Officer’s responsibilities Governance statement Remuneration and staff report Parliamentary accountability and audit report Section 3: Annual Accounts Finance report Appendix A: Independent Auditor’s Report Appendix B: Financial statements 2020/21 ANNUAL REPORT 2020/21 | NHS Brighton and Hove Clinical Commissioning Group 3 of 149 ANNUAL REPORT 2020/21 | NHS Brighton and Hove Clinical Commissioning Group 4 of 149 Performance overview The purpose of this Performance overview is to present information about the CCG to help patients, stakeholders, and the public to understand the organisation including its purpose, the key risks to the achievement of its objectives, and how it has performed during the year. This overview includes detail of how the CCG has met its statutory duties to: Have regard to the need to reduce health inequalities Improve the quality of services Involve the public in commissioning activities and to explain the impact of that engagement activity ANNUAL REPORT 2020/21 | NHS Brighton and Hove Clinical Commissioning Group 5 of 149 Statement from the Clinical Chair and Accountable Officer Welcome to the NHS Brighton and Hove Clinical Commissioning Group (CCG) Annual Report 2020/21 which provides a comprehensive overview of our performance, progress, and challenges during the last twelve months. The year was undoubtedly one of the most challenging in the history of the NHS with the coronavirus (COVID-19) pandemic and subsequent vaccine roll out, but also a year in which we saw the most incredible response from our people to care for our patients and our most vulnerable residents, and to keep our population and workforce as safe and as well as possible through an extraordinary time. A new way of working for Sussex CCGs In April 2020, a new way of working was introduced for the CCGs across Sussex which has improved how NHS services are planned, paid for and monitored. The CCGs across East and West Sussex merged to become two new statutory bodies – NHS East Sussex CCG and NHS West Sussex CCG – and now work closely together with NHS Brighton and Hove CCG as “Sussex NHS Commissioners”. The three statutory bodies have a single management team and a consistent way of working that ensures services can be commissioned more effectively and efficiently across the health and care system, as well as across local areas. This has also supported greater collaboration with other health and care organisations, in particular the local authorities, to ensure local populations’ health and care needs can be better met. Forming an Integrated Care System In May 2020, NHS England and Improvement (NHSE/I) announced that the Sussex Health and Care Partnership (SHCP), which is made up of all health and care organisations across the county including NHS Brighton and Hove CCG, successfully met the criteria to become an Integrated Care System (ICS). An ICS is a way of working across health and care organisations that allows them to work closer together to take collective responsibility for the health and wellbeing of populations across large areas. The collaborative way of working has been beneficial in the way health and care organisations across Sussex have responded to the COVID-19 crisis, with partners working together as part of the ongoing emergency to ensure our populations get the care they need. Read more about the Sussex ICS on page 12. The pandemic response in Sussex The first case of COVID-19 in the UK was confirmed as a Brighton resident last year and the CCG has seen incredible changes to the way it works and how we all live our lives since then. From the first day of response and throughout the whole year, the commitment and dedication of our GPs and other health and care teams from across the City has been phenomenal, giving their time tirelessly to make sure we can continue to provide care for those who need it. ANNUAL REPORT 2020/21 | NHS Brighton and Hove Clinical Commissioning Group 6 of 149 As the coronavirus pandemic really took hold at the end of March 2020, a Major Incident for Sussex was declared. Sussex NHS Commissioners took a coordinating role in making sure the local health and care system was able to cope with the urgent demand and ensure local populations got the care they needed throughout this time of emergency – whether for COVID-19 or other health and care needs. Like the rest of the health and care system, GP practices across Brighton and Hove swiftly transformed the way they worked to ensure local patients remained safe and got the care they needed during the pandemic. Practices introduced safety measures to protect all patients and staff, with initial telephone and online assessments to enable the prioritisation of appointments for those most in need. Specific clinics were established to help support patients with COVID-19 symptoms who were not in need of hospital treatment but did need to see a GP for other conditions, so that they were kept isolated from other patients. The use of telephone appointments and video consultations were promoted wherever possible to order repeat prescriptions; view health records, including test results; and book, check or cancel appointments. In May 2020, the SHCP established the Sussex Black, Asian and Minority Ethnic Disparity Programme in response to the evidence emerging from the Office for National Statistics around the disproportionate impact of COVID-19 on Black, Asian and Minority Ethnic (BAME) communities. The programme team examined all the factors which have an impact on health outcomes, experience and wellbeing for people from ethnically diverse backgrounds including structural, institutional and interpersonal racism. Significant ongoing engagement with health and care organisation leadership teams, workforce and our communities continues. One of the key outcomes from this programme to date has been the introduction of a COVID-19 Emergency Locally Commissioned Service in general practice, specifically supporting BAME and vulnerable groups. The service supported primary care to identify BAME patients from their list who might benefit from specific interventions to reduce their risk of COVID-19 related mortality; improve communication and engagement with local BAME communities; and offer a supportive monitoring protocol for patients in vulnerable groups who develop COVID-19. People across Sussex struggling with their mental health during the coronavirus outbreak were offered additional telephone and crisis support to help them cope. Working with our largest mental health service provider we expanded the Sussex Mental Healthline to offer a 24/7 service to people needing urgent help. As well as crisis support it provided psychological support to people who have general concerns about their mental health. Sussex COVID-19 vaccination programme roll out The NHS in Sussex has made outstanding progress with the roll out of the COVID- 19 vaccination programme. By the end of the financial year (2020/21), one million people in Sussex had received the COVID-19 vaccination. Sussex NHS Commissioners took a leading role in co-ordinating the vaccination programme and, working alongside our partners in a matter of weeks had developed local vaccination services, vaccination centres and were providing health and care staff vaccinations at hospital hubs. From December 2020 onwards, each ANNUAL REPORT 2020/21 | NHS Brighton and Hove Clinical Commissioning Group 7 of 149 week saw more and more vaccination services being launched, supported by one or several GP practices, with their teams working collectively to vaccinate those identified as priority groups, including outreach to care home residents. It took significant commitment from our primary care teams across Sussex, working rapidly in a short space of time to plan for the vaccination roll out, redesign local sites and put in place safe processes to meet the tough logistical challenges of offering the vaccination – all while continuing to provide general practice services to their registered patients. Sussex met the national target of offering the vaccination to the top priority cohorts and has been continuing to vaccinate thousands of people every week. This has required an enormous collective effort across the system and the dedication and commitment of those working on the programme to vaccinate residents as soon as possible has been extraordinary. This is a huge programme of work but we are currently in a strong position to continue into 2021/22. In January, the Brighton Racecourse GP-led vaccination service opened, followed by sites at County Oak and Portslade Health Centre, offering further local support in the battle against coronavirus. Their opening meant all GP practices in the city were covered by the roll out of the vaccination programme. GP practices in Brighton and Hove have worked closely with the Brighton-based healthcare social enterprise, Here (Care Unbound), which has coordinated the Brighton Racecourse site, from planning and operations, to clinical recruitment and appointment bookings. Together, GPs and partnership teams worked flat out to set up sites that have enabled as many people as possible to be vaccinated quickly and safely. Virtual Pride shows even a pandemic cannot stop celebrations Brighton and Hove Pride is one of the city’s largest events, in usual years drawing thousands to celebrate by taking part in its parade and Preston Park event.