Cambridgeshire and Peterborough Clinical Commissioning Group

To empower our communities to keep healthy and to commission good quality healthcare for all those who need it.

NHS Reform

• Changes to Commissioning • Clinical Commissioning Groups (CCG)

• Local Commissioning Groups (LCG)

Four health systems (Cambridge, Huntingdon, Peterborough, Ely & Wisbech) with eight localities built on strong GP involvement and engagement. • Borderline • Peterborough • Cam Health • CATCH • Hunts Health • Hunts Care Partnership • Isle of Ely • Wisbech • Area Team of NHS England – Specialist Commissioninh • Local Authorities - Public Health, Prevention & Promotion.

1. Cambridgeshire and Peterborough CCG Mission, Vision and Values Our Mission  To empower our communities to keep healthy and to ensure fair access to good quality healthcare for all those who need it. Our Vision  To be an organisation that i) is led locally by clinicians in partnership with their community ii) commissions quality services that ensure value for money and the best possible outcomes. Our Values  Quality driven  Working locally  Patient focussed  excellence

Background

• Cambridgeshire and Peterborough CCG was authorised with 2 conditions from 1/4/13 ( see appendix 1). • It is the 3rd largest CCG in the country with a ONS population of 831,886 (Registered 878,359 @ 1/4/13) and a programme financial allocation of £853,942m. • This funding level gives it a per head funding of £1,026 which places the CCG among the lowest per capita funding levels. The average per head funding for the East Anglia CCGs is £1,098 and for the Essex Area £1,107 (see appendix 2) . • Funding at these levels would give the CCG an addition £58.4m and £65.9m respectively, which would mean it was more realistic to meet the ‘one size fits all’ NHS England financial metrics of a 1% surplus , 2% funds spent non- recurrently and 0.5% contingency. • Notwithstanding the above challenge, the CCG is committed to commissioning high quality healthcare for all its residents and meeting this within the resources allocated to it.

Our Strategic Context is complex.  One CCG, four health systems (Cambridge, Huntingdon, Peterborough, the Fenlands) and with eight strong localities built on good GP involvement and engagement.  Three acute providers all facing quality and financial challenges, albeit at different levels, one MH provider, one specialist provider and one community health services Trust( no longer eligible to progress to FT status). Specific provider risks are considered later.  A growing and aging population with local identified health inequalities, particularly in Peterborough and the Fens.  A financial settlement where doing nothing leaves a £27m gap in 13/14.  A challenging efficiency plan built at locality level and supplemented by central schemes with the target of delivering a £1.0m surplus in 13/14, agreed with the Area Team.  A Contingency Planning Team completing its report in Peterborough as required by FT provider regulators.

Within its challenging context, the CCG has focussed on making a difference in key clinical areas.

Due to our challenging context in conjunction with our partners and using the JSNA’s, local health and Wellbeing Board strategies, the CCG has agreed 3 clinical priority areas. 1. Improving the health for the frail elderly through enhanced multi- disciplinary team working and greater provision of integrated care , known as the Older Peoples Programme. -This programme is also fundamental to the future management of rising costs within the CCG’s allocation. 2. Improving care for those at the end of life. 3. Decreasing inequalities in health across the CCG focussing on premature death from coronary heart disease. 4. In addition, we have 3 quality metrics ( see appendix 3) Funding 2013/14

Constraints – CCG/LCG Opportunities – Voluntary Sector

No financial growth forecast Focused ideas and delivery Growing population Local health services Increasing elderly and frail population Provide services to reduce acute care admissions/readmissions New business plans need to be and delayed discharges self funding by reducing activity and spend elsewhere in the local Provide support on patient health economy. discharge We have a £26.8m do nothing Integrated Care gap in 13/14. Similar gap forecast for 14/15. Therefore we need to do things differently.

CCG – Business Cases

Prioritisation Lead commissioners decide which services are priorities for redesign

Develop specifications Lead commissioners develop outcome based specifications Lead commissioners decide whether or not to procure Options for services that are not being redesigned identified and evaluated

Procurement for selected services Commissioners lead procurements for relevant services Transfer of services that are not being redesigned Consultation Mobilisation • All new services commence All transfers complete

Completion All new services commence All transfers complete

LCG – Local services

Opportunity for localised services to be commissioned by local LCGs Service provider would need to submit plans to demonstrate how they could meet the clinical priorities, reduce spend and provide a positive impact and an improved health outcome for local service users. Meet NHS contract criteria and provide monitoring data as agreed within the contract. Contacts Local Commissioning Officers (LCO)

Peterborough & Borderline - Cath Mitchell [email protected] Isle of Ely & Wisbech – Ross Collett [email protected] Huntingdon – Rob Murphy

[email protected] CATCH/CamHealth – Nigel Smith [email protected]