Wigan Borough CCG Annual Report & Accounts 2017-2018
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SECTION 1: PERFORMANCE REPORT fsat Annual Report and Accounts 2017/18 0 SECTION 1: PERFORMANCE REPORT CONTENTS SECTION 1: Performance Report Overview Statement from Chief Officer 3 Purpose and Activities 3 Issues and Risks 7 Greater Manchester Partnership 8 Performance Summary 8 Performance Analysis Measuring Outcomes & Performance 10 Sustainability 20 Improving Quality 23 Patient & Public Involvement 25 Reducing Health Inequalities 27 Health and Wellbeing Strategy 28 SECTION 2: Accountability Report Corporate Governance Report Members Report 31 Statement of Accountable Officer’s Responsibilities 36 Governance Statement 38 Remuneration and Staff Report Remuneration Report 61 Staff Report 70 Parliamentary Accountability and Audit Report 74 SECTION 3: FINANCIAL STATEMENTS Independent Auditors Report 76 Financial Statements 80 1 SECTION 1: PERFORMANCE REPORT SECTION 1 PERFORMANCE REPORT Trish Anderson Accountable Officer 24 May 2018 2 SECTION 1: PERFORMANCE REPORT Overview 1. Welcome to the Annual Report and Accounts for 2017/18. This overview gives you our highlights from the year from the pperspective of Trish Anderson,, our Accountable Officerr. 2. It sets out briefly what we are working to achieve, what might stop us from achieving this and a summary of our performance for the year. Statement from Trish Anderson, our Accountable Officer 3. This year, as in previous years, I am pproud of what we have achieved at Wigan Borough CCG to support the delivery of high quality, sustainable NHS services. 4. Throughout the annual report you will see evidence of a well governed, disciplined organisation that focuses on improving the quality of care our patients receive and meeting our financial commitments. 5. We cannot do this without the involvement and support of our GP member practices and also the many patients and members of the public who work so closely with us in such a positive way. Purpose and Activities 6. The CCG’s objectives are: Supporting our population to sstay healthy and live longer in all areas of the Borough; Commissioning high quality services, which reflect the poopulation's needs, delivering good clinical outcomes and patient experience witthin the resources allocated and available; Functioning as an effective strategic commissioning organisation that puts the patient first; Developing a collaborative and integrated system witth partners and Updated for stakeholders to implement the outcomes of the Greaater Manchester 2017/18 Commissioning Review in order to improve the health and care of the Borough’s citizens. Functioning as an organisation that consistently delivers its statutory duties and participates fully in the Greater Manchester Health and Social Care Partnership. 7. We set about delivering these by: Treating physical and mental wellbeing as equally important; 3 SECTION 1: PERFORMANCE REPORT Understanding that factors like debt, housing and lonelineess can make a difference to a person’s health, how well they recover and how much help they need from the NHS; Focusing on those patients who are the most vulnerable and seek the most help from services; Improving the quality of out of hospital care with a focus on creating an integrated health and care service, working in partnership with providers and Council commissioners; Improving the quality of in hospital care with an emphasis on creating a high quality, sustainable hospital; Working closely with our partners and providers to create a joined-up, sustainable service that supports people to be well. 8. On thee next pages are just a few of ouur achievements that I want to highlight. Partnership Working 9. Working closely with our partners at the hospital, local council,, community and mental health providers is essential to delivering high quality local services. 10. We are an active partner in the Healthier Wigan Partnership whicch brings together local health and social care organisations to support the integration of services, including signing the Alliance Agreement in March 2018. 11. With the Council we have been invoolved in ongoing conversations about how we might best integrate the commissioning of local services as well as ttheir provision. 12. This partnership on transformation enables us to join up health and social care services, improve patient experience and save money. 13. We have also taken an active role in the Greater Manchester Health and Social Care Partnership (GMHSCP) and are commmitted to continuing to do so to ensure the best care for local residents. Image: Our Annual General Meeting held in Leigh Market, September 2017 4 SECTION 1: PERFORMANCE REPORT HIGHLIGHTS FROM THE YEAR! Recognised nationally by NICE for our work in care homes Set up a new GP service at the improving medicines hospital to support A&E. managemment and improving lives for patients. The Medicines Management team have saved £3.8million We are the best performing whilst also improving care and Borough in Greater Manchester medicines. on canceer waiting times. Actively encouraged new apprentices to join the Rated as ‘Outstanding’ by organisation and supported all NHS England for our apprentices from 2016/17 to Diabetes services. secure employment with us or partnner organisations. Engaged wwith local residents in Supporrted patients in Neuro- Orrell and Billinge on the quality rehabilitation to be safely of local services. transfeerred to a new location. Awarded the highest level of Engaged with local residents on assurance by internal auditors, the Healthier Wigan Partnership MIAA, for our work with local and whaat integrated services care homes. should look like in the area. Succeessfully delivered a leadership and management programme over six months for Practice Managers and CCG staff. 5 SECTION 1: PERFORMANCE REPORT Offer more appointments on evenings and weekends through GP Exxtended Hours – one group of practices is piloting a same day access hub. Worked with GP members to create new geographically based groups of practices that . can offer more services locally – one is piloting a service for housebound patients. Introducedd the practice nurse Developed the Integrated fellowship to promote the Discharge Team with local Undertakken commissioner visits recruitment of practice nurses partners to ensure patients are to assess quality of services, into the Borough to support the discharged from hospital quickly with paatient representatives primary care workforce – and safely with the necessary being involved in the visits. recognised as best practice support. across GM. Rolled out a big programme of Are performing above the learning development for national standards for all the practices to help them improve mental health service targets. local services. Held our Annual General Meeting in Leigh Market to engage with over 700 local residents on what the CCG does and how we can improve local services. Engaged with local residents and staff on a new End of Life Strategy on what is important to them. 6 SECTION 1: PERFORMANCE REPORT Financial Stability 14. The CCG received an allocation of £530.8m. Due to national reporting guidance this have been reduced to £521.4m to remove the prior year surplus of £9.4m that the CCG has been reporting throughout the financial year. The reporting of a higher level of surplus allocation, had previously been agreed with both GM Health and Social Care Partnership, and NHS England and was maintained through all of the financial year. 15. In accordance with the financial rules set by NHS England the CCG has spent £518.5m so generating the required ‘surplus’ of £2.9m. The required surplus includes £0.05m of statutory surplus notified to the CCG at the start of the financial year; plus the release of the 0.5% funding the CCG was required to withhold for the national system reserve totalling £2.3m; and a further release of £0.6m relating to savings made as a result of the national changes applied to non-branded drug pricing. Issues and Risks 16. The Governing Body normally receives and reviews on a quarterly basis the Assurance Framework which contains all risks rated ‘high’ or ‘extreme’ that the CCG is managing. These risks cut across all corporate objectives of the CCG covering the delivery of quality improvement; performance against national and local indicators and standards; and financial duties. 17. The Assurance Framework is also scrutinised by the Audit Committee and Corporate Governance Committee which both meet four times per year. 18. Our Annual Governance Statement found later in this report goes into greater detail describing how we have managed risk throughout the year. There have been three areas of concern reported regularly to our governing body: Urgent and Emergency Care – performance has been below the national standard of 95% of patients being admitted, transferred or discharged within four hours of arrival – the borough health system led by the CCG will continue to work together to support the department at the Royal Albert Edward Infirmary and Leigh Walk-in-Centre to effectively manage admissions and discharges; Ambulance performance - none of the six new performance standards was met between August 2017 and March 2018 - the CCG has been proactively working with GMHSCP throughout the year to highlight its concerns; Financial position – the CCG has faced a number of financial pressures during the year along with many other parts of the NHS but by year-end we are able to report that we have met the financial rules set by NHS England for CCGs. 7 SECTION 1: PERFORMANCE REPORT Greater Manchester Devolution and Partnership 19. In April 2016 Greater Manchester took charge of its health and care system as one Partnership spanning NHS and local government, commissioners and providers of both physical and mental health. In doing so, we embarked upon the most radical health and care transformation programme in the country. 20. We are now approaching the third year of the delivery of our strategy, Taking Charge. Two years into our journey, we can see a health and care landscape in Greater Manchester that looks fundamentally different.