NHS Leeds West CCG Annual Report
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NHS Leeds West Clinical Commissioning Group Annual Report and Accounts 2016–2017 CONTENTS Annual Report 3 Chair and Accountable Officer’s Foreword 4 The Nature and Purpose of NHS Leeds West Clinical Commissioning Group 11 Our Business Model 13 Our Strategy 14 Performance Report Overview of Performance – Statement from the Accountable Officer 16 Financial Outlook 18 CCG Improvement and Assessment Framework 20 Healthcare in Leeds 21 Research Studies 25 Quality and Safety 26 Improving Quality and Performance in Primary Care 30 Reducing Health Inequalities 35 Involving our Patients 44 Working with our Partners 51 Safeguarding 59 Equality and Diversity 62 Sustainable Development 65 Requests for Information / Information Security and Governance 67 Emergency Preparedness 68 Accountability Report Corporate Governance 70 Members’ Report 70 Audit Committee 72 Conflicts of Interest 72 Governing Body Profiles 72 Remuneration and Staff Report Our Staff 78 Annual Workforce Report 80 Remuneration Report 81 Statement of Accountable Officer’s Responsibilities 87 Annual Governance Statement 88 Independent Auditor’s Report to the Members 106 Annual Accounts 109 2 NHS LeedsAnnual West Report Clinical and Commissioning Accounts 2015–2016 Group ANNUAL REPORT The annual report and accounts for the year ending 31 March 2017 have been prepared as directed by NHS England in accordance with section 232 (Schedule 15, Paragraph 3) of the National Health Service Act 2006. The directions issued by NHS England require clinical commissioning groups to comply with the requirements laid out in the Group Accounting Manual issued by the Department of Health. The Group Accounting Manual complies with the requirements of the Government Financial Reporting Manual, which the Department of Health Group Accounts are required to comply with. The structure closely follows that outlined in the guidance, which has been revised this year following national feedback on previous reports. The report is broken down into three core sections: • The Performance Report - including an overview, performance analysis and performance measures • The Accountability Report - including the members report, corporate governance report, annual governance statement, remuneration and staff report • Annual Accounts NHSAnnual Leeds Report West and Clinical Accounts Commissioning 2016–2017 Group 3 ANNUAL REPORT CHAIR AND ACCOUNTABLE OFFICER’S FOREWORD It’s fair to say that this year has been one In the past 12 months we’ve been a key of the most challenging for the NHS locally partner in putting together the West and nationally. We’ve had one of the Yorkshire and Harrogate Sustainability toughest winters for services and all parts Transformation Plan (STP). This shows of the health and care system are having to how we’ll be working on a regional level address the difficult financial picture facing to address the three gaps outlined in the us. At the same time we’re all working to NHS Five Year Forward View. Alongside address the three gaps identified to help this we’ve also worked with our citywide deliver the NHS Five Year Forward View. partners to develop the Leeds Plan to These are: health and wellbeing; care and show how we can deliver some of the STP quality; and funding and efficiency. at a local level while also achieving the ambitions of the Joint Leeds Health and We want to start our reflection on the past Wellbeing Strategy. year by acknowledging the sterling efforts of all health and care staff working under We’re pleased with how we’re working extreme pressure. This includes our member together on a regional basis and this GP practices, our CCG staff, our providers, is demonstrated by a memorandum of our local authority care colleagues and understanding we’ve signed to set up a our voluntary sector partners. Without joint commissioning committee. Once up their support and resilience, in the face of and running, the committee will make escalating demands, we wouldn’t be in decisions about how STP-wide services a position where Leeds health and care are commissioned. However before this performance continues to do well in the happens we’ll need NHS England to approve face of extreme pressures. amendments to the constitutions of the 11 CCGs in our STP area. Along with our fellow CCGs, NHS Leeds North CCG and NHS Leeds South and East Our focus now will be to ensure we actively CCG, we’ve been quick to respond to the engage with all those who have an interest changing commissioner and provider in how we deliver truly transformational environment and have been looking at how changes that are sustainable and cost we can work together better to achieve this. effective. When we say all those who have an interest in our proposals we mean As a result, we end the year with an everyone – it’s important we hear from agreement to work even closer together patients, carers, clinicians, our political as CCGs and in the wider health and social partners, community groups. In fact anyone care economy. From 1 April 2017 we have who lives or works in Leeds as you’re all one Accountable Officer for the three CCGs. likely to need the support of the NHS at This is part of a programme of work we call some point. One Voice. 4 NHS Leeds West Clinical Commissioning Group To help us with this we are already working Residents at 13 Leeds care homes are with Healthwatch Leeds and their equivalents benefitting from a pilot scheme, funded by in each respective area of our STP. The first NHS England as part of the West Yorkshire area for engagement is stroke services. Across and Harrogate Acceleration Zone, allowing West Yorkshire and Harrogate, health and health and care staff to remotely monitor care services are working together to ensure their health using Telehealth. stroke services are fit for the future. The West Yorkshire and Harrogate Before decisions are made, Healthwatch Acceleration Zone received £5.4million in our region have been asked to find out revenue and £3.2million capital funding from what people think about the services that NHS England until the end of March 2017. are currently provided and what would be The area was chosen as a pilot because it has important to them now and in the future a history of partnership working across the should they have a stroke, or care for area on urgent and emergency care. someone who has. The funding is being used to demonstrate This covers the whole stroke pathway rapid improvement in these key areas of care. from prevention, the first 72 hours of care, For example when a person needs to attend through to rehabilitation and community A&E, they may see a GP rather than an A&E support. The engagement report will help doctor, where deemed more appropriate. us firm up our proposals for the future of stroke services at a regional level so that As active members of the Leeds Health people can access the necessary expertise and Wellbeing Board we were pleased to quickly to ensure they receive prompt support the development of a refreshed Joint treatment and ongoing care. Health and Wellbeing Strategy for Leeds. It’s important that the strategy fits in with the Other areas we’ll be working on across demands facing us in the face of delivering the STP area include cancer care, urgent the STP, the Leeds Plan and our own CCG’s and emergency care, mental health and strategic priorities. specialised commissioning. Again we’d like to reiterate that no decisions will be Our Health and Wellbeing Strategy is about made until we’re satisfied we’ve taken into how we put in place the best conditions in account the views of everyone concerned. Leeds for people to live fulfilling lives – a healthy city with high quality services. We’d like to encourage you to keep up The vision of the joint Health and Wellbeing to date with the latest developments on Strategy is to improve the health of the our website, social media or newsletters. poorest, the fastest. This is a vision we are Equally important is that we continue an fully subscribed to. ongoing dialogue with our local patients. This means we can actively build a picture of your experience of health and care services to identify any areas of excellence or issues that need addressing. Annual Report and Accounts 2016–2017 5 Now it’s time to look back on some of our Due to the financial pressures we’re under key achievements over the previous year. We we’ve had to make the difficult decision of want to start by once again acknowledging scaling back the amount of investment we the valuable support of our GP member can put into the scheme. This means that practices that have enabled us to be a truly there will a significant impact in accessing clinically-led organisation. We want to say seven day GP services for our population. thanks to our locality chair GPs and clinical Although we’re confident that we’ll still leads GPs for their ongoing support that have better access than we have done have helped us develop innovative projects historically it will not match the ambition that improve the health of our communities. of our previously funded scheme We’ve been delighted with the overall results from November 2014. Naturally we’re of recent inspections undertaken by the Care disappointed to have had to make this Quality Commission within our member decision but it was needed based on the practices. Out of those assessed to date 97% realities of future finances available to us. have received an outstanding or good rating. This includes five practices being rated as Access to primary care is a challenge even with outstanding.