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Salford Clinical Commissioning Group Annual Report 2013-2014

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Salford Clinical Commissioning Group Annual Report 2013-2014 Salford Clinical Commissioning Group Annual Report 2013-2014 Contents Employees 42 External Audit 44 Member Practices Introduction 4 Disclosure of “Serious Untoward Incidents” 44 Strategic Report 7 Cost Allocation and Setting of Charges for Information 44 History of Salford CCG 7 Principles for Remedy 45 Population Demographics 8 Emergency Preparedness, Resilience and Response 45 External Environment 8 Statement as to Disclosure to Auditors 45 Our Vision, Aims and Objectives 9 Remuneration Report 46 Our Business Model 10 Statement of Accountable Officer Responsibilities 51 Our Key Strengths 11 Governance Statement 52 Highlights of 2013/14 12 Independent Auditor’s Report to the Members of Salford CCG 78 Long Term Conditions (including End of Life Care) 12 Summary of Accounts 81 Children and Young People 13 Notes to the Financial Statements 85-116 Mental Health 14 Scheduled Care (including Cancer) 15 Older People 16 Unscheduled Care 17 Medicines Management 18 Continuing Healthcare 19 Quality of Commissioned Services 20 Primary Care Quality 21 Safeguarding 22 Public Involvement and Consultation 23 Partnership Working 24 What Does The Future Hold? 30 Risks 33 Sustainability Report 33 Equality Report 33 Report of the Chief Finance Officer 35 Members’ Report 40 Salford CCG’s Member Practices 40 Salford CCG’s Governing Body 41 222 3 We reviewed our maternity services looking at ways to reduce health inequalities and Member Practices’ Introduction deliver the best possible start in life for Salford’s children. We also developed a new In April 2013, the Health and Social Care Act came into force bringing with it the largest pathway ensuring the majority of children needing to be transferred from Salford reforms in the 65-year history of the NHS. Royal’s PANDA unit were able to go to Royal Bolton Hospital instead of a wide variety of hospitals further away from home. Clinical Commissioning Groups (CCGs) became the cornerstone of the new health system and now decide how the NHS budget is spent locally on the majority of health services Working in partnership with Salford City Council, Salford Royal NHS Foundation including emergency care, elective hospital care, maternity services, community and Trust and Greater Manchester West NHS Foundation Trust, we have started to mental health services. redesign services to meet the challenge of our growing and ageing population via the Integrated Care Programme for Older People and focused on increasing local clinical In Salford, each of the 50 GP practices became part of Salford CCG and, with support of and stakeholder involvement in decisions about how people in Salford access health other health colleagues, we are responsible for commissioning the best healthcare services services. for the 250,000 registered population in Salford. We delivered robust and sustainable commissioning decisions based upon analysis of Our city is growing as the number of children and young people living in Salford continues the clinical, provider and prescribing data within clinical practice (referrals, prescribing to rise - but Salford is also ageing with the amount of over 65s expected to increase by methods, disease management, patient interface etc) which influence healthcare 30% over the next few years. As our patients live longer, the number of people with long delivery, patient experience, the quality of healthcare provided and the outcomes term health conditions continues to rise. achieved by patients. Yet, while people are living longer, there are still massive health inequalities across the city. This annual report has given us an opportunity to reflect on the impact Salford CCG has Life expectancy between those living in the best and poorest neighbourhoods is 12 years made for healthcare services in the city since our authorisation 12 months ago. less for men and eight years less for women. Alcohol-related hospital admissions and the amount of people who smoke are also amongst the worst in England. Our vision is to commission high quality services to enable our population to live longer healthier lives. To achieve this, we have four aims kept at the forefront of our decision-making to provide the best possible healthcare for our Salford patients. These are: l Prevent ill health l Reduce health inequalities l Improve healthcare quality (safety, experience and effectiveness) l Improve health and wellbeing outcomes During our first 12 months, Salford CCG has commissioned services with a clear emphasis on prevention as we focused on managing the transition from an NHS that is a sickness service to one that is focused on prevention. For the 70,000+ people living with a long term condition across the city, we have launched community clinics for patients with vascular problems, provided exercise and lifestyle advice via clinics for patients living with COPD and introduced Diabetes Outreach Clinics. For our patients living with mental health needs, we funded an additional total of £2 million for a Memory Assessment Treatment Service and expansion of the Mental Health Liaison Service at Salford Royal Hospital, as well as additional recurrent funds in the service for mentally disordered offenders. 4 5 Evaluating our effectiveness The CCG is committed to supporting all staff, including Governing Body members, to Strategic Report fulfil their roles effectively. During establishment, the arrangements put in place by Salford CCG and explained within the Corporate Governance Framework were developed with extensive expert By developing our Governing Body and its individual members, it will ensure that external legal input to ensure compliance with the all relevant legislation. That legal the CCG’s aims and objectives are successfully achieved in the next, and future, advice also informed the matters reserved for Membership Body and Governing Body financial years. decision and the scheme of delegation. Governing Body training and development needs will be addressed through a range of Salford CCG has complied with the statutory duties laid down in the National Health training and development techniques, including: Service Act 2006 (as amended) and other associated legislative and regulations. The CCG l Governing Body development and strategy sessions is clear about the legislative requirements associated with each of the statutory functions for which it is responsible, including any restrictions on delegation of those functions. l Face-to-face and online training l Coaching and mentoring Responsibility for each duty and power has been clearly allocated to a lead Director. Directorates have confirmed that their structures provide the necessary capability and During 2013/14, a number of Governing Body development and strategy sessions took capacity to undertake all of the clinical commissioning group’s statutory duties. place focusing on developing, nurturing and enhancing the corporate knowledge and The accounts have been prepared under a Direction issued by the NHS Commissioning expertise of the Governing Body to rise to future challenges. Several of these sessions Board under the National Health Service Act 2006 (as amended) have been facilitated by an external organisation. The CCG’s Audit Committee has received regular reports concerning Governing History of Salford CCG Body governance and performance matters and has made recommendations for Salford CCG was established in April 2013 when it was licenced without conditions policy, procedural and process improvement throughout the financial year. The Audit under the Health and Social Care Act 2012. Committee has also commissioned several reviews in the financial year under the CCG’s Internal Auditor (Mersey Internal Audit) to evaluate Governing Body effectiveness Previously, the local health budget and health decisions had been made by in particular areas and to make recommendations for further improvement in those organisations called Primary Care Trusts (our local Primary Care Trust was known as areas, as appropriate. The Internal Audit Plan for 2013/14 awarded the CCG with NHS Salford). At the end of March 2013, all Primary Care Trusts across the country Significant Assurance. closed down and were replaced with GP practice membership organisations called Clinical Commissioning Groups (such as Salford CCG). CCGs now have overall decision-making responsibilities on how the health budget allocated by the Department of Health should be spent locally. This new way of working is not about every GP taking time away from surgeries. It is about making sure we use the people and knowledge already based within Salford to the best of our ability and achieve the best outcome for our population – GPs have the most contact with patients, therefore the best overview of the population’s health needs. Our offices are based on the 7th Floor within St James House on Pendleton Way in Salford. St James House is owned by Orbit Developments (part of the Emerson Group) and the CCG shares the building with multiple other organisations, including the Greater Manchester Commissioning Support Unit (GMCSU). At the end of the 2013/14 financial year, Salford CCG was made up of: Male Female Governing Body 11 3 CCG employees 29 61 6 7 Population Demographics Our Vision, Aims and Objectives Salford is a city within Greater Manchester. It has a registered population of Salford CCG’s vision and aims were established in the two-year Integrated Strategy and 250,000 people living across eight neighbourhoods: Operating Plan (ISOP) 2013/14 - 2015/16. l Claremont and Weaste l East Salford Our vision is
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