Annual Report 2018/19 1 Contents PERFORMANCE REPORT ..................................................................................................... 3 Performance Overview .............................................................................................. 11 Performance analysis ................................................................................................ 27 ACCOUNTABILITY REPORT ................................................................................................. 49 Corporate Governance Report .................................................................................. 50 Members Report ................................................................................................... 50 Statement of Accountable Officer’s Responsibilities ........................................ 56 Governance Statement ......................................................................................... 58 Remuneration and Staff Report ................................................................................ 82 Remuneration Report ........................................................................................... 82 Staff Report ........................................................................................................... 87 Parliamentary Accountability and Audit Report ...................................................... 97 ANNUAL ACCOUNTS ............................................................................................................ 102 2 PERFORMANCE REPORT This section of the Annual report includes an introduction from the Chief Officer and the Chair and Clinical Leader. It includes information about our vision for health and care in the district and about our performance. Continuously working to raise the Chief Officer’s Foreword standard of specialist and hospital care; Supporting Alcohol prevention initiatives This has been a remarkable year for NHS including a Pilot Pharmacy Scheme Wakefield Clinical Commissioning Group providing Alcohol advice and the Retail (CCG) and I am truly proud of the Accreditation Scheme supporting the improvements we have made to the well- responsible selling of Alcohol; being of local people through the efforts of Providing education and training to front our staff and the commitment of our line staff by promoting the use of partners. screening tools across Pinderfields Hospital through the work of the Alcohol In spring 2018 we were facing real financial Liaison Service which oversees challenges and it was important for us to discharge planning between acute care, get those under control so that we could community and primary care service. refocus our energies into continuing to drive forward improvements to health and care We had a challenging start to the year with for Wakefield people. the publication of an independent review of our capacity and capability, which was This report describes our progress during commissioned in response to the CCG not the year and the many improvements we achieving our financial targets in 2017/18. have made to health and care in the district, Our positive response to the review set the including: tone for the year, as we put our collective energy into strengthening our processes Providing better access to GP and and delivering a stretching financial primary care services 24 hours a day, recovery programme. seven days a week through extended GP opening hours and the creation of an Over the course of the year, we have urgent treatment centre; continued to seize opportunities to make the local health and care system safer, Joining up health and social care more effective and more sustainable and to services in the community with input from improve the health of the people of the third sector and housing providers to Wakefield. help people live well in their own communities; Through hard work and determination, we Strengthening the quality of care in care have delivered savings of £15m and so homes; achieved our financial plan. Improving access to psychological therapies and mental health services; We could not have achieved all that we Creating new services to enable people have done without the commitment of our with learning disabilities who need round partners to improve care for the people of the clock support to live locally; the district and get the best possible value Reducing waiting lists for children with from every pound we spend. autism spectrum disorder and providing better support for young people Our desire to deliver the best possible experiencing mental health problems; services for the district is exemplified by the fact that we continue to be at the leading 3 edge of service transformation through both New Models of Care Programmes. Services small and large scale changes. developed through these initiatives are now embedded across the district. In April 2018, we became one of the first areas in the country to operate a new style The CCG is also a key player in the West Urgent Treatment Centre at Pontefract. Yorkshire and Harrogate Health and Care Since opening its doors, the centre has Partnership (HCP); a second wave consistently performed above the national Integrated Care System. The HCP is target to see and treat 95% of patients leading the way nationally in its approach to within four hours of arrival. This service is bringing all local partners together to now an integral part of our urgent and support better ways of working, using our emergency care offer. regional resources better to continue to ensure patient care and quality of services. The work we have done with our partners has also made a huge difference for Through this partnership, we have worked children with autism spectrum disorder with local authorities and CCGs and (ASD); a year ago children were facing organisations that provide care across West unacceptably long waits and now, with the Yorkshire and Harrogate to transform the efforts of all partners, waiting lists have way services such as stroke, cancer, heart been significantly reduced. disease and mental health are organised for the benefit of the whole population. We These are just examples of the many have also shared learning to reduce improvements to primary, community, variation and to adopt changes that have mental health, learning disability and worked well in other areas. hospital services that feature in this report. In autumn, the Wakefield partnership put Partnership working in the Wakefield district itself forward to become the first local health is driven through our local Health and and care system in West Yorkshire and Wellbeing Board. Harrogate to participate in a Peer Review Challenge process. Health and care In 2018/19, Wakefield Council and the CCG colleagues from across the country visited agreed to put £119m into our Better Care the district to see how we are bringing Fund (BCF) pooled budget. £92m of this services together to prevent ill health and comes from the CCG. The financial enable people to live well for longer. The commitment to the BCF has grown peer review team gave us extremely annually. This shows our ambition to join up positive feedback on how far Wakefield has care and has helped us to invest in services travelled on our journey to become a joined that promote healthy communities, support up care system. The Peer Review Team people to stay well, to stop people needing noted our ‘universal passion and good hospital care and help people return home understanding of the needs for Wakefield more quickly after a stay in hospital. and its people, strong strategic and operational relationships and many Our collaborative approach to examples of innovation and transformation.’ commissioning health and care with There is more about this later in the report. Wakefield Council has strengthened our approach to working with public health and Recognition of how far we have progressed tackling health inequalities. We have played on our journey to join up care and the a big part in developing a whole-system benefits this brings for local people is a housing and health strategy. We have great reward at a time when things have continued to build on the opportunities been so challenging. It confirms that, by created in previous years through working together, we can make a real participation in the national Vanguard and 4 difference to the well-being of the He brings with him organisational population now and for the future. leadership experience to the post. This is a Finally, I would like to take the opportunity very exciting time for us and as such the in this report to acknowledge the Chair and members of the governing body contribution of our Chair and Clinical Leader, Dr Phillip Earnshaw. are key appointments which require outstanding individuals, who are recognised This year marks a significant change for the and respected by their peers. CCG as Dr Earnshaw steps down from occupying this leadership role in the health and care system in the district. Dr Earnshaw has been Chair and Clinical Leader since the CCG was first established in April 2013 alongside his role as a GP. He has worked in Wakefield for more than 30 years and is Senior Partner at Health Care First which runs Ferrybridge Medical Centre, Elizabeth Court, Park View and Queen Street Surgery. Phil previously worked for Eastern Wakefield and Wakefield District Primary Care Trusts, latterly as a board member. He has also served as Vice Chair of Wakefield Joanne Webster Health & Well Being Board and as a board Chief Officer member at