Agenda item

David Mehaffey, Strategy Manager for South Worcestershire CCG, worked with Mick O'Donnell, Head of Strategy for Wyre Forest and Redditch and Bromsgrove CCGs, to produce their commissioning plans. Three distinct plans had been produced but took account of countywide issues.

South Worcestershire CCG

There were 32 practices for a population of 297,973 people and a commissioning budget of £322million. The CCG had a 5 year strategy in place with priorities of:

·         Improving quality and patient safety

·         Reducing health inequalities

·         More independence for the frail elderly and those living with a long term condition and,

·         Better and faster access to urgent care

Under the current funding formula South Worcestershire CCG had the 2^nd lowest target and the lowest actual funding allocation in the area, although they were not the most challenged CCG. Half of the budget went on acute hospital services. It was difficult to compare year on year figures but mental health services were to get an increase of 3%, prescribing would increase by 4% and continuing Healthcare would increase by 7%.

Key financial plans for 2015/16 included:

·         increasing overall mental health expenditure by £1.2m

·         investing £95,000 in a social impact bond to address social isolation and loneliness

·         £750,000 to further develop the Worcester urgent care centre

·         £1.5m on proactive care services for the frail elderly

·         £160,000 on a falls response service

Operational plans include:

·         Transforming urgent care

·         Commissioning primary care

·         Developing new care models

The priorities and performance improvement were then given for urgent care, planned care, cancer care and mental health services.

Redditch and Bromsgrove and Wyre Forest CCGs.

In population Redditch and Bromsgrove and Wyre Forest were about equal to South Worcestershire. In 2015/16 Redditch and Bromsgrove would receive a funding increase of £282,000 while Wyre Forest, which had previously been comparatively over allocated, received a decrease of £398,000. Redditch and Bromsgrove needed to make a saving of 2.9% and Wyre Forest of 2.6%.

The overarching commissioning principles were a greater emphasis on prevention and self-care; an increase in the amount and range of care available in the community and corresponding reduction in hospital care; an increase in the amount of treatments delivered as day cases and an increasing focus and investment in mental health and well-being services.

Over 50% of the budget in both areas was spent on acute hospital services. For 2015/16 this would be £103m for Redditch and Bromsgrove, a small increase on 2014/15; for Wyre Forest a small increase would mean the acute services spend would be almost £68m.

The operational service delivery targets were detailed with targets for A & E waiting times, referral to treatment times, cancer care, infections and improving access to mental health services. 6 out of 11 targets were already being met.

In response to questions it was clarified that:

·         the increase in mental health expenditure included prescribing as well specialist services,

·         that acute hospital services received over 50% of the budget and therefore the bulk of the savings would have to come out of the acute budget. The CCGs would concentrate on continuing to reduce emergency admissions which had been reduced in the previous 2 years,

·         Savings would be made by commissioners through the QIPP programme and providers would work on their own efficiency plans. The CCGs could not negotiate with acute service providers on price and could only reduce activity through the actions of GPS and by reducing the numbers of people referred to or ending up in hospital,

·         Healthwatch confirmed that they attended CCG Board meetings and stakeholders received reports on a bi-monthly basis. Each CCG also had a patient and public forum and as part of the planning process GPs and patient groups had been involved in the debate about budgets. SW CCG held a budget prioritisation exercise which resulted in the view that ambulance services, cancer care and dementia care were the three areas where the public wished to preserve funding.

RESOLVED that the Health and Well-being Board noted the development of the commissioning plans for 2015/16 of the three Worcestershire Clinical Commissioning Groups.