Agenda item: 1.7 Paper No: 4

Committee:

Governing Body

Venue:

Radisson Blu Hotel, Guildford

Date:

26 January 2016

Status:

FOR REVIEW AND NOTE

Title of Report

Chief Executive Report

Presented by

Dominic Wright, Chief Executive

Author

Dominic Wright, Chief Executive

Relevant Legislation and Source Documents

None relevant

Freedom of Information

Author considers that no exemption applies:



Executive Summary:

This is a briefing for Governing Body members to highlight corporate developments which are not on the agenda, and provide an update on recent national policy and guidance and implications for any required action. Implications: Health/ CCG strategic objectives

We will improve the health of our local population We will manage the health economy within our available budget We will support GP practices to work together to organise „wrap around‟ care for the frail elderly, working with local partners We will improve and continually check the quality and safety of patient services We will involve local people in deciding what we do, respecting and valuing patient and carer experience 1

Chief Executive Report – Governing Body January 2016

We will be a learning, listening organisation that values our staff and the wider workforce, and supports partnership working and good governance within the CCG and between organisations Financial/Resource

The Chief Executive‟s Report highlights areas of financial and resource implication across a number of different areas, with some indication where priority needs to be given to ensure adequate focus is given by the CCG.

Legal/compliance

N/A

Equality Analysis

N/A

Patient and Public Engagement

Patient and Public Engagement Group

Risk (including reputational) and rating

The Chief Executive‟s Report may highlight areas of risk which will be assessed and reported as necessary in the BAF.

Recommendation(s):

The Governing Body is recommended to Note the Chief Executive‟s Report

Next Steps:

Not applicable

2 Chief Executive Report – Governing Body January 2016

Chief Executive Report 1. Christmas & Winter Performance In my last report I detailed the steps that the CCG and its partners were taking to ensure that our local health and social care systems were well prepared for the Christmas and new-year periods. The three weeks around the end of December and beginning of January are predictably some of the most pressurised periods for urgent care services, with many people requiring our care and assistance. In general I am pleased to report that our services coped well and the key barometer indicators, such as A&E attendance and treatment times, admissions, delayed discharges and ambulance waits, all improved compared with performance over the same period last year. Whilst the relatively warm weather no doubt contributed to the underlying good health of our population during this time I do think the detailed planning and steps that were put in place contributed to the good performance. I want to thank all of our partners and their staff for working so effectively during the period. That said, as an economy, the 4 hour A&E see and treat 95% target remains a challenge and there was an increased financial cost to keep additional hospital ward beds open, so there is no room for complacency and we can always reflect and look to improve these areas for our patients.

2. Community Services With the existing multi CCG contract for community services due to end on 31st March 2017, we have been having detailed discussions with our neighbouring CCGs to look at the best way to secure these services going forward. After careful thought and consideration of options we have decided to look to procure the adult services via a competitive procurement process, with children & young people‟s being procured on behalf of Surrey by our hosted children‟s commissioning team. Both procurements are intensive activities, with significant resource implications for a large proportion of the CCGs available staffing capacity during the next fifteen months. The fundamental importance of these services to our strategy of delivering as much care in, or as near as possible to, a patient‟s home means that we believe it is right to prioritise this work. 3. Stroke Services The development of a Surrey wide stroke service specification has almost been concluded. It has been worked up through a specific multi - disciplinary working group which has taken advice and reference from national experts and the more local Kent Surrey and Sussex network including the Clinical Senate. The Stroke 3 Chief Executive Report – Governing Body January 2016

Services Review “Committee in Common” across the six CCGs has had oversight of the process and in January it will meet to consider the specification and suggest how we should commission in the future to meet the new standards. This is an important piece of work that represents one of the first major collaborative commissioning reviews of a clinical service across Surrey CCGs and providers. I will update the Governing Body at its next meeting in April. In early January I joined the CCG Quality Team to visit and review the stroke pathway that is in operation for our residents at the Royal Surrey County Hospital (RSCH). Overall the team was really impressed with the commitment and knowledge of the staff, the positive patient feedback and the cleanliness of the environment. Many thanks go to Dr Adrian Blight, Tina Hetherington and the rest of the stroke team at the RSCH.

4. Royal Surrey County Hospital NHS Foundation Trust & Ashford & St Peter’s Hospitals NHS Foundation Trust Merger The proposed merger between the RSCH and Ashford and St Peter‟s Foundation Trusts is still expected to be concluded by the summer of 2016 although there is still on-going consideration by both Boards as to the financial and service strategy benefits that need to be delivered under the proposals. The outline timetable suggests that the new Chair and Chief Executive will be appointed during the spring.

5. Planning 2016/17 and beyond NHS England issued the detailed NHS planning guidance for a one year Operational Plan and a three to five year Strategic Plan shortly before the Christmas break. Subsequently the CCG received the detail around its funding allocation the implications of which, at the time of writing this report, are being worked through by the finance and commissioning teams. The CCG will produce a plan that is focused around its natural population constituency of Guildford & Waverley. It will also take into account the need to work much closer with North West Surrey CCG, if as expected, our respective main acute hospitals merge. Any plan will also need to reflect the wider Surrey context across specialist commissioning and other clinical specialist areas such as stroke and vascular care etc. We are also working with Surrey County Council and our two local Borough Councils to ensure that our plans align with theirs. Undoubtedly, both the one year and three to five year plans will need to demonstrate how the CCG is going to transform local services through its commissioning capability in line with the aspirations set out in the five year forward view. We will need to be bold in our approach if we are to commission services that deliver the national NHS mandate consistently to our residents.

4 Chief Executive Report – Governing Body January 2016

The one year plan will need to be approved by the Governing Body in April and the three to five year Strategic Plan by 28th June. 6. Surrey County Council A clear statement of intent in the NHS planning guidance is for CCGs to set out how they can better integrate with social care. For Guildford & Waverley this is a clear direction of travel which will be a thread that permeates our strategic planning vision and actions. The Better Care Fund (BCF) is an important resourcing element that encourages practical closer planning and service delivery; the challenge is to build on this and take it further. During the last four years the NHS budgets have been relatively protected compared to those for social care. This trend is likely to continue and especially in Surrey, where the latest spending review of local government proposes a very significant reduction of £49 million in the central grant to the County Council for 2016/17. By integrating further, we envisage that we will be able to achieve greater efficiency through better joint commissioning of our services.

7. Shared Surrey Patient/Client Record development Proposals are being developed across Surrey CCGs, providers and Surrey County Council to develop a common operating approach that could enable sharing of a patient/client health and social care record across organisational boundaries. Whilst we must always recognise and cherish our commitment to the patients and public we serve to protect their confidentiality, I remain passionately convinced of the need to facilitate obtaining positive consent for this from patients and clients. Appropriate and timely sharing allows practitioners to deliver better care.

8. Departures & Staff Changes Peter Ridley, the Director of Finance at the Royal Surrey County Hospital is leaving his post to take up a new opportunity as Director of Planning at the Royal Free Hospital. Peter has been a significant advocate and supporter for the development of a new partnership approach to the relationship between the CCG and our main acute service provider. He will be greatly missed. It is expected that the interim arrangements following his departure will be announced by the Chief Executive in the next few weeks. I want to congratulate Liz Uliaz who has been appointed as the Deputy Director of Adult Social Care across Surrey. Liz will take up her new role as soon as suitable arrangements can be put in place to cover her Borough Director responsibilities.

5 Chief Executive Report – Governing Body January 2016