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Annual General Meeting 15 September 2016 Annual General Meeting 15 September 2016

Welcome! • Who we are • A review of our year • Financial position Welcome! • Who we are • A review of our year • Financial position • Summary of performance • Public questions

Who we are Presented by our Chair Who we are Presented by our Chair

Chair of the CCG • Dr David Crichton • GP at Bentley Surgery • Chair of the CCG • Dr David Crichton • GP at Bentley Surgery • Elected Chair of the CCG by our Member Practices from 1 April 2016 • Membership organisation: 43 Member Practices

What we do • A statutory NHS body • We buy (or “commission”) local What we do • A statutory NHS body • We buy (or “commission”) local healthcare services for the Doncaster population – Planning services based on our population’s needs – Securing services that meet these needs – Monitoring the quality of care provided

Our Governing Body • Chair Governing Body • 10 elected Locality Leads • 3 Our Governing Body • Chair Governing Body • 10 elected Locality Leads • 3 Lay Members • Chief Officer • Chief Finance Officer • Registered Nurse • Secondary Care Doctor Audit Committee Remuneration Committee Quality & Patient Safety Committee Engagement & Experience Committee Executive Committee Primary Care Commissioning Committee

Our Member Practices Our Member Practices

What we stand for Our Vision: Work with others to invest in quality healthcare What we stand for Our Vision: Work with others to invest in quality healthcare for Doncaster patients Our Values: • The needs of our patients are paramount • We will drive forward continuous improvement • Relationships based on integrity and trust Mission Statement: A high quality and accountable Clinical Commissioning Group, encouraging responsible partnership engagement in a transparent climate of ongoing learning in order to create a patient-centred yet financially astute and corporate approach to commissioning

A review of our year Presented by our Chair & Chief Officer A review of our year Presented by our Chair & Chief Officer

Recognising our former Chair & Chief Officer Mr Chris Stainforth Dr Nick Tupper Recognising our former Chair & Chief Officer Mr Chris Stainforth Dr Nick Tupper

Catalysts for change Care out of Hospital Care of the frail Coordinated care Catalysts for change Care out of Hospital Care of the frail Coordinated care

Our priorities PRIORITY PATHWAYS Community Services Mental Health Intermediate Care Homes SYSTEM CHANGE Cancer Our priorities PRIORITY PATHWAYS Community Services Mental Health Intermediate Care Homes SYSTEM CHANGE Cancer Children’s End of Life Care Primary Care Urgent Care Dementia

 • • • Understanding the needs of residents to influence a future Care • • • Understanding the needs of residents to influence a future Care Home Strategy Holistic community nursing care Single Point of Access Community Services Care Homes Intermediate Care • • • Intermediate Care Health Needs Assessment – 1, 000 people Fed back in January Now designing the new model SYSTEM CHANGE • • Woodfield 24 More people dying in the place of their choice End of Life Care Primary Care Urgent Care • Primary Care Strategic Framework 4 pillars: • • October 2015: launch of newlook urgent care services • • • Urgent Care Centre Same Day Health Centre GP Out of Hours • Keeping people well Responsive primary care Proactive coordinated primary care Extended primary care

 • • • Mental Health Single Point of Access launched in October 2015 • • • Mental Health Single Point of Access launched in October 2015 for individuals experiencing a crisis Working in partnership with peer support organisations Catch cancer early with Doncaster Rovers: • • • Cancer “Tackle lung cancer early and get extra time” Prostate cancer: “Dribbling, not shooting” “Be breast aware” – with the Doncaster Belles • Increase in early diagnosis Children’s • • • New community paediatric model from April 2015 Autism Spectrum Disorder pathway redesign Mental Health & Wellbeing Plan Dementia • • • 5, 000 Dementia Friends in Doncaster Awareness raising Admiral Nursing service for those diagnosed with dementia

Sustainability & Transformation • Sustainability & Transformation Plan • Place based plan • Working Sustainability & Transformation • Sustainability & Transformation Plan • Place based plan • Working Together

Patient engagement • Why engage? It is the right thing to do! • Good Patient engagement • Why engage? It is the right thing to do! • Good engagement also generates insights about the experience of our patients, carers and public who access the service we commission. • These insights feed directly into our commissioning activities – they influence how we commission services. • This makes us a smarter health investor, able to achieve better outcomes and better value for our population.

Levels of engagement On our strategic plans and CONSULTATION priorities. ENGAGEMENT On how we Levels of engagement On our strategic plans and CONSULTATION priorities. ENGAGEMENT On how we specify outcomes, redesign pathways or services and procure services. VALIDATION Of the quality and performance of the services we commission.

Types of engagement. . . Partners: Website Newsletters Health Ambassadors Health campaigns Videos of Types of engagement. . . Partners: Website Newsletters Health Ambassadors Health campaigns Videos of patient stories Social media Chair’s column in Free Press Engagement Workshops PPG Network

Annual Accounts Presented by our Chief Finance Officer Annual Accounts Presented by our Chief Finance Officer

Annual Accounts • Year-end accounts for 2015/16 are complete; we met all our statutory Annual Accounts • Year-end accounts for 2015/16 are complete; we met all our statutory financial duties • Prepared under International Financial Reporting Standards (IFRS), in accordance with the Department of Health Group Manual for Accounts 2015/16 • The Statement of Comprehensive Net Expenditure captures our gross expenditure and income – £ 446, 656, 000 allocation – £ 436, 934, 000 net operating costs – £ 9, 722, 000 surplus

Summary of financial performance Duty Target £’ 000 Performance £’ 000 447, 071 437, Summary of financial performance Duty Target £’ 000 Performance £’ 000 447, 071 437, 349 0 0 446, 656 436, 934 Capital resource use on specified matter(s)does not exceed the amount specified in Directions 0 0 Revenue resource use on specified matter(s) does not exceed the amount specified in Directions (Programme) 0 0 7, 190 6, 464 Expenditure not to exceed income (Achieve a Surplus) Capital resource use does not exceed the amount specified in Directions Revenue resource use does not exceed the amount specified in Directions (Total Allocation) Revenue administration resource use does not exceed the amount specified in Directions (Admin/Running costs)

Financial position moving into 2016/17 • Financial allocations for 2016/17 have created a very Financial position moving into 2016/17 • Financial allocations for 2016/17 have created a very challenging financial position – Growth 2. 08% i. e. £ 8. 9 m – Additional costs exceed the growth allocation • • • Inflation on contracts Prescribing Continuing Healthcare Demographic growth Acute referrals Running cost pressures • Gap deficit of £ 8. 9 m – efficiency programme needed

Managing the finances • System transformation will be critical – e. g. intermediate care Managing the finances • System transformation will be critical – e. g. intermediate care model • Strong financial control during 2016/17 will be crucial to ensure delivery of the CCG’s financial targets • The local health system will only remain financially sustainable through integration and collaborative commissioning, through working closely with primary care, providers and the Local Authority • Use “Right Care” areas to target efficiency programme

A summary of our performance A summary of our performance

Our annual review 2015/16 by • Commended us on the clear and coherent CCG Our annual review 2015/16 by • Commended us on the clear and coherent CCG strategy • Noted good progress in 2015/16 on urgent care, end of life care and mental health crisis care • Noted our aim to focus on the transformation of intermediate care services in the year ahead • Noted the significant challenge of local health and social care system sustainability in 2016/17 • CCG Assurance Framework 2015/16: Well Led Organisation Delegated Functions Financial Management Performance Planning Good Good

Governance • Annual Governance Statement: no control issues • Head of Internal Audit Opinion: Governance • Annual Governance Statement: no control issues • Head of Internal Audit Opinion: significant assurance of a sound system of internal control • ISA 260 Report from External Auditors to those charged with Governance: proper arrangements to secure economy, efficiency and effectiveness in our use of resources

Annual Report & Accounts • We would like to formally present to you our Annual Report & Accounts • We would like to formally present to you our Annual Report and Accounts.

Public questions Public questions