In June 2013, NHS England announced the start of a strategic process led by NHS England in partnership with Clinical Commissioning Groups (CCGs), Health and Wellbeing Boards and national partners.
The process is intended to promote a new style and method of working focused on how best to shape care around the interests of patients now and for future generations.
A presentation providing further information will be given by Deborah Fielding (CCG), Debra Elliott (NHS England) and Maggie Rae (Wiltshire Council).
Minutes:
Noting that in June 2013 NHS England had announced the start of a strategic process led by NHS England in partnership with Clinical Commissioning Group (CCGs), Health and Wellbeing Boards (HBSs) and national partners, a request was made at the last meeting of the Board for a presentation to be made providing further details on the NHS ‘Call to Action’.
Ian Biggs (Area Director, NHS England) was in attendance to provide a presentation on ‘Call to Action’ in conjunction with Deborah Fielding (Chief Officer Wiltshire CCG) and Maggie Rae (Corporate Director, Wiltshire Council).
In making the presentation, Ian Biggs confirmed that ‘Call to Action’ was a sustained programme of engagement to seek the views of patients, the public, staff and stakeholders to assist with future planning of services to reflect the needs of the population, within the funding available.
In drawing the Board’s attention to the projected resources available up to 2020/21 it was noted that a financial gap of approximately £30bn would exist in order to meet the population needs. An ageing society, an increase in long-term conditions and lifestyle risk factors would all provide further financial pressures on the system.
Recommendations for improvement already existed with the release of key documents (such as the Bruce Keogh report and Berwick review); it was acknowledged that further changes would be required.
The way in which healthcare was delivered would need to be organised in such a way that services supported primary care and met the needs of the patient within the community itself. A significant shift in future resource was likely to provide services that allowed patients to remain at home where possible. This would meet the needs of the patient, reduce financial pressures and the associated pressures on hospitals.
Promoting healthier life paths and driving a preventative rather than reactive approach to healthcare would be required. This would be achieved by giving service users a greater control over their health and moving away from a one size fits all model of care.
Deborah Fielding confirmed that Wiltshire was in a strong position in comparison with many other areas, noting the preventative measures already in place. This would be emphasised further with the support of the clinical executive who would continue to focus on local services, policy development and planning.
Noting the financial implications a severe winter could have on resources, information on the preparations of all three hospital trusts in the area, Primary Care, Wiltshire Council the Community and Medvivo WMS was highlighted.
As part of ongoing consultation, NHS England has requested CCGs to lead on the development of a local 5 year plan, noting that financial planning in the past has been arranged in one or two year blocks. Wiltshire CCG were currently in the second year of their ‘Clear and Credible’ Plan and were currently working up commissioning intentions for 2014/15 which would be announced shortly. The 5 year plan would run from 2014/15 to ensure an overlap with the 2014/15 Delivery Plan.
Key assumptions had been used in relation to the Medium Term Financial Plan which included an expected tariff inflation of 2.9% per annum (now expected to be 2.1%). This was likely to put further pressure on acute services, noting that each were already required to continue with 4% efficiency savings year on year.
The growth in allocation was also likely to reduce to 1.8% in 2015/16 from 1.9% in 2014/15, below inflation. This would need to be taken into account with the 10% running costs of commissioning organisations and would again result in further pressures.
In highlighting the Medium Term Financial Plan it was noted the significant change to the Integrated Transformation Fund (ITF) allocation which, in 2015/16 would have approx £20m ringfenced from the budget for primary care, community care and social care purposes.
To help drive the 5 year plan workshops were currently being planned with the CCG facilitators at Attain, the first of which took place on 29 October with the CCG governing body, NHS England and senior officers of the Council to agree the approach. A programme of workshops would start in earnest in January/February 2014.
Joint challenges in the future included:
· The need to get better at preventing disease
· Giving patients greater control of their own health
· Noting the 4,000 additional military personnel with families rebasing to Wiltshire by 2020
· The need to maintain services close to home
· Managing with reduced resources with increased needs
· The impact of specialist commissioning national service specifications
· The need to support Primary Care in its delivery
Maggie Rae, Corporate Director Wiltshire Council, concluded the presentation by reiterating the need of future service integration to ensure services remained fit for purpose and to ensure the best service was provided for the future. The vision was in line with that of the Council and which was outlined within the authority’s Business Plan.
The Chairman and Corporate Directors on the Board had recently attended a conference where the message of Wiltshire being in a stronger position than most was also highlighted.
The Chairman fully supported the need of continued joined up working and for a focus on prevention measures to remain a priority to ensure a sustainable future. In line with this the support of local communities and the voluntary sector would be required in the future.
A national group undertaking research on national barriers to integration was noted. Wiltshire CCG was one of only four in the country accepted into the pilot scheme.
Resolved:
That the Board note the work being undertaken to engage the public and stakeholders alike in the Call to Action process.