Agenda item

It was noted that the report included information outlining the key organisational changes that had been planned.  These changes included integrated care, the development of the Out of Hospital Strategy and 7 day working. 

The Board was advised that the CCG's Recovery Plan would enable the organisation to deliver £5m of improvements on its projected deficit and that it was expected to break even this year.  It was thought that this would be enabled, in part, by the financial strategy agreed for the eight North West London (NWL) CCGs which effectively provided a level financial playing field.  This strategy meant that Hillingdon had been able to put a programme of investment in place.  Furthermore, the CCG was congratulated for securing funding from the Prime Minister's Challenge Fund which was being used to establish the infrastructure for networks of GPs.   It was anticipated that these networks would help GPs in the move towards the provision of weekend access. 

It was noted that the integration of health and social care was deemed to be a priority in Hillingdon.  As such, the CCG had become an early adopter for the Whole Systems Integrated Care Pioneer Project which the organisation believed was complementary to the BCF work (focussing on the frail and elderly).  Concern was expressed that this Project was being piloted across two cohorts which were both from the north of the Borough (as the area comprised an older population), involving a total of 1,000 patients and starting in October 2014. 

Although it was anticipated that the model would be rolled out to the rest of the Borough in 2015, it was suggested that the pilot would have been more representative of the Borough's diverse population if one cohort had been from the south (where the health needs of residents tended to be greater and more complex) and the other from the north of the Borough.  It was noted that, had the Board been consulted in advance, it would not have supported the selection of two cohorts from the north as this would not give a complete picture of the issues faced by residents. 

Insofar as the savings figures included in the report were concerned, it was noted that the numbers did not make complete sense.  It was suggested that the CCG give further consideration to improving the presentation of this data so that the financial picture presented to the Board was as clear as possible.  The Board was aware that reporting on the CCG's financial situation was not straight forward as it could take time for the organisation to become aware of costs that had been incurred (for example, if a resident registered in Hillingdon received treatment in Suffolk, it may take time for this cost to be recharged to the appropriate CCG).  Furthermore, the process of producing budgetary updates was quite long winded as the CCG's 'first cut' figures were produced each month but then needed to be examined by NHSE. 

To help resolve some of the financial reporting issues experienced by the CCG, consideration was currently being given to the implementation of a new IT system in the next year.  It was anticipated that this system would prove to be a useful tool (although it would take a year before the positive impact was felt) as it included the ability to integrate social care budgetary information. 

The Board was advised that the QIPP programme savings for 2014/15 had been set at £10.3m and would be monitored through the CCG's Programme Monitoring Office function.  To provide the CCG with a cushion, it was looking to identify an additional £2m of QIPP savings.  The CCG was asked to provide a quarterly update to the Board on the progress of achieving the QIPP programme savings.  

It was noted that, for the first time ever, it had been officially acknowledged that health services in Hillingdon had historically been chronically underfunded.  However, despite this acknowledgement, the funding levels had still not been addressed and corrected and, as such, the Borough was still £15m underfunded.  

RESOLVED:  That the Health and Wellbeing Board notes the report.