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Fylde Coast Health Event and

Annual MeetingsThursday, 5 July 2018

WelcomeRoy Fisher, Chair

NHS Blackpool Clinical Commissioning Group

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NHS Blackpool CCGAnnual General Meeting

2017/18

Apologies for absence

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Minutes of the previous meeting held on 21 September 2017

Annual report and accounts 2017/18

Andrew HarrisonChief Finance Officer

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Revenue control totalEach CCG is empowered to spend the resources allocated to it based on population need

in an effective and efficient manner, but no more. Additionally included in this target NHS England sets ‘Business Rules’ to determine levels of surplus (unspent resource) for each

CCG.

Cash limitEach CCG is required to ensure that it manages the cash associated with the above

control total effectively.

Better payment practice code (BPCC)A CCG is required to pay its suppliers within 30 days of being invoiced (or receipt of

goods and services where invoices are in advance).

Key statutory financial targets

Revenue control total

13/1

4

Ach

ieved

14/1

5

Ach

ieved

15/1

6

Ach

ieved

16/1

7

Ach

ieved

16/17 Target

16/17 Actual

17/1

8

Ach

ieved

17/18 Target

17/18 Actual

Blackpool CCG � � � �

£286.2m £286.2m

����

£300.9m £300.9m

£3.9m surplus

£3.9m surplus

£5.87m surplus

£5.87m surplus

Fylde & Wyre CCG � � � �

£239m £239m

����

£246.5m £246.5m

£5m Surplus

£5m Surplus

£6m Surplus

£6m Surplus

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13/1

4

Ach

ieve

d

14/1

5

Ach

ieve

d

15/1

6

Ach

ieve

d

16/1

7

Ach

ieve

d

16/17

Target

16/17

Actual

17/1

8

Ach

ieve

d17/18

Target

17/18

ActualCash limit

Blackpool CCG � � � � £286.2m £285.6m ���� £302.0m £296.9m

Fylde & Wyre CCG � � � � £238.5m £237.9m ���� £250.2m £250.2m

BPPC

Blackpool CCG � � � � 95% 99.50% ���� 95% 99.70%

Fylde & Wyre CCG � � � � 95% 99.70% ���� 95% 98.70%

Cash limit and BPPC

NHS Fylde and Wyre CCG Annual General Meeting

2017/18

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Apologies for absence

Minutes of the previous meeting held on 21 September 2017

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Annual report and accounts 2017/18

Andrew HarrisonChief Finance Officer

Revenue control totalEach CCG is empowered to spend the resources allocated to it based on population need

in an effective and efficient manner, but no more. Additionally included in this target NHS England sets ‘Business Rules’ to determine levels of surplus (unspent resource) for each

CCG.

Cash limitEach CCG is required to ensure that it manages the cash associated with the above

control total effectively.

Better payment practice code (BPCC)A CCG is required to pay its suppliers within 30 days of being invoiced (or receipt of

goods and services where invoices are in advance).

Key statutory financial targets

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Revenue control total

13/1

4

Ach

ieved

14/1

5

Ach

ieved

15/1

6

Ach

ieved

16/1

7

Ach

ieved

16/17 Target

16/17 Actual

17/1

8

Ach

ieved

17/18 Target

17/18 Actual

Blackpool CCG � � � �

£286.2m £286.2m

����

£300.9m £300.9m

£3.9m surplus

£3.9m surplus

£5.87m surplus

£5.87m surplus

Fylde & Wyre CCG � � � �

£239m £239m

����

£246.5m £246.5m

£5m Surplus

£5m Surplus

£6m Surplus

£6m Surplus

13/1

4

Ach

ieve

d

14/1

5

Ach

ieve

d

15/1

6

Ach

ieve

d

16/1

7

Ach

ieve

d

16/17

Target

16/17

Actual

17/1

8

Ach

ieve

d

17/18

Target

17/18

ActualCash limit

Blackpool CCG � � � � £286.2m £285.6m ���� £302.0m £296.9m

Fylde & Wyre CCG � � � � £238.5m £237.9m ���� £250.2m £250.2m

BPPC

Blackpool CCG � � � � 95% 99.50% ���� 95% 99.70%

Fylde & Wyre CCG � � � � 95% 99.70% ���� 95% 98.70%

Cash limit and BPPC

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Blackpool Teaching Hospitals NHS Foundation Trust

Annual Members Meeting

2017/18

Apologies for absence

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Minutes of the previous meeting held on 21 September 2017

Annual report and accounts 2017/18

Tim BennettDeputy Chief Executive /

Director of Finance

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2017/18 – Financial headlines

• Trust delivered an operating surplus of £5.7m including Sustainability and

Transformation Fund (STF) Incentive of £4.6m (£5.2m surplus after exceptional

items).

• Surplus excluding STF Incentive of £1.2m.

• The operating surplus equates to 0.8% of turnover.

• The exceptional item relates to a revaluation of the estate which is a non cash item.

• Cash position £3.3m positive balance.

• Full details in the group accounts.

Efficiencies

• Cost savings of £21.2m.

• Highest level we have ever achieved.

• Equivalent to 5% of our cost base.

• Delivered through:

• Transformational schemes.

• Transactional schemes and increased

expenditure controls. £0.0

£5.0

£10.0

£15.0

£20.0

£25.0

£m

CIP

Recurrent

Non-Recurrent

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Investments• Improvements in clinical quality and safety including:

• Implementation of primary care streaming.

• Investments in medical staff.

• Haematology collaboration with LTH.

• Enhancement to the Diabetic Foot Service.

• Investment in Radiology out of hours service.

Investments

• Major capital investments totalling £8.7m including:

• A&E Primary Care Streaming - £1.0m.

• Medical equipment - £2.0m.

• Electronic information projects - £4.7m.

• Women’s & Children’s Building Improvements - £0.5m.

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Outlook for 2018/19• Continued financial pressure

• Increases in costs due to activity increases and pay pressures.

• Provider Sustainability fund of £6.6m dependent upon improvements in finances and

A&E performance.

• CIP target of £17.4m

• NHSI control total £4.0m deficit

• Cash position by year end – negative balance £3.3m with plans being developed on

liquidity improvements

Outlook for 2019/20 onwards

• Impact of recent funding announcement by Prime Minister not yet clear

• Significant savings will still be required

• Trust - Refresh of 2019-20 plan:

• Expected to be completed December 2018.

• Continued Fylde Coast health economy approach (Integrated Care

Partnership).

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Membership Report 2017/18

Pearse Butler – Chairman

Membership update

• In January 2018, the Council of Governors approved the following changes

to the Trust Constitution in relation to the composition of the Council of

Governors:-

o Alignment to the Healthier Lancashire & South Cumbria STP,

Cheshire & Merseyside STP and Greater Manchester STP.

o Renaming of the Lancashire and Cumbria Public Constituency to

North West Counties Public Constituency.

o Removal of three Appointed Partnership Organisations.o Inclusion of University of Liverpool and University of Buckingham as

Appointed Partnership Organisations, who receive information from

the Council of Governors.

o Removal of one Public Governor vacancy in Lancashire and Cumbria

Constituency.

o Revised quoracy for formal Council of Governors meetings.

o Amendments to paragraphs 105, 114, 139, 164, 212, 219, 222, 223

and 224 in relation to voting.

Slight decrease in public membership and slight decrease in staff membership.

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Membership committee achievements 2017/18

• Continued to implement the Membership Strategy and monitor the Key

Performance Indicator targets relating to communications, young people,

volunteering, diversity and engagement.

• Achieved the 2019 target number of schools to become involved in the Youth Health Leaders Project (10) and continue to develop links with other

local schools and colleges.

Continued to hold seminars for members covering a range of health issues,

such as Patient Activation Measures, Why Social Inclusion Matters to Our

Mental Health and Epilepsy Awareness Day.

Further information relating to membership can be found at: www.bfwh.nhs.uk

Looking forward 2018/19

• To review the Membership Strategy

• To increase engagement with diverse communities

• To increase young people’s membership

• To review the presentations from clinical speciality groups for Membership

Seminars

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Council of Governors andBoard of Directors

Pearse Butler – Chairman

• There have been no elections to the Council of Governors during 2018 –

elections take place two out of every three years, therefore the next elections

will be held in May 2019.

• There has been one Governor resignation during 2017/18 from Philip

Hargreaves, Appointed Governor for the Institute of Directors, (and, since the

end of the financial year, from Steve Winterson, Appointed Governor for

Lancashire Care NHS Foundation Trust).

• Thank you to Peter Askew for his contribution as Lead Governor until the end of

his term of office in September 2017.

• Welcome to Sue Crouch and George Holden who were elected Lead Governor

and Deputy Lead Governor respectively in November 2017.

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• Special thanks to the following Directors who have either resigned or their term

of office has ended during 2017/18:

• Doug Garrett, Dr Malcolm McIllmurray and Nicky Ingham (and, since the

end of the financial year, Ian Johnson and Karen Crowshaw).

• Thank you to Pat Oliver (Director of Operations) who will be retiring at the end

of July after 12 years’ service at the Trust.

• Welcome to the following Directors who have joined the Board during the year:

• Keith Case and Steve Finnigan, Non-Executive Directors (and, since the

end of the financial year, myself as Chairman).

IntroductionRoy Fisher, Chair

NHS Blackpool Clinical Commissioning Group

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Then, now and beyond70 years of the NHS

What does the future hold?

Wendy Swift, Chief Executive, Blackpool Teaching Hospitals NHS FTDr Tony Naughton, Clinical Chief Officer, Fylde and Wyre CCG

Amanda Doyle, ICS Chief Officer and Chief Clinical Officer for Blackpool CCG

The early NHS

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Over the years1890

• Decision made to build a hospital in Blackpool.

– Prior to this patients had to be transported by

train to Preston Royal Infirmary or go to a

‘cottage hospital’ in Lytham.

1894

• On 25 August the first patient was admitted to

Blackpool Infirmary on Whitegate Drive.

– A little girl aged four who had fallen from a hobby horse.

1897

• Queen Victoria’s Diamond Jubilee and Blackpool

Infirmary renamed ‘The Victoria Hospital’.

1936

• Blackpool Victoria Hospital moved to a new site on

Whinney Heys Road.

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The treatment journey

1936-1948

Beds – 182

Wards – 10

Building Cost £165,000

Blackpool Victoria Hospital

2018

Beds – 820

Wards – 42

Current Value £133M

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Fylde Coast Hospitals over the years

Blackpool Victoria

South Shore

St Annes

Devonshire Road

Moss Side

Fleetwood

Lytham

Rossall

Whitegate Drive (Original)

Bispham

Wesham

Clifton

Glenroyd Maternity Unit

Milton Lodge Maternity Unit

1948 – Introduction of the NHS

1947 – 1974

• Lancashire NHS services managed by the Manchester Regional Hospital Board.

1967

• Accident and Emergency Unit built at Blackpool Victoria Hospital along with the

opening of a new outpatients department and day case theatre.

1974

• Manchester Regional Hospital Board abolished and replaced by Regional Health

Authorities.

1975

• Maternity Unit opened at Blackpool Victoria Hospital.

1981

• Gastroenterology Unit and Intensive Care Unit opened at Blackpool Victoria

Hospital.

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1993

• Blackpool, Wyre and Fylde Community Services Trust formed.

1997

• Blackpool Victoria Hospital Trust formed

2001

• Primary Care Trusts (PCTs) formed for commissioning and provision of

community services.

2007

• Blackpool, Fylde and Wyre Hospitals NHS Foundation Trust formed.

2010

• Blackpool Teaching Hospitals NHS Foundation Trust formed.

2012

• New 2012 Health and Social Care Act meant PCTs were abolished and replaced

by CCGs.

• Community Services transferred to Blackpool Teaching Hospitals NHS

Foundation Trust.

Changes in healthcare provision over the years

• Demography – Life Expectancy – Multiple Health Problems

• New Technology and Improved Diagnostic Equipment e.g. CT Scans; MRI

Scans; Endoscopy

• New Drugs and Treatments:-

– Leaches

– Thrombolysis for Stroke

– Heart attacks – Bed Rest – Clot retrieval/Stents/Bypass

• Reduced Length of Stay –

– Peptic ulcers – operations obsolete now

– Knee Replacements – No procedure - 1 week plus stay – Day Case

– Cataract operations – 1 week stay – now done as an outpatient procedure

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Move to Community Developments

Increase in numbers of GPs and treatments at home and in new community

primary care facilities:-

Whitegate Drive South Shore

Ashton Ansdell

Newton Drive Lytham

St Annes Freckleton

Moor Park Thornton

Cleveleys Broadway

Dock Street Morecambe

Heysham Garstang Medical Centre

Caton

Whitegate Drive Health Centre,

Whitegate Drive, Blackpool

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Moor Park Health and Leisure

Centre, Bispham

South Shore Primary Care Centre,

Lytham Road, Blackpool

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Lytham Primary Care Centre,

Lytham

Fleetwood health centre, Dock

Street, Fleetwood

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Urgent Care Centre, Blackpool

Victoria Hospital, Blackpool

New Main Entrance, Blackpool

Victoria Hospital, Blackpool

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Our staff

A big THANK YOU to the many thousands of

staff who work for the NHS now and have done over the past 70 years.

It is their hard work and dedication which makes

the NHS what it is today

Where are we now?

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Our challenges

• Ageing population.

• Blackpool most deprived town in England.

• Highest number of antidepressants prescribed.

• Staff shortages.

• More people living with multiple long term conditions.

Our successes

• New care home models.

• Excellent Care Quality Commission ratings for GP practices.

• Improved channels of communications and engagement within our communities.

• Good financial position.

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So, what next?

Neighbourhoods

Geographical areas across which

GP practices and other health

and care services work together

to ensure joined-up care tailored

to the needs of their local

populations (typically between

30,000 – 50,000 people).

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Integrated Care Pathways• End of life care• Intermediate Care

• Falls

Other Developments• Chronic Disease

Management reviews -

COPD• Self referral• Hospital discharge

Processes• Blackpool Carers Centre

• Empowering people & • Communities• Linked services - drug and

alcohol; mental health;

Governance• Multi Disciplinary Team

meetings• Neighbourhood, Operational

and Strategic meetings

Health & Wellbeing

support

Integrated NeighbourhoodHubs / Care

coordination

Triage

Assess

Signpost

Primarycare

Communityconsultants

CommunityMatrons / Nurses

RehabilitationTherapy

Mentalhealth

Socialworker

Voluntary & third

sector Empowering People &

Communities

Regulated Care

Children & families

Integrated Neighbourhood Team

Fylde Coast Integrated Care

Partnership (ICP)‘Healthier Fylde Coast’

NHS and local authorities

formally working together to

improve the health and care

of the whole Fylde Coast

population.

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Lancashire and South Cumbria Integrated Care

System (ICS)‘Healthier Lancashire and South

Cumbria’

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What people will see

Neighbourhoods

District General Hospitals

Lancashire and South Cumbria

Nationwide

Questions and answers

Pearse Butler, ChairBlackpool Teaching Hospitals

NHS Foundation Trust

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Closing remarks

Mary Dowling, ChairNHS Fylde and Wyre Clinical

Commissioning Group