10/07/2018
1
Fylde Coast Health Event and
Annual MeetingsThursday, 5 July 2018
WelcomeRoy Fisher, Chair
NHS Blackpool Clinical Commissioning Group
10/07/2018
2
NHS Blackpool CCGAnnual General Meeting
2017/18
Apologies for absence
10/07/2018
3
Minutes of the previous meeting held on 21 September 2017
Annual report and accounts 2017/18
Andrew HarrisonChief Finance Officer
10/07/2018
4
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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5
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
10/07/2018
6
Apologies for absence
Minutes of the previous meeting held on 21 September 2017
10/07/2018
7
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
10/07/2018
8
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
10/07/2018
9
Blackpool Teaching Hospitals NHS Foundation Trust
Annual Members Meeting
2017/18
Apologies for absence
10/07/2018
10
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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11
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
10/07/2018
16
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
10/07/2018
18
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