Operational Plan 2015/16
Mick O’Donnell, Head of Strategy
“Working together to promote high quality,
affordable healthcare”
Summary of Operational Plan 2015/16
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National context
Financial Picture
Priorities for Service Change/Improvement
Key Themes for 2015/16
Reviewing wider picture 2 years on
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National Context and Process
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NHS Planning Requirement
2 Year Operational Plan 2014/15 – 15/16
NHS England Five Year Forward View (5YFV)
Changing - and emerging environment
Builds on existing plan and ambitions
Draft submission to NHS England
Positive NHS England WM feedback
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Informing R&B CCG Operational Plan
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Future Service Provision: Strategic Aims
(From 2014/15 Operational Plan; page 8)
• A greater emphasis on prevention and self care.
• An increase in the amount and range of care available in the
community and in primary care.
• A corresponding reduction in the amount of hospital in patient care.
• A reduction in the amount of people seeking treatment at A&E and
requiring emergency/non elective admissions.
• An increase in the amount of treatments delivered as day cases
• An increase in the level and range of alternatives to hospital
treatment available
• An increasing focus and investment in mental health and well being
services
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Financial Plan for 2015/16
The following highlights the key features of our financial plan
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Resource allocation - £194m
c. £1,150 per head of population
Plan to deliver
– 1% surplus
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0.5% contingency
1% Strategic Change Reserve
For mental health services - increase of 2.1% above 2014/15 (or c. £0.5m)
For acute services - increase of 0.1% (or c. £0.1m)
Better Care Fund – allocation of £10m
QIPP target of £5.8m – 2.9% of total
10% reduction in management costs has been introduced in 2015/16
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Redditch & Bromsgrove CCG: Expenditure by Care Sector 2013/14 – 2014/15
2014/15 Forecast Spend as % of Total
£000
2013/14 Expenditure as % of Total
£000
26,992, 15%
28,057, 15%
13,270,
7%
14,443, 8%
17,009,
10%
100,038,
56%
102,812, 56%
16,056, 9%
20,655, 12%
22,346, 12%
2015/16 Planned Spend as % of Total
£000
29,151, 16%
Acute
14,591, 8%
Mental Health & LD
102,946, 55%
22,956,
12%
17,142, 9%
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Community
Local Authority & Joint
Commissioning
Primary Care
Redditch & Bromsgrove CCG Expenditure: Movements within Care Sector 2013/14 - 2015/16
30,000
28,000
26,000
24,000
£000
22,000
20,000
18,000
16,000
14,000
12,000
2013/14 Expenditure
10,000
Mental Health & LD
Community
Local Authority & Joint
Commissioning
Area of Expenditure
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Primary Care
2014/15 Forecast Expenditure
2015/16 Planned Expenditure
Review of High Level Strategic performance
2013/14 – 14/15
• 1.4% reduction in non-elective admissions – very different to national
picture
• 3.5% increase in all elective episodes at WHAT:
– c. 4% decrease in elective admissions
– c. 10% increase in day case treatments
• 5% increase in referrals to secondary care
• 4.8% increase in 1st outpatient attendances
• Improved access rates for psychological therapy (though below national target),
and dementia, and improved recovery rate for those receiving
psychological therapy (both above national target)
Non – elective admission rates: National
comparisons (Annual admissions per 1000 population)
2013/2014
Redditch and
Bromsgrove CCG
CCG Peer Group
England
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2014/2015
% Change
101.1
99.8
-1.4%
98.7
101.7
2.9%
100.4
102.8
2.3%
Non elective admission rate for R&B residents is now below the national and CCG peer group
average
R&B has seen a reduction in non elective admissions in the 2 years of its existence
This is at a time when nationally admission numbers and rates have risen
This change is likely to have resulted from the range of initiatives implemented by the CCG to
reduce urgent admissions
If R&B CCG had the same rates as its peer group CCGs we would have expected a further c.320 of
our residents to have been admitted as emergencies ( or a further c.510 admissions for the national average)
Elective Care
2013/2014
2014/2015
% Change
Day Cases
17,051
19,069
11.8%
In Patients
4,411
4,252
- 3.7%
21,462
23,321
8.6%
79%
82%
Total Electives
Day cases as % of In
Patients
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An additional c.2,000 R&B residents were treated electively in secondary care in
2014/15
There were 159 fewer admissions as the great majority of these were treated as day
cases. This is less disruptive to the patient and reduces pressure on hospital beds and
staffing
During the same period referrals to secondary care rose by c. 2,300 and 1st Out
Patient Attendances by c.2,000 (+ c. 5% growth)
The RTT target for admitted patients was not achieved at WHAT in 2013/14 or 14/15
Key areas of focus for 2015/16
• Admission, A&E avoidance schemes e.g. Clinical Navigation Unit, Virtual
Ward etc
• Continued implementation of Urgent Care Strategy
• Support sustainable acute service model
• Mental Health & Wellbeing – redesign Primary Care mental health services
• Joint -commissioning of primary care
• New models of care – Five Year Forward View
• Continued integration of services
• Development of co-production
• Delivery of NHS Constitution Standards – esp A&E, RTT, IAPT
Future Service Provision: Progress on
Strategic Aims (From 2014/15 Operational Plan)
• A greater emphasis on prevention and self care
• An increase in the amount and range of care available in the community
and in primary care
• A corresponding reduction in the amount of hospital in-patient care .
• A reduction in the amount of people seeking treatment at A&E
and requiring emergency/non elective admissions
• An increase in the amount of treatments delivered as day cases
• An increase in the level and range of alternatives to hospital treatment
available
• An increasing focus and investment in mental health and well being
services
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