EPB59/941
Title of Report:
Prepared By:
Chief Executive’s Report
Simon Gilby, Chief Executive
Sponsor:
Action Required:
The Board is invited to note the content of the report
Purpose of Paper:
To ensure the Board is informed of key national local
developments.
Key Messages/Issues:
The Board’s attention is drawn to the following:




Publication of national expectations in respect of financial
management and accountability
System planning is progressing according to required
timescales
Publication of CQC inspection report on CWPT
MERIT Vanguard continues to progress as planned
Links to Strategic Objectives:
To deliver an exceptional patient experience first time, every time
To provide excellent care, ensuring effective, person-centred clinical
outcomes
To be an employer for whom people choose to work
To be an active partner, always ready to improve by working with others
To be an efficient organisation providing excellent services
Resource Implications, if
any:
There are no specific resource implications.
Links to BAF:
To highlight areas for consideration that may provide an additional
source of assurance and highlight any alignment with the BAF.
Has an Equality Impact
Assessment been
completed?
N/A
Paper History:
This is a monthly report presented directly to the Board
PB59 26 July 2016
Page 1 of 7
EPB59/941
Report to Public Trust Board 26 July 2016
Chief Executive’s Report
1.
Overview
1.1
This reports draws to the attention of the Board, key issues of national and
local importance and policy development that may have relevance for
Coventry and Warwickshire Partnership NHS Trust (CWPT). Further detail for
reference is included in the horizon scan document attached at Appendix A.
2.
Secretary of State for Health
2.1
It has been announced that Jeremy Hunt will remain as health secretary in the
reshuffled cabinet established by the new Prime Minister. Responding to the
news of his reappointment, NHS Providers chair Dame Gill Morgan said: “I
congratulate Jeremy Hunt on his reappointment as secretary of state for
health at a time when the health and care sector faces unprecedented
challenges. Mr Hunt has always maintained a relentless focus on the quality
of care. We now need to return the provider sector to financial balance and
change how we deliver care to make sure services wrap around the needs of
patients.”
2.2
A full list of ministerial appointments as they relate to health and social care
has been made available to board members under separate cover.
3.
Financial performance
3.1
NHS England and NHS Improvement published on 21 July 2016
‘Strengthening Financial Performance and Accountability 2016/17. The
document is aimed stabilising NHS finances, setting out the agreed legal
responsibilities of individual NHS bodies to live within the funding Parliament
has decided should be available to the NHS this year. Specifically, it confirms
action dramatically to cut the annual trust deficit, and to sharpen the direct
accountability of trusts and CCGs to live within the public resources made
available by Parliament and the Government in 2016/17. Individual
accountabilities will be supplemented by the Sustainability and Transformation
Plans now being developed in communities across England, which will set out
the wider, shared action they will take together to ensure broader
improvement on health, care, and financial sustainability to 2020.
3.2
The document sets out a series of actions designed to support the NHS to
achieve financial sustainability and improve operational performance,
including trust-specific incentives linked to agreed organisation-specific
published performance improvement trajectories. Each trust and CCG will
PB59 26 July 2016
Page 2 of 7
EPB59/941
have an agreed financial control total which represents the minimum level of
financial performance, against which their boards, governing bodies and chief
executives must deliver in 2016/17, and for which they will be held directly
accountable. There are new intervention regimes of special measures which
will be applied to both trusts and CCGs which are not meeting their financial
commitments.
A briefing prepared by NHS providers on these plans is attached at Appendix
B.
3.3
There are no implications for this Trust in the expectations set out in the
document that we were not aware of. It does however emphasise the
importance of a continued focus on performance against objectives, including
financial targets and it will be important to assess our anticipated position
against the proposed single oversight process that NHS Improvement will
apply to trusts (subject to completion of current consultation – see below).
There is an expectation that we take forward recommendations from the
Carter efficiency reviews, including in relation to back office functions. The
Sustainability and Transformation Plan (STP) provides a key context, and
there will be an increasing expectation that we are performance managed as
a system as well as individual organisations. We should continue to have
regard for the performance of partner organisations and our role in supporting
them. New ratings have been published today, as part of this process, on
how CCGs discharge their responsibilities. 10 CCGs are rated ‘outstanding’, a
further 82 ‘good’, 91 (including South Warwickshire and Warwickshire North
CCGs) were found to ‘require improvement’. NHS England is taking action
with 26 CCGs rated as ‘inadequate’. These include Coventry and Rugby
CCG.
4.
Proposed single oversight framework is significant change for all NHS
providers
4.1
NHS Improvement is consulting on its proposed approach to overseeing and
supporting NHS foundation trusts and trusts. The single oversight framework
sets out the main areas of focus in overseeing trusts; how information will be
collected from trusts; how potential concerns with a trust’s performance will be
identified; and how the trust sector will be segmented according to the level of
challenge each trust faced. The framework also sets out how NHS
Improvement will identify where trusts may benefit from, or require, support in
the key areas of quality of care, finance and use of resources, operational
performance, strategic change and leadership and improvement capability.
The trust’s arrangements for responding to this consultation are addressed
under a separate agenda item.
PB59 26 July 2016
Page 3 of 7
EPB59/941
5.
Coventry and Rugby and Warwickshire North CCGs
5.1
Further to recent reports on proposed exploration of a closer working
relationship between NHS Coventry and Rugby Clinical Commissioning
Group and NHS Warwickshire North Clinical Commissioning Group, based
around looking at ways of working more effectively and efficiently together, it
has now been announced that:
•
•
Dr Steve Allen has decided to step down from his role as Chief Clinical
Officer of Coventry and Rugby CCG, and that Andrea Green, the
current Chief Officer at NHS Warwickshire North CCG, will take on the
role of joint Chief Officer of both CCGs.
Dr Allen will become the Clinical Director of Coventry and Rugby CCG,
to continue the excellent clinical leadership he has provided to date.
6.
Efficiency review
6.1
It is being reported that, as a follow up to the report into the acute sector, Lord
Carter of Coles is to start the promised review of the operational productivity
and performance of community and mental health trusts in September 2016.
The review team now falls under the management of NHS Improvement is
expected to undertake a year-long review following a similar pattern to his
work in the acute sector. Lord Carter has reported that conversations have
already been held with some providers, but the trusts for the review pilot have
yet to be identified. The review team is looking for trusts of different sizes, with
varying relationships and different locations. The expectation is that the
review will look at all aspects of spend, including local variance as a result of
CCG commissioning decisions and differences in approach to specification.
7.
Sustainability and Transformation Plan
7.1
The Sustainability and Transformation Plan (STP) process for Coventry and
Warwickshire continues to progress to required timescales and the required
initial submission was made on 30 June. Fuller details are provided in
separate strategy reports to Board. The size of the financial challenge for
commissioners, including the local authorities, and provider trusts across the
footprint remains challenging and the STP represents the framework within
which new models of care need to be implemented to ensure a local,
responsive service within resources available. There is explicit agreement that
the focus is, and should be, on developing appropriate care models and care
pathways, not on organisational form. The initial next stage is a review
meeting, chaired by NHS England’s Chief Executive, with partner organisation
chief executives
PB59 26 July 2016
Page 4 of 7
EPB59/941
8.
Greater Manchester
8.1
As part of a greater drive in Greater Manchester to integrate health and social
care services, it has been announced that Manchester’s three CCGs are to
share commissioning powers over all services, worth £1.2bn, with Manchester
City Council as part of a drive to improve integration of health and social care.
A joint commissioning executive was established on 1 June, responsible for
joint commissioning decisions, including the chief officers of South
Manchester, North Manchester and Central Manchester CCGs and the
strategic director of adult social services. It is chaired by Ian Williamson, the
chief officer of Central Manchester CCG and senior responsible officer for the
Healthier Together programme, which includes all 12 Greater Manchester
CCGs. It is accountable to the boards of the three CCGs and reports to the
joint commissioning board. However, Deloitte has been commissioned to
carry out an independent appraisal of the possibility of creating a more formal
structure with responsibility for joint commissioning.
9.
Care Quality Commission (CQC)
9.1
The CQC’s report on its inspection of Coventry and Warwickshire Partnership
NHS Trust was published on 12 July 2016. The report rates the trust overall
as ‘requiring improvement’. The detail in the report and the process for
developing the trust’s response will be addressed in separate reports to the
board.
9.2
A stakeholder summit is planned for 28 July at which the CQC will present its
report and the trust will have the opportunity to comment on the report and the
action it has taken or is proposing to take to address areas identified for
improvement. A full action plan is then required by the CQC by mid-August.
Initial contact has been made with the health oversight and scrutiny
committees of Coventry and Warwickshire councils and arrangements are in
hand for the repot to be presented to each committee.
10.
Five Year Forward View for Mental Health
10.1
NHS England has published an implementation plan for the Five year Forward
View for Mental Health presented as ‘roadmap’ which provides detail on how
services will reach a million more people a year by 2020/21. It is intended as a
blueprint for the changes that NHS staff, organisations and other parts of the
system can make to improve mental health. The document sets out by
financial year what money is due to be made available, identifying what is part
of CCG baselines, what is part of STP monies, and what is national
programme money. The report also shows how the workforce requirements
will be delivered in each priority area and outlines how data, payment and
other system levers will support transparency. A briefing prepared by the
Mental health Network is attached at Appendix C.
PB59 26 July 2016
Page 5 of 7
EPB59/941
10.2
CWPT is leading on the mental health element of the Coventry and
Warwickshire STP and the core elements of the Five year Forward View are
reflected in the Coventry and Warwickshire STP. This implementation plan
will help develop the detail to underpin this commitment, including supporting
analysis of levels of investment against national expectations.
11.
MERIT Vanguard programme
11.1
The MERIT programme is progressing broadly against expected timescales.
The agreed quarterly report for boards is attached at Appendix D, and this
provides an overview of the programme alongside more detail reports on each
work stream. Funding for 2016/17 has been allocated, via CCGs, and is
available for draw down.
11.2
As part of the funding agreement we are required to carry out evaluation of
the programme, the first element of which was to identify and submit the top
10 to 20 Metrics which will be used as our national indicators. The evaluation
group through the work streams identified and refined a range of metrics
which have been submitted. Feedback is awaited. A copy of the draft metrics
has been made available to board members under separate cover.
11.3
NHS England’s first Quarterly Review took place on 13 July and was positive.
A number of external presentations have been made to share learning and
ambitions, and links are being developed with the MH Commission
established by the West Midlands Combined Authority. Ian Dodge, National
Director for Commissioning Strategy (NHS England) is visiting, at his request,
the programme on 22 July. A Patient and Carer event is being held on 18
August to support the work streams with involving patients / carers and
developing how co-production will work. The activities will be led by the
Patient Experience Leads for our organisations.
11.4
Since the last report the non-executive oversight group has met and a verbal
report of this will be available at the meeting if required.
12.
National Guardian for the NHS
12.1
The CQC has announced that Dr Henrietta Hughes, currently the Medical
Director for NHS England’s North Central and East London region and a
practising GP, has been appointed as the new National Guardian for speaking
up freely and safely within the NHS. Dr Hughes selection for appointment was
made by a panel consisting of representatives of the Care Quality
Commission (CQC), NHS England and NHS Improvement, as co-sponsors for
the National Guardian’s Office, as well as the Patients Association and Sir
Robert Francis QC, whose independent review from February 2015 into
‘whistleblowing’ across the NHS instigated the creation of the National
PB59 26 July 2016
Page 6 of 7
EPB59/941
Guardian role. Dr Hughes has over twenty years of experience across
primary, secondary and community healthcare.
13.
Junior Doctors contract
13.1
Since the last board report on this issue, the BMA has just announced that
their members have rejected the proposed new contract for junior
doctors. The Secretary of State made a statement to the House of Commons
outlining his intention to introduce the new contract in August 2016, with
doctors transitioning onto the new terms on a phased basis from October
2016. A timeline setting out this implementation plan is due to be published
shortly. Coventry and Warwickshire Partnership NHS Trust, following an
internal recruitment process, has appointed to the guardian of safe working
hours role.
Simon Gilby
Chief Executive
July 2016
PB59 26 July 2016
Page 7 of 7