Agenda item

This report introduces a range of Vale of York Clinical Commissioning Group (CCG) issues requested by the Committee, namely the CCG 2017/19 Operational Plan (Annex 2); Delayed Transfers of Care (DTOC); Continuing Health Care (CHC) and the Partnership Commissioning Unit (PCU) (Annex 1).

Members received updates on issues that been had requested from the Vale of York Clinical Commissioning Group such as the 2017/19 Operational Plan, Delayed Transfers of Care, Continuing Health Care and the Partnership Commissioning Unit.

In attendance to present these updates were the Accountable Officer, the Head of Planning and Assurance, the Interim Executive Director of Joint Commissioning and the Chief Nurse from the Vale of York Clinical Commissioning Group. The Director of Operations for York and Selby from Tees, Esk and Wear Valleys NHS Foundation Trust accompanied them to present the updates and answer Members questions.

2017/19 Operational Plan-Accountable Officer

The Accountable Officer informed the Committee that he could not present the Operational Plan, as the CCG was still under Legal Direction from NHS England which meant that they needed to wait to receive feedback before sharing the Operational Plan.

It was confirmed that although the Vale of York CCG had a financial deficit of £24.1m at the end of the year in 2016/17 this had now been revised to a forecast deficit of £28.1m.  They predicted that within the plan the percentage spend was divided in the following way;

·        60% on acute care

·        25% on Continuing Health Care

·        15% on Mental Health and other issues (legacy issues not those with the current provider)

In order to secure the acute cost, a position had been agreed with the hospital to work together to contain the cost. This position would be agreed by 31 January. The Operating Plan would not be made public until March.

Members were informed that there were three localities from which the Operational Plan would be delivered were; the northern, city and central and southern areas of the Vale of York area.

It was felt that the new localities model reflected a realisation that the ‘one size’ fits all approach previously adopted had not worked. There would be a benefit to come together as these areas had distinct populations and so priorities in these areas could be bespoke, along with efficiencies that needed to be made alongside the financial deficit.

One Member asked about whether consideration would be given to how NHS building stock could be used. It was noted that to reduce costs, it was necessary to give encouragement to providers to design services around care in general practice, or nearer to people’s homes. A challenge still remained that the buildings themselves often inspired loyalty.

Delayed Transfers of Care (DTOCs)-Interim Executive Director of Joint Commissioning

The Interim Executive Director of Joint Commissioning informed Members that there had been a difficulty in providing mental health beds in the city earlier in the year due to a change in the method of reporting. Due to a change in provider to Tees, Esk and Wear Valleys (TEWV) NHS Foundation Trust the method in reporting had become more rigorous and this had led to a leap in the figures.

It was felt that the DTOC figures were only a proxy measure and did not give the full picture. Further joint work was needed and it was noted that Continuing Health Care (CHC) assessments were also often not measured alongside DTOCs. 

Continuing Healthcare (CHC)- Chief Nurse, Vale of York Clinical Commissioning Group

Members were informed that there was an increasing cost in providing CHC. There was however, no one waiting in hospital for CHC above the timeframe.

Partnership Commissioning Unit

It was noted that staff consultation on service lines for commissioning arrangements would be taking place on 1 February, but no further details could be released.

The Accountable Officer confirmed to the Committee that he would show in a future report further details of the £28.1m deficit. The CCG would set out with partners that the allocation they had been given by NHS England would not exceed the cost of care. He stated that subject to availability, a report would be prepared in time for the March Committee meeting.

Resolved: (i) That the information provided in the report and its annexes, and at the meeting be received and noted.

                 (ii) That a report be received by the Committee in March to include further details on the Vale of York CCG deficit.

Reason:       To continue to inform the Committee of the Vale of York CCG Improvement Plan and related issues.