Agenda item

- presentation by Chris Edwards, NHSR

Chris Edwards, Chief Operating Officer, NHS Rotherham, gave the following powerpoint presentation:-

 

White Paper – Equity and Excellence – Liberating the NHS - Headlines

-        Commissioning by GPs

-        Role of regulators, monitor and CQC strengthened

-        Reduce management costs 45%

-        Major ‘listening exercise’

 

Timeframe

-        April, 2011

o       Shadow NHS Commissioning Board

o       Shadow Health and Wellbeing Board

-        April, 2012

o       Healthwatch established (views of patients and carers)

o       Strategic Health Authorities abolished

-        April, 2013

o       PCTs abolished

o       GP consortia take up commissioning responsibilities

o       Local authorities responsible for health improvement

 

Regional/Sub-Regional

-        SHAs abolished April, 2012

-        Clusters – Andy Buck appointed as CEO

-        6 in Yorkshire and the Humber

o       Calderdale, Kirkless and Wakefield

o       The Humber (4 PCTs)

o       South Yorkshire and Bassetlaw

o       Leeds

o       Bradford

o       North Yorkshire and York

 

Cluster Responsibilities

-        Performance: safety, quality, finance requirements of the NHS Operating Framework

-        Efficiency:  QIPP to improve delivery

-        Transition:  to new NHS arrangements described in the Health and Social Care Bill subject to parliamentary approval.  Development of GP commissioning consortia establishing commissioning support organisations and transferring public health responsibilities to local authorities

 

Local Picture – NHS Rotherham

-        Abolition of NHS Rotherham April, 2013

-        New management structure and governance arrangements to manage transition

-        Establishment of GP consortia in shadow form

-        Complete ‘Shaping our Future’ – transfer of RCHS – TRFT, RDaSH, Social Enterprise, Hospice

 

NHS Rotherham – Current Position

-        Meeting financial targets

-        Reduce running costs by 45% (2 rounds of VR completed)

-        Performance currently judged as ‘good’

-        Good quality secondary care (all foundation trusts)

-        Good reputation

 

Single Integrated Plan

-        Challenging next 4 years

-        Plan assumes growth in allocations of 2.2% each year 2.8%

-        Providers have to make 4% efficiencies (approximately £12M a year, £48M over 4 years)

-        But we still require further system efficiencies of £24.5M over 4 years

-        Total efficiencies required - £73M over 4 years

 

The Future

-        GP consortia development

-        £73M savings across health services for Rotherham patients required over 4 years

-        Establishment of NHS commissioning support bodies

-        Development of Healthwatch and Health and Wellbeing Boards

-        Public health transfer to RMBC

 

Discussion ensued on the presentation with the following issues raised/clarified:-

 

§         The Government had announced a ‘pause’ on the proposals, which meant that the way forward was uncertain -  NHS Rotherham was trying to make sure it was in a position to react/adapt to whichever Policy developed

 

§         In respect of Public Health, the detail on the devolvement of budgets had not been determined as yet but it was expected that funding would be transferred from the NHS to Social Care to cover the elements of the service that were being transferred

 

§         Public Health would transfer to 2 bodies; Public Health England would take responsibility for the research element and public health functions such as health improvement and health promotion would transfer to the Local Authority.  The funding currently received by the NHS would transfer to the Council

 

§         A 45% reduction in management costs would undoubtedly increase risk.  The cluster arrangements would work when gaps appeared and would work together to plug them

 

§         Over prescription of medicines was 1 of the top 3 programmes

 

§         There were no specific efficiency programmes relating to the older people’s services.  The services in the hospital would be subject to 4% efficiency each year

 

§         Patients should not notice any difference in service due to the clustering of GPs.  The intention was to manage and restrict growth and not to reduce services

 

§         There was the risk of waiting lists growing but it was the aim to manage GP referrals at 1% a year. The GPs felt that there a number of the referrals could be managed differently

 

§         There was no reason why a representative of the GP Consortia could not attend the Scrutiny Panel

 

§         It was the intention to have high level engagement with the voluntary sector and involve them wherever possible

 

Resolved:-  That Chris be thanked for his informative presentation.