Agenda item

The report informed the Commission on the Quality, Innovation, Productivity and Prevention (QIPP) System Reform Plan.  The QIPP plan is a coordinated response to the challenges of delivering increased quality across health and social care whilst at the same time responding to the financial pressures placed on the system by the downturn in the economy.  A Health and Care Transformation Board consisting of the Chief Executives of the following organisations, together with a GP commissioner representing Peterborough Clinical Commissioning Group had been formed.

• NHS Peterborough
• Peterborough City Council
• Peterborough and Stamford Hospitals NHS Foundation Trust
• Cambridgeshire and Peterborough NHS Foundation Trust
• Peterborough Community Services

A Director level Delivery Board with representation from the same organisations had also been established in order to coordinate the delivery of the required change and ensure that change in one organisation did not have unforeseen consequences in other organisations.

The following priority areas of work had been identified:

·         Children and Maternity

·         Acute Care

·         Planned Care

·         Mental Health

·         Health Improvement

·         Primary Care

·         Community and older people

·         End of Life

·         Learning Disabilities

Observations and questions were raised and discussed including:

·         You have stated that there is a financial gap of £100 million across several services.  What percentage does this equate to in the overall budget?  The figures quoted are Peterborough’s share of the nationally quoted £15bn-£20bn. There was currently a £330 million budget per annum and this budget would continue to rise over the next 3 years. The £100 million quoted represented the pressure that would occur if spending continued to rise as it had in past years and thus represented the challenge to be addressed.

·         Can you please explain what End of Life – reducing unnecessary referrals, un-planned and emergency admissions to hospital means?  This was about making sure that in the final period of a patient’s life being very clear of the patients needs and wishes e.g. making sure that if they wish to stay at home to receive treatment then their wishes were met.

·         How do you ensure that a quality service is still provided whilst providing prevention so that people lived longer, growth and cut backs?  There was a continual watch on any work that was undertaken to ensure that the quality of service and safety was not compromised. We are absolutely clear that quality and patient safety will not be compromised through this process and indeed there is considerable evidence that quality improvements very often yield productivity improvements.

·         Members were concerned about setting targets for the Ambulance Trust to ensure alternatives were in place to reduce conveyances to A&E, with more patients triaged/treated at the scene.   How could they ensure that the right treatment would be given at the scene?  It was important that the correct assessment and treatment was given on arrival at the scene and that it might not be appropriate to take the patient to hospital. There would be options available to the patient and the decision on the course of action would be made with the Ambulance Trust on what was safe to do.

·         The cost of running the NHS and PCT has gone up.  How are you going to reduce the administration costs?  The PCT were already engaged in a process of reducing its running costs through a reduction in management and administration staff.

·         The report mentioned productivity opportunities.  Can you explain what these are?  The main approach was through benchmarking.  Benchmarking indicators would be used to compare Peterborough with other systems to identify areas where there was evidence of things that work. This would enable the system to look at the cost effectiveness of certain areas of health and compare it with the National picture and then make an assessment as to where the local system should be on the efficiency curve.

·         You state in the report that stakeholders and the public and patients would be fully engaged in the proposals.  Do you intend to continue to have regular consultations?  There would be continuous engagement with any patients that would be affected by talking to the patient groups, their families and carers to help redesign a service.  If there were to be a full scale major change then a full consultation would take place.

·         What are you going to do regarding saving money in respect of the rising cost of utilities?  Members were informed that the PCT did have a Green Agenda but it had not been mentioned in the report.  Members requested further information regarding this.

·         Members wanted to know if there was a QIPP plan in place and how it would impact on Peterborough City Council financially.  Members were advised that there was no formalised QIPP Plan but as each idea evolved it would be reported back to the Commission in detail with any financial impact.  The NHS Peterborough had the responsibility of coordinating the process and part of that process was to ensure that something was not changed in one part of the partnership that impacted on another.

·         A member of the public addressed the Commission and voiced concerns about the reduction of staff and that there may not be enough trained staff to deliver the service going forward.   The model of delivery going forward was about changing the shape of care and not necessarily relying on admission to hospital.  There was a strong commitment to invest in the right staff for the future.

ACTION AGREED

The Commission requested that a regular report be provided on the development of the Quality Innovation Productivity and Prevention Plan (QIPP) and Reform Plan.