Agenda item

(To receive a report from the Lincolnshire Sustainability and Transformation Partnership (STP) which provides information on the operational efficiency aspects of the Lincolnshire STP.  Andrew Morgan (Chief Executive, Lincolnshire Community Health Services NHS Trust) and Darren Steel (Portfolio Director (Operational Efficiency) will be in attendance for this item)

The Chairman welcomed to the meeting Andrew Morgan, Chief Executive, Lincolnshire Community Health Services NHS Trust, Darren Steel, Portfolio Director (Operational Efficiency), STP System Delivery Unit and Kerryn Marriott, CCG Prescribing Programme Lead.

The report provided information on the operational efficiency aspects of the Lincolnshire Sustainability and Transformation Partnership (STP).  The report also provided details of the main efficiency schemes undertaken on a system-wide basis as well as reference to those managed individually within organisations.

The Committee was advised that the system approach to the efficiency agenda was focussed around areas developed in the original STP and variations highlighted in the Carter Report and the NHS RightCare initiative.  Details relating to the Carter Efficiency Schemes were detailed on pages 25 to 27 of the report; and information relating to a number of schemes that had been implemented to address variations in prescribing costs and implement the efficient management of drugs alongside a number of other prescribing initiatives was shown on pages 27/28.

It was highlighted that the 2018/19 priorities currently under development were:-

·         A focus on shared service of back-office functions;

·         Temporary workforce solutions;

·         Countywide prescribing initiatives;

·         Estates rationalisation; and

·         Pharmacy and prescribing.

In conclusion, the Committee was advised that the more collective approach for 2018/19 should lead to better system management across Lincolnshire NHS, collective performance monitoring and clearer reporting of system savings.  It was highlighted that the system efficiency target remained challenging and that further work was required to continue to develop and implement new specific schemes.

During discussion, the Committee raised the following issues:-

·         Efficiency savings – The report presented advised that the original five year STP had outlined an operational efficiency requirement for the Lincolnshire NHS of just over £60m by 2020/21.  The Committee was advised that the Operational Efficiency strand was just one element of the STP.  Other elements of the STP included clinical service redesign.  There was an aim that the Lincolnshire health system would be in financial balance by 2021;

·         The impact of patients going out of county for treatment – It was noted that patients were entitled to exercise choice and for many patients an out of county provider would be their nearest provider; CCGs would aim for the best outcomes for patients within the money available to them;

·         The importance of ensuring that individuals get registered with a GP as resources followed registration;

·         Consultation – Some concern was expressed as to the lack of formal consultation been undertaken to date in respect of the STP.  The Committee was reassured that consultation was not being bypassed, but that operational efficiencies were things that the NHS was getting on with day to day, as any other organisations would do with internal efficiencies.  In respect of any proposals for Clinical Services redesign, these would be subject to public consultation once finalised;

·         Shared low level procurement – Confirmation was given that there was already collaboration between the three provider trusts; which would see a reduction in management fees;

·         Some members welcomed the work being done to improve the prescribing and the management of drugs;

·         A question was asked as to when the three provider trusts would become one?  The Committee was advised that there was no plan for this, as at the moment the three trusts were concentrating on what was required to deliver the integrated services and looking in to the financial situation;

·         Lincolnshire CCG structure – Some members of the Committee had learned that the Lincolnshire CCGs were currently in the process of developing a single management structure across the four organisations;

·         Hospital medicines optimisation – It was noted that United Lincolnshire Hospitals NHS Trust was looking at how to best manage medicines as part of its own plans, as part of the Pharmacy transformation programme; and

·         Workforce efficiencies – The Committee was advised that a lot of work was going on to reduce reliance on temporary staff.  One member requested information as to how many non-clinical managers were paid in access of £50,000.  The Committee was advised by representatives that this information was not available. 

The Committee agreed that going forward there needed to be an update on the STP as more information became available.  The Committee agreed to the establishment of a small working group to meet for a maximum of three meetings to receive updates as and when developments occurred.

RESOLVED

1.    That the report on the progress on delivering the operational efficiency aspects of the Lincolnshire STP be received.

2.    That a small working group be established comprising of Councillors C J T H Brewis J Kirk, C S Macey and M A Whittington to consider updates relating to the operational efficiency aspects of the Lincolnshire STP as they become available.