Agenda item
North East London Sustainability and Transformation Plan; Finance
Minutes:
Henry Black Chief Finance Officer, Tower Hamlet CCG and NEL STP Finance lead presented his paper outlining the financial case for change and the reasons for the creation of the STP.
He said that over the course of 2016, the health and care organisations across 7 boroughs in North East London (NEL) had worked together to develop a draft STP plan. The STP set out how the NHS Five Year Forward View would be delivered across the NEL footprint and how local health and care services would need to transform in order to ensure their financial sustainability and improve their clinical effectiveness.
He referred members of the Committee to pages 33- 36 of the agenda and explained in detail the various scenarios, projections and modelling undertaken by the STP and why it was important achieve financial sustainability.
Members of the Committee asked the following questions to which Mr Black responded:
Councilman Mead – Page 41 refers to making better use of infrastructure. Are you seeking to co-locate services and free up assets?
Yes, that is the aspiration. NHS needs to make better use of its assets and with the improvement in digital technology there may be less need for ‘bricks and mortar’ – buildings.
Councilman Mead – What will happen with the funding raised?
The capital receipts would be reinvested but we need to ensure we are utilising our asset stock correctly. The Naylor review stated organisations would retain capital receipts. We need a clear strategy on how we manage space and the number of departments we need. There is opportunity to lobby Parliament on how we access funding.
Cllr C Harrisson – What impact has the Bart’s Trusts deficit had on the STP and will you not be shifting the cost onto Local Authorities, who do not have funding, rather than make an actual saving?
We are mindful of this and hope to improve access to care at an earlier stage. The STP is trying to create an accountable care system and this is our direction of travel. Transformation of resources and a whole systems approach is required, which includes local authorities.
Barts Health Trust has the biggest deficit in the Country – but not in percentage terms. The government has acknowledged this and we are working to bring this down. This year the deficit was £82m but we are moving in the right direction to reduce this.
Denise Radley, Corporate Director for Health, Adults and Communities at Tower Hamlets added that the figures presented in the report were purely NHS finances and whilst Social Care was moving towards a more integrated model, there were gaps in finance which needed to be factored in.
ACTION: The STP to provide financial figures showing a more integrated financial model.
Cllr M Mustaquim – Page 33 states the population is set to grow by 18% in the next fifteen years. How are you going to bridge the gap in our borough?
The Clinical Strategy sets this out in more detail. We have modelled population increases in our predications and with the use of technology and care in a community/primary care setting, we can make savings were needed.
Cllr A Munn – 3.5 states £38m is for collaborative productivity. What sort of things does this involve?
The £38m is over the next five years and it will involve things such as a shared bank of staff, rather than the use of agency staff, by creating a more flexible workforce plus savings that can be made in back office functions such as HR and Finance. In addition various schemes can deliver savings such as the shared Pathology service which is being piloted.
Cllr S Masters – Has the impact of Brexit been factored into the financial modelling? Also the savings which you wish to make will come a lot later so population increases will impact on the STP.
The setting up of the STP was a requirement and we are mandated to have this process. We have mapped the population increases expected and will target areas but it is difficult to be precise. Each partner organisation has their own financial plan and have submitted the savings they intend to make. We are on track to achieve these saving for the 1st year.
With respect to Brexit, at this stage we cannot model for this, but we know it will have an impact. Demographics may change has a result.
Cllr B Hayhurst – At the end of December, we were told the hospital budgets would be signed off. Homerton received a greater amount of funding than other hospitals, for the same volume of work. Can you state what percentage decrease the other hospitals on the patch received?
The Bart’s Health Trust contract is supported by 12 CCG areas, some have made an investment and others have made a saving. In terms of volume funding is calculated using the national funding mechanism – each unit of work is set nationally i.e. on the national tariff. The Bart’s contract has seen a 2.5% increase in its funding.
The Chair, Cllr Clare Harrisson thanked Henry Black and NHS Representatives for their responses.
Supporting documents:
- item 5 cover sheet STP, item 6. PDF 52 KB
- Item 5_Sustainability and Transformation Plan paper INEL JHOSC, item 6. PDF 489 KB