Agenda item

To consider the mid-year performance of the Blackpool Clinical Commissioning Group for 2016-2017 (April 2016 – September 2016).

Mr David Bonson, Chief Operating Officer, Blackpool Clinical Commissioning Group presented the Clinical Commissioning Group’s mid-year performance for 2016-2017 (April 2016 - September 2016).

He explained that the Clinical Commissioning Group purchased various services provided by other organisations and so shared performance responsibility. National reporting requirements underpinned by key performance measures covered a range of access to service areas which included referrals from GPs to hospital cancer appointments, time taken to get treatment in accident and emergency wards, access to psychological therapies and ambulance response times to get to incidents.

David Bonson added that NHS England had introduced a new Improvement and Assessment Framework which allowed each clinical commissioning group to be benchmarked against national averages to identify potential good practice and areas needing improvement. 

He highlighted areas where performance was below target and needed improving and where good progress had been made.

David Bonson explained that the target for accident and emergency waiting times from arrival to being discharged after treatment was for 95% of patient visits to be achieved within four hours. The mid-year outcome had dropped to under 90%. Accident and emergency waiting times were nationally challenging and winter months had a knock-on impact for the rest of the year with ongoing efforts to regain performance.  He added that historically Blackpool rates had been above 95% but recent pressures had been severe.

He referred to performance being below target for securing first appointments for cancer treatment within 62 days of referral from a GP. There were various reasons for delays including patient choice.

The Chairman noted that excellent progress had been made in some areas. He referred to the headline targets of accident and emergency turnaround times for treatment, access to cancer treatment services (first treatment following referral) and the missed target for ambulances responding to all ‘red’ (serious) incidents within 19 minutes. Immediate life-threatening incidents required faster responses times but those targets were being met. He noted that the three headline targets had been missed the previous year and queried if they had been set too high.

David Bonson agreed that there was a risk of targets not being realistic in view of the same demand pressures and complexities of cases occurring nationally. Particular concerns were delays in accident and emergency having a ‘knock-on’ impact on other parts of the health system. Most pressures were at the acute services ‘front-door’ and were being managed but nationally acute services were under extreme pressure. He referred to the £10m funding being given by the NHS Improvement Agency to support the work, and efficiencies required, of Blackpool Teaching Hospitals. The improvement funding would help alleviate some of the accident and emergency pressures.

The Committee enquired about access to psychological therapies and recovery rates being below target. David Bonson clarified that access rates had improved but full recovery was more challenging in view of the complex conditions people had. Counselling ‘talking’ therapies were a common support mechanism.

The Committee enquired about the 62 day first cancer treatment (following GP referral) being below target and whether staff shortages were having an impact. David Bonson confirmed that there were no staff issues but that the small number of patients involved meant that figures could easily present a skewed picture. Two delayed cases had been due to patient choice. Another two cases had been referred to Blackpool Teaching Hospitals but the missed target was reported as belonging to Blackpool as the end service provider.

In response to questions, Mr Roy Fisher, Chairman, Blackpool Clinical Commissioning Group was able to confirm that he was not aware of any proposed tendering of local health services to be run by the private sector.

The Committee agreed:

1.             That future performance reports should contain actual numbers and percentages for proper context as well as explanatory commentary.

2.             For the next performance report to include patient satisfaction data, quality of care figures and financial budget monitoring.