NHS South Norfolk CCG – Financial context and QIPP Programme

1. NHS South Norfolk CCG – Financial context and QIPP Programme James Leeming Interim Turnaround Director

2. Local challenges: • Populations are living longer • Living with long term conditions • Demands on access to care across health and social care is increasing • The rate of lifestyle-related health conditions continues to increase • NHS faces frontline recruitment issues, particularly in Primary Care

3. Financial context: • 2016-17 budget – total budget £272.6m • Of which: • £139m is spent on acute (hospital-based) services • £33m is spent on community-based services • £23m is spent on mental health services and services for people with learning disabilities • £42m is spent on Primary Care (primarily prescribing) • £20m is spent on Continuing Health Care • £5m is allocated towards the running of the CCG

4. QIPP (1): • ‘QIPP’ – Quality, Innovation, Productivity and Prevention • Transformation initiative introduced in 2010 • Identify efficiencies within commissioning to reinvest in frontline care • ‘Thinking differently’ about commissioning, and putting local patients at the forefront of commissioning decisions • All CCGs are tasked with developing QIPP Programmes to drive efficiency locally

5. QIPP (2): • NHS England requires CCGs to achieve a 1% surplus • Since the its inception in 2013-14, the CCG has set ambitious QIPP plans to achieve financial balance, as well as the required 1% surplus • The CCG has delivered its QIPP plans each year, but has not always delivered a 1% surplus • This has created an underlying deficit in the CCG’s budget of £8m • The CCG’s 2016-17 QIPP programme is £13.9m to reduce this deficit to £2.8m

6. QIPP (3): • Methods of delivering QIPP plans: • Transactional: Financial, contractual and performance-related details • Transformational: Strategic, pathway changes, and changes in national policy • Relational: Historic relationships, communication, local knowledge and experience