Board Meeting in public of NHS England, 24th September 2015
NB The notes below are only items of particular interest – not a summary of the agenda.
CCG Co-commissioning: Nearly 150 CCGs will be co-commissioning primary care either through delegation or collaborative commissioning arrangements.
Personalised medicine: This is a move away from “one size fits all” approach to the treatment of patients with a particular condition, to one which uses emergent approaches in areas such as diagnostic tests, functional genomic technologies, molecular pathways, data analytics and real time monitoring. Inherent to any Personalised Medicine Strategy is the recognition that many of the currently available drug treatments are only effective in between 30% - 60% of treated individuals. Adopting a personalised medicine approach will allow appropriate intervention for the individual, reducing costs and preventing adverse reactions in those who will not respond to certain treatments. This shift is already underway. The NHS has contributed to the 100,000 Genomes Project and supports the NHS in becoming one of the most advanced healthcare systems in the world in relation to genomic medicine. This includes improved prevention based on underlying predisposition, earlier diagnosis of disease, more precise diagnosis, and effective treatments.
A healthy workforce: The Five Year Forward View commits the NHS to setting a national example in supporting its own staff to stay healthy. NHS staff absence due to poor health is estimated by Public Health England to cost £2.4bn a year - around £1 in every £40 of the total budget. Staff absence is linked to unsafe care of patients and poorer outcomes. A large number of initiatives are being introduced to advance this policy – from yoga, weight management and physiotherapy, to including fruit in discounted meal deals.
Finance: The total planned NHS expenditure in 2015/16 is £101,333m. At month 4 the full year forecast shows an overspend on the cancer drugs fund budget of £70m, offset by an underspend on other costs. 22 CCGs have planned deficits and no CCGs are forecasting unplanned deficits, although two are forecasting a position worse than their annual plan – both are closely monitored and are producing recovery plans.
Referral to Treatment times: The NHS Constitution gives patients the right to start consultant led treatment within 18 weeks of referral. The referral to treatment standard from 1st October 2015 will be that 92% of those still waiting to start treatment have been waiting less than 18 weeks, with a sanction for incomplete pathways of £300 – replacing the earlier admitted and non admitted standards and sanctions.
Cancer waiting times: There are nine cancer waiting time standards, of which all but one were met in the first Quarter of 2015/16 – the 62 days for Urgent Referral to First Treatment standard was missed, achieving 81.7% against a target of 85%, which is attributed to the increasing number of urgent referrals for suspected cancer, currently growing at over 10% per annum.
Ambulance services: Trials are underway giving 999 call handlers an extra 2 minutes to assess calls other than those in the most urgent Red 1 category, before responding. It is hoped that this will reduce the inappropriate dispatch of vehicles, which can then be available for the most urgent calls.
Access to mental health services: National waiting time standards are being introduced in 2015/16 – 75% of patients being seen within six weeks and 95% within 18 weeks. £10m of non-recurrent funding has been made available to CCGs to support improved access to psychological therapies.
Also from April 2016, more than 50% of people experiencing a first episode of psychosis will be treated with a NICE approved care package within two weeks of referral.
Children and Adolescent Mental Health Services: £1.25bn extra funding has been allocated over five years to improve these services and to tackle eating disorders in young people, with funding allocated to CCGs following regional assurance of their plans to transform services.
NHS Outcomes Framework: 68 national indicators are in five groups that the NHS is aiming to improve:
- Preventing people from dying prematurely
- Enhancing quality of life for people with long-term conditions
- Helping people recover from episodes of ill health or following injury
- Ensuring that people have a positive experience of care
- Treating and caring for people in a safe environment and protecting them from avoidable harm
Next meeting: This will be in London on Friday 20th November 2015.