Annual General MeetingAnnual General Meeting
Thursday 27Thursday 27thth September 2007 September 2007
Broadfield StadiumBroadfield StadiumCrawleyCrawley
Welcome & IntroductionWelcome & Introduction
Barbara WilkinsBarbara Wilkins
Acting ChairActing Chair
John WilderspinJohn Wilderspin
Chief ExecutiveChief Executive
Highlights for 2006/07Highlights for 2006/07
Highlights for 2006/07Highlights for 2006/07
What do PCTs do?What do PCTs do?
Creating the new PCT Creating the new PCT
Delivering on key objectivesDelivering on key objectives
Challenge of Fit for the FutureChallenge of Fit for the Future
A Breath of Fresh AirA Breath of Fresh Air
Dr Andrew FoulkesDr Andrew Foulkes
Chairman, Professional Executive Chairman, Professional Executive CommitteeCommittee
A breath of fresh airA breath of fresh air
Management of long term conditionsManagement of long term conditions
Improvements in end of life careImprovements in end of life care
Care closer to homeCare closer to home
Long term conditions
COPD• Practice registers• Expert patients• Better management• Less exacerbations of
illness• 40% reduction in
admissions to hospital
End of Life care• 37% died at home : national stats for all causes
20%
• 20% died in the acute hospital: national stats 56%
• 46% patients had had no unplanned crisis admissions to hospital in the last six months
• 56% patients obtained their preferred place of death
• 72% cases had been offered bereavement support
• 73% patients included on the palliative or supportive care register
• 76%patients discussed at primary health team meetings at least monthly
Early LifeEarly Life
Finance West Sussex PCT Finance West Sussex PCT 2006 / 072006 / 07
Neil FerrellyNeil Ferrelly
Director of FinanceDirector of Finance
Key financial targetsKey financial targets
In 2006/07 the PCT failed to achieve financial In 2006/07 the PCT failed to achieve financial balance on the revenue account for the year, balance on the revenue account for the year, recording a deficit of £12.86m. It did however recording a deficit of £12.86m. It did however achieve the remaining targets:achieve the remaining targets:
• Full cost recovery for the services that the Full cost recovery for the services that the PCT provides out of its own resourcesPCT provides out of its own resources
• Full utilisation of the cash resources Full utilisation of the cash resources allocated to the PCTallocated to the PCT
• Keeping capital expenditure within the Keeping capital expenditure within the limit set by the Department of Healthlimit set by the Department of Health
Note Note (from full Annual Accounts)(from full Annual Accounts)2.1 Revenue Resource Limit (RRL)2.1 Revenue Resource Limit (RRL)
Note (from full Annual Accounts) 2.1 Revenue Resource Limit (RRL)
The PCTs' performance for 2006/07 is as follows: 2006/07 2005/06
£000 £000
Total net operating cost for the financial year 984,852 911,451
Less: Non-discretionary Expenditure 6,023 6,908 Operating Costs less non- discretionary
expenditure 978,829 904,543
Final Revenue Resource Limit for year 965,967 902,270 Under/(over) spend against Revenue Resource
Limit (12,862) (2,273)
Analysis of expenditure by service 2006/07 £millionAnalysis of expenditure by service 2006/07 £million
2006/07 (£m)
Other, 99
Mental Health & Learning
Disabilities, 113
Ambulance, 22
Community / Social Care &
Dental, 87
Prescribing, 129
Primary Care, 115
Specialist Services, 44
Acute Services, 368
Revenue resource expended by former organisationsRevenue resource expended by former organisations
The amount of revenue resource expended by former organisations to 30 September 2006 as a percentage of the total anticipated RRL for West Sussex PCT is as follows:
Net operating costs for the first six months of 2006/07 £000 Adur, Arun and Worthing PC 150,161 Crawley PCT 68,270 Horsham and Chanctonbury PCT 65,829 Mid Sussex PCT 82,897 Western Sussex PCT 118,262
Total 485,419 Anticipated RRL for West Sussex PCT for 2 006-07 as 965,967 notified by the Department of Health on 16 April for 31.3.07 Percentage of RRL used to September 2006 50.25%
Value for MoneyValue for Money
The PCT actively sought Value for Money in its business activities and The PCT actively sought Value for Money in its business activities and during the period 1 April 2006 to 31 March 2007. The PCT’s key during the period 1 April 2006 to 31 March 2007. The PCT’s key approaches to ensuring value for money were:approaches to ensuring value for money were:
Rigorous review of all contracts for purchasing goods and services.Rigorous review of all contracts for purchasing goods and services.
Effective use of national purchasing contracts through the NHS Effective use of national purchasing contracts through the NHS
Purchasing and Supply Agency (PASA).Purchasing and Supply Agency (PASA).
The Local Delivery Plan process The Local Delivery Plan process
involvement of partners / prioritisation of investments.involvement of partners / prioritisation of investments.
Reconfiguration of the existing five PCTs to a single, leaner Reconfiguration of the existing five PCTs to a single, leaner structure across West Sussex.structure across West Sussex.
Refining the PCT’s performance monitoring process.Refining the PCT’s performance monitoring process.
Continued close scrutiny of budgets and the identification of savings Continued close scrutiny of budgets and the identification of savings that can be made.that can be made.
A new mind-set for improving health and well-being
Annual Report of Director of Public Health for West Sussex, 2007
Securing Health of the Securing Health of the PopulationPopulation
““We are We are notnot tinkers tinkers who who merely patch and merely patch and mend what is brokenmend what is broken. .
we must be watchmen, we must be watchmen, guardiansguardians of the life of the life and the health of our generation, and the health of our generation,
so that so that stronger and more able generations stronger and more able generations may come aftermay come after.”.”
Dr Elizabeth Blackwell (1821-1910)Dr Elizabeth Blackwell (1821-1910)The first Woman DoctorThe first Woman Doctor
A celebration of good healthA celebration of good health
A celebration of Good Health A celebration of Good Health in West Sussexin West Sussex
Life expectancy at birth is 78 years for men Life expectancy at birth is 78 years for men and 82 years for womenand 82 years for women
Between 1993 to 2005:Between 1993 to 2005: 21% reduction in overall death rates21% reduction in overall death rates 14% reduction in cancer death rates14% reduction in cancer death rates 42% reduction in deaths due to circulatory 42% reduction in deaths due to circulatory
diseasesdiseases
3.2 deaths under 1 year per 1000 live births 3.2 deaths under 1 year per 1000 live births compared to 5 per 1,000 nationallycompared to 5 per 1,000 nationally
Significant, Unacceptable, Unfair, Significant, Unacceptable, Unfair, widening variations in healthwidening variations in health
At electoral ward level life expectancy ranges At electoral ward level life expectancy ranges from from 70.1 years to 84.8 years70.1 years to 84.8 years (note impact of nursing (note impact of nursing homes)homes)
‘‘Healthy Life Expectancy’ Healthy Life Expectancy’ (Life Expectancy without (Life Expectancy without Limiting Long Term Illness),Limiting Long Term Illness), is 66.8 years. is 66.8 years. On average in West Sussex the On average in West Sussex the last 12.9 years of last 12.9 years of
lifelife are limited by long term illness are limited by long term illness At electoral ward level a range of At electoral ward level a range of 8 years8 years lived lived
with a long-term illness with a long-term illness to 17.9 yearsto 17.9 years in more in more deprived wards. deprived wards.
Healthy life expectancy & deprivationHealthy life expectancy & deprivation: Life Expectancy without Limiting Long Term Illness for West Sussex Wards (1998 – 2002) and the Index of Multiple Deprivation 2004
R2 = 0.74
55
57
59
61
63
65
67
69
71
73
75
0 5 10 15 20 25 30 35
Index of Multiple Deprivation 2004
Lif
e ex
pec
tan
cy w
ith
ou
t lo
ng
ter
m
illn
ess
(yea
rs)
Source: ODPM 2004, Public Health Mortality Files (1998 – 2002), Census 2001
From Analysis to ActionFrom Analysis to Action
Cause of Cause of deathdeath
SMRSMR LLLL ULUL
Circulatory Circulatory diseasedisease
120.2120.2 114.8114.8 125.8125.8
Respiratory Respiratory diseasedisease
137.4137.4 127.8127.8 147.5147.5
All cancersAll cancers 111.2111.2 104.8104.8 118.0118.0
Breast cancerBreast cancer 99.899.8 80.480.4 122.4122.4
Lung cancerLung cancer 132.7132.7 116.2116.2 150.9150.9
Standardized Mortality Ratios (SMR) for LNIAs by cause of death (West Sussex = 100)
Choosing health?Choosing health?Living and Planning Today with tomorrow in mindLiving and Planning Today with tomorrow in mind
AlcoholAlcohol: Reducing harm, evaluating : Reducing harm, evaluating traditiontradition
Working together to reduce Working together to reduce ObesityObesity Reducing sexually transmitted diseasesReducing sexually transmitted diseases Health and well-being in Health and well-being in workplacesworkplaces Promoting Promoting mental health and well-beingmental health and well-being
Role of three key players: Individuals, communities, institutions
Developing sustainable servicesDeveloping sustainable services
Focus, Trust and Commitment on targeting Focus, Trust and Commitment on targeting
People and Places in most needPeople and Places in most need Primary Care Primary Care Prevention Prevention Partnerships Partnerships Promoting Promoting full engagementfull engagement of people and of people and
communities and communities and Capacity buildingCapacity building for for health improvement health improvement
Living today with tomorrow in mind Living today with tomorrow in mind
Securing Health of the Securing Health of the PopulationPopulation
““We are We are notnot tinkers tinkers who who merely patch and merely patch and mend what is brokenmend what is broken. .
we must be watchmen, we must be watchmen, guardiansguardians of the life of the life and the health of our generation, and the health of our generation,
so that so that stronger and more able stronger and more able generations may come aftergenerations may come after.”.”
Dr Elizabeth Blackwell (1821-1910)Dr Elizabeth Blackwell (1821-1910)The first Woman DoctorThe first Woman Doctor
Thanks and Closing RemarksThanks and Closing Remarks
Margaret BamfordMargaret Bamford
Acting Vice-ChairActing Vice-Chair
Annual General MeetingAnnual General Meeting
Thursday 27Thursday 27thth September 2007 September 2007
Broadfield StadiumBroadfield StadiumCrawleyCrawley