Agenda and minutes

1.1      The following non-prejudicial interests were declared:

Councillor John Muldoon: governor at South London and Maudsley NHS Foundation Trust, day patient at Guy’s hospital, patient at Lewisham and Greenwich NHS Trust and a member of the Joint Health Overview and Scrutiny Committee concerning the Our Healthier South East London (OHSEL) programme.

Councillor Alan Hall: governor at South London and Maudsley NHS Foundation Trust, Chair of the Bellingham Health Forum and a member of the Joint Health Overview and Scrutiny Committee concerning the Our Healthier South East London (OHSEL) programme.

Councillor Pat Raven: a family member in receipt of a package of social care.

Councillor Paul Bell: member of King’s College Hospital NHS Foundation Trust.

1.2     Following the meeting it was noted that Councillor Jacq Paschoud had the following non-prejudicial interest: a family member in receipt of a package of social care.

a) Setting the context (circa 1 hour)

This part of the meeting will contain brief introductions on financial position and strategic outlook from Lewisham CCG and NHS trusts working across South East London.

b) System resilience (circa 45 minutes)

c) Neighbourhood Care Networks - Delivery Community Based Care (circa 45 minutes)

2.1     Tony Read (Chief Financial Officer Lewisham CCG) introduced the information regarding Lewisham CCG. The following key points were noted:

·      The budget of Lewisham CCG for this financial year was £407m received from NHS England. The CCG is required to deliver a £7.6m surplus from that budget. The CCG is also required to deliver a £8m efficiency saving. The CCG has predicted it will meet its budget this year.

·      The impact of the Comprehensive Spending Review is not yet fully known. The income for the NHS for the next financial year should be announced on 17 December, and detailed guidance on how that will spent across the NHS was not expected until the end of December.

·      Lewisham CCG is a key part of the Our Healthier South East London (OHSEL) programme. The basis for the OHSEL programme was that demand in outstripping supply and the 6 CCGs across South East London need to work together to manage that.

2.2     Tony Read, Colin Stears (Managing Partner St John’s Medical Centre), Lynn Saunders (Director of Strategy, Business and Communications, Lewisham and Greenwich NHS Trust) and Aileen Buckton (Executive Director Community Services) answered questions from the Committee. The following key points were noted:

·      The CCG’s budget surplus would have to be returned to NHS England. The CCG was not free to decide how it should be spent, including mitigating against the announced in-year cut to the Public Health grant or assisting NHS trusts with their overspend. If the CCG does not deliver this £7.6m surplus at the end of the year, this part of the budget would not be returned to the CCG in the following year.  

·      NHS England uses a formula to determine how much funding each CCG would receive. This takes account of population factors such as age, number of people etc. The data on the population used for this formula is mix between the GP registered population and data from the Office for National Statistics. There are also opportunities for CCGs to bid for additional funds to run specific projects. As there is often a requirement for match-funding, they can end costing the CCG more instead of bringing money into the borough.

·      There isn’t a system that can handle bookings for appointments across different providers in Lewisham. The IT systems used are not quite joined up yet but the CCG and Lewisham and Greenwich NHS hospital trust have made some progress in sharing patients’ records via the Connect Care system.  

·      There has been an increase in demand in some services including emergency care but it was not possible to provide a clear reason. There has been anecdotal evidence for increased demand for GP services, but the reasons are unclear.

·      A change in the health and social care system is needed to deal with the existing financial problems. The deficits for provider organisations were widening. The aim is to provide care that is as effective but in a lower cost setting. There should be more focus on early intervention.

·      Public  ...  view the full minutes text for item 2.

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