Agenda item

To consider a presentation from the Change Director – Lancashire and South Cumbria Change Programme (Heathier Lancashire) and colleagues on proposals relating to STPs.

This item had been added to the Committee’s work programme following agreement at the last meeting.

Mr Gary Raphael, Finance Director, Lancashire and South Cumbria Change Programme (Healthier Lancashire) (L&SC) attended the meeting and consideration was given to his presentation on the STPs that was supported by a series of slides as contained on pages 473 to 488 of the Book of Reports.

In his presentation the Finance Director (L&SC) provided information on ‘delivering the change across Lancashire and South Cumbria concentrating on the major gap, Finance and Efficiency.

The financial approaches, to include areas of extra spending to 2021 and where that extra spending would be used were explained.  This included an explanation of the short term action required and mitigation through new models of care.

The presentation concluded with a summary of the L&SC plans to:

·         hit their nationally set financial controls totals each year

·         break even by 2020/21

·         keep acute income flat for two years and reduce in last two years (by £16m and £32m)

·         spend 21% more on primary, community, mental health and continuing healthcare over the next four years (to enable demand for acute services to be flattened)

·         deliver substantial provider savings (£176m)

·         mitigate social care shortfalls (national announcement awaited)

In discussion comments and questions were raised in respect of the following:

·         Annual Figures (aggregated provider deficit before £44m STF)

·         Indicative extra spending required to stop the growth in acute activity (extra spending – dip in figures after 2018/19)

·         Commissioning doctors for local practices

·         Rural areas – approaches to health support

·         Budget restrains – impact on services, staff shortages, retention and recruitment

·         Availability of “appendices” as referenced (Finance & Estate Workbooks)

·         Efficiency approaches (procurement) – rationale to disposal/recycling equipment (crutches; zimmer frames); liaison with  manufacturers/ /chemists (drugs & consumables dispensation quantities); stock-control (consistency of approach)

·         Savings and efficiencies – utilising digital technology

·         Efficiency approaches (services) - clinicians working across services; treatment / links outside West Lancashire; tackling bureaucracy

·         Approaches to “sharing of costs” – distribution of funds

·         West Lancs LDP –  West Lancs CCG Contract / Virgin Health Care

The Finance Director L&SC answered questions and provided clarification on the points raised.  He indicated that information referred to, when published, would be made available on-line.

The Chairman, on behalf of the Committee, thanked the Finance Director, L&SC (Healthier Lancashire) for his attendance and contribution to the item.

RESOLVED:  As a consequence of the discussion on this item it was recommended:

(1)       That a request be made for a representative of the Cheshire & Merseyside STP to attend a future meeting of the Committee, to talk about the shortfall of £8million (identified in the L&SC STP) which does not reflect the actual deficit within West Lancashire because of boundary issues.

(2)       That the Finance Director, L&SC, be requested to provide a further (all Member) briefing / update as more information on the STPs becomes available.

(3)       That the provision of additional information referred to by the Finance Director, L&SC and presentation be noted.