Agenda item

BSOL Integrated Care System - Updates on performance against Finance and Recovery Plans

BSOL ICS to present updates on performance against Finance and Recovery Plans.


The Chief Finance Officer for BSOL ICS presented the report, detailing how the establishment of the ICS on a statutory basis in July meant it was possible to provide a full system financial position. The following points were highlighted:

·  BSOL ICS had submitted a breakeven plan for 2022/23 and each of the 5 NHS Providers and the CCG/ICB each individually submitted breakeven plans.

·  In regards to performance to Month 5, the system was currently showing a deficit of £12.2m at the end of August 2022, but was still anticipating achieving a breakeven position at year end.

·  For efficiency delivery, the system had a total efficiency targets of £97.1m. The Committee was updated on the delivery of a number of system efficiency programmes.

·  BSOL ICS had secured additional funding for a number of service areas, including Elective Recovery, Urgent and Emergency Care, as well as Discharge Schemes.

·  The Committee received an update on the delivery of Recovery Plans, including in regards to Urgent and Emergency Care, Elective performance and waiting list backlogs. There were also updates on other Operational Performance, including ambulance handover delays, Cancer performance, as well as Primary Care access.


Members raised a number of questions, which in summary included the following:

·  Members noted how the update detailed how additional funding had been announced in May 2022 to support increases in inflation, particularly around energy costs and requested a further update on this.

·  The Chief Finance Officer for BSOL ICS detailed how the additional £1.5bn funding announced nationally related to additional inflationary funding – this had enabled BSOL ICS to cover inflationary pressures up to approximately 5.5 per cent. Linked to this, it was explained how the majority of the BSOL ICS energy contracts had been set 12 months in advance.

·  Members noted how the presentation provided an update on ambulance handover delays greater than 60 minutes. They queried whether data on ambulance waiting times was available. Members also questioned whether evidence was available on people travelling to hospital sites directly, due to the waiting times for ambulance services.

·  Members highlighted the increase in demand for GP appointments and queried whether any information or data had been collated on what might be causing this.

·  The Chief Finance Officer for BSOL ICS detailed how they were working with GP teams to review the data available. He explained how BSOL ICS was working with GP pilot sites to support more robust recording of appointment activity, to help understand trends and the reasons for demand.

·  Members detailed challenges residents faced in accessing Primary Care. They queried whether any evidence was available which indicated residents were accessing appointments at a later stage than intended, which meant they required further treatment and support.

·  The Chief Finance Officer for BSOL ICS explained how it was recognised that the operational pressures faced across the whole NHS system was likely to be resulting in increased demand for GP appointments. This included people seeking advice on the timescales for receiving different treatments to patients whose condition may be getting more acute due to waiting times. The Chief Finance Officer for BSOL ICS detailed the work being undertaken on this across Primary and Secondary Care. This included providing more administrative capacity in Primary Care settings, to provide additional information and advice to patients,

·  Members queried the work being undertaken with any specific GP teams that may be facing challenges in responding to residents and offering timely appointments. Members also raised the data provided on GP appointments for 22/23 vs. 19/20 and queried why there appeared to be a spike in October 2019.

·  The Chief Finance Officer for BSOL ICS detailed how a range of support was offered to the GP teams, which included targeted interventions and peer support. Going forward, the annual patients’ survey for General Practice was being reviewed, to help determine any GP teams that may benefit from further support. In regards to the spike in GP appointments in October 2019, the Chief Finance Officer for BSOL ICS explained this was likely to relate to national vaccination programmes and would look to provide Members an update on this.

·  Members explained they recognised that an increased volume of appointments was being offered in Primary Care; however they emphasised how many residents contacted them with concerns about accessing services. They queried whether any data or evidence could be provided on the waiting times for residents using phone lines to book Primary Care appointments, including unsuccessful contacts. Members also requested for data to be shared on the volume of Primary Care appointments completed, as well as those offered. They also asked for the range of Primary Care appointments offered to be provided as well, including for GP’s, vaccinations, Nursing teams and Pharmaceutical advisors, in recognition of residents needing to access a range of services. It was confirmed this further information could be provided at future JHOSC meetings.

·  Members welcomed the additional funding secured for Mental Health Urgent and Emergency Care, as well as the approval of Wellbeing and crisis hubs. They queried what metrics were recorded for Mental Health services, in order to monitor performance against targets.

·  The Chief Finance Officer for BSOL ICS explained how a wide range of metrics were recorded and monitored for the delivery of Mental Health services and confirmed an update on this could be shared following the meeting.



  The Joint Health Overview and Scrutiny Committee:

(i)  Noted the BSOL ICS update on performance against Finance and Recovery Plans.

(ii)   Agreed for the additional information requested, as detailed above, to be shared with the Committee and reported to future meetings.


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