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