To review the quality and sustainability of  services commissioned by the Herefordshire Clinical Commissioning Group (CCG) from Wye Valley NHS Trust (WVT) on behalf of the population of Herefordshire.

The accountable officer, Herefordshire Clinical Commissioning Group (CCG) and the manging director, Wye Valley NHS Trust (WVT) presented the slides (appendix a).  A number of key points were highlighted:

•      Wye Valley NHS Trust was the major health service provider commissioned through a contract of £118million funded through the Department of Health. The Trust received additional income from out of county patients, for example Powys, contributing some 20% of WVT income.

•      WVT had been lifted out of special measures by the Care Quality Commission in 2016 and was now rated as “requires improvement”.  A new leadership team was making a difference to performance along with other factors including One Herefordshire, with organisations working together as part of the wider health and social care family. WVT had identified clinical and organisational priorities for 2017/18 to help sustain improved performance.

•       The financial context of WVT was not unique, as it was not unusual for small rural hospitals to have financial challenges because of how the national funding formula worked. However, there was a cost improvement programme in place for 2017-18 that was designed to reduce the deficit to between £15m and £20m.  The sustainability and transformation plan was designed to support efficiencies in service provision as a contributing factor.

•    The most significant performance targets reflected local needs and concerns. In particular:

o   the CCG and WVT had created a plan that had enabled additional funding to be secured to meet the national standard requirement for 92% of patients to be seen within 18 weeks of referral

o   There was work to do around continued improvement in A&E performance. However, it was noted that the national standard was met in Warwick and the new leadership arrangements, with links to South Warwickshire Foundation Trust, would provide access to good practice approaches to make a difference in Hereford

o   Cancer services were improving and all standards had been achieved in May

o   Steps were being taken to ensure that delayed transfers of care were improving and to work towards a model of ensuring people are supported to leave hospital with the right care at home.

•    The future performance of WVT would be supported through the contract with the CCG, and ensuring this worked in the best interest of population. There was increasing opportunity with other NHS providers and the voluntary and community sector working together to support this.

During the presentation members raised a number of questions and comments, with the following responses offered by officers:

In answer to a request for more detailed information on how money is spent, it was explained that it would be possible to provide a breakdown in the portfolio of contracts, although it should be noted that much of the income was driven by national arrangements such as the GP contract and so there was little discretion around price of services. 

In terms of out of county patients and particularly in relation to Powys services, there was a good relationship and there was a  ...  view the full minutes text for item 7