Commissioning Group (CCG) NHS Salford Clinical Business ... · NHS Salford CCG Business Plan...

NHS Salford Clinical Commissioning Group (CCG)

Business Plan 2018/19

NHS Salford CCG Business Plan 2018-19

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Foreword from the Chair and Chief Accountable Officer

Salford is changing. Unprecedented private and public investment over the last ten years, including renowned schemes such as MediaCityUK, is transforming the city from its industrial roots.

As a result, more people than ever are choosing Salford as a place to live, work, invest and visit. Salford’s economy is growing well above regional and national averages and is outperforming both London and Manchester to become the UK’s hot spot for starting a new business. With a strong cultural and tourism offer, a renowned heritage and huge swathes of beautiful green spaces, the city truly has something for everyone.

But Salford also remains a city of contrasts, with some of the most prosperous and deprived wards in the country. From a health perspective our challenges are significant - 70% of our patients live in highly deprived areas and we know that people in poorer areas of the city live up to 14 years less than those in our richer neighbourhoods. We have 12,000 children in poverty and nearly 10% of the working population is long-term unemployed. With ongoing pressures to Local Authority and NHS funding we recognise the need to develop radical new ways of working with our partners, residents and vibrant voluntary and community sector to make the best use of the city’s collective resources. At the heart of our collective approach is our ambitious plan to transform Health and Wellbeing – The Salford Locality Plan.

Salford locality currently spends £473m per annum on Health and Social Care. There is currently a planned deficit in the NHS provider sector in Salford. Projecting the funding and expenditure forward up to 2020/21, the “do nothing” scenario predicts an estimated financial shortfall of circa £65m for Salford Locality. The impact of delivering and investing in the priority areas identified in the Locality and GM transformation plans has been assessed and closes the financial gap within Salford locality. It is projected that the £65m gap could be fully closed by 2020/21 if all of the schemes deliver their intended outcomes. The majority of efficiencies will come from provider reform, supported by neighbourhood and better care arrangements, as well as savings attributable to targeted prevention work.

The Salford Locality Plan is the ‘blueprint’ for our health and social care system. It explains how providers of public services - like the NHS, Salford City Council, Fire Service and Police - will work closely together with service users as well as partners within the private and voluntary, community and social enterprise sectors. This joint working is already having a significant impact to improve population health. Some highlights so far include:

- Our health system is one of, if not the strongest in the country with both the Clinical Commissioning Group and the local hospital (Salford Royal NHS Foundation Trust) rated outstanding for the last two years along with some of first GP practices rated outstanding by the CQC. Following our Safer Salford programme the quality of care in our care homes across the city is also improving.

- We have a ground-breaking Integrated Care Organisation (the first in the country) which brings together hospital and community services with mental health services and adult social care.

- Following large scale public engagement including our recent BIG Conversation we have begun rolling out new services for urgent care and enhanced care in local neighbourhoods which brings care closer to home. An example of the success this is having can be seen in the 10% improvement we have made to reduce delays transferring patients from hospital into the community in the last year.

http://www.salfordccg.nhs.uk/salford-locality-plan


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- The early diagnosis of cancer has a huge impact on survival and in Salford lung cancer is one of our most significant challenges. Through our focus on cancer we are working to improve the speed of cancer diagnosis. This includes developing a national pioneering programme of targeted lung health checks with mobile CT scanners and a new e-cigarette smoking cessation programme. The impact can be seen in smoking rates during pregnancy which have fallen from 13.8% to 12.8% and deaths from cancer down 8% in the last year.

- Working together with our public health team, GP practices and community pharmacists we are also improving health protection with some of the highest levels of immunisation against childhood diseases in the country (98.2%) and flu vaccination rates in our over 65s at around 80%.

- Working with Salford Council and Bolton NHS Foundation Trust we have recently opened the Ingleside Birth and Community Centre. This new facility, the only free-standing (midwife-led) birth centre in Greater Manchester, will provide care for women who want to give birth in Salford as well as other support to local families.

The Salford Clinical Commissioning Group’s (CCG) Business Plan for 2018/19 has been developed using patient insights from our citizen panels and engagement events and feedback from patient surveys as well as our detailed needs assessment and knowledge of pressures, quality, safety and performance within the services we commission.

Working as a leading partner in the Greater Manchester Health and Social Care Partnership and also locally with Salford Council and the City Mayor this plan includes our joint working to ensure patients in Salford benefit from the highest quality joined up care. It also integrates all national NHS expectations set out each year by the Department for Health to ensure we continue to keep Salford at the forefront of delivering ‘outstanding’ services to patients.

It is not the purpose of this document to detail all of the services we commission and how they will be delivered; it contains our key our strategic programmes from 1st April 2018 until 31st March 2019 to ensure we play our leading role in delivering the Salford Locality Plan.

Dr Tom Tasker Anthony HassallChair Chief Accountable Officer

NHS Salford CCG Business Plan 2018-19 4

Strategic Plan on a Page 2018-2019


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Locality Plan - Vision and OutcomesVisionStart, live and age well in Salford - Citizens will get the best start in life, will go on to have a fulfilling and productive adulthood, will be able to manage their health well into their older age and die in a dignified manner in a setting of their choosing. People across Salford will experience health on a parallel with the current “best” in Greater Manchester (GM), and the gaps between communities will be narrower than they have ever been before.

The overall aim of the Locality Plan is to “improve health and wellbeing across the city and remove health inequalities” in Salford. Our approach to achieving this prioritises prevention, self-care and public health, whilst creating integrated, effective and financially sustainable health and care services. It acknowledges the importance of both mental and physical health in achieving our vision, and aligns with the priorities of the Salford Partnership; Wellbeing, Growth and Social Value.

Our business plan summarises the work led by Salford CCG to contribute to the delivery of the Locality Plan and improve health and wellbeing outcomes for the population of Salford. These were developed collectively with residents and partners and are summarised below:

Starting Well - Children will have the best start in life and continue to develop well during their early years.

• I am a child who is physically and emotionally healthy, feel safe and able to live life in a positive way.• I am a young person who will achieve their potential in life, with great learning, and employment

opportunities.• I am as good a parent as I can be.

Living Well - Citizens will achieve and maintain a sense of wellbeing by leading a healthy lifestyle supported by resilient communities.

• I am able to take care of my own health and wellbeing, and am able to manage the challenges that life gives me.

• My lifestyle helps me to stop any Long Term Condition or disability getting worse, and keeps the impact of this condition or disability from affecting my life.

• I lead a happy, fulfilling and purposeful life.

Ageing Well - Older people will maintain wellbeing and can access high quality health and care, using it appropriately.

• I am an older person who is looking after my health and delaying the need for care.• If I need it, I will be able to access high quality care and support.• I know that when I die, this will happen in the best possible circumstances.

For further information about the Salford Locality Plan please visit http://www.salfordccg.nhs.uk/salford-locality-plan.

Delivery of our Locality Plan is in the context of the Greater Manchester Strategy for Health and Social Care. CCG leaders and staff will continue to play an active role in leading on a range of Greater Manchester wide transformational workstreams. For example standardising acute care, breast services, bariatric surgery, neuro-rehabilitation, incentivising reform (new contracting and payment models), mental health, dementia, dermatology and hyper acute/community stroke. In addition, the CCG Chair is also the Chair of the Association of Greater Manchester CCGs. This Greater Manchester level work is fundamental and complementary to delivery of our Locality Plan within Salford.




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Strategic Programme 1: Quality of Care

Executive Lead Francine ThorpeClinical Lead Jeremy TankelLay Lead Alison Kelly

Locality Plan Priorities:

Work with providers to secure improvements in the quality, safety and safeguarding of commissioned services.

Ensure that patients’ experience of using services is captured and used to drive improvements. Develop a culture where the potential for harm is actively considered, processes are embedded for early

identification of risks and mitigation strategies implemented to minimise any adverse impact on people using services.

Develop a culture of evidence based commissioning and decision making that utilises research evidence, innovation and knowledge translation. Car

CCG Priorities 2018-19

Develop and begin delivery of a new Quality and Safety Strategy (2018-20). Refine the Quality Assurance Process for the Integrated Care Organisation (ICO). Develop an integrated approach to quality assurance for Children’s and Public Health Services. Deliver year 3 priorities form the Research and Innovation Strategy. Implement a process to secure quality improvement in General Practice. Implement a clinical assessment process for Children’s Continuing Healthcare. Develop a system wide approach to shared learning around safety. Establish an improvement collaborative to achieve smoother handover between hospital and care homes. Develop new Salford Carer’s Strategy. Improve handover between hospital and GP practices. Co-produce the care homes excellence programme in partnership with the ICO to ensure that

investment is resulting in improved quality in care homes and an improved service user experience

Other existing or developing delivery plans or strategies:

Research and Innovation Strategy City Wide Medicines Strategy

Salford Carer’s Strategy Salford Standard

Performance Measures:

Core Indicators:Mixed Sex Accommodation BreachesNumber of patients not treated within 28 days of last minute elective cancellation (SRFT)Referral to Treatment Times (RTT): Incomplete Pathways (>52 Weeks)Trolley Waits in A&E (>12 hours) (SRFT)

Other key performance indicators:Healthcare Acquired Infections – MRSA and CDIFFNumber of Escherichia coli (E. coli) bacteraemia (CCG)Reduction in the Trimethoprim: Nitrofurantoin prescribing ratioNumber of Trimethoprim items prescribed to patients aged 70 years or greaterNHS Continuing Healthcare (CHC) assessments take place in an acute hospital setting


Strategic Programme 2: Population Health and Prevention

Executive Lead Karen Proctor; Judd Skelton; David HerneClinical Lead Tom TaskerLay Lead Brian Wroe


Use behavioural approaches towards the achievement of population scale prevention and self-care. Support the social movement for change by developing an integrated, place-based approach to achieving

improvement to people’s wellbeing in the City. Raise aspirations and put in place support which will enable young people to achieve their potential in life,

as well as reduce demand for services in the medium to long term. Put in place public health programmes which will promote, support and enable healthy lifestyles at all

ages, in order to improve health outcomes and reduce demand for primary and acute care. Put in place programmes, activities and services which will promote, support and enable good mental

wellbeing at all ages, in order to improve health outcomes and reduce demand for clinical care. Increase the effectiveness of screening and early detection programmes so that disease can be detected

early, more effectively and treated with the minimum need for expensive and aggressive treatments. Work with partners to reduce the harmful impact of the social, environmental and economic conditions in

which people live on their health and wellbeing.


Establish the Population Health Advisory Board. Deliver enhanced voluntary sector capacity and develop/implement a Neighbourhood approach to Social

Prescribing. Implement plans relating to cancer screening, early detection and prevention. Improve access to Diabetes structured education and Diabetes prevention programmes. Review and redesign stop smoking services across Salford. Complete service review of Tier 3 weight management service. Implement Physical Activity Framework (PAF) actions for 2018-19. Enhance partnership working to agree and deliver a health and housing approach to tackle the impact of

poor housing on health.


Salford Locality Plan Salford Population health plan


Core Indicators:Women’s smoking status at the time of deliveryCancers diagnosed at early stageDiabetes education and checks

Other key performance indicators:Decrease alcohol related harm – Alcohol related hospital admissions Smoking cessationFlu vaccination coverage targeted groupsChild weight measurement and number of young people who are overweight


Strategic Programme 3: Integrated Community Based Care and Long Term ConditionsExecutive Lead Karen Proctor; Judd SkeltonClinical Lead Tom ReganLay Lead Paul Newman

Locality Plan Priorities: Implement the integrated care system (ICS) to enable the achievement of the Integrated Care

Programme improvement targets by 2020. Through the integrated care organisation, redesign person centred services through integrated

pathways, workforce alignment and supply chain arrangements. Develop and agree a vision, objectives and deliverables to extend the benefits of integrated care to

children, young people and families. Receive a comprehensive evaluation (National Institute of Health Research) on the effectiveness of

the integrated care programme by 2017. Design and implement the Integrated Care System new model of care within a neighbourhood

footprint by 2017. Improve access to primary care services, including improved opening at weekends and the evening

and supporting the delivery of 7 day access to health and social care. Facilitate opportunities for practices to work in a federated way with each other or with other services,

where this is expected to improve patient experience or be efficient in terms of cost or workforce. Develop a working relationship with primary care provider organisations in order to identify

opportunities to contract for primary care based services at scale, rather than at individual practice level.

Invest in the workforce to increase capacity and capability and by building a primary care development and education programme.

Incentivise practices to more pro-actively identify and manage individuals with, or at risk of, illness and improve the quality of provision in primary care.

Work with all providers of physical health, mental health and social care services, to develop and invest in out of hospital services, delivered where appropriate at a neighbourhood level.

Invest in high quality community premises and improved technology to enable primary care to be the hub of out of hospital care.

Move towards more of a primary care focus for the management of patients with LTCs as a first step towards our ambition for community based care with greater integration across community areas and a shift towards more proactive care with patients better enabled to self-manage care needs.


Integrated Care Review delivery of the Adult Service and Financial Plan 17/18 – 20/21 and produce a plan for the Adults

Integrated Fund (19/20) working with all partners. Work with partners to collaboratively redesign neighbourhood health and social care delivery models,

considering emerging evaluation findings from transformation projects. Redesign the proactive care model to ensure the benefits delivered from MDGs are maintained, with both

improved efficiency and alignment to other neighbourhood developments, such as Enhanced Care. Set out Salford’s strategic approach in establishing new models of Extra Care service to meet our

strategic objectives around reducing reliance on care home provision and improving quality and outcomes.

Oversight and assurance of the new Home Care model in meeting the needs of service users and providing ethical terms of employment.

Primary Care Evaluate the impact of the Primary Care Transformation schemes which support the ‘sustainable primary

care’ priority of integrated care including Extended Access, GP Streaming, acute home visiting, neighbourhood working and care navigation.

Monitor the outcomes of the Ordsall South temporary primary medical services contract.


Undertake a fundamental and comprehensive review of the Salford Standard with revised standards rolled out for the 2019/20 contract.

Service Developments Undertake identified reviews of community services and locally commissioned services. Scope options for the expansion of Personal Health Budgets, make recommendations on a model to

broaden the current offer and establish test cases. Develop, implement and monitor an outcomes based contracting model for community service bundles. Complete the procurement process, award the contract for and mobilise the Community Eye Service. Implement recommendations of children’s integrated care test cases for children and young people with

disabilities and those requiring speech and communication support. Other existing or developing delivery plans or strategies:

Adults Service and Financial Plan Salford Standard Mental Health Strategy

Carer’s Strategy National Diabetes Prevention Programme (NDPP) Primary Care Investment Agreement


Core Indicators:% of diabetes patients have achieved all the NICE recommended treatment targets% of people with diabetes diagnosed for less than a year who attended a structured education courseSalford wide extended access pilot (SWEAP) (evenings and weekends) at GP services – Local DataSalford wide extended access pilot (SWEAP) (evenings and weekends) at GP services – Published Data

Other key performance indicators:Waiting times for routine referrals to children and young people eating disorder servicesWaiting times for urgent referrals to children and young people eating disorder servicesLong Term support needs of older people (aged 65 and over) met by admissions to residential and nursing care homesNumber of personal health budgets that have been in place, at any point during the quarter, per 100,000 CCG populationPercentage of children waiting 18 weeks or less for a wheelchairAntibiotics prescribed in Primary Care


Strategic Programme 4: Transforming Hospital Care

Executive Lead Steve Dixon; Karen ProctorClinical Lead Tom ReganLay Lead Chris Babbs


Development of a Standard Operating Modelo Governance model for Trusts which form part of Groupo Improved and more effective decision makingo Delivery of Outcomes Based Healthcare – based on the Porter model of value based healthcareo Delivery of the digital health enterprise – delivering efficiency and a reduction in spend through

digital transformationo Deliver a model which is replicable at a local, regional and national level

Emergency Department (ED):o Reduce time to patient assessment and increase the percentage of patients seen by a senior

decision makero Increase the percentage of A & E attendances waiting less than 4 hours

Acute Medicine:o Reduce length of stay and patients admitted from acute to other wardso Improve mortality rates

General Surgery:o Improve mortality rates and emergency general surgery patients seen by a consultant 24/7o Reduce length of stay, re-admission and achieve consistent and timely access to theatre, critical

care and diagnostic servicesPaediatrics:

o Reduce admissions whose needs could be met in the community or at homeo Improve mortality rates and emergency admissions seen by a consultant paediatrician within the

first 24 hours of admissiono Increase patient satisfaction and hospital staff satisfaction

CCG Priorities 2018-19 Support Greater Manchester CCG’s to ensure effective specialist (i.e. Tier 3 and 4) weight management

pathways are in place. Support and engage with GM in relation to the GM Cancer Plan. Provide advice and support on behalf of GM CCG Directors, to GM Theme 3 projects for Neuro-

rehabilitation and Breast services. Assess urgent care services and develop and implement mid-term and long-term action plans for priority

areas. Implement the Maternity Pioneer Programme – widening choice and personalisation. Establish Ingleside as a safe and comfortable environment for women to have a positive experience

of child birth. Support a review of breast services across the NW sector. Review paediatric services in response to GM and Bolton, Salford and Wigan Partnership (BS&WP) case

for change and standards. Support the development and commissioning of a local Advice and Guidance system. Develop a GM Dermatology model framework, assessment criteria for key conditions and review of GM

wide advice and guidance. Ensure the Healthier Together model for General Surgery is delivered in line with GM timescales. Ensure the Healthier Together model for Acute Emergency Medicine is delivered in line with GM

timescales.Other existing or developing delivery plans or strategies:

Healthier Together GM Cancer Plan

Bolton, Salford and Wigan Partnership (BS&WP)



Core Indicators:NWAS Ambulance Response Programme | Category 1 - Life threatening (mean response time [07:00])NWAS Ambulance Response Programme | Category 2 - Emergency (mean response time [18:00s])NWAS Ambulance Response Programme | Category 1 - Life threatening (90th percentile in 15mins)NWAS Ambulance Response Programme | Category 2 - Emergency (90th percentile in 40mins)NWAS Ambulance Response Programme | Category 3 – Urgent (90th percentile in 120mins)NWAS Ambulance Response Programme | Category 4 – Less Urgent (90th percentile in 180mins)Delayed Transfers of Care - Bed Days (SRFT)RTT: Incomplete pathways (<18 weeks)Diagnostic Test Waiting TimesA&E Waiting Time - Seen within 4 hours (CCG)A&E Waiting Time - Seen within 4 hours (SRFT)Cancer Patients - 2 Week Waits (Urgent GP Referral)Cancer Patients – 2 week wait for breast symptoms (where cancer was not initially suspected)Cancer Waits - 31 Days (All Cancers)Cancer Waits - 31 Days (Surgery)Cancer Waits - 31 Days (Drugs)Cancer Waits - 31 Days (Radiotherapy)Cancer Waits - 62 Days (Urgent GP Referral)Cancer Waits - 62 Days (Screening Service)Cancer Waits - 62 Days (Decision to Upgrade)Delayed transfers of care, per 100,000 population (aged 18+)One year survival from all cancers

Other key performance indicators:Women’s’ experience of maternity servicesChoices in maternity services


Strategic Programme 5: Mental Health and Learning Disabilities

Executive Lead Judd SkeltonClinical Lead Jenny WaltonLay Lead Edward Vitalis


Early intervention – meeting needs early and preventing the escalation of mental health problems (including transition planning from children’s services).

Addressing the stigma and discrimination that surrounds mental health. Rapid and convenient access at all times (and in all services, and relevant settings). Fair access, based on people’s needs, not who they are, or where they live in Salford. Recovery – with service users returning to full health, moving through services, and being discharged

where clinically appropriate. Recognition of the links between physical health and mental health, and the government pledge to

achieve parity of esteem. Support to remain in your own home and to live independently for as long as possible. The lowest possible number of people placed out of area (outside of Salford). The best possible outcomes for service users, their carers, and their families (including fewer symptoms

of ill-health, the ability to lead as normal a life as possible, and maintain contacts with family, friends and local communities).

The lowest possible number of complaints and untoward incidents. Excellent value for money.


Develop business case to address high demand in Early Intervention in Psychosis. Develop and launch new all age Mental Health Commissioning Strategy. Implement Salford Suicide Prevention Strategy and action plan. Support the development of the GM Suicide Prevention Strategy and lead the commissioning of the GM

Suicide Bereavement service. Develop and improve the employment pathway for people with serious mental health problems. Improve IAPT capacity and pathway to meet the increased access rate, waiting times and ensure that

IAPT provision has a perinatal frame of mind to meet perinatal mental health duties. Ensure Salford’s MH Liaison service meets 24-7 compliance and access targets. Develop a grants programme for the VCSE sector to enable a broader response in meeting mental health

need and supporting improved mental wellbeing. Improve pathways between IAPT services and key physical health services. Develop diagnostic and post diagnostic services for ASD and ADHD in line with national policy and

standards. Deliver the national policy and strategy around Transforming Care for people with a learning disability

and/or autism. Review supported employment pathways for adults with learning disabilities. Explore new models of mental health care; identify opportunities for development and transformation in

Salford. Implement priorities of CAMHS Transformation plan and Emotional Health & Well Being test case for

children and young people.Other existing or developing delivery plans or strategies:

Salford Suicide Prevention Strategy Mental Health Strategy

Carer’s Strategy CAMHS Transformation plan



Core Indicators:Patients diagnosed with dementia whose care plan has been reviewed in a face-to-face review in the preceding 12 monthsDementia (aged 65 and over)IAPT Recovery Rate (CCG) – PUBLISHEDIAPT Waiting Times - 6 Week Wait Ended Referrals (CCG) - PUBLISHEDIAPT Waiting Times - 18 Week Wait Ended Referrals (CCG) - PUBLISHEDPeople experiencing a first EIP treated within two weeks of referralImprove access rate to, and waiting times of, Children and Young People’s Mental Health (CYPMH) ServicesProportion of people with a learning disability on the GP register receiving an annual health check

Other key performance indicators:Care Programme Approach (CCG)Reliance on specialist inpatient care for people with a learning disability and/or autismCompleteness of the GP learning disability registerMental health out of area placementsMental health crisis team provision


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Strategic Programme 6: Enabling Transformation

Executive Lead Hannah Dobrowolska; Steve DixonClinical Lead Tom TaskerLay Lead Edward Vitalis

Locality Plan Priorities: Streamlining, joining up and sharing responsibility and budgets for commissioning of services. Streamlining, joining up and sharing responsibility and budgets for ‘back office’ commissioning

support. Maximise the opportunities to achieve efficiency through the use of digital technology. Rationalise the use of public sector estate to achieve efficiencies and effectiveness in delivery across

all sectors and allow provision of a range of accessible settings. Enable a suitably skilled workforce and working conditions in order to achieve transformation and new

ways of working. Work collaboratively with voluntary, community and social enterprise (VCSE) and other local providers

to maximise reach, outcomes and impact beyond statutory provision. Build from Salford’s successful innovation and research programme to test and embed new ways of

working to support our transformation aims. Radically change engagement practice from consultation to involvement of the public in an equal

conversation.CCG Priorities 2018-19

Establish a Strategic Commissioning Function (SCF) and integrated commissioning decision making for health and social care between the CCG and Salford City Council.

Scope the requirements for integrated enabling functions across the CCG and Salford City Council. Establish a Best Value Workstream considering efficiencies and savings required across health and social

care commissioning. Ensure the CCG continues to meet its wide range of statutory duties, maintaining and improving its robust

governance and performance management systems. Support the development of incentive payments across health and social care pathways enabling care to

be delivered in the most appropriate setting. Provide contract and finance support to GM and GM Health and Social Care Partnership to deliver the

objectives of the GM Devolution Programme. Lead the process to develop new payment and contract models for Salford. Deliver Locality IM&T plan. Roll out a single solution across all GP systems to engage patients with online services. Deliver communications and engagement work plans for the CCG, Locality Plan and other partnerships. Further improve staff and member engagement, building on high Staff and Stakeholder Survey results. Deliver the Diversity and Inclusion work plan including embedding the Equality Analysis (EA) process and

the role of Personal, Fair, Diverse staff champions. Deliver the Social Value work plan with a focus on Carbon Literacy and taking action to support those

living in poverty, including through promoting the Real Living Wage. Review Locality Plan delivery arrangements including programme management. Work with Salford City Council to review risk management strategies and arrangements.


Estates Strategy and Strategic Estates Plan Primary Care Estates Strategy Digital Innovation Schemes Communications Strategy and work plan Engagement Strategy and work plan

Organisational Development Strategy and work plan HR Strategy and work plan Salford Locality Plan Risk Management Strategy


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Contracting and Financial performance monitoringMandatory training ratesStaff attendance ratesStaff survey resultsCCG Improvement and Assessment (IAF) Quality of Leadership ratingThere are also four financial statutory duties as follows: Revenue - delivery of the CCG’s planned control total (which is breakeven for 2017/18). Cash management - The CCG has been allocated a maximum cash draw down limit of £434m for the

year. Current guidance requires the cash balance at the end of the month to be less than 1.25% of the cash draw down for that month.

Better Payment Practice Code (BPPC) - 95% of invoices paid within the agreed terms or within 30 days if there are no specified terms.

Running costs - manage within the CCG’s running cost allocation.


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Risks to the delivery of Salford CCG’s business plan for 2018-19

NHS Salford CCG’s Risk Management Strategy and Risk Management Framework details how our strategic programmes, key work programmes and activities are aligned and explains the method by which risks are assessed, scored, monitored and reported.

Our strategic programmes are the primary focus for risk identification and horizon scanning. Strategic risks are recorded in our strategic risk register which is held in the integrated business planning, performance and risk system. Operational risks are captured in specific programme and project risk registers across the organisation.

Details on the CCG’s risk appetite, risk assessment process, risk ownership and accountability and training and reporting arrangements can be found in the CCG’s latest Risk Management Strategy.

All strategic risks are subject to a bi-monthly review by executive leads and also by clinical and lay leads within the CCG’s Governing Body through the regular board assurance framework report. This includes progress against our plans, risks and the latest performance breaches including plans for recovery.

The latest Strategic Risk Register heat map below (April 2018) shows the distribution of Strategic Risks across the CCG.

There are currenlty 2 risks rated as high, these relate to;

Achievement of national performance targets against constitutional standards and;Cyber Security threat.

Each strategic risk has a comprehensive risk assessment including existing controls, gaps and assurances and any further risk treatment plans as required.

Salford CCG’s current programme risk profile is summarised below. The full programme risk registers are available on request.

http://www.salfordccg.nhs.uk/download.cfm?doc=docm93jijm4n5381.pdf&ver=5720

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