With challenging financial objectives facing Mansfield and Ashfield, and Newark and Sherwood Clinical Commissioning Groups (CCGs), the senior team needed a current analysis of cost control options and QIPP opportunities to inform robust decision making.
NHS Arden & GEM Commissioning Support Unit undertook an initial financial analysis to investigate cost drivers, demand pressures and identify trends. The output was then used to facilitate a series of deep dive workshops in the three main pressure areas.
As a result, the CCGs now have a greater understanding of what is driving high cost increases and activity trends, a robust framework for cost containment and recommendations for achieving both budget and QIPP levels.
Understanding the challenge
In the current challenging financial environment, CCGs are under continual pressure to control costs and radically improve productivity.
The Mid-Nottinghamshire CCGs (Mansfield and Ashfield, and Newark and Sherwood) have a QIPP target of £33m for the current financial year (2017-8) and needed to build on currently available information and analysis by commissioning a high level review of cost control options and QIPP opportunities.
Arden & GEM’s finance team comprises professionals with a breadth and depth of experience in effective decision support, gained in both the public and private sectors. By engaging independent expertise, the CCGs were able to benefit from a fresh, impartial perspective that provided a different ‘lens’ through which to examine their challenges.
Developing a solution
A senior financial management expert, from our service, worked collaboratively with the CCGs’ Chief Finance Officer, Turnaround Director, finance team, business intelligence team and clinicians, to deliver the project.
Our initial review triangulated cost, activity and local population data to create a series of meaningful observations and trend analysis around cost pressures and demand pressures.
Across the key activity areas of acute, prescribing, Continuing Healthcare (CHC), primary care, community and mental health there was specific focus on:
- Cost and tariff pressures
- Environment and population pressures
- Current initiatives
- Further opportunities.
The initial review was completed in just 12 days before submission to the Turnaround Board.
The second phase involved running deep dive workshops in the three main pressure areas identified by the initial review: prescribing, CHC and acute care.
Facilitated by our senior financial management expert, and including attendees from the CCGs’ finance, business intelligence and clinical teams, the structured sessions covered:
- Available information and datasets
- Identification and agreement of the top areas for cost containment and service improvement
- Emerging risks and future trends
- Likely growth and risk issues with an ageing population.
There was a specific focus on contract management and reducing clinical variation as levers for improving efficiency and productivity which will support the achievement of both budget and QIPP levels.
Outcomes
The CCGs now have a greater understanding of what is driving high cost increases, as well as a quantitative and qualitative based framework that links activity, cost and trend data.
By bringing the right people and information together at the workshops, we were able to ensure that identified cost control initiatives could also have a positive impact on service quality and patient outcomes.
As a result, the CCG was able realise £3.5m of QIPP savings towards its overall target in the financial year 2017/18, across primary care, CHC and acute care.
"With a challenging budget and QIPP target, we needed to quickly identify areas to increase cost control and improve productivity. The finance team at Arden & GEM was able to offer meaningful analysis and insight, as well as practical frameworks, to improve our understanding of pressure areas and test out initiatives with internal stakeholders. We are now in a position to make robust decisions underpinned by activity, cost and trend data."
Sandy Hogg, Transformation Director at Mansfield and Ashfield, and Newark and Sherwood CCGs