Our assurance rating

NHS England has released its annual assurance rating for NHS Kernow and the progress that is being made to develop an integrated health and care system.

The ratings take into account the performance of Cornwall and the Isles of Scilly’s health and care system, the quality of services that are commissioned, leadership and our financial pressures.  For this reason, NHS England has rated the CCG as inadequate. However, there has been significant financial recovery and our leadership is already working hard as a committed team to address the areas highlighted in the rating and the improvement of the CCG’s performance, and as a result we are seeing steady progress. 

NHS England recognised the CCG shows areas of strength and good practice when working with partners across the health and care system, an improved financial position and strengthened governance arrangements.    

Jackie Pendleton, NHS Kernow’s Chief Officer, said: “I would personally like to thank all of you who have contributed so tirelessly to the huge amount of work that we have carried out to continue to improve our organisation. Although there is still much to do, we are moving forward and you should be rightly proud of our achievements.” 

The report made particular note of the improved system wide approach to delivering improvements to urgent care services. Other areas of good practice highlighted were: the CCG ensured that it met the 15 per cent target set by NHS England of all NHS Continuing Health Care Assessments (packages of care for adults with complex needs) taking place in acute hospital settings by successfully achieving zero per cent in the final months of the assessment time frame, a key priority in helping to reduce the delay of transfer from acute hospitals. 

NHS England also highlighted that the CCG involves and engages patients and the public and works in partnership with others, including Cornwall Council. 

Whilst we acknowledge the rating, it is important to note that it is based solely on the last financial year (April 2017 to March 2018), which ended more than three months ago. 

Considerable progress has been made during the past 12 months to address the issues that are faced by both our organisation and the wider health and care system.  However the most significant positive impacts on health and care took place in the final months of last year and into this one.  This progress and the results of these achievements have not been taken into account in NHS England’s annual assurance rating published today (Thursday 12 July). 

There are key improvements that have taken place in the last few months that the rating does not recognise because of the time frame.  For example the year end position for medicines optimisation as part of the delivery of our financial plan for last year and our investment into primary care.   There has been a significant reduction in the number of people with mental health needs being treated out of Cornwall, thanks in part to the opening of a new 12-bedded rehabilitation and step down unit (Cove ward) in Redruth to support people with complex needs to safely and confidently return back into the community. 

An additional £1 million has been invested in improving specific services for children and young people. This funding was used to provide further support for children and young people with eating disorders and grants to voluntary sector organisations, including the Intercom Trust which helps people with gender identity and sexual orientation. 

In May we were delighted to announce an exciting new initiative developed by ourselves, Royal Cornwall Hospitals NHS Trust, Cornwall Partnership Foundation Trust and Cornwall Council to create a multi-agency hub to support people in Cornwall who are at risk of experiencing a mental health crisis has been awarded £1.5m funding from the Government. 

For the first time in our history, NHS Kernow, Cornwall Partnership Foundation Trust and Royal Cornwall Hospitals are working together to deliver a joint financial recovery plan, which underlines our commitment to meet demand for services and create a sustainable, clinically-led NHS and care system for the future. 

We know there is still more we can do to reduce the length of time people are waiting for non-emergency procedures and we need to sustain the recent improvements we have seen in our emergency department and getting people home from hospital with packages of care to support them.   

We will continue to build on the firm foundation of health and care colleagues truly working together that we have seen since spring.  This has produced an improvement in the number of people seen within four hours in the emergency department in Treliske and more recently in Derriford and a reduction in the numbers of people waiting in acute and community hospitals for health and social care support, falling from a daily average of 174 in January 2017 to 90 at the time of writing in July 2018. 

NHS Kernow is also pleased there has been a recognition of areas where the NHS in Cornwall and the Isles of Scilly is excelling.  Earlier this year the country’s most senior NHS mental health director praised Cornwall for making sure that additional mental health investment is being used to improve the right services for people who need support for their mental health.   

The NHS in Cornwall has also been praised for the launch of a new GP Out of Hours and 111 service.  The new service isa collaboration between the GP provider organisation, Kernow CiC, Royal Cornwall Hospitals NHS Trust and Vocare and is the first step to creating a joined-up system of GP surgeries, community pharmacies, minor injury services, out of hours clinics, community hospitals, urgent treatment centres, emergency departments and self-help advice services such as NHS 111 and has been held up as an example of excellent partnership working. 

We are confident that as our ambitious plans to integrate health and care services evolve, people will benefit from an improved service.  We are also hopeful that the significant improvements that have already been made both by NHS Kernow and the wider health and care system will positively impact on the ratings next year.