Evidence submitted by Adur, Arun and Worthing
PCT (Def 51)
INTRODUCTION
The purpose of this short note is to provide
Health Select Committee Members with a brief background note about
Adur, Arun & Worthing PCT (AAW PCT).
BACKGROUND
AAW PCT was formed on 1 April 2002. It was created
from five organisations: three primary care groups (Adur, Arun
& Worthing), the Community Services element of Worthing Priority
Care Trust and some of the statutory functions of the former West
Sussex Health Authority.
The PCT serves an urban population of 220,000
along a narrow coastal strip in West Sussex. It is distinguished
by a high proportion of older people (24% aged 65 years or over
compared with 16% in England and Wales) and by higher levels of
ill health and deprivation than is typical in surrounding PCTs,
but has lower levels of mortality and morbidity than England
and Wales. (Standardised Mortality Ratio for AAW in 2002-2004
was 95 and the age standardised ratio for limiting long-term illness
in AAW in 2001 was 88). These overall rates mask significant variations
in health within the PCT area, with life expectancy at birth ranging
from 70.1 years to 84.8 years.
AAW PCT is structurally more complex than most
PCTs by providing a number of major services to other PCTs and
NHS organisations. In particular we manage Specialist Commissioning
(£115,000,000 turnover), Sussex Acute Commissioning (£752,000,000
turnover) and Sussex Health Informatics (average 407 staff (full
time equivalent), £24,000,000 turnover). These services,
along with our own local PCT budget of £310,000,000, give
a turnover in excess of £1 billion. However because AAW is
acting as the "agent" of other NHS organisations for
hosted services no financial advantage is conferred on the PCT
by handling such a large turnover, indeed the opposite is the
case.
During this period the PCT has achieved the following
financial results:
| 2002-03 | £968,000 underspend against resource limit
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| 2003-04 | £1,690,000 underspend against resource limit
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| 2004-05 | £3,653,000 underspend against resource limit
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| 2005-06 | £2,972,000 underspend against resource limit
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There have been other improvements too. In service access
despite rising levels of demand for emergency (16%) and planned
(12%) care the number of patients waiting for an outpatient appointment
reduced by 26% and 35% fewer waiting for inpatient care. The time
patients wait has reduced across the board too, for outpatients,
inpatient, A&E and primary care. New services have also been
created, such as intermediate care, community matrons, specialist
stroke services etc, many in partnership with Social & Caring
Services.
The PCT has a workforce, excluding hosted services, of 960,
of whom 860 are clinical staff and their support and management
and 100 management and back office staff. The PCT runs two small
community hospitals and a number of health centres and clinics.
Approach to Financial Management
PCT financial strategy was established in the preparatory
phase of the creation of the PCT. Delivering good results has
not been easy and has not been a consequence of benign circumstances.
The strategy reflects six key inter-connected approaches:
1. A strong value base of financial discipline.
2. A strong financial and commissioning strategy.
3. A strong performance management approach with providers.
4. A strong grip of internal financial control.
5. A strong culture of openness and trust with staff and
particularly with GPs.
6. A strong approach to governance and scrutiny by the
Board.
Steve Phoenix
Chief Executive, Adur, Arun and Worthing PCT
June 2006
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