Transcript Calderdale & Huddersfield health & social care
Mike Potts
Chief Executive
Local overview and key challenges across the four themes set out in the Operating Framework
Calderdale, Kirklees and Wakefield District – the place Calderdale Halifax Kirklees Wakefield
About us …
• 991,000 local people • 582 staff • £1.68 billion budget • Significant health challenges • 4 shadow CCGs • 1 West Yorkshire Commissioning Support Service • 3 Health and Wellbeing Boards
About us …
(Contd) Main providers: • 2 acute (1FT, 1 aspiring FT) • 1 mental health/care trust (FT) • 1 ambulance service (aspiring FT) • 2 social enterprises • 138 GP practices • 127 dental practices, • 200 pharmacies • 114 optometry providers Wider system leadership: • Emergency planning (West Yorkshire) • 111 implementation (Yorkshire & the Humber)
Strong relationships with our local authorities
Our role
3 PCTs - one cluster board and one executive team from October 2011 Our role: • lead the local NHS • improve the health of local people • commission high quality safe and sustainable services within resources • implement NHS reform ∙ manage transition to the new commissioning system ∙ manage transition of PH to LAs and support establishment of Health & Wellbeing Boards ∙ support provider development
Our focus Control Create Close
•
Maintaining quality & safety
•
Delivering performance
•
Managing the money
•
Maintaining resilience
•
Creating the new commissioning system CCGs, CSS, public health, H & WBBs
•
New relationship with public
•
Embed transformational change
• • •
Formal Closure of PCTs Handing over our legacy Celebrating our achievements
Challenges for health and social care
• Ageing population – increased pressure on health and social care services.
• Do things differently – encourage innovation and transformation.
• Embrace new technologies.
• Integrating care across agencies – move from competition to co-operation/partnership.
• Improve health & health outcomes - ownership, lifestyle choices, wider determinants of health.
• Meaningful engagement with our patients and local communities.
• Limited resources – need for greater efficiency.
Operating Framework 2012/13
4 key themes:
• Getting the basics right • Maintaining our grip on performance • Meeting the quality and productivity challenge • NHS reform
Getting the basics right Control
• Cluster quality governance • Swift response to CQC inspections • Performance: grip on key quality performance indicators • Hospital acquired infections • Patient safety • Safeguarding • Assuring and improving quality through transition • Quality metrics across the system • Quality impact assessments
Getting the basics right
Contd
Create
• CCG quality governance/infrastructure • National and local CQUIN development • Focus on improving patient experience
Close
• Close down process in place • Legacy documents • Quarterly reporting to NHS North of England • Face to face handovers Q3 and Q4
Performance – the challenge
Keeping a grip on performance: • A&E and Referral to Treatment (RTT) 18 weeks monthly delivery by speciality • Increased pressure on delivery of zero Health Care Acquired Infections (HCAIs) • Continued focus on zero Mixed Sex Accommodation (MSA) breaches Focus on sustainability Plans to Board in May
Quality, innovation, productivity, prevention
(QIPP) • Strong record of managing within resources and delivering QIPP targets.
• QIPP targets 12/13 to 14/15:
2012/13 2013/14 2014/15 TOTAL Calderdale £m
5.5
4.8
5.3
15.6
Kirklees £m Wakefield £m CLUSTER £m
9.5
10.0
12.5
11.4
27.5
26.2
10.0
29.5
11.4
35.3
26.7
80.4
Our 5 transformational QIPP Programmes (2012-15) Preventing unplanned admissions and managing long term conditions Changing planned care pathway Assistive technology and risk stratification Alternative community services Stronger mental health and learning disability services
Whole system integration
• Mobile response • Emergency plans .
• Single point of access • community care teams • E consultation • Personalised care planning • Case management • Risk stratification LA Community provider
Person first
Primary care Acute trusts • Community care teams .integrated health and social care on primary care footprint • Virtual ward • A/E navigation • E consultation • Telemedicine • Virtual ward • Community consultants
System enablers
• Assistive technology • E-consultation • Integrated provision • Case management • Risk stratification • Leading Large Scale Change Support Programme
Whole system health and social care transformation
50% of QIPP savings delivered through two Major transformation programmes:
• Calderdale & Huddersfield Health and Social Care Transformation Programme • Wakefield District and North Kirklees Health and Social Care Transformation Programme
The transformation map
CCGs: Greater Huddersfield & Calderdale Partner Trusts: SWYPFT, Locala CKW Cluster Board CHFT Board Calderdale Council Kirklees Council
Calderdale and Huddersfield health & social Care transformation Elective care:
Joint approach to delivery of redesign and QIPP
Urgent care:
Joint approach to delivery of non elective and urgent care and QIPP
Health strategy refresh:
Future service vision Transformation Delivery of QIPP/CIPs
Cross Cutting:
communications and engagement; clinical leadership; quality and safety; workforce, PMO governance and risk management
Calderdale & Huddersfield health & social care transformation
Aims: • A strategy for the next 5 years to deliver high quality care in the most appropriate setting.
• To be in top 10% nationally for safe, reliable patient centred care.
• Maximise the benefits of the NHS reforms and respond to demographic changes.
• Focus on the needs of people with LTC.
• Affordable and sustainable services, where local leaders are recognised for their approach to partnerships and integrating care.
CCGs: Wakefield North Kirklees Partner Trusts: SWYPFT, Locala NHS North Partner PCTs: NHS Leeds CKW Cluster Board MY Hospitals Trust Board Wakefield Council
Wakefield District and North Kirklees health and social care transformation Programme executive Recovery and service improvement
• Financial recovery • Service improvement
Transformation programme
• Care outside hospital • Urgent care • Clinical services strategy • Primary medical services
Foundation Trust application
Transactional processes Kirklees Council
Cross Cutting:
Communications and engagement; clinical leadership; quality and safety; workforce, PMO governance and risk management
QIPP schemes – some examples Diabetes e consultation
– linking GPs and secondary care clinicians (early indicators 75% reduction in referrals)
Telehealth in Care Homes –
supporting end of life care – (10% – 15% reduction in emergency admissions)
Dementia Care
– new model of specialist day care – 10% increase in day care activity
Primary care transformation
– to increase primary care capacity – ( 8% reduction A&E attendances 5% reduction in LTC admissions)
Implementing NHS Reform
NHS Commissioning Board
Chief Executive Sir David Nicholson Chair Professor Malcolm Grant
Local clinical commissioning groups (CCGs)
Chair Applying for authorisation
Calderdale 27 Dr Alan Brook 1 st phase (July)
RAG rating
Greater Huddersfield Wakefield Alliance 40 Dr Steve Ollerton North Kirklees Health Alliance 31 Dr David Kelly 40 Dr Phil Earnshaw 2 nd phase (Sept) 3 rd phase (Oct) 1 st phase (July)
Commissioning support service (CSS)
• West Yorkshire wide approach • Already operational – from this month • Business case submitted • Expect to be fully operational by end October. • Currently consulting on senior staffing structure • MD appointed
Alison Hughes
Provider development
• All remaining NHS trusts move to Foundation Trust status.
• New provider models e.g. social enterprises, joint ventures.
• More choice, competition and co-operation • Any qualified provider.
Public health transition
Public health – local authority • Public health functions to: • Public Health England • Local authorities • NHS Commissioning Board • Joint Directors of Public Health x 3 • Transition plans agreed. • Plans assured by NHS North of England.
• Ready for start of shadow period: Oct 12.
Health & Wellbeing Boards
• Three shadow boards in place.
• Strong relationships developed with CCGs.
• Joint Health and Wellbeing Strategies being Health & Wellbeing Boards developed.