The NHS outer north east London commissioning cycle 2012/13 – 2014/15

1. The NHS outer north east London commissioning cycle2012/13 – 2014/15 Jane Gateley Director of planning and delivery

2. Contents • Requirements • London time lines • Design principles • Roles and responsibilities • NHS outer north east London (NHS ONEL) approach • The NHS commissioning cycle • NHS ONEL resource plan and time line

3. Planningfor 2012/13 – 2014/15 • What is required? • Three year plan • Build on existing plans for 2012/13 – 2014/15 • - more detail on how QIPP initiatives will be delivered workforce • strengthened financial, activity, and work force analysis • Enable PCTs to meet their strategy planning requirements and cover all elements of healthcare to be commissioned • Provide pathfinders with CCG level plans that can be used as part of their authorisation process (Jul – Dec 2012) • Need to align with Operating Plan cycle 12/13 • What should be provided? • overview of local health economy • vision for local commissioning • areas for improvement • description of initiatives that will be implemented to deliver vision • based on JSNA and priorities identified in Joint Health and Well Being Strategy • What format should plan take? • Key elements: • Exec summary • Vision and strategic goals • Approach • Case for change • Key priorities • Opportunities (current and new) • Enablers • Delivery impact • Sustainable commissioning • Implementation

4. Timeline for planning cycle

5. Design principles • Strategic plans will be developed with the relevant partners and maximise the opportunity to increase clinical engagement in strategic planning • Cluster chief executives will be held to account for delivering plans on time • There will be clear leadership and lines of accountability within a cluster for the production of each element of the plan, especially where pathfinders have received delegated responsibilities • Pathfinders should engage in developing the whole commissioning strategy plan, and own their local commissioning strategy plan • Clusters will support pathfinders in developing their local commissioning strategy plans • HWBs must be engaged early in the development of plans and must endorse relevant elements of the plans before they can be formally agreed • What can be done once across London, should be done once across London including the London-wide strategic priorities endorsed by the GP Council. Through its assurance role, NHS London will facilitate the identification of pan-London strategic priorities • Plans will develop and further substantiate existing four-year PCT cluster plans and as such be clear where they are building on existing plans • Learning from previous planning processes will be considered throughout the processbyall • Strategic planning will be aligned with and feed into the operating planning process for 2012/13 • NHS London will continue to provide ongoing assurance over the planning process and of the plans themselves to report to DH

6. Roles and responsibilities

7. NHS ONEL approach • Meet with each CCG to discuss local approach in early September • Use NHS commissioning cycle as an enabler for matrix working (see next slide and detailed resource plan and timeline) • Begin implementation from mid September • Communicate/engage partners • Submit approved plan that meets authorisation requirements by end of November • Signed contracts in place by end of February • Joint implementation plans in place with trusts by end of March

8. NHS ONEL approach: use the NHS Commissioning Cycle based on principles …. Plan, Execute, Manage • Assess needs: through a systematic process, understanding of the health and health care needs of the PCTs resident population. • Describe services and gap analysis: reviewing the services currently provided and based on needs, defining the gaps (or over provision). • Deciding priorities: given a list of desirable actions, using available evidence of cost effectiveness and based on robust and defensible ethical framework, prioritise areas for purchase. • Risk management: understanding the key health and health care risks facing the PCT and deciding on a strategy to manage it. • Strategic options: bring together all the available information into a single strategic commissioning plan that outlines how the PCTs will deliver its core objectives (including those of the SHA and DH). • Contract implementation: put those strategic plans into action through contracting. • Provider development: (including care pathway re-design and demand management): support provider improvements or introduce new providers to deliver the services required (including setting up demand management systems and designing new care pathways). This includes supporting providers in decommissioning of services where appropriate. • Managing provider performance: monitor and manage the performance of providers against their contracts, especially against KPIs • Lead: Jane Moore • Output: Prioritised JSNA for each borough • Lead: Conor Burke • Output: Service and gap analysis • Lead: Conor Burke • Output: Commissioning intentions • Lead: Jane Gateley • Output: Risk assessment of plans • Lead: Jane Gateley • Output: Commissioning Strategy Plan • Lead: Conor Burke • Output: Signed contracts and SLAs • Lead: Conor Burke • Output: Joint implementation plan • Lead: Conor Burke • Output: Performance reporting

9. Current opportunities • Opportunity 10 • Primary care discharge facilitation adults • A&E discharge team • Rapid Response – PELC/NELF • Surgical hot clinics • Model for urgent/UCC utilisation • SPA/111 DoS • Ambulatory care

10. Opportunities – future priorities? • O10 What would a good urgent and emergency care service look like? • “A good urgent and emergency care service is the range of healthcare services available to people who need medical advice, diagnosis and or treatment quickly and unexpectedly. People using services and carers should expect 24/7 consistent and rigorous assessment of the urgency of their care need and an appropriate and prompt response to that need.” Dr AgnelloFernandes – August 2011 • Key principles • No confusion of what to do, who to call or where to go • 999 immediate life threatening calls • NHS 111 • Electronic Directory of Service • A joined up and co-ordinated system • 24/7 rapid response team • ICM • LTC management • EoLC • Reablement

11. Opportunities future priorities cont’d Safe responsive and a high quality service Improved patient access to urgent same day GP appointments High quality responsive out of hours service Multi professional urgent and emergency care workforce MH services located in EDs Out of hours services co-located and integrated with urgent care services 24/7 social care response service Safeguarding the young and vulnerable Child protection and adult safeguarding will be statutory responsibilities Patient and public involvement Improved public education and marketing or urgent and emergency care services Patient representation on the Boards of Commissioners

12. Next steps • A “good” CSP will be developed and tested with: • All GP practices • Patients and public • Clinicians including secondary care • Providers • Health and well-being boards • Local authorities

13. High level timeline