Operational Plan Summary 2012/13

1. Operational Plan Summary 2012/13

2. Contents Forward by Carl Ellson, South Worcestershire CCG Chair............................................................................ Section 1 Introduction to South Worcestershire .......................................................................... Section 2 Our vision, values, objectives and priorities ................................................................. Section 3 2011/12 Achievements................................................................................................. Section 4 2012/13 Corporate objectives....................................................................................... Section 5 2012/13 Commissioning priorities................................................................................. Section 6 Our priorities in more detail.......................................................................................... - authorisation.............................................................................................................. - engagement.............................................................................................................. - local service priorities............................................................................................... - joint service review ................................................................................................. - finance and quality, innovation, productivity and prevention (QIPP) ......................... Section 7 Contact us ................................................................................................................. Glossary .................................................................................................................... 3 4 6 8 11 12 13 14 20 21 22 27 28

3. Forward by Carl Ellson, CCG Chair The NHS reforms have placed clinicians absolutely at the forefront of improving healthcare commissioning and in South Worcestershire we are determined to grasp this challenge and to improve services and outcomes for our population. Now that the Health and Care Bill has been passed, we will be concentrating this year on our application to be authorised as a statutory organisation which will provide us with the responsibilities and freedoms we require to commission the best care possible within the resources available to us. This Operational Plan Summary reviews our achievements in 2011/12 and sets out our overall vision and priorities and importantly how we will deliver these during 2012/13. A full version of our plan is also available. We are undoubtedly in a period of great change, with the health care reforms and the country’s wider financial challenge greatly influencing how we approach 2012/13. We will be working collaboratively with patients and the public, our NHS providers, other CCGs, the Local Authority and the voluntary sector to deliver much of the work outlined in our plan. The Joint Services Review of Worcestershire health services is a major component of this collaborative work across the county and I am committed to us playing a major role in shaping the outcome of that work. Dr Carl Ellson Clinical Executive Lead and Accountable Officer South Worcestershire CCG

4. Introduction to South Worcestershire South Worcestershire CCG will be the biggest of the three CCGs in Worcestershire, accommodating approximately half of the health budget being delegated in the County. We are a collection of 32 General Practices serving a population of 292,000 people. The age and demographic profile for South Worcestershire is similar to that of the county as a whole. However, there is a slightly greater proportion of people aged 65 or more. Despite what appears to be a typical population profile, there are challenges that we will need to address. For example: • The significant proportion of the elderly population at risk due to rural isolation. • There are significant areas of social deprivation in urban parts of South Worcestershire’s area. • Across South Worcestershire there are significant variations in the appearance of chronic long term conditions. • Mental health is the single largest area of long term disease related spend.

5. Our Board Dr Anthony Kelly Dr Carl Ellson Dr David Farmer Dr Jonathan Thorn Dr George Henry Dr Felix Blaine Dr Nikki Burger

6. Our vision and purpose We exist to ensure that the population of South Worcestershire enjoy lives which are as healthy as possible. To achieve this we will aim for the following: South Worcestershire Clinical Commissioning Group will be recognised as a model organisation for providing innovative and creative healthcare services for its patients. Our Practices will work together to achieve goals and maximise primary care efficiency. We will use scarce resources wisely and our community will understand that unpopular decisions are taken in the interests of the community as a whole. Ten years from now the delivery of healthcare for residents of South Worcestershire will have improved significantly and NHS care provided will guarantee clinical quality for our patients. Our core purpose as an organisation is to: • Improve the health of our patients by commissioning high quality, value for money healthcare services. • Listen to and gains the respect of the community • Work in partnership with statutory, voluntary and private sector organisations for the betterment of the population we serve • Invigorate healthcare delivery by creating value based competition founded on improved patient outcomes. • Pioneer new and innovative ways to provide healthcare. Throughout this Operational Plan we will outline how we plan to meet this purpose and ultimately deliver our Vision. Whilst our vision will take a number of years to deliver, this plan outlines the steps that we plan to take over the coming 12 months.

7. Our values • Organisational Values • Be clinically effective, quality focused and patient centred. • Secure value for money in everything we do. • Be an organisation that values its staff. • Not tolerate mediocrity – to have “why not”, rather than “cannot” embedded in our vernacular. • Be nimble, decisive, proactive and dynamic • Challenge bureaucratic NHS behaviour. • To demand of each other what is right, even if our actions and decisions impact on our popularity. To deliver our vision for South Worcestershire we need to build and develop a successful organisation that is clear in what it is trying to achieve. Successful organisations have clear values; values which everyone who works in the organisation share. Last year, our Board took time to develop and share these values and they continue to drive our work. We recognise that for values to be more than “nice words” we need to act upon what we say. Our Organisational Development Plan (a separate document which underpins our Operational Plan, outlines in far more detail how we plan to embed these cultural values in everything we do.

8. 2011/12 Achievements In our 2011/12 Business Plan, we set out 6 priorities areas for the financial year. Below is a summary of the progress that we have made against each priority

9. 2011/12 Achievements continued In our 2011/12 Business Plan, we set out 6 priorities areas for the financial year. Below is a summary of the progress that we have made against each priority

10. 2011/12 Achievements continued In our 2011/12 Business Plan, we set out 6 priorities areas for the financial year. Below is a summary of the progress that we have made against each priority

11. Our corporate objectivesWe have defined these objectives for 2012/13

12. 2012 /13 Commissioning Priorities SWCCG is committed to working with partner organisations in order to achieve the best health outcomes for the people of Worcestershire. For 2012/13 priorities have been shaped by the constituent practices with checks back to our partners and the NHS Operating Plan to assess alignment. During 2012/13, we will develop ever closer dialogue with partners to ensure a more integrated approach and evidence based commissioning. The steps that we are taking are: • Sharing and analysing the data from the Joint Strategic Needs Assessment (JSNA) through the locality groups. • Building a culture that uses evidence and data to shape decision making. Business Intelligence reports will be used as a key data source. • Consulting on and implementation of a public engagement plan to understand the priorities of patients. • Continuing as a key player of the Health & Well Being Board with Dr Carl Ellson as vice-chair. • Fully participating in the Joint Service Review of hospital and community services in Worcestershire • Developing a partnership model of commissioning which demands quality services but which seeks to understand and resolve challenges faced by providers.

13. Our priorities in more detailAuthorisation By April 2013, the government aims for all Clinical Commissioning Group to be authorised as statutory organisations and to take over full commissioning responsibilities . Primary Care Trusts and Strategic Health Authorities will be abolished on 31st March 2013. All CCGs are required to submit an application to the National Commissioning Board to be authorised as statutory bodies. Applications will be made in 4 ‘waves’. South Worcestershire CCG, together with the other 2 Worcestershire CCGs has elected to submit an application in Wave 2 on 1st September 2012. The application process has a number of phases: • Preparation – over the spring and summer, we will be gathering evidence to demonstrate our capacity and capability to commissioning services for our local population • Stakeholder survey-in July, the National Commissioning Board will send a survey to all our constituent practices and a range of other stakeholders to seek their views on the CCGs capability • Application- the formal application will be submitted on 1st September • Site Visit – During October, 6 members of the National Commissioning Board will visit us to discuss our application • Outcome – During November, we can expect to hear whether our application has been successful. The National Commissioning Board has the powers to authorise CCGs in full, to authorise with conditions with a development plan to be followed before full authorisation or to reject the application. For any CCG which fails to achieve authorisation by April 2013, the National Commissioning Board will manage commissioning for that population until such time as the application is successful.

14. Our priorities in more detailEngagement • We recognise the role that engagement has in identifying the opportunity to improve services – both through proactive involvement in planning and through responding to patient and community views following their involvement with our services. We also recognise that it is important to engage with a wide range of individuals and groups, not just those that are active and easy to access. • Our intentions for engagement are to: • Make sure engagement is absolutely integral to how we work and to build communications and engagement into the commissioning process to ensure that all commissioned schemes have been developed considering patient and stakeholder feedback. • Understand our communities and their needs and develop a culture that involves patients and the public at all levels of decision making. • Develop methods of communicating with and engaging South Worcestershire residents to assist the organisation to develop a real understanding of the local population and significant ideas and opinions amongst communities. • Ensure people are fully informed and that we are open and honest about what is possible and create flexible opportunities for people to be involved • Establish excellent relationships with stakeholders and inside and outside of the health economy to achieve joined up engagement, messages and campaigns. • Develop processes, infrastructure and capacity to deliver effective engagement • Ensure that all engagement is accessible and takes into account the varying needs of different groups of the local population. • Support the planning and delivery of campaigns and initiatives. • Contribute to the development of an operating model for Healthwatch and raise awareness of Healthwatch among local Public Patient Participation Groups and other patient fora.

15. Our Engagement Plan • The key aspects of our engagement plan are to provide the right opportunities for engagement. This includes: • Participation in decision making from a relatively small group of those who wish to be actively involved. • Informed contribution through a range of participative bodies that contribute to the wider debate • Providing information of interest to the public on ideas, innovations and major decisions.

16. Engagement • In implementing this plan to date, we have: • Set up public meetings to consult on our draft plan. • Commissioned a project to help us work with the people of the 6 most deprived wards in Worcester City to help us work in partnership with the community to commission services which better meet the needs of local people. • This year, we will: • Develop our processes to ensure that we build engagement into our routine business, including collecting and acting on patient feedback. • Seek feedback on our own performance as an organisation. • Establish a patient, public and stakeholder committee to advise SWCCG Board. • Consult on establishing SWCCG as a ‘membership’ organization. • Develop a strong partnership with LINk (Healthwatch from 2013). • Jointly train commissioning professionals & our members to carry out quality monitoring visits at our provider organisations.

17. Local response to our draft engagement plan What we asked you… Does the Levels of Engagement Diagram (below) make sense and is it easy to understand?

18. What you told us… Levels of engagement

20. Our priorities in more detailPriorities for local service development At a development day held in October 2011,SWCCG priorities for local improvement in 2012/13 were defined as: • The development and implementation of a new service model for integrated community services which maximisesvalue, enhances the patient experiences and keeps patients at home wherever clinically appropriate. • The development and implementation of enhanced support for patients in care homes drawing on the evaluation of the 2 year pilot in Malvern Hills & PershoreLocality. • Enhancement to primary care mental health services which meets NICE guidance, delivers value for money and frees capacity in secondary care mental health services. • Three development priorities for 2012/13: • A new service model for integrated community services. • Enhanced support for patientsin care homes. • Enhanced primary care mentalhealth services

21. Our priorities in more detailManaging our local health economy – Joint Services Review A strategic system wide approach is being taken to fundamentally review the options for securing a high quality financially sustainable providers. We are actively involved in this process and will participate fully. The review is chaired by Bryan Smith, Non-Executive Director for West Mercia, with Dr Anthony Kelly, SWCCG Board member acting as Clinical Lead. SWCCG has representatives on the 4 work streams of the review as follows: The results of the Joint Services Review will not be known until later in the year and therefore our focus in the coming year is on participating in the review to the fullest extent and we will outline our response to the major issues in next year’s operational plan. However, right now we have a clear understanding of what we want the JSR to achieve for our community and patients. Our ambitions include to achieve sustainable high quality services that are as close to, if not in, people’s own homes. This will needs to come through enhancing quality, capacity and capability in the role of primary care and community teams, investment in enabling technology, a stronger focus on preventing illness and the virtual elimination of urgent care admissions for known high risk groups. As well as delivering transformational change, this also means addressing the core weaknesses in our current system around access to services such as A&E and Stroke. These are bold ambitions, but by engaging in the process, working with our stakeholder, partners and community we are confident that we can make significant strides in this very positive direction.

22. Delivering Quality, Innovation, Productivity and Prevention (QIPP) QIPP (quality, innovation, productivity and prevention) is the government’s approach to health services achieving more from the resources available to enable us to manage the growing needs of an aging population. Across Worcestershire the QIPP challenge for 2012/13 is £11.4m. The estimated share of South Worcestershire’s contribution to this total is £5.7m. Further work is being undertaken to establish the exact value but for the purposes of this plan we are aiming for the £5.7m. The following pages provide an overview of the QIPP programme along with a summary of actions around what SWCCG will do specifically to support delivery of these targets. SWCCG recognises the importance of owning and delivering the QIPP agenda, not just because of the contribution it makes to the financial health of the CCG, but also because of the opportunity it provides to significantly improve quality and genuinely transform the way in which some services are delivered.

23. Our priorities in more detail - Financial plan and QIPP The annual budget of £310,452,038 for South Worcestershire CCG represents the projected spending requirement for 2012/13. This sum includes an agreed transfer of £2m from Wyre Forest CCG and this enables South Worcestershire to start the year with an operational risk reserve of £2.95m, which equates to 1% of the overall CCG budget. The budget requirement is dependent on the CCG delivering the commissioner QIPP schemes of £5.7m. This is a risk that can be managed through robust project management of the QIPP programme.

24. Delivering QIPP – our urgent care projects

25. Delivering QIPP – our planned care projects

26. Delivering QIPP – our primary care schemes

27. Contact us The government reforms of health services which have culminated in the Health and Social Care Act (2012) aim to increase the accountability of health care organisations to their local population. We seek to be an open, transparent organisation which is accessible and listens to our local community and all our stakeholders. Read more about us on our website - www.southworcsccg.nhs.uk where you will find a full version of our Operational Plan We will be holding further public events during 2012/13 and we are in the process of building a list of members and volunteers to work closely with us. Read more about these opportunities in our Engagement Plan. We look forward to hearing from you.

28. Glossary A&E Accident and Emergency CCG Clinical Commissioning Group CQUIN Commissioning for Quality and Innovation GP General Practitioner ICATS Integrated Clinical Assessment & Treatment Service IV Intra-venous JSNA Joint Strategic Needs Assessment JSR Joint Services Review LINk Local Involvement Network NHS National Health Service NICE National Institute of Clinical Excellence PPI Patient and Public Involvement PRG Patient Reference Group QIPP Quality, Innovation, Productivity and Prevention RAID Rapid Access Interface Discharge SWCCG South Worcestershire Clinical Commissioning Group WAHT Worcestershire Acute Hospital Trust