What we are asking the Health and Wellbeing Board to do today

1. Northumberland Five Year Draft Health and Care PlanHealth and Wellbeing BoardThursday 12 June 2014

2. What we are asking the Health and Wellbeing Board to do today • To reflect on what public engagement and demographics are telling us • To consider the draft five year plan and provide feedback on the direction of travel • To endorse the five year testing panel approach • To identify any gaps in development

3. What our engagement is telling us……. • We want to see a greater focus on more localised, • community-based services We want continuity of care • I want to be seen as a person first; as myself, rather than my health conditions or my age We want timely access to primary care

4. What our demographic information is telling us…… Life limiting long term illness 17% increase by 2018/19 Dementia 21% increase by 2018/19

5. Health and care in Northumberland: the seven elements of care Building a caring future We already have the plans for our hospital settings Building care in our communities We now need to focus on building capacity in primary care and our communities Care closer to home Turning our services to face and become embedded in the community: base hospitals, mental health, learning disabilities Care without walls Care is delivered in an integrated way where needed and is not limited by buildings or professional boundaries Transformation Blurring the boundaries between secondary and primary care/ physical and mental health/ social care and health care Parity of esteem Patient at the centre Single points of access Easy navigation of the system Focus on full life course Reduction of variation Doing things once Innovation Personal care led by the patient People are fully engaged and truly empowered to make decisions and take control of their own health and care Self-care

6. The building blocks: our system enablers • A shared approach to the use of capital and premises across the system • A real commitment to work towards shared information and the supporting IT infrastructure • A shared financial framework – which is real and transparent and medium term • No barriers – financial or organisational – resources flow to where patient need is • An innovative and flexible approach to workforce design and leadership development

7. So, what does this mean for Planned Care? • Reduced demand on urgent care; more care will be planned • Single point of access • Community-facing care closer to home • Efficient services offering value for money • Reducing demand through the prevention and self-management of conditions

8. So, what does this mean for Long Term Conditions, Unplanned Care and Primary Care? • Locally led solutions & models for primary care access and urgent care • Caring for our highest risk patients • Continuity of care where it matters most • Focus on dementia diagnosis and services • Changing the culture of how we manage long term conditions to encourage personalised care planning, self-care

9. So, what does this mean for Mental Health and Learning Disabilities? • Parity of esteem • Shift from inpatient to community and models that support independence • Potential for a series of whole system but locally sensitive footprints for MH/ LD services in the future • Reduction of variation in practice • Refocus mental health as a Long Term Condition

10. So, what does this mean for End of Life care? • Delivering patient choice • Personalised care and individualised care planning • Integrated end of life pathways • Communication and better conversations with the public on death and dying • De-medicalisation of death and seeing death as a life event

11. So, what does this mean for the prevention agenda, those who are pre-high risk, carers, self care and influencing demand? • Area that requires the most development • Early detection and diagnosis • Increase screening uptake rates • Self management of conditions • Support carers and the development of robust self care models to empower individuals in the community • Leisure, transport, housing

12. Five year plan testing panel: to act as a sounding board and critical friend in the development of the plan Take an inclusive, co-design approach Panel membership: Chair: Councillor Scott Dickinson Two carers Two patients Allied Health Services Social Care Healthwatch General Practice Specialist Nurse Other parties will be asked to engage based on need Support and critique the plan Take an active part using their personal and professional experience Provide assurance to wider audiences of the co-design approach

13. How we work in Northumberland

14. Our system-wide membership

15. Our system wide vision • Vision • Providing seamless high quality care for the people of Northumberland • Empowering our communities to live long and healthy lives at home • Principles • Care without walls’ – care is delivered where needed – and is not limited by buildings or professional boundaries • People are fully engaged and truly empowered to make decisions and take control of their own health and care • Seamless high quality care is centred around the patient and service user supported by aligned incentives • We will make the right thing to do the easiest thing to do • Create the right conditions and environment to allow new services to be developed safely • Create one single coherent story and supporting programme of work • Commitment to working collectively to improve outcomes for our population – with a willingness to take and share risk for the benefit of the system • Objectives • Whole population commissioning across the Northumberland system • High quality care provided in the most appropriate setting • Blur the boundaries between secondary and primary care/ physical and mental health/ social care and health care • Reduce health and social inequalities and prevent ill health • Transform primary and community care • Development of high quality, at scale pathways of care commencing with the complex elderly population • Drive innovation and reduce variation • Localised community services where possible, centralised where necessary • Skilled workforce delivering the right care in the right place at the right time