Team brief February 2016

1. Team brief February 2016

2. Chief officer’s accolade • A special thank you to the Safeguarding team • Jennifer Aldridge • Alice Marquis-Carr • Alison Taylor • Fiona O’Donoghue • Annlouise Stephens • Janice Harling • Linda Tattersall • Went above and beyond to ensure safety at a local nursing home • When safeguarding issues arise there isn’t always much notice nor time to act

3. Collaborative Working

4. NHS five year forward view • Over next five years dissolve traditional boundaries between care • Long term conditions are now a central task of the NHS • Out-of-hospital care needs to become a much larger part of what the NHS does • Services need to be integrated around the patient • Learn much faster from the best examples • Evaluate new care models to establish which produce the best experience for patients and the best value for money

5. Delivery – Five Year Forward View Focus on:- • Restoring financial balance • Delivering core access and quality • Closing three identified gaps • Health and wellbeing gap • Care and quality gap • Finance and efficiency gap.

6. NHSE requirements All NHS organisations to produce: • Operational Plan for 2016/17 • ‘Sustainability and Transformation Plan’ (STP) covering October 2016 – March 2021

7. Operational Plans for 2016/17 • Year one of five year STP • Progress on 7 day services (mandate) • Reducing excess deaths – increase consultant cover and diagnostic services • Improved access to Out of Hours by better integration • Improving access to primary care

8. Sustainability and Transformation Plan • Covers all CCG and NHS England commissioned activity and better integration with local authorities • System wide financial sustainability plan • Plan assessed on: - Quality (including scale of ambition and track record) - Reach and quality of local engagement - System leadership - NHS England’s confidence in arrangements

9. Healthier Lancashire – collaborative footprints 1 x Lancashire Five year Sustainability and Transformation Plan Cumbria Lancashire Cheshire and Merseyside 5 x Health Economy Five year Plans Lancashire North and South Cumbria Fylde Coast Central Lancashire Pennine Lancashire West Lancashire and Southport and Formby 16 x OrganisationalOperational Plans for 2016/17 Focus on national ‘must dos’ C CCG LN CCG B CCG FW CCG GP CCG CSR CCG BwD CCG EL CCG WL CCG SF CCG UHMB BTH LCFT LTH ELH S&O

10. Healthier Lancashire – driving footprints ‘Driving’ planning footprints for care programmes Sharon Martin Linda Riley Debbie Nixon David Bonson Peter Tinson Jan Ledward Jan Ledward Lancashire Urgent & Emergency Care Learning Disability Mental Health Care Homes Acute Specialised CAYPMH Health Economy Primary Care Organisational

11. Fylde Coast Financial Sustainability • Blackpool CCG Forecast = Surplus £0.56 Recurrent / Normalised = Deficit £4m • F&W CCG Forecast = Surplus £4.1m Recurrent / Normalised = Surplus £8m • BTH Forecast = Deficit of £14.4m Recurrent / Normalised = Deficit of £18.5m There are significant underlying financial problems across the main health partners.

12. What Does This Tell Us? • Significant financial pressures across the next 5 years; • We need to focus on actions to reduce cost and improve the health of the population; • Whilst we need to have a contract in place this should reflect our joint plans to ensure sustainability and transformation and not be seen as an end in itself.

13. Review of Fylde Coast Health and Social Care Strategic Plans

14. Work • 14 existing strategic plans reviewed • Over 400 initiatives identified and grouped into programmes • 7 interviews with system leaders • Workshop with 15 system leaders • 4 broad challenges identified • complex, varied and changing patient needs • recognition that current service models deliver sub-optimal quality • workforce challenges • financial challenge

15. Resourcing and Governance – geographical scope • Natural footprint • Rationale Recommended geographical scope:- 1. Prevention • 2 HWBBs/ Fylde Coast • Would continue to be led by the two HWBBs, coordinated across the coast 2. Primary and community care • Fylde Coast • Would be part/next stage of the Vanguard, led across the coast 3. Acute Sector (including planned care and maternity) • Lancashire wide • Some changes to be Lancashire-wide for scale (others by BTH with partners) 4. Children • Fylde Coast • Services would benefit from scale/best practice on quality and efficiency 5. Frail and elderly care • Fylde Coast • Extensivist model part of the Vanguard • Care homes leadership TBD 6. Management of multiple LTCs • Fylde Coast • Part of the Vanguard, led across the coast 7. Urgent and emergency care • Fylde Coast • Some changes to be Fylde-coast wide for scale 8. Mental Health and Learning Disabilities • Lancashire wide • Part of the work of the Mental Health Group, led across Lancashire 9. Enablers: Workforce, IT, and analytics • Fylde Coast • Coordination required across Fylde Coast 10. Enablers: Incentives, contract types, payment • Fylde Coast • Coordination required across Fylde Coast

16. Resourcing and Governance – geographical scope • Natural footprint • Rationale Recommended Fylde Coast Commissioning Advisory Board focus:- 1. Prevention • 2 HWBBs/ Fylde Coast • Would continue to be led by the two HWBBs, coordinated across the coast 2. Primary and community care • Fylde Coast • Would be part/next stage of the Vanguard, led across the coast 3. Acute Sector (including planned care and maternity) • Lancashire wide • Some changes to be Lancashire-wide for scale (others by BTH with partners) 4. Children • Fylde Coast • Services would benefit from scale/best practice on quality and efficiency 5. Frail and elderly care • Fylde Coast • Extensivist model part of the Vanguard • Care homes leadership TBD 6. Management of multiple LTCs • Fylde Coast • Part of the Vanguard, led across the coast 7. Urgent and emergency care • Fylde Coast • Some changes to be Fylde-coast wide for scale 8. Mental Health and Learning Disabilities • Lancashire wide • Part of the work of the Mental Health Group, led across Lancashire 9. Enablers: Workforce, IT, and analytics • Fylde Coast • Coordination required across Fylde Coast 10. Enablers: Incentives, contract types, payment • Fylde Coast • Coordination required across Fylde Coast

17. Resourcing and Governance – delivery resources 1. Prevention Each programme of work will need to have dedicated leadership and resources, working jointly at the Fylde Coast level: • A senior responsible officer (SRO) per programme • CEO or Director-level • From one of the Board member organisations • Clear focus on representing the overall interests of the Fylde Coast LHE • Held to account on progress/impact of ‘their’ programme by the FCSPB • Draws together appropriate teams for design /delivery of the programmes • A senior Clinical lead or leads from relevant organisations • A programme manager per programme from any relevant organisation • Design & delivery resources • Work is required to create a baseline of staff working on related programmes today and to develop proposals for future organization of the work and of the resources 2. Primary and community care 3. Acute Sector (including planned care and maternity) 4. Children 5. Frail and elderly care 6. Management of multiple LTCs 7. Urgent and emergency care 8. Mental Health and Learning Disabilities 9. Enablers: Workforce, IT, and analytics 10. Enablers: Incentives, contract types, payment

18. Fylde Coast – programme leadership roles

19. Collaborative Working - drivers • National commissioning system context • Healthier Lancashire • Fylde Coast, McKinsey ‘alignment of plans’ • Vanguard and Multispecialty Community Provider development • Sustainability and Transformation Plans • Financial context and QIPP • National provider system context

20. Fylde Coast – functional collaborative working • Functional leads identifying opportunities:- • Planning • Business Intelligence • Quality • Communication • Engagement • Contracting • Procurement • Finance – already commenced • Human Resources • Organisational Development • Encapsulates both CCG and CSU employed staff

21. Reminder: HFMA Finance Modules To those staff who signed up to do some HFMA Finance modules: Please complete your modules by 31 March 16 as we will lose this facility from this date! Congratulations to Phil Hargreaves and Beth Connolly who have both already completed five modules.