Making sense of Lansley ‘The Sheffield Way’

1. Making sense of Lansley‘The Sheffield Way’ Dr Zak McMurray Joint Clinical Director NHS Sheffield

2. Sheffield Update • Constructive engagement, involvement and commitment much in evidence. • One Sheffield CCG with four strong localities • Commissioning purpose of Localities will be to, “support the CCG to achieve its authorised objectives of reducing health inequalities, narrowing the gap in life expectancy across the city, increasing patient satisfaction and maintaining financial balance.” Locality Paper approved by CCG Committee August 2011 • Completed city wide election process and appointments to Board, Executive and Clinical Reference Group.

3. Mandate from practices Patient participation groups @ practice / locality level Locality 1 member practices Engine Room CET QIPP Themes Governing body CCG Committee Locality 2 member practices Locality 3 member practices Skills & Resources Locality 4 member practices Internal CCG GPs and Clinicians in practices CSO Partners: LA other CCG Other external support

4. Governance of the CCG (2) • Sheffield CCG Membership • Core Members : • Up to 4 GPs (elected citywide representatives) • 4 GPs (appointed locality representatives) • Up to 4 Lay Advisors • Chief Operating Officer *1 • Chief Finance Officer *1 • Clinical Director (GP) *1 • Associate Director of Clinical Quality & Improvement (Nurse) *1 • And subject to further guidance from the Department of Health;A doctor who is a secondary care specialist – Advised by the NHS CB for all CCGs • In attendance: • Associate Director of Commissioning Services and Compliance *1 • Director of Public Health *1 • Director of HR/OD *1 • Company Secretary *1 • 4 Locality Managers (appointed locality representatives) *1 • Local Authority Representative *2 • Patient representative group *2 • Local Medical Committee representative *2

5. Vision • The Sheffield Clinical Commissioning Group will be a strong and forward thinking organisation. Working with partner organisations, constituent practices and local communities in the delivery of its strategic aims. The city’s strong mutually supportive localities will be the principle vehicles charged with leading the implementation and delivery in key priority areas. Practitioner, patient and stakeholder engagement will be embedded in full within our commissioning process. SNCCG Draft Prospectus September 2011

6. Objectives • Collectively, we will: • Establish an organisation which has effective integrated corporate governance systems in place and which, as a minimum, adhere to the requirements of the Nolan Principles and the NHS Constitution • Be sound custodians of Sheffield’s health care budget, ensuring we achieve a balanced outcome at the end of each year.   • Empower our high calibre clinical leaders in motivating and influencing the wider clinical population to ensure health improvement and healthcare for our population • Strive to provide the best possible health and health services for the people and patients of Sheffield, delivered through strong local structures, taking account of the individuality of localities and the different needs of local practices and their communities • Seek evidenced based best practice and share knowledge to ensure that we deliver the best possible individual care across care pathways. • Work together, engaging staff, patients and the public to communicate and ensure the integrity of our local and collective decisions and the decision making processes across Sheffield. • Engage with our local communities to ensure jointly owned approaches to local needs and concerns. • Work to have strong collaborative relationships with relevant statutory bodies, including the local NHS Provider Organisations, the National Commissioning Board, Health and Wellbeing Boards, Local Authorities, Healthwatch, Voluntary Sector, Politicians, Local Professional Committees

7. Going Forward • Governance in place, new GP’s and Lay Advisors induction • Organisation Development starts • Developing Commissioning Support • Commissioning Support Units/Organisations (CSU’s/CSO’s) • Local commissioning staff • Delivering 2011/12 & planning a sustainable 2012/13 • So what? – Making the difference work for Sheffield.

8. Right First Time

9. The 5 Year Vision RIGHT FIRST TIME PROGRAMME Prioritise the elderly and beyond:- • Best quartile for admission rates and length of stay in the country • Best in comparison to other core cities • Working in partnership across Health and Social Care • Flexing the system to achieve best care for our patients • Moving capacity into community setting • Avoiding financial instability YEAR 1 • Maximise potential for admission avoidance – GSM Project / Enhanced Community Care • Significantly reduce LOS by avoiding long term care needs assessment in hospital (4 days maximum stay once medically fit)

10. Key Priorities for 2012/13 Three priority areas: • Mapping the system • Understanding what inputs add value to patient care and removing those that don’t • Older people, including dementia • Reducing avoidable admissions • Reducing length of stay • Prompt health / social care assessment for longer term care • Redesigning the response to need • Risk stratification and community response (redesigning community teams / practice associations) • Tighten admission threshold (integrated unscheduled care response - A&E / Collaborative / Broad lane / MAU / GSM work/ Dementia support)

11. The Opportunity Activity and benchmarking • Balance of care audit 2004 • Interqual over 75 audit 2010 • Geriatric / stroke medicine pilot 2011 • Core city benchmarking The Sheffield Way • Collaboration and partnership with a hard commissioning edge • Health and Social Care Transforming Sheffield’s Health Steering Group • Chief Executives and Chairs Partner Organisations – transformational agenda

12. The Risks • Population culture of overdependence on secondary care • Institutional cultures • Financial flows – PBR / Monitor • ‘Liberating the NHS’

13. Project 1 SRO Penny Brooks iCARE OD Support RFT Programme Project 2 Team Project 3 SROs SRO Mike Richmond Eddie Sherwood Eithne Cummins RFT Programme Team Programme LeadsZak McMurray / Kirsten Major / Steven Haigh Programme Managers / Comms Support / Public Health / IT Support / Finance Support / Locality Input / Facilities Input Right First Time Programme Structure TRANSFORMATIONAL BOARD

14. Thank you Any questions