Mike Potts Chief Executive

1. Mike Potts Chief Executive Local overview and key challenges across the four themes set out in the Operating Framework

2. Halifax Halifax Halifax Calderdale Calderdale Calderdale Batley Batley Batley Todmorden Todmorden Todmorden Wakefield Wakefield Wakefield Pontefract Pontefract Dewsbury Dewsbury Dewsbury Wakefield District Wakefield District Huddersfield Huddersfield Huddersfield Huddersfield Kirklees Hemsworth Hemsworth Calderdale, Kirklees and Wakefield District – the place

3. About us … 991,000 local people 582 staff £1.68 billion budget Significant health challenges 4 shadow CCGs 1 West Yorkshire Commissioning Support Service 3 Health and Wellbeing Boards

4. About us … (Contd) Main providers: • 2 acute (1FT, 1 aspiring FT) • 1 mental health/care trust (FT) • 1 ambulance service (aspiring FT) • 2 social enterprises • 138 GP practices • 127 dental practices, • 200 pharmacies • 114 optometry providers Wider system leadership: • Emergency planning (West Yorkshire) • 111 implementation (Yorkshire & the Humber)

5. Strong relationships with our local authorities

6. Our role 3 PCTs - one cluster board and one executive team from October 2011 Our role: • lead the local NHS • improve the health of local people • commission high quality safe and sustainable services within resources • implement NHS reform • manage transition to the new commissioning system • manage transition of PH to LAs and support establishment of Health & Wellbeing Boards • support provider development

7. Our focus • Creating the new commissioning system - CCGs, CSS, public health, H & WBBs • New relationship with public • Embed transformational change Control Create • Maintaining quality & safety • Delivering performance • Managing the money • Maintaining resilience Close • Formal Closure of PCTs • Handing over our legacy • Celebrating our achievements

8. Challenges for health and social care • Ageing population – increased pressure on health and social care services. • Do things differently – encourage innovation and transformation. • Embrace new technologies. • Integrating care across agencies – move from competition to co-operation/partnership. • Improve health & health outcomes - ownership, lifestyle choices, wider determinants of health. • Meaningful engagement with our patients and local communities. • Limited resources – need for greater efficiency.

9. Operating Framework 2012/13 4 key themes: • Getting the basics right • Maintaining our grip on performance • Meeting the quality and productivity challenge • NHS reform

10. Getting the basics right • Control • Cluster quality governance • Swift response to CQC inspections • Performance: grip on key quality performance indicators • Hospital acquired infections • Patient safety • Safeguarding • Assuring and improving quality through transition • Quality metrics across the system • Quality impact assessments

11. Getting the basics right Contd Create • CCG quality governance/infrastructure • National and local CQUIN development • Focus on improving patient experience Close • Close down process in place • Legacy documents • Quarterly reporting to NHS North of England • Face to face handovers Q3 and Q4

12. Performance – the challenge • Keeping a grip on performance: • A&E and Referral to Treatment (RTT) 18 weeks - • monthly delivery by speciality • Increased pressure on delivery of zero Health • Care Acquired Infections (HCAIs) • Continued focus on zero Mixed Sex Accommodation • (MSA) breaches • Focus on sustainability • Plans to Board in May

13. Quality, innovation, productivity, prevention (QIPP) Strong record of managing within resources and delivering QIPP targets. QIPP targets 12/13 to 14/15:

14. Our 5 transformational QIPP Programmes (2012-15) Preventing unplanned admissions and managing long term conditions Stronger mental health and learning disability services Assistive technology and risk stratification Alternative community services Changing planned care pathway

15. Whole system integration Person first • E consultation • Telemedicine • Virtual ward • Community consultants

16. System enablers Assistive technology E-consultation Integrated provision Case management Risk stratification Leading Large Scale Change Support Programme

17. Whole system health and social care transformation 50% of QIPP savings delivered through two Major transformation programmes: Calderdale & Huddersfield Health and Social Care Transformation Programme Wakefield District and North Kirklees Health and Social Care Transformation Programme

18. The transformation map

19. CCGs: Greater Huddersfield & Calderdale CKW Cluster Board CHFT Board Calderdale Council Kirklees Council Calderdale and Huddersfield health & social Care transformation Partner Trusts: SWYPFT, Locala Programme Office Health strategy refresh: Future service vision Transformation Delivery of QIPP/CIPs Elective care: Joint approach to delivery of redesign and QIPP Urgent care: Joint approach to delivery of non-elective and urgent care and QIPP Cross Cutting: communications and engagement; clinical leadership; quality and safety; workforce, PMO governance and risk management

20. Calderdale & Huddersfield health & social care transformation Aims: A strategy for the next 5 years to deliver high quality care in the most appropriate setting. To be in top 10% nationally for safe, reliable patient-centred care. Maximise the benefits of the NHS reforms and respond to demographic changes. Focus on the needs of people with LTC. Affordable and sustainable services, where local leaders are recognised for their approach to partnerships and integrating care.

21. CCGs: WakefieldNorth Kirklees NHS North CKW Cluster Board MY Hospitals Trust Board Wakefield Council Kirklees Council Wakefield District and North Kirklees health and social care transformation Partner Trusts: SWYPFT, Locala Programme Office Partner PCTs: NHS Leeds Programme executive • Transformation programme • Care outside hospital • Urgent care • Clinical services strategy • Primary medical services Foundation Trust application Transactional processes • Recovery and service improvement • Financial recovery • Service improvement Cross Cutting: Communications and engagement; clinical leadership; quality and safety; workforce, PMO governance and risk management

22. QIPP schemes – some examples Diabetes e consultation – linking GPs and secondary care clinicians (early indicators 75% reduction in referrals) Telehealth in Care Homes – supporting end of life care – (10% – 15% reduction in emergency admissions) Dementia Care – new model of specialist day care – 10% increase in day care activity Primary care transformation – to increase primary care capacity – ( 8% reduction A&E attendances 5% reduction in LTC admissions)

23. Implementing NHS Reform

24. Chair Professor Malcolm Grant Chief Executive Sir David Nicholson NHS Commissioning Board

25. Local clinical commissioning groups (CCGs)

26. Commissioning support service (CSS) West Yorkshire wide approach Already operational – from this month Business case submitted Expect to be fully operational by end October. Currently consulting on senior staffing structure MD appointed Alison Hughes

27. Provider development • All remaining NHS trusts move to Foundation • Trust status. • New provider models e.g. social enterprises, • joint ventures. • More choice, competition and co-operation • Any qualified provider.

28. Public health transition • Public health functions to: • Public Health England • Local authorities • NHS Commissioning Board • Joint Directors of Public Health x 3 • Transition plans agreed. • Plans assured by NHS North of England. • Ready for start of shadow period: Oct 12.

29. Health & Wellbeing Boards • Three shadow boards in place. • Strong relationships developed with CCGs. • Joint Health and Wellbeing Strategies being • developed.

30. Group discussions We want to hear from you Your contribution is important