Oxfordshire PCT Ambitious about improving the health and wellbeing of local people.

1. Oxfordshire PCT • Ambitious aboutimproving the health and wellbeing of local people. • Developing the PCT Strategy • Local Medical Committee • October 18th 2007

2. Why we are here • PCT is seeking feedback on its draft 5 year strategy from a wide range of organisations and individuals • Attending range of meetings with different stakeholders, including LRCs & PBC • Holding 5 meetings for patients, public and voluntary organisations across the County • Holding a theme based meeting on each of our 3 commissioning priorities • Inviting written comments via strategyfeedback@oxfordshirepct.nhs.uk • Using all comment to inform redraft for formal adoption by the Board 29th November • First draft

3. Outcomes we’re trying to achieve – our Vision • Oxfordshire PCT will work with its partners to deliver a transformation in local health services, so that by 2012 the people of Oxfordshire will: • Be healthier – particularly if they live in our most deprived communities. • Be working with the PCT to promote well being and prevent ill health. • Be actively supported to manage their own health and care needs at home, when this is appropriate. • Have access to a choice of high quality, safe and appropriate health services. • Get excellent value for money from their local health services.

4. Starting point • We need to: • Focus on a few things that will make the biggest difference to health in Oxfordshire • Get better at forecasting and planning ahead, for example anticipating the impact of changing demography on health spend • Improve our ability to analyse health spend v. health gain/outcome • Adopt a strategy for the whole PCT that covers what we commission and the services we provide directly

5. Commissioning priorities for 08/09 • Breaking the cycle of deprivation • Partnership based activity to tackle physical and mental health inequalities and improve outcomes for deprived children in targeted geographical areas. • Better deal for older people • Focus on older people’s physical and mental health services by: tackling avoidable admissions to hospital, providing more services in the community and improving our understanding of the economic impact of the growing population and how we might get a better return on investment by shifting spend. • Commissioning excellence • Implement the diabetic pathway work as a model to test out: ways to improve long term condition management, care pathway redesign, shifting to outcome based commissioning and getting a better return on investment.

6. What we know now is: • Health outcomes are good, except in deprived areas – and the best way to try and start breaking the cycle of deprivation is through targeted partnership work on early intervention, prevention and mental health services with children and families • Over 85s will increase by 126% by 2029 - and we know health spend is highest on this age group, and that some of this spend is avoidable or could deliver better outcomes • Partnership working between all those involved in commissioning and delivering services to older people with mental health problems needs to improve • Prevalence of long term physical and mental health conditions is increasing and this will present us with service redesign and resource challenges • Redesign work for diabetes gives us a model for a way of working that, if successful, we can apply to a range of other conditions • Diabetes is a LTC where we are appear to be deliveringbelow average outcomes for above average investment and growth in prevalence is expected • Breaking the cycle of deprivation, providing a better deal for older people and commissioning excellence – particularly for LTCs like diabetes – are priorities shared by our local partners.

7. What about the rest of the PCT’s work? • We will continue to deliver: • Community health services • Locally agreed service improvement programmes (eg MSK, heart failure and COPD) • Mental health priorities as set out in the agreed mental health strategy • Commitments made in partnership with the Children and Young People’s Partnership Board –safeguarding, teenage pregnancy • Public health programmes such as GUM programmes, obesity, screening, infectious diseases and breastfeeding • Faster access to treatment and improved choice • Planning for the development of care outside hospital

8. Our approach to financial planning • We will plan to create a recurrent surplus that can be used to invest in our priorities. • Cost drivers (eg demographic change, technological advances) and agreed cost improvement targets will be factored in at the start of the budget setting contract negotiation stage. • Future financial planning will consider potential disinvestment where evidence of poor return on investment exists.

9. Questions • Do you have any initial feedback the strategy and specifically our three proposed strategic priorities • Breaking the cycle of deprivation • Better deal for older people • Commissioning excellence • How do you think the strategy could be improved?