NHS BOLTON CLINICAL COMMISSIONING GROUP Public ......3.2 The GM Devolution Team will be supporting...
Transcript of NHS BOLTON CLINICAL COMMISSIONING GROUP Public ......3.2 The GM Devolution Team will be supporting...
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NHS BOLTON CLINICAL COMMISSIONING GROUP Public Board Meeting AGENDA ITEM NO: ……8………………… Date of Meeting: …………29th April 2016……………… TITLE OF REPORT:
Update on Bolton Locality Plan Assessment
AUTHOR:
Melissa Laskey – Associate Director of Commissioning
PRESENTED BY:
Melissa Laskey – Associate Director of Commissioning
PURPOSE OF PAPER: (Linking to Strategic Objectives)
To provide an update to CCG Board on the assessment of the Bolton Locality Plan Implementation Plan by the GM Devolution Team and the next steps in the development of both the Locality Plan and the Implementation Plan to ensure that the locality is “investment ready” to bid for GM Transformation Funding. It should be recognised that the implementation plan is being regularly updated and needs more work to:
• Ensure the communications plan reflects all partner inputs.
• Future prioritise workstreams. • Scrutinise potential expenditure against value
and resources available. • Decide the actual schemes that will receive
funding and revise the plan accordingly.
RECOMMENDATION TO THE BOARD: (Please be clear if decision required, or for noting)
To note the content of the paper and next steps
COMMITTEES/GROUPS PREVIOUSLY CONSULTED:
CCG Executive, Bolton Locality Plan Delivery Group
REVIEW OF CONFLICTS OF INTEREST:
To be considered as the implementation plan is developed
VIEW OF THE PATIENTS, CARERS OR THE PUBLIC, AND THE EXTENT OF THEIR INVOLVEMENT:
Included as a key component of the Locality Plan
EQUALITY IMPACT ASSESSMENT (EIA) COMPLETED & OUTCOME OF ASSESSMENT:
An EIA will be completed in the next iteration of the Implementation Plan
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Update on the Bolton Locality Plan Assessment
1 Purpose of Paper 1.1 This paper provides an update the Bolton CCG Board on the Bolton Locality
Plan. 1.2 The draft Implementation Plan, together with the Implementation Plan
(attached at Appendix 1) were submitted to the Greater Manchester (GM) Devolution Team to allow for assessment of our Plan against the comprehensive criteria which the central team recently developed as an objective tool to ensure all 10 GM plans are fully "implementation ready" over the next few months (to allow to investment through the GM Transformation Fund).
2 Current Position 2.1 All Locality Plans were assessed as to whether they met 25%, 50%,75% or
100% of the GM criteria. 2.2 The Bolton Locality Plan was assessed against the criteria for:
• Alignment to GM Strategy (assessed as meeting 50% of the criteria)
• Readiness to Deliver (assessed as meeting 50% of the criteria
• Wider Stakeholder Support (assessed as meeting 50% of the criteria)
• Robust Financials (assessed as meeting 25% of the criteria)
2.2 Overall, the Bolton Plan was assessed as meeting 50% of the criteria, with 5 GM Locality Plans being assessed as meeting only 25% of the criteria, 3 other plans meeting 50% and only Salford meeting 75%.
2.3 The areas of strong performance identified by the GM Team for the Bolton Plan
were the following:
• clear strong links to the GM initiatives (population health and enhancing primary and community care)
• clear vision for organisations
• commencement of a high level implementation plan
• the population segmentation approach used
• clear definition of the outcomes to be achieved with supporting Key Performance Indicators (KPIs)
• a comprehensive communication plan
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2.4 The areas for development (recognised through the self assessment completed by the Locality Plan Delivery Group, comprising of senior officers from the CCG, BMBC, Bolton FT, Bolton Healthwatch and Bolton CVS) were identified as:
• the need to further develop the financials
• the need to describe the governance infrastructure for delivery
• the need for a detailed implementation plan (with clear actions and milestones)
• the need for further alignment across all organisations involved as well as formal sign off by the H&WBB, GP Federation and the VCSE
• the need to define the Locality Care Organisation (LCO)
3 Next Steps 3.1 KPMG has been commissioned to support the further development of the plan
over the next 2 months, specifically:
• the refinement of both the Locality Plan and the Implementation Plan so that both can be signed off by the H&WBB and all partners
• development of the "Business Cases" for investment (with clear cost benefit evaluation) and assisting with the financial analysis required
• further defining the population segmentation and risk stratification work completed to date
• facilitation of an LCO development session with senior executives from all organisations
• supporting the development of the enabling workstreams (Estates, IT and workforce)
3.2 The GM Devolution Team will be supporting all GM localities to enhance their Plans to ensure that they become "investment ready" and the second stage of the evaluation will take place at the end of May.
4 Recommendations 4.1 NHS Bolton Clinical Commissioning Group Governing Body Board is asked to
note the content of this report and next steps in the development of the Bolton Locality Plan and Implementation Plan.
Melissa Laskey Associate Director of Commissioning 21st April 2016
Bolton Locality Plan
High Level Implementation Plan
Version 1
1 April 2016
Contents
Content Page
1. Strategic Context 3 - 8
2. Target outcomes for 2020 9 - 11
3. Key priorities for delivery by April 2016 12 – 14
4. Overview of workstreams and delivery 15 – 16
5. Governance framework, including responsibilities for delivery 17
6. Workstream and detailed activity plan 18 - 30
7. Enablers of change 31 – 34
8. Financial plan 35 – 36
9. Timeline for implementation 37 – 39
10. Communications and engagement schedule 40
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1. Strategic Context
The Bolton Locality Plan sits within the context of the Greater Manchester Devolution Programme which is aimed at driving the biggest and
fastest improvement to the overall health and wellbeing of the GM population by the end of 2020.
For Bolton, this plan sits within the GM context, but focusses on the elements which will be delivered locally, by all partners working
together to deliver significant transformation change. It makes reference to the elements which will be delivered through the North West
Acute Sector programme (under Healthier Together) and to the work programmes which are being developed and delivered on a GM
footprint.
The Locality Plan sits under the Vision Strategy. The latter being the 20 year strategy for the whole system reform across Bolton, including
the Economic Strategy and Health and Wellbeing Strategy. The enabling workstreams (of IT, Estates, Workforce, Innovation and
Engagement/Communication) underpin all of the strategies, including the NW Sector and GM programmes.
The diagram shown on page 17 illustrates the current Bolton Vision Governance Structure and priorities up to 2016/17 and where the
Locality Plan currently sits. The strategy and governance arrangements are currently under review and will become Bolton’s Vision 2020
and will focus on ‘people and place’ and ‘growth and reform’. The Health and Wellbeing Strategy is also currently under review to ensure it
is aligned to both the refreshed Vision Strategy and the Locality Plan.
The Financial Position
There is an identified gap of £162m across the whole health and care economy in Bolton by 2020. Individual organisation and joint plans for
cost improvement (through efficiency and effectiveness programmes, focus on improving quality and outcomes and vertical and horizontal
integration opportunities) can reduce this recurrent gap by £84m (to £78m). With the requested £20m for the protection of social care this
gap would reduce to £58m. However, the residual gap will require the whole system to reform which will only be possible with transitional
investment particularly in early intervention and prevention services as well as in the estate and IT infrastructure.
Population Health Improvement Programmes
To commission for services to effectively meet the needs of the population of Bolton, we have segmented the locality population (of
300,000) into four “tiers”.
The agreed strategy in the Locality Plan is to pump-prime the new delivery models which will enable the longer term shift in the proportion
of funding from unplanned hospital admissions and long term care placements (reactive care in Tier 1 predominantly) to proactive and
preventative care (Tier 2 for the neighbourhood working, Tier 3 for the medium term and specifically Tier 4 for the longer term)
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1. Strategic context (cont.)
Tier 1 (2%): multiple Long Term Conditions, frail elderly – individual Multi-disciplinary care plans
Tier 2 (10%): developing significant risks associated with Long Term Conditions or frailty - need early intervention and tertiary
prevention to prevent/delay progress of condition and for over 65s: to stay well
Tier 3 (20%): secondary prevention and early identification: targeted interventions for individuals and communities at risk
Tier 4 - System-wide interventions to improve health and wellbeing and prevent future ill-health (primary prevention)
The top tier comprises of 2% of the population (6,000 people) who have two or
more long term conditions, are the high risk frail elderly or those at the end of
their life. There has been significant investment already made into services to
support the individuals within this Tier, including:
Admissions Avoidance
Redesigned Intermediate care services (home and bed based)
Services to support the most vulnerable and complex dependency
The second tier is the population that has started to become ill or frail, but
currently not requiring significant health treatment and/or hospital admission
(and therefore will not necessarily have a risk stratification score) but are
eligible for social care services. These individuals need preventative
interventions to stop them moving into the top tier within the next few years
requiring higher levels of health and social care resources. This is estimated to
be about 10% of the population (30,000 people).
The third tier is population wide early identification and prevention with
targeted interventions for individuals for those at risk of poor health and
wellbeing (20% of the population: 60.000 people). This tier includes a large
proportion of the population who are at risk of long term conditions, for example
due to smoking or being physically inactive, or who may already have long
term conditions, such as hypertension, but don’t yet have social care needs,
and may not be accessing health services beyond primary care. Future
demand on health and social care services could be prevented or delayed
through targeted prevention and early intervention with this population.
Tiers 2 and 3 are where transformation of existing services together with
additional funding is required to commission new and enhanced interventions to
be delivered at individual or on a wider scale. A business case covering all
elements of the transformation programmes is in development. At high level this
includes the following:
Secondary and tertiary prevention, focusing on the specific long term conditions
(and their risk factors) which are most prevalent across the locality: heart
disease, respiratory disease and diabetes - delivered through Integrated
Teams wrapped around general practice (on a neighbourhood basis) –
including Health Improvement Practitioners, ANPs, district nurses, pharmacists,
mental health practitioners and MSK practitioners. This will include signposting
people to the right provision of support, including social prescribing with a
focus on emotional wellbeing and physical activity, to enable individuals to
develop their health skills and knowledge to build their capacity to manage their
own health and wellbeing including stopping smoking, reducing alcohol harm,
eating healthily and becoming physically active. This will include Increasing
dementia diagnosis and improving care, preventing falls, providing GP
care to the frail elderly and ensuring people aged over 65 retain their
independence for as long as possible through physical and mental activity and
reducing social isolation through participation in activities/groups within the
community (to be delivered though expansion of the Staying Well programme
based around GP Practices and full roll out of the Safe, Warm and Dry
initiative).
Population Health Improvement Programmes (cont.)
Putting in place new service delivery models (with investment £23.75m over 5 years) aimed at reducing demand on the system for those currently in
Tiers 1 and 2 now will start to pay back within 1 year and has been calculated to deliver savings of £26.545 over 5 years).
1. Strategic Context (cont.)
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Key programmes of work targeted at the tier 3
population include:
Integrated Team model (also supporting Tier 2 as
set out above), who will also focus on:
Increasing uptake of screening, including cancer
screening programmes, focusing on populations with
low uptake rates
Increasing uptake of vaccinations – specifically flu
and childhood immunisation
Critical to the successful delivery of the new
neighbourhood models of care is community
development, capacity building and engagement.
These are essential to improving the health of the
population and reducing health inequalities. We will
work with communities which face the poorest health
outcomes, using asset based community
development approaches to build resilience and
empower communities to play an active role in
improving their own health and wellbeing. This will
include a focus on social prescribing, building on the
strengths of the voluntary, community and social
enterprise sector in engaging local communities,
including hard to reach groups, and improving health
and wellbeing. Additional investment could
accelerate the development of these social
prescribing and self-care programmes.
1. Strategic Context (cont.)
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The fourth tier is system-wide primary prevention to promote good health and wellbeing across the population. This includes population-wide
strategies to promote good health and wellbeing and addressing the wider determinants of health. The Early Years New Delivery Model is key
to this and is a key call on the GM Transformation fund for all localities.
To secure a financially sustainable health and social care system, the impact of interventions in the short, medium and long term needs to be
considered. Investment is needed both in interventions which are likely to deliver a return on investment in the timescale covered by the Locality
Plan, as well as those interventions which will take longer to deliver returns on investment but have the potential to secure greater savings and
significant improvements in population health.
Critical to delivery of the locality aims is the fostering and implementation of a genuine “whole system” approach which includes the community
and voluntary sector as a key driver.
1. Strategic Context (cont.)
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2. Target outcomes for 2020 (cont.)
Our locality plan prioritises a series of outcomes against which we will monitor our progress in improving health and reducing inequalities. We have
set ambitious targets for each of these outcomes which aim to exceed or narrow the gap with the England average or our peer comparators,
improving the overall health and wellbeing of the population and reducing demand on services. NB: Work has been commenced to look at key
outcomes that will be measured across GM. The initial set of locality plan outcomes and targets may need to be revised as the GM work develops.
OutcomeTarget
Quantifiable benefit at year 5Related delivery
programmeYear 1 Year 2 Year 3 Year 4 Year 5
Reduce local life expectancy
gap to the Greater Manchester
average: men
11.3 11.0 10.7 10.4 10.1 28,439 people in Bolton will live
an average 1.2 years longer.
Integrated
Neighbourhood
Health Improvement
Staying Well
Reduce local life expectancy
gap to the Greater Manchester
average: women
10.9 10.3 9.7 9.0 8.4
Bolton to achieve ‘Better than
average’ yellow ranking on
‘Longer Lives’ for heart
disease and stroke when
compared to similar areas
88.0 77.7 67.5 57.2 47.0 An additional 17 residents/year
will live beyond age 75 years.
Integrated
Neighbourhood
Health Improvement
Staying Well
Reduce the inequality gap
between Bolton and England
for premature respiratory
mortality to half by 2020
46.5 42.8 39.2 35.5 31.9 In 2020, 98 more people in
Bolton will live to over 75 who
would not have done
previously.
Reduce suicide rate 9.5 9.4 9.2 9.1 8.9 8 suicides will be avoided each
year
Integrated
Neighbourhood
Health Improvement
Staying Well
Reduce self-harm admissions
in children
531.7 480.0 428.4 376.7 325.0 93 child admissions will be
avoided each year
Early Years New
Delivery Model
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2. Target outcomes for 2020
OutcomeTarget
Quantifiable benefit at year 5Related delivery
programmeYear 1 Year 2 Year 3 Year 4 Year 5
Increase the percentage of people
expected to have dementia being on
the dementia register
0.73 0.75 0.77 0.78 0.80 2,834 people will be on the
dementia register
Dementia
Staying Well
Improve breastfeeding at 6-8 weeks
to England average
39.9 41.4 42.9 44.3 45.8 210 more mothers will breastfeed
to 6-8 weeks
Early Years New
Delivery Model
Reduce smoking in pregnancy 15.1 13.8 12.6 11.3 10.0 228 fewer mothers will smoke in
pregnancy
Early Years New
Delivery Model
Children achieving a good level of
development: narrow the attainment
gap between children receiving free
school meals and children not in
receipt of FSM at ages 2,3, 4 and
EYFS.
Original outcome target no longer
applicable. New target needs to be
considered.
Early Years New
Delivery Model
Reducing excess weight in school
children
33.6 32.1 30.5 29.0 27.4 234 fewer children will be of excess
weight when they reach Year 6.
Early Years New
Delivery Model
Reduce the number of alcohol-related
admissions (narrow definition) in
Bolton back to the England average
733.0 711.0 689.0 667.0 645.0 There will be 234 fewer alcohol-
related admissions per year.
Integrated
Neighbourhood
Health
Improvement
Reducing injuries due to falls 890 847 803 760 716 No increase in admissions due to
falls per year. Without a
comprehensive falls prevention
strategy we would expect
admissions to increase to
1082/year by 2020 due to
demographic changes alone.
Falls
Staying Well
Improving Flu vaccination uptake
rate
74.1 75.6 77.1 78.5 80.0 2,874 more older people will
receive flu vaccination per season.
Staying Well
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3. Priorities for delivery by April 2016
There are priority areas which need to be in place by April 2016 (in high level form) to enable the collaborative design and delivery of the
population health outcomes programmes. These include new contractual models, new commissioning models and new models of care and are
set out below.
Workstream Key Area Lead Actions by April 16 Outcomes RAG
status
Key Priorities for Delivery by April 2016 to enable collaborative design and delivery of population health outcomes programmes
New Contractual
Models
New contractual
model between
Bolton CCG and
Bolton FT
AW (with
SW)
Agreement of new outcome based contractual
model for 2016/17
Agreed contract within financial envelope
to allow the focus on service redesign to
reduce acute demand and overall cost of
care to the system - within the agreed
strategic aim of transformation of the
system from reactive to proactive care
which is based around a person and
community centred approach
Green
Overall Financial
Affordability
Whole system
financial
modelling
AW 5 year view of total cost of the system compared
to the expected income to identify year on year
affordability gap and therefore whole system
savings required
Identification of the combined efficiency
savings required to bridge the significant
financial gap to be bridged – leading to
whole system focus on solutions to
deliver this.
Implementation of the Bolton Offer.
Green
New Commissioning
Models
GM wide
commissioning
GM JCB Agree which areas will be commissioned locally
and which will be on a GM wide basis
Commissioning footprint for locality,
sector and GM footprint agreed to allow
for pooling of budgets and integrated
delivery
Amber
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3. Priorities for delivery by April 2016 (cont.)
Workstream Key Area Lead Actions by April 16 Outcomes RAG
status
Key Priorities for Delivery by April 2016 to enable collaborative design and delivery of population health outcomes programmes
New Commissioning
Models
Integrated
Commissioning:
locality
ML (with
AC)
For locally commissioned services, agree
which will be included within an integrated
commissioning function across CCG and
Council with pooled budgets and appropriate
governance arrangements
Fully integrated commissioning across
health and care to ensure most efficient
and effective use of available resources
and commissioning for outcomes to
deliver the Bolton vision
Green
Design and implement local integrated
commissioning function and governanceAmber
Right Care ML Ensure full use of Right Care Commissioning
for Value approach to identify areas for
evidence based improvement whole system
focus (to include decommissioning)
Strategic whole system prioritisation of
service transformation which is clinically
driven and evidence based and is
centred around improvement of
population health outcomes
Green
Population
Segmentation:
macro and meso
ML (with
AC)
Enhancement of population segmentation
understanding across the 4 tiers, with
commissioning based on this
Commissioning appropriate services
and care based on the understood
needs of the population
Amber
Micro
commissioning for
outcomes
ML (with
AC)
Significantly expand use of personal (health)
budgets to maximise use of resources and
ensure person-centred care to empower
individuals
Individuals and carers have control of
their health and care through deciding
on the services which meet their needs
Amber
Co-production and
Social value at the
heart of
commissioning
ML/AC/DK/A
T
Embed within commissioning full commitment
to social value, maximising the impact of
public expenditure and ensuring the best
possible health and care outcomes.
Fully embed parity in decision making and
developing outcomes locally. Develop a co-
production/user voice programme within the
CVS and Healthwatch
Revolutionise the local approach to
service and system transformation
Red
(continued on next page) 11
3. Priorities for delivery by April 2016 (cont.)
Workstream Key Area Lead Actions by April 16 Outcomes RAG
status
Key Priorities for Delivery by April 2016 to enable collaborative design and delivery of population health outcomes programmes
New Models of
Care
Local Care
Organisation (LCO)
model
JLG Define and agree new model of care for locality
(MCP or PACS)
Appropriate provider models of care in
place which are appropriate to Bolton as
a place
Amber
Design and
implement
neighbourhood
teams based on
need
LH (with
RT/MC/ML and
KS)
Engagement of GP practices re new models of
care / neighbourhood working
Commence scoping of workforce requirements
Commence scoping of health needs of the
neighbourhoods (JSNA for populations to allow
for commissioning of appropriate health and
care teams for neighbourhoods based on
these)
Actions 2016/17:
Agreement of defined neighbourhoods
Determine health and care needs of defined
neighbourhoods
Alignment of Integrated Neighbourhood teams
Alignment of wider community and social care
providers including the voluntary and
community sector
Scope service delivery model including
specialist input
Understand and scope health and social care
capitated budgets
Neighbourhoods are appropriately
resourced, centred around general
practice, to meet the needs of the
populations they are looking after.
Reactive and proactive care models to
make a significant impact on improving
health and wellbeing
Reduction in non-elective conditions for
ACS conditions
Information sharing agreements in place
Access to health and social care records
across the economy
Patient experience measures
Appropriate workforce in place,
determined at scoping phase
Amber
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Where are we now
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4. Overview of workstreams and delivery
Population growth:
• By 2020 Bolton’s population is expected to reach 289,000, a 3.0%
increase from today.
• Over the next 5-10 years pre-school, older teenager (16-19 years), and
younger adult (20-24 years) populations will reduce, whilst primary,
secondary school ages, and older age groups, increase.
Ageing population:
• The population aged 65+ is expected to grow by almost 20% to around
57,300 people in 2025. This includes substantial growth in the population
aged 80+ which will increase by over 40% to approximately 16,500 in
2025.
Employment:
• After Manchester and Salford, Bolton is expected to experience the
largest employment increase in Greater Manchester.
• Local employment growth is expected to be concentrated in professional
and business services.
Long-term conditions:
• Long-term conditions, especially cardiovascular disease (CVD), are the
chief causes of Bolton’s health inequalities.
• Diabetes and other forms of CVD are very strongly associated with
ethnicity and deprivation e.g. risk of diabetes for people of South Asian
ethnicity is about 6 times higher than for people of white ethnicity.
• Approximately 16,000 people in Bolton today have some form of CVD and
this is likely to increase to over 17,000 people by 2020.
• The total number of people with diabetes is expected to reach 12,160 in
the next four or five years.
• Trends in CVD and diabetes will also be strongly influenced by rising
rates of obesity.
Social care needs:
• An estimated 20,500 older people in Bolton have some social care
need. This could grow to 27,100 people by 2030.
• Assuming continuation of current patterns of care:
• Local authority-commissioned home care hours would need to increase
from 20,800/week to 27,600 by 2030
• day care placements would need to increase from 410 to 540
• supported residential placements from 840 to 1,100
• 150 additional care home places will be required by 2020 and a further
260 places by 2025.
Dementia:
• Number of people aged 65+ with dementia is expected to grow by 35.9%
to 4,203 in 2025.
• ¼ of hospital beds are occupied by patients with dementia and these
patients stay in hospital longer than others with the same condition.
Falls:
• 30% of people aged 65+ living at home and 50% of people aged 80+
living at home or in residential care will experience a fall at least once in a
year.
• This equates to approximately 20,000 falls/year in Bolton now
and 25,000/year by 2025.
Social isolation:
• There are estimated to be between 3,670 (6%) and 4,705 (13%) people
over 60 years who often or always feel lonely in Bolton today. These
numbers are likely to increase with growth of older population.
Our vision is to significantly improve health and wellbeing outcomes for the whole population of Bolton. Within this our key aims are to improve life expectancy and experience for all people living in Bolton and reduce inequalities in life expectancy within the locality.
To achieve this we are focussing on the key areas of transformational change noted in the Greater Manchester Plan, Taking charge of our Health and Social Care. These are:
a) Population health/early intervention and prevention
b) Transforming community based care and support
c) Standardised acute and specialist care
d) Standardised clinical support and back office
On this page we have set out a high level overview of how we will achieve our vision in relation to the two areas of transformational change that are able to be influenced at the local level: population health/early intervention and prevention and transforming community based care and support.
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4. Overview of workstreams and delivery (cont.)
Early Years: New Delivery Model
Reduce levels of liver disease
Early identification: find the missing 1000s
Increased physical activity
Social prescribing, self care
Reduced social isolation and retention of
independence
Early intervention: secondary and tertiary
prevention to prevent/delay progress of one or
more long term conditions
CASE FOR CHANGE PRIORITY POPULATION GROUPS STRATEGIC
INITIATIVES
A Healthy and Vibrant Bolton Locality
a) Population health/early intervention and
prevention
b) Transforming community based care and
support
Improved assessment and care planning -
frailty
Improved Home Care
Significant improvement in falls prevention
care
Improvement in dementia diagnosis and care
Reactive care delivery: Reduction in
unplanned hospital admissions and long term
residential care placements
Last Year of Life Care
Improved and Sustainable Care Home SectorT
he tra
nsfo
rmation w
ork
ste
am
s
Emotional Wellbeing
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5. Governance framework
Priority
themes:
Partnerships:
Prosperous
Economic
Partnership
Health &
Wellbeing
Health &
Wellbeing
Board
Children &
Young
People
Children’s
Trust
Clean &
Green
Cleaner &
Greener
Partnership
Safe
Be Safe
Strong
Stronger
Partnership
Bolton Vision Strategy 2016/17
Bolton’s current Community Strategy that focuses
on the priorities of:
Achieve economic prosperity and maximise
local benefit
Narrow the gap in outcomes between the
least and most well off
Vision Steering Group
Has overall responsibility for the strategy;
provides strong leadership and challenge
Public Sector Leadership Group
Has specific leadership around key challenges
across Bolton’s public services overall
Health &
Wellbeing
Strategy
Locality
Plan
Economic
Strategy
Complex Dependency
(including Family First and Working Well)
Bolton
Community
Homes Board
Based on the agreed vision for significant improvements across Bolton, the workstreams required to ensure delivery of these have been identified
and set out below. The transformation workstreams have been broken down to align with the key areas of transformational change set out in the
Greater Manchester strategy for reform:
a) Population health/early intervention and prevention
b) Place-based integration
c) Standardised acute and specialist care
d) Standardised clinical support and back office
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6. Workstream and detailed activity plan
Transformation
Workstreams
Key Areas Lead Actions and Outcomes Year 1
(2016/17)
Actions and Outcomes Year 2
(2017/18)
Actions and Outcomes Years 3-5
(2018/19 to 2020/21)
a. Population
health/early
intervention and
prevention
Early Years
New Delivery
Model
NL GM bid to transformation fund for GM-
wide implementation of EYNDM
Learning from the Early Adopter area to
inform full implementation of the
EYNDM in Bolton from 2016/17
Include the development of a local
service model for parent and infant
mental health aligned with GM
developments of peri-natal MH
Scope plans for a re-designed
integrated service for 0-19 year olds.
Re-profiling of current investment and
service re-design to focus on
prevention. Identify investment
required for peri-natal mental health
Early Years New Delivery Model
implemented as part of 0-19 integrated
service.
Reduce infant mortality
Increase breastfeeding at 6-8 weeks to
45.8%. This equates to an additional
210 more mothers breastfeeding per
annum.
Reduce smoking in pregnancy to 10%.
This equates to 228 fewer mothers
smoking in pregnancy.
Children achieving a good level of
development: narrow the attainment
gap between children receiving free
school meals and children not in receipt
of FSM at ages 2,3, 4 and EYFS.
Requires investment of £2.15m per
annum. Starts to “pay back” after 10
years with full savings being delivered
at 20 years.
6. Workstream and detailed activity plan (cont.)
Transformation
Workstreams
Key Areas Lead Actions and Outcomes Year 1 (2016/17) Actions and Outcomes Year 2
(2017/18)
Actions and Outcomes Years 3-
5 (2018/19 to 2020/21)
a. Population
health/early
intervention and
prevention
Increased
physical
activity
NL Work with locality partners including the
Leisure Trust and NHS providers to develop
physical activity as a key pathway linked to re-
designed health improvement services.
Develop local plans for family-focused
approaches to increasing physical activity in
response to new national obesity strategy.
Include costs of programme within the new
neighbourhood model (from GM
Transformation Fund)
Begin implementation of local plans. Reduce premature mortality from
heart disease, respiratory disease,
cancer and stroke. Reduce
prevalence of heart disease,
stroke and type 2 diabetes.
Reduce excess weight in school
children to 27.4%. This equates to
234 children per year no longer
being of excess weight in Year 6.
b. Transforming
community based
care and support
Reduce levels
of liver
disease
amenable to
health:-
Alcohol related
harm
Blood borne
viruses
Non - alcoholic
fatty
KS
&
LH
Deliver and evaluate complex lifestyle service.
Implement integrated liver group action plan.
Include support for medium risk drinkers
within re-designed health improvement
service.
Implementation of a revised Primary Care
pathway
Increased referrals into local health
improvement services from GPs and PNs
Development of a specialist liver workforce in
primary care
Develop a Fibroscanner Pathway for Primary
Care – to be used for a range of metabolic
syndromes
Develop a new workforce – Health
Improvement Practitioners (HIPs) to work at a
Neighbourhood level to target specific
interventions (Include costs within the new
neighbourhood model [from GM
Transformation Fund]
Use evaluation results to inform future
plans for complex lifestyle support.
Re-design/ re-tender specialist
services.
2-3 GPs with a special interest in liver
disease
Provision of 2-3 specialist liver
disease clinics within primary care
Implementation of a Fibroscanner
Pathway for Primary Care
Improved health outcomes within
primary care closer to home
Access to a range of specialist
behaviour change services for people
at increasing/high risk/dependent
drinkers
Re-designed service in place
Reduce alcohol related
admissions to 645 per 100,000.
This equates to 234 fewer alcohol
related admissions per year
Equity of access to targeted liver
interventions across all
neighbourhoods
Early identification of alcohol
related liver disease
Whole system approach for
tackling liver disease amenable to
health
17
6. Workstream and detailed activity plan (cont.)
Transformation
Workstreams
Key Areas Lead Actions and Outcomes Year 1
(2016/17)
Actions and Outcomes Year 2
(2017/18)
Actions and Outcomes Years 3-5
(2018/19 to 2020/21)
b. Transforming
community based
care and support
Emotional
Wellbeing
KS Complete mental health and wellbeing
needs assessment, including suicide
audit.
Develop local action plan to improve
mental health and wellbeing.
Include emotional wellbeing as a focus
within plans for social prescribing and
health improvement.
Develop local mental health action
plan that speaks to the GM Mental
Health Strategy
Include costs of programme within the
new neighbourhood model (from GM
Transformation Fund)
Develop business case(s) to support
implementation of local action plan.
Continue to implement local action
plan.
Local plans fully implemented.
Reduce suicide rate to 8.8 per
100,000. This equates to a reduction
of 8 suicides per year.
Reduce self harm admissions among
children and young people to below
190 for ages 10-24. This equates to 93
child emergency admissions avoided
per year.
b. Transforming
community based
care and support
Sustain early
identification
at scale and
find the
missing 1000s
LH Scope work needed to improve uptake
of NHS Health Check and screening
programmes in populations with low
uptake rates and/or increased risk
Development of new
strategies/campaigns to increase
uptake in populations with low uptake
rates and/or increased risk
Ongoing review of NHS
Check/screening programmes to
improve uptake
Reduce premature mortality from heart
disease and stroke. An additional 17
residents/year will live beyond age 75.
Increase % of people expected to have
dementia who are on the dementia
register to 80%, so that there are
2,834 people on the dementia register
in Bolton.
Ongoing review of NHS Health
Check/screening programmes to
improve uptake
18
6. Workstream and detailed activity plan (cont.)
Transformation
Workstreams
Key Areas Lead Actions and Outcomes Year 1
(2016/17)
Actions and Outcomes Year 2
(2017/18)
Actions and Outcomes Years 3-5
(2018/19 to 2020/21)
b. Transforming
community based
care and support
Increase early
intervention at
scale and
secondary
and tertiary
prevention to
prevent/delay
progress of
one or more
long term
conditions
SL/LH/K
S
Redesign health improvement services
to provide health
coaching/interventions for specific
identified cohort of population (people
who are developing significant risks
associated with Long Term Conditions)
as key component of the primary care
Integrated Neighbourhood Teams.
Specific focus on reducing prevalence
of and harm from respiratory disease,
CVD, cancer and type 2 diabetes
Develop business case to redesign
services and deliver secondary and
tertiary prevention at scale.
Maximise use of mental health
expertise in integrated care teams
Workforce modelling to deliver new
primary care model
Development of effective targeted
interventions to communities of
identity: use of VCSE and housing
services
All of the above elements included
included within within the new
neighbourhood model (from GM
Transformation fund)
Evaluation of re-designed service.
Reduction in prevalence and improved
management of LTCs.
Reduce internal life expectancy gap
between most and least deprived
areas to 10.1 years for men and 8.4
years for women. This equates to
28,439 people living on average 1.2
years longer.
Improve flu vaccination update rates to
over 80%. This equates to 2,874 more
people being vaccinated per season.
Reduce premature mortality from heart
disease and stroke. An additional 17
residents/year will live beyond age 75.
Reduce the inequality gap between
Bolton and England for premature
respiratory mortality to half by 2020. In
2020, 98 more people in Bolton will
live to over 75 who would not have
done previously.
19
6. Workstream and detailed activity plan (cont.)
Transformation
Workstreams
Key Areas Lead Actions and Outcomes Year 1 (2016/17) Actions and Outcomes Year 2
(2017/18)
Actions and Outcomes Years 3-5
(2018/19 to 2020/21)
b. Transforming
community based
care and support
Social
prescribing,
self care
People
looking after
themselves
and each
other
SL/L
H/K
S/D
K
Develop local plans for social prescribing.
Consider social marketing needed to
transform the population’s approach to self
care and use of services.
Agree a shared understanding across
sectors of the appropriate model for social
prescribing in Bolton.
Develop a voluntary sector led model that
can be accessed by multidisciplinary teams
from the statutory and voluntary sector.
All of the above elements included included
within within the new neighbourhood model
(from GM Transformation fund)
Align model to Staying Well, Integrated
Neighbourhood Teams and new
neighbourhoods (around GP Practices)
Develop a voluntary sector pilot project for
Bolton on a particular demographic to test
the approach for effectiveness. Embed
within the pilot the principle of self-care.
CVS to build capacity within the sector and
support and facilitate the sector to take a
goal orientated, outcome-based approach.
Invest in capacity work to enable individuals
to recognise and realise their own assets in
improving their health and wellbeing.
Begin implementation of social
prescribing and self care plan.
Support neighbourhoods to take
an asset based approach to
improving self care.
.
Social prescribing and self care plans
fully implemented.
Reduce internal life expectancy gap
between most and least deprived
areas to 10.1 years for men and 8.4
years for women. This equates to
28,439 people living on average 1.2
years longer.
Voluntary and community sector that
can deliver goal orientated, outcome-
based support services
20
6. Workstream and detailed activity plan (cont.)
Transformation
Workstreams
Key Areas Lead Actions and Outcomes Year 1
(2016/17)
Actions and Outcomes Year 2
(2017/18)
Actions and Outcomes Years 3-5
(2018/19 to 2020/21)
c. Standardised
acute and
specialist care
Reduced
social
isolation and
retention of
independence
RT More people remaining in their own
home
Improvement in Care and Repair
Service (Home Improvement Agency)
Increase in Safe Warm and Dry
Initiative
Local action plans to align to the
Ageing Well GM Strategies and
agenda
Investment in Asset based approaches
to reduce social isolation and build
stronger community connections
through the Ambition for Ageing
Programme in Bolton
Develop business case for GM
transformation funding to expand
Staying Well programme
Applying learning from pilot projects in
Ambition for Ageing identified areas
and upscaling areas of effective
delivery
Staying Well implemented city wide.
Increased number of older people
connected in their communities
Reduction in social isolation
Reduction in demand on health and
social care services
Increased number of older people
realising their assets to improve their
own health and wellbeing
Reduce internal life expectancy gap
between most and least deprived
areas to 10.1 years for men and 8.4
years for women. This equates to
28,439 people living on average 1.2
years longer.
c. Standardised
acute and
specialist care
Improved
assessment
and care
planning -
frailty
AC/RT/
LH
Investment in scaling up the innovation
and demand reduction work through a
programme of behaviour change/
workforce reform that alters the
mindset of individual practitioners
(micro-commissioners).
This changes ‘micro-commissioning’
behaviour and if wrapped around
reformed primary care with community
health partners, it will make a
significant contribution to improved
outcomes including reduced spend on
items such as prescribing, acute care
and adult social care
21
6. Workstream and detailed activity plan (cont.)
Transformation
Workstreams
Key Areas Lead Actions and Outcomes Year 1 (2016/17) Actions and Outcomes Year 2 (2017/18) Actions and
Outcomes Years 3-5
(2018/19 to 2020/21)
c. Standardised
acute and
specialist care
Improved and
Sustainable
Care Home
Sector
AC Carry out a comprehensive review of the Care
Home sector in Bolton
Run market engagement events residential &
nursing care. This will cover engagement with
providers and also start discussions with
service users around co-producing service
specifications
From the market engagement events we will
identify forward thinking, innovative and
creative providers to work with on co-producing
service specifications and new funding models
that incentivise improvements in quality, a
reduction in hospital admissions and increases
in preferred place of death.
Implement new funding models and monitor
effectiveness
Carry out Market Shaping to ensure future delivery
of suitable in borough provision
Explore new build opportunities and new capital
funding models
Manage poor provision out of the market
Reduction in number of
out of borough
placements
Sustainable high quality
care home sector
c. Standardised
acute and
specialist care
Improved
Home Care
AC /
ML
Alongside GM we will produce an ethical
service specification for home care. This new
service will be renamed to reflect a reformed
approach involving a blended health and social
care model with an integrated front line worker
We will shape the home care market in ways
that ensure that home care staff are full
members of integrated neighbourhood teams,
along with primary care, social care and
community health
As opportunity presents we will deliver the ethical
service specification for reformed home care
Moving away from time and task support will be
flexible with use of PDA/smart phone technology to
monitor compliance and facilitate time banking.
Care will be proactive with carers encouraged to be
intuitive and do what is required not what is on their
task sheet.
Carers to be upskilled to carry out lower level
medical tasks reducing duplication and allowing
district nurses to focus on higher prority patients
Work with the GM team and CQC to revise the
regulatory
framework to facilitate a blending of health and
social care roles.
Sufficiency and stability
ensured in the market.
22
6. Workstream and detailed activity plan (cont.)
Transformation
Workstreams
Key Areas Lead Actions and Outcomes Year 1 (2016/17) Actions and Outcomes Year 2
(2017/18)
Actions and Outcomes Years 3-5
(2018/19 to 2020/21)
c. Standardised
acute and
specialist care
Significant
improvement
in falls
prevention
care
AC/M
L/KS
Complete falls needs assessment.
Develop falls action plan.
Review and re-design falls pathways.
Develop business case to enhance falls
prevention pathway/ services.
Implement the home safety check service
through the Care and Repair Home
Improvement Agency
Implement local plans to establish
a comprehensive falls prevention
pathway.
Comprehensive falls pathway
implemented.
No increase in admissions due to falls
per year. Without a comprehensive
falls prevention strategy we would
expect admissions to increase to
1082/year by 2020 due to demographic
changes alone.
This requires additional investment of
£500k per annum and starts to pay
back from year 1 (£432k) with savings
of £2.443m per annum being realised
from year 5.
c. Standardised
acute and
specialist care
Improvement
in dementia
diagnosis and
care
AC Re-establish Bolton Dementia Partnership to
oversee delivery of our ambition
Develop business case for improved dementia
support and care.
Pilot Dementia Friendly Communities (DFC)
approach in Horwich.
Establish Dementia Action Alliance.
Participate in GM Dementia United programme
Local work re dementia diagnosis improvement
(within 12 weeks) and actions to improve care
for people with dementia including helping
them to remain at home.
Achievement of waiting times from referral to
diagnosis and ensure comprehensive post
diagnostic support for dementia in place
Develop plans to roll out DFC
borough wide (subject to
successful evaluation).
Improve choice of specialist care
locally (EMI Nursing/ challenging
behaviour) including the
development of specialist housing
provision
Develop expertise within the local
workforce for dementia care
Ongoing improvement in case
finding for dementia registers
Implement 5 Dementia United
Pledges across the whole system
Implement Dementia Keyworker
model
DFC in place borough wide.
GM Dementia Programme established
Increase % of people expected to have
dementia who are on a dementia
register (from 68.5% to 80%. This
equates to 2,834 people being on the
dementia register.
This requires additional investment of
£500k per annum and starts to pay
back from year 2 (£366k) with savings
of £1.11m per annum being realised
from year 5.
23
6. Workstream and detailed activity plan (cont.)
Transformation
Workstreams
Key Areas Lead Actions and Outcomes Year 1 (2016/17) Actions and Outcomes Year 2
(2017/18)
Actions and Outcomes Years 3-5
(2018/19 to 2020/21)
d. Standardised
clinical support and
back office
functions
Reactive care
delivery: Reduce,
Prevent, Delay:
Admission avoidance
health and care
teams and improved
reablement and home
based care for
population most at
risk of unplanned
admission
ML/AC Reduction in unplanned hospital
admissions and long term residential care
placements
Reduction in hospital length of stay
Reduce non elective admissions by x per
year.
Reduce long term residential placements
by x per year
Reduce length of stay by x days
d. Standardised
clinical support and
back office
functions
Last Year of Life Care ML/AC Implement strategy
Housing Housing for Independence Strategy
complete and being implemented
Disability Housing Registered updated
Housing Stock condition survey completed
Housing Needs survey completed
Home Improvement Agency/Safe Warm
and Dry radical upgrade proposal –
underway and due for completion first
quarter 16/17 – for implementation
throughout 16/17
Homelessness – help for single
homeless service implemented –
working being undertaken jointly with
Wigan and Rochdale and in
collaboration with the Complex
Lifestyles Project
VSCE All VSCE assets mapped across Bolton,
Voluntary Sector Strategy - being written
following refresh of Bolton Vision Strategy
– due for completion Q2 16/17
VSCE Provider group co-producing this
VSCE grants changed to outcome focus
and realigned to early intervention and
prevention – all grants awarded
Social Isolation – Public Health and
Adult Social Care engaged with the
Ambition for ageing partnership, ageing
and a VSCE and RSL (registered social
landlord) partnership working in 3 wards
in Bolton.
Learning will be used to inform other
initiatives across the rest of our wards
and adopted by other registered social
landlords via the Bolton Community
Homes board
24
6. Workstream and detailed activity plan (cont.)
System Redesign
In order to deliver the radical change in population outcomes, requiring a significant shift in the way we use of resources (moving from
reactive to proactive care models), we need to redesign the current systems of care- from how services are commissioned and
delivered, to how they interface and react with each other.
Transforming Primary and Community Care in Bolton
Central to the new system for Bolton is the redesign of a primary care system which has integrated working at the heart, around
neighbourhoods of natural communities
Phased Approach to the New Models of Care
25
6. Workstream and detailed activity plan (cont.)
Actions from April 2016 (shadow year) to deliver step 1
• Increase the Bolton Quality Contract payment level to £98 per weighted patient (i.e. paid difference between GMS/PMS/APMS and this level) –
additional payment this year reflects general practice team time required to give longer to frail elderly, complete standard care plan, sign up to
info sharing, work with Integrated neighbourhood teams
• Organise all practices into neighbourhoods to develop modernised workforce, i.e. work together to employ pharmacists, health improvement
practitioners, mental health workers, etc. to support GPs to spend more time with most complex patients and to fix workforce gaps that exist by
thinking traditionally
• Support from current ‘Staying Well’ team, Bolton CVS and HealthWatch Bolton to ensure neighbourhoods work on building community assets as
part of their approach to meeting patient need.
Actions from April 2016 (shadow year) to deliver step 2
• Require practices in these neighbourhoods to direct and lead the integrated neighbourhood teams, and build their direction of district nursing etc.
• Both practices and their INTs will have KPIs relating to the production of Care Plans (this is a second step as the shift of leadership will take time
to embed).
Actions from April 2016 (shadow year) to deliver step 3
• Support neighbourhoods to identify the specific needs of their patients and build outreach support from hospital based specialists in areas such
as Heart Failure, COPD, to reduce hospital admissions
• Contractual arrangements will expect providers to work together to deliver outcomes: no change to current employment of any staff but alignment
of incentives in this shadow year
2017/18 plan
• Opportunity to have agreed a new contractual form for a new model of provision (based on Multi-specialty community provider) that builds on
weighted capitation basis that Bolton Quality contract has commenced, with sharing of system savings
26
6. Workstream and detailed activity plan (cont.)
In hoursDeflect back to primary care/other (including patients requiring referral for routine outpatient appointment
Immediate Referral to Admission Avoidance Team – being expanded to provide 24/7 care
Ambulatory Care Centre10am till 10pmSenior CliniciansAll appropriate surgical and medical conditions adults and children (not initially assessed as requiring inpatient admission)
For patients who require an urgent apt with a Consultant within 24 hours: Rapid Access Clinics (mornings 7 days per week)
Senior Clinician – front of A&E
A&E stream
Minors A&E –see and treat within 4 hours
Primary care stream
Out of HoursIf patients need to be seen within 24 hours –appt in OOH in A&E
Out of HoursIf patients do not need to be seen within 24 hours –refer back to own GP practice
Ambulatory Care Urgent Outpatient Alternative to Inpatient Admission
Majors/Resus
Transforming the Urgent Care System
Bolton health and care economy has developed a strategic plan for the redesign of urgent care – to ensure delivery of responsive, emergency and
urgent care when this is required, with the ethos of primary and community based care being the first point of contact for non life threatening illness
and injury. For patients who do enter the urgent care system, the focus is on ensuring that they get to the right service as rapidly as possible to
enable them to return to their home in a timely fashion, with to maximum amount of independence retained.
To this end, the first element of the system redesign is at the front door of the Emergency Department. Having a senior clinician undertaking a rapid
clinical assessment of all those presenting to A&E will ensure that patients who enter the urgent care system are directed to the most appropriate
place (and person) to deliver that care, including the patient’s own GP for appropriate conditions/presentations.
27
The other key element of the redesign of the urgent care system locally is efficient and effective transfer of patients back to their own home (or
usual place of residence). This involves appropriate usage of Intermediate Tier services – with the focus on “think home first”.
The following indicators will be used by the locality in measurement of the success of the urgent care system and all partners will hold each other to
account for delivery of the new system.
28
6. Workstream and detailed activity plan (cont.)
Outcome Domain Metrics
Local Whole System
Balance Measures
SAFER metrics, including:
o Senior clinician review within 2 hours of initial presentation
o Maximum time from decision to admit in ED to transfer to a bed
o Discharge of 40% of people before midday and 75% before 4pm
Reduced Delayed Transfers of Care
Reductions in time to put in place packages of care to keep people at home (maximum of x hours from decision of appropriate
care package)
Reduced time for assessment completion
Reduced Acute Bed Days
Reduced Non elective length of stay
Reduction in Unplanned Hospital Admissions and Readmissions
Number of care packages delivered per 1,000 population
Increased proportion of people able to remain in their own home
Improved support to carers
Improved access to assistive technology
Improved Supported Living
Reduced number of falls
Improved dementia care
Patient survey results on Primary Care Access
Number of additional primary care appointments filled
Reduction in the number of long term placements to residential care on discharge
Increased percentage of people remaining at home 91 days post discharge
Reduced delayed transfer of care for people out of area
Access to RAID services 24/7
National standards including A&E 4 hours target, ambulance handovers and ambulance response times
Increase in the percentage of 111 dispositions to primary/community based care
There are a number of whole system strategic workstreams which underpin the delivery of the locality plan vision and outcomes. Each of these has
a strategy in development with an underpinning governance structure and action plan. The high level deliverables of each of the workstreams is set
out below.
29
7. Enablers of change
Enabling
Workstreams
Key Areas Lead Actions and Outcomes Year 1
(2016/17)
Actions and Outcomes
Year 2 (2017/18)
Actions and Outcomes
Years 3-5 (2018/19 to
2020/21)
Estates Reconfigure the
Bolton Public Estate
to provide patients
and staff with safe,
quality, health and
care environments in
an appropriate
location ensuring
facilities are fit for
purpose for the
services that are
being delivered.
ST Map current estate and
utilisation
Design future estate
requirements (including asset
disposal) in line with strategic
estate plan
Implement year 1 of the Estates
plan
Implement year 2 of Estates
Plan
Implement years 3-5 of estates
plan
Efficiency savings of £2.4m
realised
IT Locality IT Strategy AU Implement Carecentric phase 1 -
agree data sharing agreement
and basic shared care plan to
allow sharing across key
workers (OOH, DNs, social care,
integrated teams).
Implement end of life plans
within shared care plan.
Implement GP feeds to populate
integrated digital care record and
provide staged access to health
and social care
Carecentric phase 2 -
extend use of mobile apps
to key groups Eg District
Nurses. Implement
additional feeds (adult social
services, community and
acute).
Investigate Patient portals
and apps and develop
strategy for deployment.
Carecentric Phase 3 -
implement patient portal to
facilitate self-help. Implement
further feeds (GMW, NWAS).
Extend access to other key
health and care professionals.
Implement patient mobile apps
7. Enablers of change (cont.)
Enabling
Workstreams
Key Areas Lead Actions and Outcomes Year 1
(2016/17)
Actions and
Outcomes Year 2
(2017/18)
Actions and Outcomes Years
3-5 (2018/19 to 2020/21)
Workforce Workforce
Analysis and
Planning
HC Complete analysis of whole
current workforce including the
VCSE
Complete analysis of future
workforce requirements
Develop strategic workforce plan
to bridge gaps including a
competency framework
Communication
and Engagement
Communications
Strategy and Plan
NO /
AT /
Bolton
CVS
Development of robust
communication and engagement
plan
Communications and
engagement activity will look at
raising awareness of the locality
plan and the challenges facing
our health and care services,
whilst also encouraging people to
get involved and make a
#BoltonTakingCharge pledge.
Implement
communication and
engagement plan.
Roll out
communications across
all channels
Monitor the success of
communication activity and
contimue rto focus on key
internal and extern lines of
communication
North West Sector Partnership
Bolton is working in collaboration with Salford and Wigan (acute Trusts and CCGs predominantly) under the Greater Manchester
Healthier Together Programme to deliver significant changes in terms of health outcomes and clinical and financial sustainability. This
North West Sector Partnership has its own strategy and governance infrastructure, and is interlinked with the Bolton Locality Plan, as
the aims and outcomes detailed within the Locality Plan can only be achieved through collaborative working with other NHS and wider
organisations.
30
7. Enablers of change (cont.)
Services Identified for Potential Priority Review
Transformation
Workstreams
Lead Actions by March 2017 Outcomes
Development of
Shared Single
Services
MW Establishment of Shadow Single Service Board for
Priority Services
Pilot of single service Board underway to roll out to
future models
MW Agreed system of performance management and
governance for shared services
Pilot of single service governance underway to roll out
to future models
MW Appointment of new consultants of a single service basis
for identified priority services and those under the
Healthier Together Programme
All future appointments made on the assumption of the
single service within the sector and recruitment
processes and contracts adapted to be fit for the future
MW Agreed clinical model to meet Healthier Together
Standards
Healthier Together Business case Completed.
List of Services Rationale for inclusion Justification Planned
year for
delivery
GM Led?
Breast Lacks clinical resilience for long term: 12mth interim
solution in place
SRFT has an interim only solution. Need to
develop options for sector specific services
within 6 months to inform GM level strategy.
Need to secure resilience
Year 1
(2016/17)
YES
Dermatology Lack of clinical resilience at WWL. SRFT gaps in
capacity.
National medical workforce shortage
Rapid review of options for improving resilience
at WWL.
Clinical quality and safety.
Year 1
(2016/17)
NO
Full sector review with sector solution within 12
months.
Clinical resilience all sites.
Year 1
(2016/17)
NO
Urology Benign Lack medical workforce resilience x 2 FTs Service lacks resilience at BFT and WWL.
Need to develop options for sector specific
services within 6 months. Clinical Quality and
Safety
Year 1
(2016/17)
NO
Key Enabling Objectives
31
7. Enablers of change (cont.)
List of Services Rationale for inclusion Justification Planned
year for
delivery
GM Led?
Interventional radiology
non-vascular
Inadequate service across the
sector. Unable to meet HT
standards for General Surgery
Non-vascular IR services are suboptimal across GM.
There is a pressing need to make progress with
solutions for NV IR services given the co-dependency
with Emergency and Elective General Surgical services
and delivery of the GM HT Standards of care. Workforce
challenges and securing standards of care.
The work will inform GM level work.
Year 1
(2016/17)
HT
Prog
Paediatric General
Surgery (emergency)
Adult GS service changes
requires review of this service.
There is no service at SRFT
which is the high risk EGS site
for the sector.
SRFT is not and will not be a receiving site for Paediatric
General Surgical emergencies. Wigan and Bolton
provide services 24/7 7/7. Whilst GM level work will be
required. Need to develop options for sector specific
services within 6 months to inform Sector Business Case
and to inform GM level work.
Co-dependent service requiring a solution.
Year 1
(2016/17)
HT Prog
Neuro-rehabilitation Lack of capacity in line with
demand. Patient not able to
access right care, right place.
High care costs of delayed
transfers.
Services across the sector are inadequate to meet the
needs of the population. Funding arrangements are not
workable.
GM level work is underway but delivery will rely on a
sector level review of services and pathways.
Quality of care, Experience of Care and Costs
Year 1
(2016/17)
YES
Cardiology Potential for changes within
GM, which may affect volumes
and accreditation of existing
sector units.
The focus is on specialised cardiology. There is a need
for greater information and engagement with specialised
commissioners to understand what changes are
proposed.
Changes unclear at this time.
Year 2
(2017/18)
YES
32
Services Identified for Potential Priority Review (cont.)
As the system starts to reduce the amount which is being spent on reactive care, more resource will be released back to invest in the schemes
(targeted at the population at Tiers 3 and specifically 4) which will pay back in the medium to longer term (including the Early Years New Delivery
model which starts to pay back within 10 years but delivers significant whole system cost reduction and improvements in whole population
outcomes from year 20).
8. Financial plan
33
Savings projected from transformation plansCCG
000's
LA
000's
FT
£000's
Total
£000's
Sa
vin
gs fro
m T
ran
sfo
rma
tio
n
Pu
mp
Pri
min
g
Reducing demand on hospital due to INT redesign LTC management etc £5,366
Stop increasing demand on hospital due to falls prevention management
Reducing demand on social care due to falls prevention over 5 years £4,588
Reducing demand on hospital due to dementia £1,583
Reducing demand on social care due to dementia £1,443
Reducing demand on hospital care due to Staying well £1,013
Reducing demand on social care due to Staying well £2,834
Reducing demand on hospital services due to health promotion and self care etc £1,013
Emotional wellbeing £3,525 £2,179
FT cost reduction reduced LoS, bed days £3,000
Total Savings from Transformation Pump Priming £12,500 £11,045 £3,000 £26,545
Ad
ditio
na
l
Sa
vin
gs
Redesign of Urgent Care £8,084
Right Care £3,356
Readmissions £43
Additional Local Authority Savings TBC
Additional FT Savings (as per Bolton roll up) £30,000
Total Additional Savings £11,483 £0 £30,000 £41,483
Total Savings £23,983 £11,045 £33,000 £68,028
8. Financial plan (cont.)
34
-83
-16 -22
1 5
-45
-10
-28 -24-11
-33
(90)
(80)
(70)
(60)
(50)
(40)
(30)
(20)
(10)
-
10
CCG 20/21 LA 20/21 Provider 20/21 Net 20/21Position
CCGImprovement
LAImprovement
ProviderImprovement
Net 20/21Position afterImprovement
CCG Positionafter
Improvement
LA Position ProviderPosition AfterImprovement
Whole locality do nothing income/expenditure and impact of plan (£m)
35
9. Timeline for implementation
Year 1
16/17
Year 2
17/18
Year 3
18/19
Early Years New Delivery
Model
GM bid to transformation fund for
GM-wide implementation of
EYNDM
Scope plans for a re-designed
integrated service for 0-19 year
olds.
Early Years New Delivery Model
implemented as part of 0-19
integrated service
Increased physical activity Develop local plans Begin implementation of local plans Reduce premature mortality from
heart disease, respiratory disease,
cancer and stroke.
Reduce levels of liver disease Deliver and evaluate complex
lifestyle service
Re-design/ re-tender specialist
services
Reduce alcohol related admissions
to 645 per 100,000.
Emotional Wellbeing Develop local action plan to
improve mental health and
wellbeing.
Develop business case(s) to
support implementation of local
action plan.
Local plans fully implemented.
Early identification: finding
the missing 1000s
Scope work needed to improve
uptake of NHS Health Check and
screening programmes
Development of new
strategies/campaigns to increase
uptake
Reduce premature mortality from
heart disease and stroke
Early intervention -
secondary and tertiary
prevention to prevent/delay
progress of one or more long
term conditions
Redesign health improvement
services to provide health
coaching/interventions for specific
identified cohort of population
Evaluation of re-designed service Reduce internal life expectancy gap
between most and least deprived
areas
Social prescribing, self care Develop local plans for social
prescribing
Begin implementation of social
prescribing and self care plan
Social prescribing and self care
plans fully implemented
Reduced social isolation and
retention of independence
Local action plans to align to the
Ageing Well GM Strategies and
agenda
Develop business case for GM
transformation funding to expand
Staying Well programme
Staying Well implemented city wide
and reduction in social isolation
Transformation
workstream
36
9. Timeline for implementation (cont.)
Year 1
16/17
Year 2
17/18
Year 3
18/19
Improved assessment and
care planning - frailty
Investment in scaling up innovation
and demand reduction work through
a programme of behaviour change /
workforce reform
Improved and Sustainable
Care Home Sector
Carry out a comprehensive review
of the Care Home sector in Bolton
Implement new funding models and
monitor effectiveness
Reduction in number of out of
borough placements
Improved Home Care Alongside GM we will produce an
ethical service specification for
home care
As opportunity presents we will
deliver the ethical service
specification for reformed home
care
Sufficiency and stability ensured in
the market.
Significant improvement in
falls prevention care
Review and re-design falls
pathways.
Implement local plans to establish a
comprehensive falls prevention
pathway
Comprehensive falls pathway
implemented.
Improvement in dementia
diagnosis and care
Develop business case for
improved dementia support and
care.
Develop plans to roll out DFC
borough wide (subject to successful
evaluation).
DFC in place borough wide and
GM Dementia Programme
established
Reactive care delivery Reduction in unplanned hospital
admissions and long term
residential care placements
Reduce non elective admissions
and long term residential
placements
Last Year of Life Care Implement strategy
Transformation
workstream
9. Timeline for implementation (cont.)
1. Assess current state 2. Outline interventions3. Detailed design and
implementation planning4. Implement and monitor
1
23
4
Gain an understanding of the
overall position in Bolton,
evidenced issues, and scope
for improvement.
We will:
■ Map the ‘current state’ with
clinical and operational
teams.
■ Look at enabling functions
that also need to be
considered as part of the
transformation plan.
■ Factoring in the impact of the
wider GM strategy and other
service improvement plans.
Define the transformation
interventions required in detail
prioritising and agreeing the
solutions that will achieve this.
We will:
■ Scope what is achievable
within the required time and
cost envelope.
■ Define what are the most
effective interventions to
implement in order to achieve
the required transformation.
Develop detailed plans for
implementation including
defined KPIs, milestones and a
robust quality impact
assessment.
We will:
■ Develop a detailed business
plan for each solution.
■ Deliver the required
communications, training and
briefings to staff to ensure
they have the understanding
and skills to implement the
revised ways of working.
Implement the detailed plans
and robustly monitor their
completion, impact and
outcomes.
We will:
■ Support the delivery owners
in implementing
transformation plans.
■ Monitor the completion of
actions and data analysis to
confirm impacts.
Our plans for the implementation of the outlined transformation workstreams broadly follow a four stage approach. The delivery of this will differ
according to the maturity across each workstream, the time taken to deliver may differ according to the complexity of the activities.
The four stage implementation process1. Assess current state
2. Outline interventions
3. Detailed design and implementation planning
4. Implement and monitor
37
The communications and engagement activity outlined in this plan will be led by the CCG. As the Locality Plan itself is shared between the CCG,
council, and FT we will seek to share it with our partner organisations and encourage them to support and participate in activities as far as possible.
Communications and engagement objectives
• Raise awareness of the locality plan and the big challenges facing health and social care in the coming years.
• People have an enhanced understanding of how their own behaviour (for example in relation to their lifestyle or being active in their
communities) directly contributes towards supporting the future of public services. This changes their perception of the relationship the
individual and local services, which in turn influences and changes their behaviour.
• Obtain input from the public
• Feedback on the plan – has anything been missed?
• Pledges for what they will do - #BoltonTakingCharge
Stakeholders/Key Audiences
Bolton’s locality plan is relevant and likely to be of interest to everyone in Bolton – as users of health and care services. There are nine protected
characteristics set down by the Equality Act 2010 which are listed below -
• Age
• Disability
• Gender (male/female)
• Gender re-assignment (transgender issues)
• Pregnancy and maternity
• Race
• Religion or belief – including lack of belief
• Sexual orientation (lesbian, gay, bisexual, heterosexual)
• Marriage and civil partnership
It is vital that as part of any engagement planned, the above protected characteristics are targeted and given the chance to get involved. This may
require additional work with certain groups, as they may struggle to engage or have never been involved with public service engagement of this kind
before.
10. Communications & engagement plan
38
Key messages
10. Communications & engagement plan (cont.)
Doing what we have always done is now no longer an option.
This is the start of an important journey for Bolton – we’re on the way to better health and care services, plus a
healthier population.
You’ll be hearing a lot more about our vision for health and care in Bolton over the coming years.
Challenges
More people are living longer, often with complicated health
problems, so they need more help and support to stay well.
The health of residents in Greater Manchester lags behind the
rest of the country – we want to change this.
Money
We need to find ways to do more with less.
If we don’t make some big changes, Bolton will spend more and
more on health and care in the coming years – that’s money we
can’t afford!
By 2020, there will be a gap of £135m between the cost of
health and care in Bolton and the money we have available to
pay for it.
Over the coming years, we will need to change the way we
provide health and care in Bolton so we can balance the books.
Money is tight so we need to look carefully at what the ‘Bolton
pound’ can, and should, be paying for when it comes to health
and care.
Public money should only be spent on treatments and services
that have the most benefit for Bolton people.
£
Aims
We want everyone in Bolton to live longer and healthier
lives.
Our vision is all about changing health and care so we
spend less on hospital care and more in the community.
Our health and care services need to get involved earlier –
before someone gets so ill they need to be rushed into
hospital.
We plan to focus on people with the greatest need for extra
help and support, to stay healthy and independent. This is
likely to be older people with long term conditions.
We want to offer more support to people who are at risk of
developing health problems, before they become ill. This
means more screening and vaccinations, as well greater
support for those who want to lose weight, stop smoking, or
drink less alcohol.
This isn’t just about physical health – improving the mental
health and wellbeing of Bolton people is a big priority too.
We want to provide greater support and better care for those
with mental health problems. This means getting the right
care when it’s needed - whether that’s urgent support in a
crisis or counselling sessions for anxiety.
39
Key messages (cont.)
10. Communications & engagement plan (cont.)
How
To change things, we’ll need to work differently.
We want health and care services to work in a more joined up way, in Bolton, and right across Greater Manchester.
We’ve got lots of ideas for how things can change so your health and care services are even better. Now we want to know what you
think.
Nothing will change overnight. This is all about gradual service changes to meet the difficult challenges ahead.
Taking Charge
• Bolton Taking Charge is part of a Greater Manchester wide
movement in response to the significant challenges now
facing our health and care services.
• Bolton Taking Charge is all about getting local people
involved in thinking about and planning for the future of health
and care in Bolton.
• We need to make big changes and we can’t do it alone – you
have a big part to play.
• We want to change the way people and communities take
charge of, and responsibility for, their own health and
wellbeing - whether they are well or unwell.
• We want Bolton people to do more to take care of their own
health and wellbeing, which could mean taking steps to stay
healthy, managing a long term condition, or using health and
care services appropriately.
#BoltonTakingCharge pledges
• We can all make a difference - what will you do?
• How could you take charge of your own health?
• What could you do in your local community to
support your health and care services?
• Examples:
– Pop in to see an elderly neighbour for a cup of
tea.
– Set up a walking group in your community.
– Stop smoking.
– Reduce the amount of alcohol you drink.
– Call NHS 111 when your child is unwell, before
heading straight to A&E.
• Make your pledge today on social media, the
online forum, or by writing it on a pledge card.
If pushed….
This is not a consultation and we are not talking about specific service changes. If there are any future changes which may affect how services are
provided there will be formal consultations with the public and affected staff.
40
Communication & Engagement Mechanisms
Communications and engagement activity will look at raising awareness of the locality plan and the challenges facing our health and care services,
whilst also encouraging people to get involved and make a #BoltonTakingCharge pledge.
Putting more responsibility on members of the public to take action to protect their health and care services is a core element of the plan. This will
be highlighted in Bolton by encouraging people to make their own pledges for what they will do. Pledges may relate to lifestyle changes or
community activities. This will provide the CCG with valuable intelligence about the public’s response to the core messages in the plan, as well as
helping to grab people’s attention and get them engaged. Members of the public will be encouraged to send their feedback and
#BoltonTakingCharge pledges using social media, the online forum, the Let’s Make It email address, or a freepost envelope. We will look into the
use of post boxes distributed to GP practices for a previous campaign and whether these could be used for #BoltonTakingCharge.
We will invite members of the public, GPs, CCG staff, and any local key influencers to be photographed with their pledge. The photographs will
then be used for a range of purposes including social media and issued with press releases. Short films will also be made of individuals sharing
their #BoltonTakingCharge pledges, including community group leaders and board members. This could include other languages, such as BSL and
Urdu.
Activity will begin mid-February to time with Greater Manchester led initiatives. There will follow a concentrated push from mid-February to April to
grab attention and engage local people. We will then build on this foundation with continued activity and communications over the coming months.
All of the communications and engagement activity set out in this plan will be rolled out under the Let’s Make It brand. However,
#BoltonTakingCharge will need a recognisable visual ‘identity’ within this brand to help us to build familiarity and recognition with the public.
Digital communications
• New, dedicated page on the new CCG corporate website. With link to the online forum on the Let’s Make It website.
• Will be used as an opportunity to boost use of the Let’s Make It forum. Tactics will include encouraging partner organisations to post and
starting focused topic threads, with promotion via social media.
• Daily messaging using corporate and Let’s Make It social media channels. This will be supported by images to ensure that posts are eye
catching and more likely to be shared.
• Social media will be planned with a thematic focus for different weeks, reflecting the locality plan. The #BoltonTakingCharge call to action
posts will continue throughout.
• Local partners will be asked to support by sharing posts and using a list of pre-prepared social media posts provided by the CCG on their own
channels.
10. Communications & engagement plan (cont.)
41
Digital communications (cont.)
• Members of the public will be encouraged to post their feedback and #BoltonTakingCharge pledges using social media or the online forum.
• New background images linking to the artwork and messages for this work will be used on CCG Facebook and Twitter channels for a pre-
agreed length of time.
• Short filmed interview with Wirin and Paul Horrocks (£) – available online and screened at public meetings, events etc.
Media relations
The launch of the #BoltonTakingCharge initiative will be launched with a press release, which will be posted on the CCG’s corporate website and
the Let’s Make It website, as well as a column in the Bolton News.
The Bolton News and Bolton FM will be asked to support this initiative. We will also seek to utilise our relationship with the Bolton Wanderers
Community Trust, as it may be possible for messages to go on their social media, matchday programmes, website etc. Other channels to consider:
• Xplode (there is a cost for coverage in the magazine)
• Bolton Carers Support newsletter
• Bolton CVS
• Tower FM
• Key 103
• Bolton Live (online channel)
• Manchester Evening News
• Living in BL (free newspaper for West Bolton)
• Horwich Advertiser
Further opportunities for media coverage will be sought, such as:
• Progress report on pledges received so far.
• Key 103 bus visit.
• ‘Don’t miss your chance’ towards the end of the designated period for submitting feedback.
• Link to national awareness days/weeks/months:
• National Salt Awareness Week – week beginning 29 February
• Ovarian/Prostate Cancer Awareness Months – March
• International Women’s Day – 8 March
10. Communications and engagement plan (cont.)
42
Media relations (cont.)
• International Women’s Day – 8 March
• No Smoking Day – 9 March
• Bowel Cancer Awareness Month – April
• World Health Day – 6 April
• European Immunization Week – week beginning 25 April
• Follow up – encourage media to attend board meeting where analysis will be presented.
• Feature – Bolton Deaf Society recording their #BoltonTakingCharge pledge in BSL
Design/print materials (£)
• A3 poster – distributed to usual locations (e.g. GP practices, pharmacies, libraries etc. plus others)
• Postcard with space for people to write their pledge
• Large pledge cards for use in photos and films
• Summary leaflet
• Presentation
• Social media images
Internal communications
GP practices are on the front line of local health services and practice staff are often a patient’s main point of contact with the NHS. It is therefore
important that practices are aware of and engaged with this initiative. The following will be undertaken to achieve this goal:
• Launch article and follow up articles in the Practice Bulletin.
• Presentation at a clinical leads meeting
• Email briefing from Wirin to GPs
Many CCG staff are Bolton residents and key influencers as well informed individuals in their social networks and local communities. The issues
raised in the locality plan will be relevant to the work of everyone in the organisation. The following will be undertaken to communicate with staff:
• Launch article and follow up articles in the Practice Bulletin.
• Presentation at staff briefing, with pledge cards handed out and a post box at the briefing and then placed in a central place in the building.
• Mention in Su’s exec update emails.
• Posters around the building.
10. Communications & engagement plan (cont.)
43
Paid advertising
Paid advertising, such as on buses or on street, is expensive and not proposed for use as part of this project. However, two possibilities have been
identified that would be more targeted and cost effective than other options.
• Life Channel
• Targets members of the public at their GP practice at a time when they are already thinking about their own health as well as local
services.
• They are a ‘captive audience’ waiting to see their GP, with fewer demands on their attention.
• Bolton News online adverts
• Website has high readership – more likely to be younger?
• Online adverts allow people to click straight through to the website where they will find more information and be encouraged to make a
pledge.
Public engagement
1. Use our increasing contact lists and the Let’s Make It Happen people bank to make sure that people are aware and how they could get
involved.
2. Special edition of the LMI newsletter – ‘what does this mean for you?’ to encourage our contacts and panel to get involved, and an invite for
us to visit to give a presentation.
3. A focus group with a presentation - aimed at those hard to reach groups.
4. ETAG - presentation, round table discussions and request further feedback.
5. Attend public events to hand out summary leaflet and collect pledges/feedback. Public events (so far): Health Mela (12th March), CCG
roadshow (date tbc)
6. Roadshow – use the campervan to interview the public and gather footage to include with the final report to Board. Also collect pledges and
encourage people to have their pictures taken holding their pledges.
7. Presentation - includes the GM context and then more detail on the plan for Bolton. In simple but hard hitting language so that the public fully
understand the situation, and understand what their role is. This presentation to be given to all groups visited and placed on the website.
8. Visuals to be sent to Bolton Uni/Bolton College for display on their screens.
9. Theme based focus groups held with the voluntary sector.
A survey will be run at a GM level, along with a roadshow run by Key 103.
10. Communications & engagement plan (cont.)
44
Feedback Process
As the CCG will be gathering a lot of feedback from the public, it is important it is clear what will happen to the feedback, and we have a full process
in place to collate and analyse everything that is received. All hand written views/pledges/feedback posted on our websites/twitter etc. will be
inputted into an excel database and coded according to theme. This database will have a category for how the feedback was received. Admin
support will be needed to input these responses and pledges, and a regular check done every week by the team to see what themes are emerging.
A full report and analysis will be written and presented to the CCG’s Board. The analysis of what is collected will be done by the CCG. This analysis
will be published by using our normal channels such as the CCG and LMI websites. All feedback will also be sent onto the GM Devo team for them
to take into consideration.
Risks / challenges
45
10. Communications & engagement plan (cont.)
What’s ‘up for grabs’?
It is important to be clear that this is not a consultation and does not
relate to specific service changes. We must manage expectations
and be clear as to the process, what we are asking, and what can be
influenced by the public.
‘It’s just like Healthier Together’
This initiative will follow soon after the announcement of the
Healthier Together judicial review. This process has meant that the
controversial consultation has been in the public eye a great deal
over recent months. Some people may view this as being similar to
Healthier Together, impacting on how receptive they will be to our
messages.
Limited resources
The communications and engagement activity set out in this plan
reflects a significant amount of resources in terms of both NHS
funds and staff time. We must be clear at the outset as to what can
be delivered and what budget is available, in order to manage the
expectations of CCG senior managers and board members.
It is also important to prevent ‘cross over’ work being done by the
CCG and those who are also involved from a local or GM level.
GM influence and control
Although this is a locally driven initiative, #BoltonTakingCharge links
into a wider GM led programme of work. This means that our work
in Bolton may be influenced and affected by other events outside of
our control. It is important for the reputation of the CCG and the well
established relationships with have local community groups that we
complete the ‘feedback loop’ and provide an update once all the
feedback and pledges have been submitted. However, we will to an
extent be reliant on GM bodies to feed back to us before we are able
to do this.
Activity Date Location Lead person Resource (£) Progress
Printing and delivery of summary leaflet (x2000) 11/02/16 JP £303 Completed
Press release - launch (issue 08/02/16 – embargo for 15/02/16) 15/02/16 SFH £0
Completed
Dedicated web page on CCG corporate website 15/02/16 SFH £0 On LMI website
Start thread on Let’s Make It forum 15/02/16 SFH £0 Completed
Social media calendar – themed posts 15/02/16 –
29/04/16
SFH - content
JP – design of images
£0
Posts in progress
Article in Practice Bulletin 16/02/16 SFH £0 Completed
Presentation at staff briefing 16/02/16 NO £0 Completed
Wirin’s column - launch 23/02/16 SFH £0 Completed
Article in Staff Focus 25/02/16 SFH £0 Completed
Press release – National Salt Awareness Week (issue 22/02/16 – embargo for
29/02/16)
29/02/16 SFH £0
Not started
Wirin’s column – mental health 01/03/16 SFH £0 Completed
Press release - Key 103 bus (issue 01/03/16) 08/03/16 Vic Sq SFH £0 Not started
Press release – progress report on pledges received so far March SFH £0 Not started
Press release – Prostate/Ovarian Cancer Awareness Months March SFH £0 Not started
Include in Su’s Exec Update to CCG staff March SFH £0 Not started
Press release – International Women’s Day (issue 01/03/16 – embargo
08/03/16)
08/03/16 SFH £0
Not started
Press release – No Smoking Day (issue 02/03/16 – embargo 09/03/16) 09/03/16 SFH £0 Not started
Press release – don’t miss your chance to feed back April SFH £0 Not started
Press release – Bowel Cancer Awareness Month April SFH £0 Not started
Press release – World Health Day (issue 30/03/16 – embargo 06/04/16) 06/04/16 SFH Not started
Press release – European Immunisation Week (issue 18/04/16 – embargo
14/04/16)
25/04/16 –
30/04/16
SFH £0
Not started
Press release – CCG roadshow May SFH Not started
Article in Xplode tbc SFH £700
(dble page)
Look at next financial
year
Press release – analysis to be presented at CCG board tbc SFH £0 Not started
Interview film with Wirin tbc SFH £0 JP supplied filming
contact
Life Channel advertising tbc NO £? Not started
Bolton News online advertising tbc SFH £? Details to be agreed
Pledge cards tbc JP £? Not started
Posters tbc JP £? Not started
Large pledge card for photos/films tbc JP £? Not started
10. Communications & engagement plan (cont.)
Communications and engagement plan delivery schedule
46
Engagement Date Location Lead person Resource (£) Progress
Roadshow February HC £? Asked Key for date they
are visiting Bolton
Stall at Health Mela 12/03/16 HC £0 Booked to attend
Presentation to Youth Council 02.02.16 NO/JP/HC £? HC writing presentation.
Info gathered. JP
developing props
Special edition of newsletter Feb HC £0 Not started
Presentation/pledge session with New Openings (LD) tbc HC £0 Not started
Send electronic posters to Bolton College/Uni for display on their screens tbc HC £0 Waiting for poster to be
designed
Presentation/pledge session with Care4 (LD) tbc HC £0 Check HW are not
already visiting group –
LD carers
Presentation/pledge session with LGBT group tbc HC £0 Asked Bolton LGBT
partnership for help.
They are looking into
when I could visit to
present/gather pledges
Presentation/pledge session with Bolton Blind Society tbc HC £0 Not started
Presentation/pledge session with Bolton Deaf Society? tbc HC £140 interpreter
cost
Check if HW are visiting
them
ETAG session March NO/HC £0 Not started
Targeted email to GP patient forums February HC £0 Not started
Send posters to supermarkets/takeaways February HC £0 Not started
Posters in black bag to all primary school February HC/Sports & Living at
Council
Cost of printing
posters Not started
10. Communications & engagement plan (cont.)
Communications and engagement plan delivery schedule (cont.)
47