Right Care, Right Time, Right Place Programme Monitor & NHS England

Developing Health Services in

Calderdale and Kirklees

7th May, 2015

Matt Walsh

Carol McKenna

Objectives

To understand

Commissioners strategy and plans

The changes we are making

The changes we are planning to make

The high level timetable

The current Contract position

The Issues and Gaps we have identified

Engagement - findings and themes Improved access to health services More services in the community All agencies working together, to deliver integrated health and

social care Improved discharge planning and better resourced hospitals Staff training to improve communication and transparency Regular check-ups - for people with chronic conditions Improved management of risk and safeguarding when people

are unwell More education and information Support for Self Managed Care Investment in technology Consideration around travel and transport Improvements to mental health services Greater community participation

One size does not fit all

The needs of the community by locality must be considered

The key is prevention and empowering patients to take responsibility for their own health

Improve access to services outside of normal working hours

Ensure transfer of care commences at the right time

Need to see the models work in practice

Both CCGs are committed to ensuring everyone will

have a say in how the future services are planned,

commissioned, delivered and reviewed.

Care Closer to Home Key Themes CCCG & GHCCG

So what is our challenge?

Early intervention and diagnosis

Support self managed care

Closer to home wrap around services

Realigning mind-sets of individuals, their carers and their health professionals to this vision

Changing the way we commission and provide services to drive this change

jennyshepherdSticky NoteBut the CCGs keep telling everyone CC2H is what patients, public and clinicians are saying they want, so how come "realigning" their "mindsets" is a challenge?

Carol McKenna

Matt Walsh

Commissioners Strategy &

Plans

Understand the Case for Change.

Reflected on our Engagement to Date

People need to experience Community first

Changes to the Hospitals will be required

We are working with the Provider to identify how we mitigate risks they identified in the OBC

We are continuing to get ready for Consultation

When we are ready we will consider when

We will continue dialogue with Calderdale Scrutiny, Kirklees Scrutiny and Joint Scrutiny Committees

CCGs Strategy

Programme Phasing

Phase 1 Strengthen existing

community services in line with the new

model of care

Phase 2 Enhance community

services which is likely to require more

engagement

Phase 3 Hospital changes.

Will require formal consultation.

Matt Walsh

The Changes we are making

NHS Calderdale CCG

Current Position Community

Services

Phase One - What have we done

Agreed the model and services in Phase One with KPIs

Approved the Phase One specification and engagement assurance.

Agreed the Commissioning approach

Used Feedback from stakeholders in our model & case studies.

Delivered three stakeholder events.

Aligned CC2H with BCF and QIPP schemes

Actively engaged our current community service providers

Presented to Calderdale OSC and JOSC

Submitted a successful Vanguard bid

Established the Governance and work streams.

Calderdale Care Closer to Home (CC2H) Programme

Single Point of Access design work underway

Upper Valley Programme underway

Finalise the scope of services in Phase Two

Agree the Engagement and Equality action plan for Phase Two

Develop the Phase Two Specification (that includes services in Phase 1)

Long term commissioning process and approach to be developed

Calderdale Care Closer to Home Programme

What's Next

Calderdale Care Closer to Home Programme Plan

CC2H Timeline (Version 9.0) D J F M A M J J A S

Run SPA workshop 16

Share specification with providers by email 22

Refresh CHFT Community Contract Meetings 7

Share draft Dashboard with GB Dev Session 15

Meeting with providers on process (week commencing) 19

Share spec and process with OSC (public at this point) 27

Workshop for Upper Valley (to be confirmed)

Design SPA

Design Upper Valley Programme

Share final Dashboard with GB Formal 12

Final P1 spec and KPIs to Quality Committee 26

Draft P2 Spec to Quality Committee 26

Measure progress at contract meetings 5 5 2 7 4 2 6 4

Assess progress using Dashboard, prepare reports 15

Share findings with F&P Committee 30

Share findings with Quality Committee 30

Findings and recommendation to GB Formal 15

Start commissioning process (approach to market)

Carol McKenna

The Changes we are making

NHS Greater Huddersfield CCG

Current Position Community

Services

Kirklees Care Closer to Home

Greater Huddersfield and North Kirklees have agreed to use a competitive dialogue procurement process

The tender was issued 20 October

Pre-qualification questionnaire (PQQ) stage concluded

Established and recruited a patient/carer panel, involved patients, carers, children and young people in evaluation process

Two bidders invited to participate in competitive dialogue (ITPD)

Received and evaluated the responses from potential bidders

Notified bidders of the shortlist and issued the ITCD

Completed the dialogue sessions with bidders

Currently evaluating final submissions

New contract award in May; to take effect from October 2015

Workstream Aug 2014 Sept 2014 Oct 2014 Nov 2014 Dec 2014 Jan 2015 Feb 2015 Mar 2015 Apr 2015 May 2015 Jun 2015 July 2015 Aug 2015 Sept 2015

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CC2H Timeline Kirklees

PQQ Evaluation

Pre-Qualification Standstill

Key: CCG Lead CSU Lead with CCG involvement

Contract Award

Provider

Invitation to Participate in Dialogue (ITPD)

Invitation to Continue in Dialogue (ITCD)

ITPD Evaluation

ITCD Evaluation

Engagement (CCG/CSU/LA/GPs/Clusters)

Update Demographics

Confirm Scope/Lots/Outline

Spec/services

Confirm Scope (estates)

Articulate Vision & Technical PQQ

Questions

Develop PQQ Docs / Market Analysis & Stimulation

Confirm Contract Duration

CCG Sign Off

Confirm Approach to PQQ Fin Assessment

Develop Docs

Develop Docs

Revise Specs/ Model

Finalise Contract Documentation

Develop detailed Estate Info

Develop detailed TUPE Info

CCG Programme Management

Develop Commercial Approach & Questions

Programme Board

Create benchmark information to assess VFM

CCG Communications (Pro-active and reactive)

CCG Sign Off

CCG Sign Off

CCG Sign Off

Advert Issued

Provider Implementation

Contract in place

Market Sounding

B2B Mtg 24/9

Develop Contract Documentation

B2B Mtg 13/05

Phase Two Community Services

To continue to enhance community services and begin to move services out of

hospital that can be provided more

appropriately in communities, as per

ongoing engagement.

Any potential significant Service change to be included in the engagement and

consultation in relation to Hospital

Carol McKenna

Matt Walsh

The changes we are

planning to make

Hospitals Have to Change

Workforce pressures.

Increasing Demand.

Increasing specialism.

Financial pressures.

Quality challenges.

Regulation & Standards.

The question is how?

Specialist sites we can do this ourselves Planned Care

Unplanned care

Network solutions we can do this with other hospitals Acute providers operating at scale

Integration solutions we can become more than a hospital DGHs integrating with other community, social and

Primary Care

Scope - Hospital Future Model of Care

Acute, Emergency and Urgent Care

Paediatrics and Maternity

Planned Care (Elective, Day Case & Diagnostics)

Utilisation of Estate and Specialist Commissioned Services

Hospital Services (1) We have agreed our hospital standards

We have established the outputs and outcomes we expect these standards to achieve.

We have established a Hospital Services Programme Board.

A joint CCG Assurance Group has looked at the Providers OBC.

Findings considered by Hospital Services Programme Board.

Agreed to produce Commissioners Future Model of Care for Hospital Services that reflects our proposed changes to Community and our Hospital Standards.

Completed work on the Financial Case for Change pending development of proposals for changes to Hospital Services

Hospital Services (2) We have completed five clinicians workshops

20th Nov - CCGs clinicians to consider different model of care

22nd Jan - CCGs clinicians developed Commissioners thinking regarding the future provision of Hospital services

24th Feb - CCGs and CHFTs clinicians to understand collective thinking

14th Apr - CCGs clinicians Commissioners position on outline model

16th Apr - CCGs and CHFTs clinicians to develop collective thinking

Define the Financial Envelope

Undertake a Feasibility study with CHFT (Inc. 24 x7 operation, GP OOH).

Data to understand the demand/volumes/patient flow

Relationship with other community based urgent care and transport services including Ambulance transfers

Establish and publish roadmap for change

Continue to consider the perspective of patients and the public alongside clinical considerations

Engage the clinical senate in relation to Hospital services

Continue our work on the Case for Change

Consolidate this work into a pre-consultation Business Case

Next steps

Carol McKenna

Matt Walsh

The High Level Timeline

Jul- Oct 14 Scoping

Nov Sept 15 Pre consultation

(Design)

Oct - Dec 15 Consultation

(Implementation)

Jan 16 Post- Consultation

(Planning for Delivery)

Agreed high level scope

of services Develop Hospital

Standards for high level services

Develop high level outcomes and benefits

Baseline Finance

Ph

ase 3- H

osp

ital Ch

anges

Procurement, Contracting and

Delivery

Finalise the high level

outcomes and benefits Develop metrics for

balanced scorecard Develop Commissioners

Hospital Future Model of Care

Refresh of Hospital standards outcomes and benefits

Consultation resource plan complete

Options Development and Appraisal

Equality assessment Pre-consultation

engagement Write the Pre-consultation

business case Finalise proposal Write consultation

documents and consultation questions

Agree consultation plan and appoint resources

Stakeholder engagement and communications plan

Develop approach to market NHS England sense check 2

Deliver public consultation

Plan for post consultation

Stakeholder engagement and communications

Consider and respond to consultation feedback

Finalise proposal including additional work on finance, workforce and implementation planning

Equality assessment Write decision making

business case Stakeholder engagement

and communications Finalise approach to

market

Detailed implementation plans

Service specifications Capital business cases (if

required) Service change Stakeholder engagement

and communications

Timeline Hospital Phase 3 (Draft V3.5)

Solution

Design

Comms &

Engagement

Assurance

Governing

Body Dates

Oct Nov Jul Jan Feb Aug Sept Mar Apr May Jun

Financial

Case for Change

approved

Options

development

& Appraisal

EQIA

Outline

Proposals

Informal

Clinical

Senate

Key Milestone Key Deliverable Key Decision Key Greater Hudds

Gov Body

Calderdale

Gov Body

NHSE Sense Check Two

Hospital Services High Level Plan Pre-Consultation (Design)

High Level

Outcomes

and Benefits

approved

Quality & Safety

Case for Change

Timeline Hospital Phase 3 (Draft V3.5)

10th Sept

9th Sept 10th June

11th June

Inc Stakeholder events

PCBC approved

Report of findings

Finalise

consultation

document

Deliberation

Outline

Consultation

Document

Pre- consultation

Engagement Develop

Narrative

Questionnaire finalised

Consultation Plan

Resources for consultation secured

Consultation Doc approved

Outline draft

Hospital Model Ind Fin

Revie

w

Clinical

design

Finalise

PCBC

NHSE Sense Check One-

completed Gateway Review

Formal Clinical Senate

Transformation Road

Map

Launch Public

Consultation

We expect to demonstrate readiness for consultation in 2015

Once we have demonstrated that we are ready for consultation we will determine when that consultation should commence

Confidence that Community services are working well

Performance framework developed by both CCGs to measure the impact of the changes

being made in Community

Demonstrating Readiness for Consultation

Our Current Position Summary

We are progressing our changes to Community.

We need to baseline and set ambition for our quality and performance outcomes (metrics).

We understand the financial pressure we are facing

We are developing our Quality and Safety Case for Change.

We have considered six different models of care.

We have agreed the Commissioners position on what the potential future model could look like.

We have agreed to work together with the Providers clinicians to arrive at a collective view on the potential future model.

The issues and gaps we

have identified

Carol McKenna

Matt Walsh

Issues and Gaps

Workforce

Establishing existing and required capacity and capability

Assumptions and criteria for workforce modelling on options

Expected workforce benefits

Finance

Availability of capital funding

Independent Financial Assurance

Business Case

Writing the Pre-Consultation Business Case