NHS TRAFFORD CLINICAL COMMISSIONING GROUP GOVERNING BODY 25 th March 2013

Transcription

1 Agenda Item No: 9.0 Part 1 X Part 2 NHS TRAFFORD CLINICAL COMMISSIONING GROUP GOVERNING BODY 25 th March 2013 Title of Report Purpose of the Report Green Paper - Estates Strategy To consider the Estates needs for Trafford in order to offer integrated services. The CCG are proposing leading a development of an Estates Strategy along with Partners for Trafford. Actions Requested Decision x Discussion Information Strategic Objectives Supported by the Report Recommendations 1. Consistently achieving local and national quality standards. 2. Delivering an increasing proportion of services from primary care and community services from primary care and community services in an integrated way. 3. Reduce the gap in health outcomes between the most and least deprived communities in Trafford. 4. To be a financial sustainable economy. The Governing Body is recommended to accept this proposal and to receive regular updates through the rep[ort of the CCO to the governing body.. Discussion history prior to the Governing Body Financial Implications Risk Implications Impact Assessment Communications Issues Public Engagement Discussions at management team which supported the development of this green paper to the Governing Body.. Any financial implications should be picked up through pass through costs as part of the commissioning of services. Risk of some primary care building not being fit for purpose. Risk around capacity of estate in the community to deliver integrated care. Lack of coordination of estate development and the alignment to integrated care. To be undertaken by each provider Once agreed this process will need to be disseminated through the organisation governance and communication structures so that all those generating potential strategies are aware of their requirements

2 Summary Prepared by Responsible Director Gina Lawrence, Chief Operating Officer Gina Lawrence, Chief Operating Officer Page 2

3 Green Paper - NHS Trafford CCG Estates Strategy 1.0 Introduction 1.1 As part of the development of integrated services a range of community teams have been put in place. These teams currently operate out of existing buildings which are not fit for purpose. 1.2 Recent alignment of social and community services means that existing estate is at a premium with teams requiring co-location. 1.3 The integrated strategy that was developed 5 years ago looked at teams operating from neighbourhoods which had integrated hubs within them. These hubs would be suitable for offering state of the art integration and be easily accessible for the Trafford public. 1.4 Trafford CCG has been developing all the component parts of the strategy but had considered that the estate would be one of the last elements to be developed. Technically the CCG is not responsible for the estate of providers but due to the complexity of the integrated service and the number of providers on the Trafford patch the CCG would like to lead this process in order to ensure good quality estate is developed in line with the newly commissioned services. 1.5 This green paper is being presented to the Governing Body to seek approval for the CCG to lead on the Estates Development Strategy. 2.0 Current Position 2.1 Trafford CCG has a range of community providers who are operating out of a wide range of buildings. Some are owned by providers, some are rented - these range from premises above shops to small dwellings and many are no longer fit for purpose. 2.2 As part of delivering an integrated care model, it is important that services are delivered from buildings which are modern, have adequate access and meet the standard to deliver the high quality services from. Trafford CCG has a whole programme of service design which is externally focused on community and primary care service expansion. The new redesign of services, will be initiative, benefit from new technology, provide greater access, to meet the needs and the expectation of the service users. The estates need to be able to offer the standards required, and not to impact on the quality of the services that are being offered as this can lead to poor patient perception of the services and poor experience. Currently, access to some of the sites is difficult with some of the centres having poor parking or delivered from are old premises that need modernising (or in some cases de-commissioned). Page 3

4 2.3 Following the disestablishment of Primary Care Trusts in 2013, CCG s no longer hold responsibility for estates but are allowed to commission the specification of the provision it would require within any new estate development working alongside NHS Property Services who took over the ownership and management of PCT premises from April Impact of Future Developments 3.1 NHS Trafford commission a number of healthcare organisations to provide community services. As part of the Integration Strategy and Community Standards there will be a requirement for additional space as detailed below: 3.2 Pennine Care Foundation Trust (PCFT) PCFT are the main provider of Adult and Children s Services, and operate out of a number of community facilities with their main premises being located at Meadway which has already undergone extensive modernisation to achieve its maximum capacity. As PCFT provide the majority of the CCG s unscheduled care provision, which, is expecting to increase by 17% in deflection activity from Acute Trust s over the next five years, further estates infrastructure will be required. 3.3 Community Children s Services Pennine Care Foundation Trust and Trafford Borough Council have been commissioned by NHS Trafford to integrate the children s services in order to move to more consultant clinics and offer multi-disciplinary clinics in the community. During an agreed programme the services will relocate up to 50% of their current out-patients activity into an integrated community facility. The full business case for this new model of working is currently being written. 3.4 Podiatry Services PCFT host the podiatry service, however, it is currently being tendered out and as such may require premises as the existing service is housed within PCFT s owned estate. 3.5 Greater Manchester West Mental Health Services (GMW) Community Mental Health Services which are already at capacity operate out of existing community premises which includes improving access to psychological therapies (IAPT) which has a target growth of 15% over the next three years and cognitive behavioural therapy. Page 4

5 3.6 Outreach Stroke Services Currently, there is no provision within the community for a stroke service. NHS Trafford CCG are working with two potential providers however, this will require additional community premises in order to provide the outreach service. 3.7 Patient Care Coordination Centre (PCCC) NHS Trafford is leading on the procurement through competitive dialogue of a PCCC which will support the Integration Strategy by providing an innovative solution to coordinating the care of all registered patients in Trafford. The solution will require an appropriate home which has the required level of IT infrastructure to manage all of the requirements within it s service specification. 3.8 Primary Care Strategy NHS Trafford will over the next five years work with General Practice Members to secure a more robust and sustainable model for General Practitioners across Trafford working together to deliver a locality model that supports Member Practices in delivering improved access, continuity of care and improved outcomes for patients, without placing undue burden on individual practices through the shift of increased care delivered out of hospitals. Working to address the needs of the local population, a wider portfolio of locally commissioned services will be developed to provide increasing amounts of care outside of hospitals, and closer to patient s homes. Trafford CCG will be working with NHS England in the development of the Primary Care estate strategy for Trafford. 4.0 Additional Pressures on Existing Estate 4.1 The Better Care Fund is a single pooled budget to ensure transformation in integrated health and social care. Trafford CCG and Trafford Borough Council has coproduced and submitted a bid which if approved will see a further shift of services out of Acute Trusts and into the community along with a greater integration and alignment of services. As part of meeting these challenges, there will be an expectation that social care services will need to expand beyond 5 day working and unscheduled care outside of acute services will match and be on a 7 day basis. 4.2 Further integrated services will be required within community settings within the next 5 years. Page 5

6 5.0 Vision for Trafford Estate 5.1 TMBC and GMP operate services on a four neighbourhood system in Trafford, the CCG has agreed to support these four localities in the way it commissions and delivers services. The original vision had two main hubs one in the north of the borough and one in the south with smaller centres in the east and west. 5.2 It has become increasingly apparent that in order to offer high quality services that the public are prepared to use the image of the building is paramount. Trafford residents are used to accessing large Foundation Trusts with high quality estate and for integration in the community to work there must be a similar offer. 5.3 There is opportunity to develop centres both in the north and south at the current time. 5.4 North - the north area has a facility being developed by Trafford Housing Trust which gained capital from a European Funding bid this has a range of services that could potentially be housed in the new building. The main stakeholders who will utilise the building are CMFT, TMBC, Pennine Care and potentially GMW and Primary Care. The list below gives an indication of the types of services that are likely to go into this building: Innovative multi-use development 80 Apartment Extra Care Scheme Single front of house Community Facilities GP Services Dental Services Mental Health Wellbeing Pharmacy Library / Advice Services Café This development has been planned for a number of years and the CCG has been supportive of this in order to create the integrated hub in the north of the area. There is an expectation that this centre will serve the population as far as the Urmston area. 5.5 South CMFT has developed a community hospital on the new Altrincham Hospital site this offers a range of facilities which centre around treatments which are done as a single intervention. The CCG has been looking at the old Altrincham General Hospital site in order to support the community services in the south, the new care coordination centre and a range of innovative services that support integration. These two sites would offer the integrated hubs that are required to be able to expand integrated services and offer them in brand new state of the art facilities. Page 6

7 6.0 Next Steps 6.1 Development of a steering group chaired by the Chief Operating Officer, Trafford CCG which has senior organisational representation from: NHS England NHS Property Services Community Health Partnerships Pennine Care Foundation Trust Greater Manchester West Mental Health Services University Hospitals South Manchester Central Manchester Foundation Trust Trafford Borough Council Greater Manchester Police Healthwatch Trafford 6.2 The purpose of the group will be to consider the estates requirement for the whole of Trafford for all key stakeholders, any developments will be fed back to each organisations own Board through their normal governance structure. 7.0 Conclusion 7.1 NHS Trafford is being seen across the country as being at the leading edge of developing a system wide approach to Integrated Care. However, without matching the estate provision with this innovative strategy, it will be difficult to achieve. 7.2 As part of Integration, there has always been a vision of bringing all of the existing new services together in to a single purpose built premise. 8.0 Recommendations 8.1 The Governing Body are asked to note the contents of this report and approve the establishment of the Estates Steering Group. Page 7