Item 7 KIDDERMINSTER HEALTH SERVICES PROJECT INITIATION Director of Delivery Head of Communications and Community Engagement

Transcription

1 Trust Board 18 November 2009 Item 7 KIDDERMINSTER HEALTH SERVICES PROJECT INITIATION Director of Delivery Head of Communications and Community Engagement Recommendation Introduction Project Initiation Document Proposed Approach and Methodology The Board is asked to note this report and approve the Project Initiation Document for the establishment of a review of healthcare service needs for the population of Kidderminster and surrounding area. In Emerging Issues update NHS Worcestershire committed to the establishment of a Project Team to assess the range and level of services required to meet the healthcare needs of the people of Kidderminster and surrounding area. It stated that this would involve the completion of a full health needs assessment and the generation and assessment of a range of potential commissioning options, before the selection of a proposed preferred option which would subsequently be submitted to the Trust Board for approval. The Project Initiation (PID) Document attached to this report as Appendix One sets out how NHS Worcestershire intends to progress this work. It sets out the proposed Objectives, Scope, Deliverables and Goals of the project together with the proposed remit, membership, chairing and reporting arrangements for a Project Team to deliver these outputs. In addition, it proposes that a more broadly based Non-Executive Director led Steering Group be established, with representation from the local patient and population groups and NHS and local authority partners so that the Project Team has the benefit of a wider overview and perspective on a regular and ongoing basis. In taking forward this work NHS Worcestershire is proposing to follow the approach which has to date proven successful in the project that has been reviewing community health services in Evesham. As with the Evesham project in order to ensure this is a comprehensive piece of work which fully reflects the future needs of the local population this will commence with a detailed assessment of the Wyre Forest population s health needs. This assessment will comprise of a review of the current health status of the Wyre Forest population, their use of healthcare services (including general practice, hospital and community services) and how this compares with access to and usage of the Kidderminster Health Services Project Initiation Page 1 of 12

2 services in other parts of Worcestershire and the country. It will include an analysis of future demographics and anticipated population movements to fully identify the population s future requirements for healthcare services. This work has already commenced and the outcome will inform the Project Team s work including the generation of future options for the model of healthcare provision for residents who live in the Wyre Forest area. In its work, the Project Team will follow NHS Worcestershire s key strategic aims and goals and will actively pursue service re-design which particularly contributes to, and is consistent with, the strategic priority areas to achieve significant improvements in performance and health outcomes. In addition, the overall work will be consistent with the relevant national policies and guidance which are highlighted in Section 11 of the PID. A detailed timetable for this work will be developed by the Project Team and regular progress reports will be submitted to the Trust Board. Scope of Review This project will cover all healthcare services to be provided to the Kidderminster population and will range from primary care, secondary care and more specialist services, including hospital, community, GP and mental health services. The review will also explicitly consider opportunities for closer alignment of services and collaboration between the providers of health and social care in the area. This is a complex project and engaging and involving the local community and stakeholders will be an integral part of the work. For this reason it is proposed to establish a Project Steering Group with wide representation from the local NHS, Practice based Commissioners, stakeholders and patient groups. The remit of the Project Steering Group is outlined in more detail in the PID. Wyre Forest Context and Issues As well as these national, regional and countywide issues there are a number of factors which are specific to Kidderminster and the Wyre Forest area which will need to be considered: Kidderminster Hospital Site The Kidderminster Hospital Site is owned by Worcestershire Acute Hospitals Trust which provides a range of services from Kidderminster including minor injuries and urgent care, elective surgery, renal dialysis, outpatients and diagnostics. The Independent Sector Treatment Centre run by Interhealth has provided elective orthopaedic surgery from this site, although the end of the 5 year lease in February 2010 means that the service will no longer be provided by the current company and the use of the buildings and facilities will be a matter for the owners, Kidderminster Health Services Project Initiation Page 2 of 12

3 Worcestershire Acute Hospitals Trust from that date. Clearly this provides opportunities for the future provision of services from the Kidderminster site and this will be a consideration within the Project Team s review. The Worcestershire Mental Health Partnership Trust also provides services from the Kidderminster Health Unit on the site and it is important that mental health services are therefore also considered as part of the overall Wyre Forest review. The PCT s Provider arm also provides a range of services from Block A on the site. A number of Wyre Forest patients currently travel to the Dudley Group of Hospitals for a range of secondary care services. The health needs analysis will examine this, and analyse the underlying reasons behind this as part of its overall assessment. Both the Dudley Group of Hospitals and Worcestershire Acute Hospitals Trust have attended recent meetings of the Wyre Forest Patient Participation Groups to present their proposals for services which the two Trusts could provide to the Wyre Forest population. The review will explicitly consider both the opportunities presented by the vacation of the treatment centre in Kidderminster and the Kidderminster Hospital site in general in terms of what opportunities there are for service location that would best serve the future needs of the local population. Overall Estates Strategy It is important that the review develops a clear vision not just of overall service provision but also of the optimum estate strategy. As part of the Transforming Community Services work NHS Worcestershire is required to produce a Commissioning Investment Asset Management Strategy (CIAMS) by the end of March 2010 and this work is currently in progress. The majority of the Kidderminster site is owned by Worcestershire Acute Hospitals Trust, who have also been working on their Estates Strategy for the Kidderminster site. It is crucial that there is co-operation and alignment between these two pieces of work so that the outcomes are consistent with NHS Worcestershire s overall strategic intentions for the local NHS. The estates strategy should also take into account wider public sector estates opportunities e.g. the Building Schools for the Future initiative. The proposed Project Initiation Document considers how these estates opportunities can be aligned and makes allowance for close co-operation and information sharing between the various organisations. Practice Based Commissioning Practice Based Commissioning (PBC) has an integral role to play in the review both in terms of the GP s particular understanding of the health needs of the population and how best they may be met Kidderminster Health Services Project Initiation Page 3 of 12

4 as local primary care clinicians, and also via their role as local commissioners of services. In order that this particular knowledge and understanding can be fully utilised the membership of the Project Team includes 2 PBC clinical representatives as well as the Cluster Commissioning Manager whilst the Steering Group includes a further primary care clinical representative. Primary and community care facilities Similarly, there is a need to develop a clear strategic approach to primary care facilities within the area. There are a number of current proposals regarding the development of primary care facilities in Wyre Forest: A proposal to re-develop the PCT Provider Arm s Kidderminster Health Centre facility in Bromsgrove Road, which also houses 2 GP Practices that would need to be relocated in any re-developments; Proposals to relocate the Aylmer Lodge and Northumberland House Surgeries, potentially onto the Acute Hospitals Site; A proposed new Medical Centre in Bewdley. It is important that these Primary and Community Care proposals are not considered in isolation but rather form part of a coordinated service and estates strategy for Wyre Forest. Kidderminster Health Services Project Initiation Page 4 of 12

5 CONTEXT AND IMPLICATIONS Process Monitoring Review The project management arrangements are outlined in more detail in the report. The Director of Delivery is the lead Director for the project. Progress will be monitored by the Project Steering Group and regular progress reports will be tabled at NHS Worcestershire Board meetings. Equality and Diversity Implications The Health Needs Analysis will identify groups within the population of Wyre Forest and surrounding area whose health outcomes are indicative of deprivation or disadvantage. An Equality and Diversity Impact Assessment will be undertaken as part of the review process. Patient and Public Involvement Financial consequences A Communications and Engagement Strategy that includes opportunities for patient and public involvement, along with input from other stakeholders, will be presented to the Project Steering Group for discussion and approval. The starting point for this work is that it must be at least revenue neutral although the changing financial climate may require the work to look for potential savings as part of the overall QIPPPP agenda. This will be kept under review as the work progresses. Legal consequences Health inequalities Healthcare standards/ PCT aims The Project is examining the whole spectrum of services required to fulfil the statutory responsibilities of NHS Worcestershire to commission health care for the population. The Health Needs Analysis being prepared by the Director of Public Health will include identification of health inequalities. Proposals to commission services for the future will include a requirement to promote equality. This project enables the PCT to progress key Corporate objectives and addresses several Health Care Commission Standards (C5, C6, C7, C17, C18, C20, C21, C22 and C23). Kidderminster Health Services Project Initiation Page 5 of 12

6 Appendix One Kidderminster Health Services Project Initiation Document November Kidderminster Health Services Project Initiation Page 6 of 12

7 Kidderminster Health Services Review Outline Project Initiation Document 1. Project Objectives To review and identify the most appropriate model of service provision and means of delivery to best meet the health care needs of people living in Kidderminster and the surrounding area. To generate and assess a range of commissioning options to deliver these services and select a preferred option for consideration/approval by NHS Worcestershire Board. 2. Project Scope 2.1 Geographical and population scope The population included within the Wyre Forest local authority boundary and served by the 13 Wyre Forest GP practices. There are no initial specific exclusions (eg relating to age, sex, health status, type of care provision etc). 2.2 Service scope All clinical, health and wellbeing service needs of the population will be considered as part of the review. This will explicitly include all acute, community, primary, intermediate and mental health care services. 2.3 Provider scope The current and potential provision of services from a comprehensive range of potential suppliers and sectors will be explicitly considered (e.g. NHS Trusts, GPs, Independent and Voluntary sectors). 2.4 Wider strategic considerations Where the potential provision, or expansion, of a service within Wyre Forest may have a strategic implication across the county or beyond the Wyre Forest population, this will be referred to the appropriate planning body within NHS Worcestershire o that those implications can be assessed in a strategic and equitable manner. 3. Project Sponsor NHS Worcestershire. 4. Project Owner Chief Executive NHS Worcestershire. Kidderminster Health Services - Project Initiation Nov 09 Page 7 of 12

8 5. Project Director Director of Delivery, NHS Worcestershire. 6. Project Deliverables The project will deliver proposals in the following 7 areas: - 1. A clear understanding of the future health needs and health care services required by the Wyre Forest population; 2. A clear assessment of how these services can be best provided for the population and how NHS Worcestershire can best commission and contract for them using the range of resources and facilities available; 3. Options for any proposed changes/developments in the provision of estates/facilities; 4. A good initial indication of the costs involved, and possible funding options; 5. An assessment of the potential risks and constraints involved in delivering this (including generation of mitigating strategies); 6. A process for taking the work forward including critical next steps, via a project plan and timetable; 7. An understanding of relevant complementary strategies (such as Worcestershire Acute Hospitals Trust Estates Strategy for the Kidderminster site and Practice based Commissioners views) and how NHS Worcestershire s commissioning plans will relate to this. 7. Project Goals In order to set the direction and outcomes for this work the following have been identified as the key benefits to be secured from the project: to improve health status of people in the Kidderminster and surrounding area through the provision of improved and where necessary reconfigured services and facilities; to commission services/facilities that support local people to remain healthy and independent and support self care programmes and healthy lifestyle initiatives; the provision of services/facilities that support primary and community practitioners in increasing the amount of care delivered outside of the acute hospital setting; the provision of locally based in patient, step up/step down, ambulatory, day patient, diagnostic and out patient services; the provision of facilities to support outreach and hospital at home services; the development of services, facilities and policies which actively encourages and supports greater integration and increased partnership working (e.g. care pathways and shared care arrangements) involving local primary, secondary and community care providers including 3 rd sector partners; Kidderminster Health Services - Project Initiation Nov 09 Page 8 of 12

9 the provision of suitable intermediate facilities and rehabilitation services which will support the strategic aim of reducing the burden on acute hospital providers and the provision of care closer to home; the provision of a choice of healthcare providers/settings to local people and NHS commissioners; flexibility to cope with demographic and demand changes; improvement in the quality of the healthcare estate and facilities so that it is capable and flexible enough to deliver modern and evolving models of care and supports multi agency partnership working; increased focus on improving safety, quality, productivity and performance of healthcare services; identify and facilitate disinvestment in activity/practices which are not clinically effective or efficient; provision of modern palliative care services supporting the policy of increasing the number of people fulfilling their wish to die at home; provide facilities which are recognised by local people as a focus for NHS Worcestershire commissioned services. 8. Project Structure NHS Worcestershire Board Project Team Project Steering Group Communications and Engagement Workstream Finance Workstream Healthcare services workstream Estates and Facilities Workstream 9. Project Steering Group A Project Steering Group will be established to oversee and take forward the implementation of the project. Broadly the remit of the Steering Group will be to: Approve the Project Execution Plan for the Project; Receive regular progress reports from the Project Director; Consider any recommendations made by the Project Director; Consider, sign off and comment on the outputs from each stage of the Project; Kidderminster Health Services - Project Initiation Nov 09 Page 9 of 12

10 Ensure that patients and the public, local GPs, partner agencies and other key stakeholders have had a full say in establishing future commissioning plans for services in Kidderminster; Provide a communications link to pass on information regarding the project to the organisation or group they represent and to the local community; Help to develop links with local groups and networks; Assist in seeking the views of the wider community; Identify opportunities and projects for members of the Group and the wider community to get involved and be heard. The Steering Group will be chaired by a Non Executive Director of NHS Worcestershire and the following organisations will be invited to propose a representative: Project Team Members 3 rd GP Main providers o Acute o Mental Health o PCT Provider arm 2 x Patient representatives District Council County Council Part of the Steering Group s role will be to make sure that other partners and stakeholders who are not directly represented on the Group have had an opportunity to participate and submit their views. Other stakeholders who will be consulted include: Local General Practices Dudley Hospitals Group TCN HOSC League of Friends MPs Worcestershire County Council Wyre Forest District Council/Councillors Wyre Forest Local Strategic Partnership Other patient representatives and LINK Local Carers group and the Voluntary and Community Sector 10. Project Team 10.1 A Project Team will be established with the remit to; Manage the overall project and produce interim reports and a final report to the NHS Worcestershire Board in line with the Project Objectives and anticipated benefits: Ensure that structures, processes and resources are in place to enable delivery of the project s aims and objectives; Kidderminster Health Services - Project Initiation Nov 09 Page 10 of 12

11 Develop monitoring and reporting mechanisms; Ensure documentation and audit trails are maintained; Commission external support as necessary; Develop project plans and report on progress of those plans; Establish and support the project workstreams; Develop and maintain a risk register, utilise risk mitigation strategies; Ensure the effective engagement of and communication with staff, service users and other stakeholders Membership and Chair The Project Team will be chaired by the Project Director and will comprise the following membership: Proposed Membership (tbc) Simon Hairsnape Delivery (Chair) Simon Trickett Communications and Engagement Mick O Donnell Strategic Planning Dr Jonathon Leach Medical Director Sandra Rote Director of Clinical Development and Lead Nurse Lynda Dando or Nigel Higenbottam Primary Care Toni Slater - Finance Derek Scully- Estates Ash Banerjee Public Health/Locality Planning Lyn Takavarsha Community Commissioning Chris Emerson Acute Commissioning Peter Arch Joint Commissioning Unit 2 Wyre Forest PBC representatives Heather McDonald Wyre Forest PBC Commissioning Manager It is anticipated that the Project Team will establish a number of Working Groups to take forward the following workstreams Healthcare Services Engagement and Communications Estates and Facilities Finance 11. Policy Context The following key policy drivers are highlighted in respect to this project High Quality Care for All (Darzi Review) Our Health, Our Care, Our Say (DH) Investing for Health (West Midlands SHA) Investing in Health For Worcestershire (PCT 5 year draft strategy) Kidderminster Health Services - Project Initiation Nov 09 Page 11 of 12

12 Care Planning Partnership/Clinical re design programme (NHS Worcestershire) Transforming Community Services (DH) and Worcestershire Community Services Strategy (Draft) Clinical Commissioning; Our Vision for Practice Based Commissioning (DH) Sustainable Community Strategy for Worcestershire (Worcestershire Partnership) Delivering Care Closer to Home (DH) Our Health, Our Care, Our Community; Investing in the Future of Community Hospital Services (DH) Contestability and Choice Agenda/The NHS as our Preferred Provider (DH) 12. Potential Constraints Project management capacity and skills; Staff time constraints/prioritisation; Partner agencies prioritisation/motivation to wider project remit; Changes in policy e.g. NHS as preferred provider ; Uncertainty arising from the evolving picture regarding the Transforming Community Services agenda; Uncertainty regarding future capital and revenue finance. Kidderminster Health Services - Project Initiation Nov 09 Page 12 of 12