Norfolk and Waveney STP. Meeting with East Suffolk Partnership 27 September 2017

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1 Norfolk and Waveney STP Meeting with East Suffolk Partnership 27 September 2017

2 2 The Norfolk and Waveney STP Members Waveney District Council

3 Focus of Norfolk and Waveney STP Our plan is in line with the national must dos in the NHS five year forward view: Acute services review and sustainability Urgent and emergency care Maternity Cancer Demand management Mental health Prevention Primary care and integration with community services

4 Norfolk and Waveney STP Governance Arrangements July 2017 Health & Wellbeing Boards County, District, City & Borough Councils Boards of Provider Organisations Governing Bodies of CCGs. Health Overview & Scrutiny Committees STP Oversight Group (Non-Executive) Chair: Independent Chair (Strategic oversight) STP Executive Board Chair: STP Lead (Leadership, monitoring & assurance) STP Stakeholder Board Chair: Appointed by Board (Oversight & assurance of engagement, communications and consultation) STP Delivery Board Chair: Programme Director (Design & Delivery Planning & Implementation) Delivery Workstreams STP Clinical & Care Reference Group Chair: Joint Chairs (Clinical & care expertise to support the development of new models of care) Prevention, Primary & Community Care Demand Management (RTT) Acute Care Mental Health Workforce Cross-Cutting System Enablers ICT Estates Finance & BI EXECUTIVE SUPPORT to STP - PMO, Comms & Eng.

5 Strategic intent and STP leadership New independent Chair and new STP Lead STP executive has recently reviewed progress Focus on commissioning model and simplifying the Norfolk and Waveney system, plus finance and delivery Striving to half the number of organisations by April 2019 Continuing to develop our model for an Accountable Care Organisation

6 STP decision making - together and at pace One single commissioning approach for health and social care within the STP with a single commissioning committee One leadership team providing a single strategic approach for the whole population of Norfolk and Waveney New Joint Strategic Commissioning Committee to include local authority as soon as possible Integrated commissioning intentions and single commissioning teams eg children s, mental health, out of hospital care, primary care Single CCG leadership team by quarter 1 in 2018 STP will oversee pooled population based funds

7 Primary Care and the STP - National context General Practice Year Forward View Next steps in the Five Year Forward View introduces the concept of locality working in general practice Clear messages on expectations for primary care at scale, extended and 7-day access with targets for 50% population by March 2018 and 100% by March 2019 Clear messages on extending skill mix in primary care, e.g. mental health therapists, clinical pharmacists, housing and advice staff and occupational therapists Vanguards around MCPs (multi-specialty community providers), PACs (primary, acute and community providers) and care homes

8 Local challenge Increasing demand on health services driven by our ability to keep people alive longer Increasing age profile, increasing proportion of the population over 65 and over 85 Over 85s significant proportion with dementia and increasing need for health and care services Increasing prevalence of other mental health conditions Increasing number of people with multiple-morbidities and more age related conditions

9 Changing general practice The role of a GP is becoming more complex and therefore we have to take a different approach to primary care Previously many GPs owned their own premises and had personal liability in partnerships Now GP roles are changing and they are looking for portfolio careers, some working in A&E and other hospital specialities as well as general practice Patient needs are increasing and changing There needs to be a wider group of people caring for individuals Because of the increasing demand and changing role there will be a big deficit in primary care in the future

10 What this means a stronger focus on population health, prevention, supporting and mobilising patients and communities; more integrated urgent care as part of a reformed urgent and emergency care system; integrated community based teams of GPs, nurses, pharmacists, therapists, with access to intermediate beds, in reach to hospitals, eg redesigning outpatients, geriatric care Diagnostics patients will increasingly consult different health professionals as part of the new care models

11 What it means in Waveney Two localities locality lead GPs identified Supporting development of locality level plans for transformation and at scale working South Waveney practices are developing an out of hospital model and provision of minor injuries and phlebotomy services Lowestoft practices are developing shared back office functions, common policies and protocols and home visiting services

12 The emerging landscape

13 Benefits for patients Consistency of service provision and quality Potential for better access and flexibility on how to access Ability to access more services in the community Supporting prevention and self-care across the system Seamless services to reduce duplication and hand-offs

14 Discussion

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