Standardising Acute and Specialised Care Theme 3 Governance and Approach to Hospital Based Services Strategy Overview 28 th July 2017

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1 Standardising Acute and Specialised Care Theme 3 Governance and Approach to Hospital Based Services Strategy Overview 28 th July 2017

2 Background Theme 3 builds upon previous key strategic commissioning decisions already undertaken across GM Theme 3 needs to support and drive development of the LCOs Addresses the need to improve patient outcomes, ensure that hospitals are financially sustainable with an appropriately resourced clinical workforce Lessons learned from previous programmes of work mean we are ensuring robust, consistent engagement across the whole partnership system

3 Issues to Consider Clear strategic context and approach Where Theme 3 fits and links to other themes Healthier Together decisions Range of services currently in and out of Theme 3 Links with local care organisations, primary care strategy, adult social care transformation and clinical networks 3

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5 Progress Approach to Hospital Based Services Strategy paper developed Revised governance structure developed, including creation of Theme 3 Executive group Healthier Together now brought within Theme 3 governance Stocktake paper in development Ensuring alignment with other themes, specifically Theme 2, Transforming Community Based Care and Support Sir Jonathan Michael involvement

6 Theme 3 Priority Projects Below clinical specialties account for two thirds of all hospital activity and represent 61% of inscope acute costs in GM (in-scope services represent 1.6bn of 2.7bn of in-scope spend). Area Specialties Urgent and emergency care Where we are now (phase) Healthier Together Acute Medicine General Surgery IMPLEMENTATION GI bleeds Medicine Cardiology and Respiratory Scoping SCOPING assessment Women s and Children s Paediatrics and Maternity Breast Services DESIGN DESIGN Surgery MSK / Orthopaedics Urology DESIGN DESIGN Specialised services Neuro-Rehab (part specialised, part non-specialised) Vascular OG Cancer Urology Cancer DESIGN DESIGN (starts Mar) IMPLEMENTATION DECISION MAKING 6

7 Acute Efficiencies through Community Integration Enhanced End of Life, Stockport Together 70% of deaths in hospital were expected District Nurse acts as case manager and plans palliative care in the place of choice for patient, with fortnightly reviews Death in the preferred place of care (own home) has improved by 90% Predicted savings over 3 years equates to 1.6million by reduction of bed days Paediatric Community Services Single point of GP referral to community based centre for paediatric patients presenting with medical complaints ANP staffed centre, open 08:00-22:00 Observation and assessment Reduced attendances at A&E Reduction in bed days at acute trust for patients admitted for O&A ERAS + ERAS+ is a pre and post-surgery programme proven to improve recovery following major surgery Reduced of postsurgery respiratory complications by 50% 3-day reduction in length of stay, plus annual savings of over 0.5m Subsidised gym membership to be offered, post-operative exercise has shown to reduce complications ERAS+ planned to be implemented in 6 Trusts across GM by 2020

8 Hospital Based Services Strategy - 18 month timeline Area of work Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Develop approach and system approval Revise governance Stocktake / case for change Identification of any gaps in current work* Develop Decision Making Framework Dynamic estates model & baseline Project design phase *Inc. gaps identified Articulation of end vision Develop specification and appoint partner Case for change, Standards, Model of Care development Develop detailed specification; baseline; test and run model Modelling and 0ptions Appraisal Implementation of quick wins Draft Commissioning Strategy Stakeholder engagement key topics shown Test and communicate strategy approach Develop wider comms and engagement strategy Patient and stakeholder involvement in project design work Engagement linked to strategy 8

9 Theme 3 and GM Health and Social Care Partnership Governance Strategic Partnership Board / Executive Portfolio Board Joint Commissioning Board / Executive Specialised Commissioning Oversight Group Responsibilities: Strategy & direction - SPB Decision Making JCB / SCOG Theme 3 Execution of the Strategy and Assurance Implementation Provider Transformation Lead clinical working groups Finance and Estates Reference Group Clinical Reference Group Workforce Reference Group Theme 3 Board Theme 3 Executive Provider Transformation Lead clinical working groups Healthier Together Delivery Board Cancer Surgery Implementation Board* * OG Cancer Urology Cancer

10 Next Steps Continued development for stocktake, ensuring alignment with GM transformation programmes, plus other GM H&SCP Themes Ensure appropriate clinical specialties are brought within scope of Theme 3 Develop specification for procuring modelling partner, to create a dynamic financial, clinical and estates model Continued development of communications strategy Review approach to patient and public involvement and engagement