NORTH SOMERSET COMMUNITY SERVICES. Welcome

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1 NORTH SOMERSET COMMUNITY SERVICES PROCUREMENT Welcome Jeanette George Chief Operating Officer

2 Our Vision We know that for people to be truly healthy it is not only the quality of the services that matter. That is why we are committed to working together with our whole population, individuals and other organisations to create the healthiest communities.

3 The story so far.. Building on involvement and engagement throughout CCG s first year Specific pre-procurement participation and engagement - ends 31 st May 2014 Working closely with our local partners joint procurement with Local Authority Strong clinical leadership and involvement Broad range of services under consideration Not constrained by what is, focus on outcomes Gathering learning from elsewhere

4 Quotes Clinical Leader Community Services We look forward to the opportunities that can be developed in the community to transform services Service Users Community services should be responsible for actively facilitating and owning referrals (not signposting) to other forms of service GPs are telling us they want to see more services moved from secondary to primary care

5 A system focussed on the person.. System focussed around the needs of our population, and patients as individuals Understanding those who are at higher risk of illness or progression of illness Understand their needs and develop care plans with them and their families so that they understand how to maintain quality of life, know the triggers to illness and what to do if their symptoms worsen suddenly or over time

6 Urgent and emergency care.. When people need care urgently, we do everything we can to provide what they need as close to home as possible When patients require urgent or emergency care, they know where to go and that first point of contact is sufficiently qualified to be able to treat them, or direct them to the most appropriate tier of the system to assess, diagnose or treat

7 Working together to get people back home again.. When a patient is admitted for hospital-based care, the whole system works together to get them back home as soon as they are physically fit enough with a plan for ongoing care. Those patients requiring rehabilitation and re-ablement services can access these close to home, with specialist advice and support to prevent further episodes of ill health

8 We are facing a number of strategic challenges.. 1. Meeting rising demand in a flat cash environment 2. Securing a safe and sustainable provider base 3. Delivering financial balance 4. Supporting a challenged social care system 5. High degree of stakeholder interest 6. External processes eg: Acute Sector eg: NBT, UHB, WAHT 7. Engaging and motivating GPs 8. Shifting care into the community and closing beds 9. Agreeing a shared integrated transformation position 9

9 .. but we have a plan Working with the wider community RSS MSK Community wards Contract management Implement enabling schemes (FY14/15) Enhanced primary care Enhanced community care Revised front door Outcome-based contracting Closing acute capacity Maximise current (FY13/14) Map of Medicine Integrated H&SC team Support to care homes MH liaison & LD intensive support Personal budgets Community geriatricians Develop integrated care services (FY Plan for long term change (FY15/16 & beyond) FY16/17) Telemedicine and telecare Patient education Prevention strategy Acute reconfiguration Community reprocurement 22

10 What opportunities are there in North Somerset? Julie Kell Head of Joint Commissioning Becky Pollard Director of Public Health

11 North Somerset Area

12 Our patients have diverse needs.. Joint Strategic Needs Assessment Key Issues: Mental Health Drug and alcohol misuse Reduce premature mortality Growing population Older People Pockets of deprivation People and Communities Board Key Issues: Alcohol High impact families Increase self-care and independence The population is growing and ageing - the number of people over 85 is expected to increase by 36% by 2021 Demand for health and social care is growing Drug abuse and alcohol are already significant challenges There will also be a big increase in numbers of children and young people, with 5-14 year olds growing by 21% by There are already a growing number of children with complex needs There are 22,313 unpaid carers in North Somerset, and this figure is growing There is 22 year gap in life expectancy and this is increasing

13 Business in North Somerset Between 7,900 and 8,200 businesses 86% employ 1-10 people, over 97% of business employ less than 50 people 9.8% of the working age population are self employed Nearly a third (30%) of businesses in North Somerset are home-based Major employers (employing over 100) are dispersed across the area 46.9% of all people who are employed in North Somerset are employed in the Major Group 1-3 (i.e. managers, senior officials, professionals and technical) compared to 42.8% in the south west.

14 AGE 0-4 AGE 5-9 AGE AGE AGE AGE AGE AGE AGE AGE AGE AGE AGE AGE AGE AGE AGE AGE AGE 90+ Our patients needs are changing with demography Demographic Growth Projection - 5 years to North Somerset will see around a 32% increase in the number of people aged over 75 in next 5 years compared with national average of 11% 2008 Registered Pop 2013 Registered Pop 2018 ONS Projected Pop Growth

15 Service innovation A model of care, designed by key stakeholders, that focuses on the outcomes patients want, not on the input activity. Organisational arrangements to support the integration of modern technology services Challenging the status quo of provider configuration, but also being clear on the benefits to organisations involved and organisational accountability. A shift of resources between health and social care to where they are needed most, and a shift in culture so that health and social care work towards a common aim. Plans that demonstrate how this funding could be transparently re-invested in appropriate demand management and improved discharge schemes and reduction in acute admissions to secondary care.

16 Outcomes Reduction in permanent admissions of older people (aged 65 and over) to residential and nursing care homes, per 100,000 population Increase in proportion of older people (65 and over) who are still at home 91 days after discharge from hospital into reablement / rehabilitation services Reduction in delayed transfers of care from hospital Reduction in avoidable emergency admissions Improve health and wellbeing outcomes for children and young people

17 Ambitions Ensuring an integrated health and social care system for adults and children, driven by quality and innovation Reducing health inequalities, working in partnership Giving people confidence and skills to take care of themselves and stay as healthy as possible Improving patient care by ensuring there is easy access to shared information, which is up-to-date, meaningful and accurate Deliver safe care, good patient experience and evidence based practice A successful, dynamic organisation that provides a rewarding place to work

18 Evidence Edwards, N. (2014) Community services - How they can transform care. Kings Fund. kf/field/field_publication_file/community -services-nigel-edwards-feb14.pdf Report from a working group convened by the Kingsfund to identify a process for transforming community services Mason A, Goddard M and Weatherly H (2014) Financial mechanisms for integrating funds for health and social care: an evidence review, University of York: Centre for Health Economics. ments/papers/researchpapers/cherp97_ Financial_mechanisms_integrating_funds _healtthcare_social_care_.pdf Review explores mechanisms to integrate funding Examples from elsewhere Cambridge and Peterborough CCG Commissioning for Outcomes Drafted outcomes framework based on a range of information sources, stakeholder feedback, provider dialogue and external expert review peterboroughccg.nhs.uk/pages/ older-peoples-programme.htm

19 Working in partnership in North Somerset Claire Leandro Assistant Director Adult Care North Somerset Council

20 Current adult integrated services CCG and North Somerset Council Single Point of Access Access and Hospital Support Team enablement service Integrated Care Teams (2 out of 4 established) Community Learning Disabilities Services Mental Health Services Integrated with health providers and voluntary sector provision

21 North Somerset Council Children s Services Children s Centres are key hubs for local delivery of services, this includes health visiting. Key for North Somerset Council is the use of childfriendly venues in the community We work in partnership across a range of agencies particular areas of importance are Looked After Children, safeguarding, early years and early help

22 North Somerset Procurement Timetable SWCSU Procurement team 6

23 Procurement Timeline Formally advertise the tender on 1 st July 2014 Contract award will be 1 st May 2015 Contract start date will be 1 st April 2016

24 Procurement Timeline Between September 2014 and February 2015, we will have at least two ITN stages. The contract will be the standard NHS Contract for a minimum of 5 years (with the possibility of an extension)

25 BREAK

26 OPEN FORUM Q&As

27 CLOSE