Strategic Change SITREP - End May 2018

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Strategic Change SITREP - End May 2018 This paper provides an updated summary of current strategic change programmes affecting Powys residents. Area Strategy / Programme Lead Organisation(s) Status Key Points / Impact Powys Powys Health and Care Strategy Powys RPB Approved by PTHB 10 year Strategy for Powys Powys Teaching Health Board & Powys County Approved by Powys County Council Council Mid Integrated Medium Term Plan Powys Teaching Health Board Approved by PTHB March 2018 Approved by Welsh Government June 2018 Well-being Plan Powys PSB Approved by PSB March 2018 Publication due May 2018 Mid Collaborative Committee Mid and West Regional Planning Group Mid Statement of Intent Powys Teaching Health Board; Hywel Dda University Powys, Pembrokeshire, Ceredigion and Carmarthenshire Local Authorities Intention to develop Statement of Intent and Work Programme during Summer 2018 3 Year Plan for Powys, fully aligned to Health and Care Strategy Long term generational view and plan for wider determinants of wellbeing Brings together strategic ambitions and intentions across Mid Shropshire, Telford, Powys NHS Future Fit Shropshire CCG; Telford CCG; Powys Teaching Cross Border Formal Consultation May September 2018 NHS England confirmations received regarding capital and consultation Consultation commenced 30 May 2018 and concludes September 2018 PTHB working with the CCGs to ensure equity of consultation process in Powys and shared efforts underway for the planning and implementation of consultation mechanisms Page 1 of 6

Shropshire, Telford, Powys Herefordshire & Worcestershire North (Anglesey, Gwynedd, Conwy, Denbighshire, Flintshire, and Wrexham) GP Out of Hours Services Herefordshire & Worcestershire STP Clinical Sustainability Strategy Stroke Review Wye Valley Acute Trust Services Living Healthier Staying Well Multiple PSB Wellbeing Plans / RPB Area Plans Shropshire CCG; Telford CCG; Powys Teaching Herefordshire CCG; South Worcestershire CCG; Redditch & Bromsgrove CCG Betsi Cadwaladr University Formal Procurement process PTHB Project established to consider options in response Clinical Sustainability Strategy developed via Clinical Reference Group Stroke Proposals developed Engagement planned for summer 2018 North Clinical Strategy in development and Director of Transformation newly in post Local Government reorganisation also in train Known sustainability challenges in key service areas - neurology; ophthalmology; ED; maternity. Diversion to alternative providers in place for ophthalmology and neurology. Business Continuity planning in place for ED. Future model will be included in Future Fit proposals. Shropshire & Telford Tender process completed July 18 Extension of current Shropdoc contract for six months to end September 2018 to ensure interim service delivery PTHB model and options in development, taking into account NHS 111 and local GP OOH STP Clinical Sustainability Strategy produced by a Clinical Reference Group Joint Foundation Group structure with South Warwickshire to develop a sustainable infrastructure for delivery Known sustainability challenges in Wye Valley acute services managed via commissioning assurance framework Stroke Review - engagement exercise expected in summer 2018 Long Term programme Living Healthier Staying Well Improvement Framework (now at end of Phase 3) Renal Services changes at Welshpool BCUHB have communicated to patients West and South West Page 2 of 6

West and South West (Carmarthenshire, Ceredigion and Pembrokeshire) West and South West South West (Bridgend, Neath Port Talbot, Swansea) Transforming Clinical Services(TCS) ARCH Regional Collaboration Programme (as below) ARCH Regional Collaboration Programme ABMUHB Recovery and Sustainability Programme Your NHS help us change for the better Hywel Dda University TCS is a formal consultation ending mid July 2018 Initial engagement on TCS completed 2017 included Powys Public consultation 19th April 12th July 2018 Board to Board communication between HDUHB & PTHB prior to this. PTHB delivering Consultation Plan to engage Powys residents. Range of activities planned to consult key communities. Alignment of SATH NHS Future Fit messaging required and joint events planned during June. ABMU and Hywel Dda Programme ARCH Programme proposes Singleton Health Campus as centre of excellence for diagnostics, same day and rehabilitation and Morriston Health Campus as regional centre for specialist treatments ARCH programme is aligned to the areas listed under the SW Regional Planning Committee Watching brief on schemes and service change proposals Abertawe Bro Morgannwg University Engagement programme currently underway Targeted intervention measures Engagement on reduction of beds and strengthened community care currently underway until 27 June (consideration will then be made regarding full consultation with CHC) Executive level agreement reached regarding provision of consultant outreach for urology, diabetes and orthopaedics at Ystradgynlais Hospital. Page 3 of 6

South West South West Regional Planning Committee NHS Organisations in SW Variety of Projects at various stages / statuses (With some cross-over to the ARCH programme noted earlier) Alternative solutions will need to be discussed for Ultrasonography Consultation recently concluded on transfer of Bridgend responsibilities to Cwm Taf UHB, as noted below Work Programme includes items already covered above and some additional collaborative areas: Non surgical Cancer Strategy Cardiology/ Cardiac Opthalmology Dermatology Neurological Conditions Vascular Interventional Radiology Pathology Centre Elective Orthopaedics Centre Stroke Acute medical take at Morriston Paediatric Dental Anaesthetics *NB Taken from 17/18 Work Programme documentation, due to be refreshed South (Merthyr Tydfil and Rhondda Cynon Taf) IMTP Recent transfer of Bridgend services Former South programme implementation phase (Royal Glamorgan Hospital service changes) Cwm Taf University South and South East Implementation of former South programme service changes to Royal Glamorgan Hospital Implementation of former South programme includes changes to services at Royal Glamorgan Hospital - IMTP includes plans for service model and developments/ improvements No current implications identified however watching brief on key services including Obstetrics and Paediatrics Consultation concluded on the proposed transfer of Bridgend County Page 4 of 6

Borough area responsibilities including Prince of Hospital from ABMUHB to Cwm Taf UHB clinical flows group established to monitor these flows South (Cardiff & Vale) South East (Blaenau Gwent, Caerphilly, Monmouthshire, Newport, Torfaen, South Powys) South East All / South Shaping Our Future Wellbeing Clinical Futures (South East ) The Grange (SCC) South East Regional Planning Committee Work Programme Transforming Cancer Services Cardiff & Vale University Aneurin Bevan University PSB/RPB and Regional Planning Group NHS and Local Authority bodies All NHS organisations in SE Ongoing strategy/ programme of work Clinical Futures is a Strategy and a Programme The Grange (SCCC) FBC was approved October 2016 and currently under construction Work Programme contains variety of Projects at various stages / statuses All / Specialist Services Velindre NHS Trust responsible for Velindre Cancer Centre Transforming Cancer Services is a Programme Included for completeness; watching brief for any service change impacts Five Year Strategy and Programme to develop networks of hospitals; rebalance primary/community care and centralise specialist and critical care New build Specialist and Critical Care Centre The Grange completion 2021 Interim service changes in place including paediatric provision at Nevill Hall and Royal Gwent. Work Programme includes items already covered above and some additional collaborative areas: Paediatric, Obstetric and Neonatal ENT Emergency Services Sexual Assault Referral Centres Emergency Surgery Emergency Medicine Regional Elective Centres Royal Glamorgan Diagnostic Hub Vascular Service *NB Taken from 17/18 Work Programme documentation, due to be refreshed Programme set up to develop patient centred Cancer services including new Cancer Centre Page 5 of 6

South Thoracic Surgery in South WHSSC Capital development within that outline planning permission granted OBC supported by PTHB and other commissioners March 2018 Engagement completed CHC decision that consultation required; preparation underway Outline Planning Permission granted 2017; OBC completed; PTHB support confirmed for the commissioning direction set out in the OBC Satellite options as part of longer term plan to be considered Engagement concluded with single site recommendation CHC consideration that formal consultation required s approval of Consultation Document/Plan complete. Consultation process in progress 3 July -27 August 2018. South Major Trauma WHSSC Consultation concluded Consultation concluded with recommendation for Major Trauma Network in South and West and South Powys; designation of UHW as a Major Trauma Centre and Morriston as Major Trauma Unit Recommendations supported by PTHB subject to inclusion of points of feedback from Powys All Ambulance Programme(s) - IMTP All National Delivery Plans / Work Programmes WAST All NHS Organisations IMTP and Programme of work; including collaborative work with PTHB National Implementation Groups/ Delivery Plans and Local Delivery Plans PTHB IMTP aligned to WAST IMTP; collaborative programmes of work. WAST now attending the PTHB Strategic Change Steering Group to strengthen collaborative approaches and planning for key change consultations and engagement Added for completeness / watching brief as strategic change requirements may arise from National Delivery Plan areas of work Page 6 of 6