PENNINE LANCASHIRE TRANSFORTION PROGRAMME Reporting Group: System ers Forum Date: 21 December 2016 Time: 3.30 pm 6:00 pm Venue: Blackburn Technology Management Centre, Challenge Way, Blackburn, BB1 5QB Enquiries: Mazz Akhtar ELCCG.PennineLancsTransformationProgramme@nhs.net Attendance Name Initials Job Title Graham Burgess (Chair) GB Chair, Blackburn with Darwen CCG Harry Catherall HC Chief Executive, Blackburn with Darwen BC Chris Clayton CC Chief Clinical Officer BwD CCG Ailsa Cormack AC GP Irwell Medical Practice, GP EU of GPs Phil Huxley PH Chair, East Lancs CCG Councillor Mohammed Khan MKh er, BwD BC Mike Kirby MKi Director of Corporate Commissioning, Lancashire County Council Dean Langton DL Managing Director, Pendle Borough Council Kevin McGee KM Chief Executive, East Lancashire Hospitals Trust Sally McIvor SM Strategic Director, Pennine Lancashire Transformation Programme Heather Tierney-Moore HTM Chief Executive, Lancashire Care Foundation Trust Dr Mohammed Umer MU Chair of Local Primary Care, Blackburn with Darwen Federation of GPs Mark Youlton MY Programme SRO, Accountable Officer East Lancs CCG and Chair Finance and Investment Group In Attendance Michelle Cloney MC Associate Director Workforce and System Transformation, Pennine Lancashire Transformation Programme Apologies Councillor Azhar Ali AA Cabinet Member for Health and Well Being, LCC Angela Brown AB Director of Corporate Business, East Lancs CCG David Eva DE Chair, Lancashire Care Foundation Trust Eileen Fairhurst EF Chair, East Lancashire Hospitals Trust Keith Griffiths KG Director of Sustainability, East Lancashire Hospitals Trust Councillor Mohammed Iqbal MI Pendle District Council / minated Representative for East Lancashire District Roger Parr RP Chief Finance Officer, BwD CCG Trevor Purt TP External Adviser, Pennine Lancashire Transformation Programme Page 1
Dionne Standbridge DS Programme Director, Pennine Lancashire Transformation Programme Jo Turton JT Chief Executive, Lancashire County Council Minutes Mazz Akhtar Pennine Lancashire Transformation Programme Meeting Formalities 036/16 Welcome and Introductions GB welcomed attendees and introductions were completed. 037/16 Apologies received Apologies received and noted above. 038/16 Declarations of Interest There were no Declarations of Interest received. Minutes of Meeting 039/16 Minutes of the meeting held 16 vember 2016 HTM noted the need to amend wording in some areas of the Mental Health Update regarding bed reduction and the funding bid that has been put forward in respect of liaison work. PH noted the need for clarification on the Gateway for Accountable Care System workshop regarding the number of neighbourhoods mentioned in the minutes. It was confirmed that the minutes referred to the Blackburn with Darwen Multi-Speciality Community Provider (MCP) level of four neighbourhoods. agreed to amend minutes as requested. Subject to these amendments the minutes were approved as an accurate record. All members confirmed receipt of the Briefing te for the Accountable Care System Workshop held on 16 vember 2016. All members agreed upon and accepted this briefing. All members agreed the need to provide a briefing note after each meeting of System ers Forum. MK raised the communication by Lancashire County Council on the new operating model that with begin in early 2017. This will be shared with System ers Forum. 040/16 Action Log Review of Action Tracker A review of the action tracker was undertaken. An updated version of the Action Tracker will be circulated with the minutes. to update action tracker. Page 2
Workstream Reports 041/16 Mental Health HTM updated members of the System ers Forum that steps have been taken to strengthen and progress the Mental Health workstream. further action required. 042/16 Acute and Specialist Care KM updated members of the System ers Forum that the 12- week piece of work focusing on Acute and Specialist care was being led by Jan Ledward. An initial meeting was held on 20 December 2016 which resulted in good feedback and found the work was progressing well. KM updated members that the Provider Chief Executives met on 12 December 2016. KM was nominated as the Chair of this group. The Provider Chief Executives discussed working together positively and differently as a group of providers and there is a commitment to working more cohesively which will connect to what can be achieved at an STP level especially work on areas such as Stroke and Cancer. KM noted the need to ensure a duplication of work is not created with work already done by Jan Ledward and that the group seek to influence this work in a positive way. further action required. Governance 043/16 Gateway for Accountable Care System Workshop SM gave a presentation to System ers Forum which provided an update on the: Solution Design Process Emerging Models of Care Economic Modelling Terminology Progressing Accountable Care System. Solution Design: SM explained that the programme is moving towards the consultation phase which will involve a wide range of engagement events. Emerging Models of Care and Economic Modelling: Living Happy, Healthy and Well HTM and DL enquired what is meant by the term Modelling, why these four interventions have been used and why housing has not been used. SM and GB explained that the interventions chosen have Page 3
emerged from the SRO group and that these should be adaptable and build on the model HTM noted the need to understand how the models have been developed and the evidence base for this SM noted that assurance of the evidence base can be explored within these interventions going forward HC noted that the four interventions must be based on the business case and the need to look at the biggest impact, improved outcomes and return on investments SM agreed to provide a process assurance update to System ers in January 2017. Keeping Happy, Healthy and Well/Joined-Up Care and Support HTM enquired what scale the Hub footprint would be based on SM updated members that the scale is still being worked on but we need to make further assessments on travel time and population HTM noted the importance to look at technology infrastructure as this may allow us to move away from a physical HUB KM and MY noted there are some physical areas that are not being used to their maximum capacity though they already fit the district to relieve the stress on other areas. SM updated members that the Transformation Steering Group is meeting on 22 December 2016 and will be working on modelling in the community, the costing and the level of staff working in these settings In Hospital Care and Support SM updated members of the continued work over the next 12 months on In Hospital Care and Support and KM updated members of the need to reduce the bed base by 20% to improve In Hospital Care and Support and increasing the use of INT teams by March 2017 PH noted the need to look at the types of beds in the care sector, such as step down beds and to create a strong narrative to show that we are working to increase At Home Care by 20% HC noted that hospitals must work to the maximum of their efficiencies within their current funding; this would then allow any new investment to be fed into the new developed system KM and MY noted the need to continue engagement with the public through workshops being held and the need to bring demand out of hospitals and into physical and virtual Hubs Economic Modelling Page 4
SM updated members on the emerging financial forecasts provided by Deloittes and the residual gap that will need to be addressed in the ACS SM noted that Deloittes are developing the model through working directly with the Senior Responsible Officers Deloittes will continue to work closely with SROs over the next five weeks. KM and HC noted the need for absolute assurance that the model being developed by Deloittes can be achieved it must be deliverable in the next 5 years. HC noted the need to be ambitious with the model though also focussing on the return on investment MY explained that the Deloittes model will be handed over to trained people within the PMO and we will be able to update the model as interventions and models of care continue to be refined. HTM requested the System ers Forum be able to view the Deloittes model PH updated members on the feedback from the Care Professionals Board who felt they must work closer with the SROs and Deloittes It was agreed that Deloittes would be invited to the next meeting of System ers Forum, alongside SROs, to participate in a workshop session on the emerging models of care and economic modelling. Terminology SM updated members on the Place Based Design and Delivery and Suggested Working Terms. SM noted an agreement has been reached that there are 13 Neighbourhoods across Pennine Lancashire that each have between 30,000 and 50,000 population. HC enquired how many of the 13 neighbourhoods are actually set up and MY explained that 10 neighbourhoods are set up and the three neighbourhoods are in the final stages of being set up. PH advised that if the neighbourhoods are defined by listbased primary care then the work also needs the backing from Lancashire County Council MK updated members that LCC is working on a report that is due out in January 2017 which has the potential to align with the model and fitting the localities All members agreed on the suggested working terms. Accountable Care System Page 5
SM updated members on the Accountable Care System key elements and their alignment with the Solution Design and the Care Models. HTM noted that LCFT cannot sign up to Gateway 4 on the ACS at present but LCFT can continue to work to creating a shadow ACS by April 2017 SM noted the ACS must respond to the care models and both must exist symbiotically to work towards the shadow ACS target of March 2017 and directed members to the Next Steps slide in the presentation which is an updated form of Gateway 4 KM noted that we must continue to use the ACS gateways as a guide on how we should be progressing but we must be ready to continue with this work even if it takes more than the five years period All members agreed to continue focus on the financial model as this will help achieve progression through the stages to an ACS. Decisions: The System ers reviewed and agreed upon on the Terminology and the Suggested Working Terms. SM agreed to provide a process assurance update to System ers Forum in January 2017. to send invite to SROs and Deloittes to attend next System ers Forum workshop session on the emerging models of care and economic modelling in January 2017. Programme Update 044/16 SRO Update Report Paper reviewed by members of System ers Forum and approved. further action required. 045/16 Joint Committee Update MY updated members of the System ers Forum that the Joint Committee of CCGs met for the first time on 8 December 2016 and the work progressing from the first meeting had been positive. The Terms of Reference are being worked on and the Joint Committee of CCGs is to meet on a monthly basis. MY noted the need to include the minutes of the Joint Committee of CCGs on the System ers Forum agenda as a standing agenda item and to extend an invitation to Phil Watson to attend a System ers Forum meeting in 2017. Set Joint Committee of CCGs minutes as recurring agenda item. SM Page 6
Invite Phil Watson to a System ers Forum meetings in 2017. Programme Plan 046/16 Pennine Lancashire Monthly Programme Update Paper reviewed by members of System ers Forum and approved. further action required. 047/16 Financial Report MY updated members of the System ers Forum of the financial gap that has been identified through the Finance and Investment Group. MY noted the need to include finance updates to the System ers Forum on a quarterly basis as a regular agenda item. Set Finance Report Update as agenda item every 3 months. A & E Delivery Board 048/16 Chair s Report KM updated members of the System er Forum that the A & E Delivery Board continues to focus on capability and capacity across all of the system during Christmas and New Year. The local government partners are working well with the A & E Delivery Board. KM noted there is a workforce challenge over the Christmas and New Year period in base wards and emergency departments. KM updated members of the temporary closure of Accrington Victoria Hospitals Minor Injuries Unit to allow the workforce to be utilised in Urgent Care and Emergency departments over the Christmas and New Year period KM updated members of the daily system review that takes place each morning which allows the hospital to react quickly to impacts and any crisis. This escalation process is working well on a day by day basis. KM updated members of the NHSI target of 85% occupancy bed rate which is an ambitious target that we are working to achieve by 23 December 2016. further action required. Workforce Presentation 049/16 Workforce Presentation MC gave a presentation on the One Workforce workstream which includes the paid and the unpaid workforce. MC informed members that the One Workforce Directors held their first meeting on 21 December 2016 and that the engagement programme of work during 2017 will be keeping in line with the solution design process but at a Page 7
much smaller scale. During this process the programme will scrutinise each element of supply, upskilling, new roles, quality assurance, leadership and new ways of working. MC noted the need to continue engagement with our workforce. GB enquired if a workforce savings target has been set and suggested a 20% reduction in cost MC noted a savings target has not yet been set at present but this should come through alongside the workforce development HC noted the need to maximise productivity by creating new combined roles and ensuring people work to the maximum of their role It was agreed that the One Workforce workstream would ensure that its future work programme reflects: 20% reduction in cost maximising productivity and performance Oversight across Pennine of agency usage further action required. Communications and Engagement 050/16 Comms Plan Update Paper reviewed by members of System ers Forum. DL updated members that some council board members have requested more feedback from the programme and the need to invite the Pennine Lancashire Transformation Programme to present at the next Pendle Council Board meeting. DL to send dates for next council board meetings. PLTP to present a programme update to council board members. Any Other Business 051/16 Any Other Business HC referred to an email sent to System ers regarding the proposed process to develop national transformation funding and the deadlines that have been laid out in this. SM noted that we must respond to this across the Pennine Lancashire area and welcomes feedback from system leaders. For Information 052/16 For Information Date and Time of Next Meeting Tuesday 31 January 2017, 1:00pm 5:00pm Blackburn Technology Management Centre DL MC/SM Page 8
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