The North Central London Sustainability and Transformation Plan and Camden Local Care Strategy Caz Sayer Chair, Camden CCG
About the Sustainability & Transformation Plan (STP) N C L North Central London Sustainability and Transformation Plan STP triple aims: 1. Close gaps in Health & Wellbeing 2. Close gaps in Care and Quality 3. Close gaps in Finances
What is North Central London (NCL)? N C L North Central London Sustainability and Transformation Plan Enfield CCG / Enfield Council 320k GP registered pop 48 GP practices Chase Farm Hospital Barnet CCG / Barnet Council 396k GP registered pop 62 GP practices Stanmore Hospital Barnet General Hospital St Michael s Primary Care Centre Haringey CCG / Haringey Council 296k GP registered pop 45 GP practices Edgware Community Hospital Finchley Memorial Hospital North Middlesex Hospital St Ann s Hospital Islington CCG / Islington Council 233k GP registered pop 34 GP practices Camden CCG / Camden Council 260k GP registered pop 35 GP practices Central Middlesex Hospital Highgate Hospital Royal Free Hospital University College Hospital London Ambulance Service East of England Ambulance Service The Whittington Hospital Tavistock Clinic, Portman Clinic, Gloucester House Day Unit St Pancras Hospital Moorfields Eye Hospital Great Ormond Street Hospital
The NCL case for change N C L North Central London Sustainability and Transformation Plan Health & Wellbeing Gap Care & Quality Gap Financial Gap People in NCL are living longer but in poor health. Differing levels of health and social care needs. Different ethnic groups with differing health needs. Widespread deprivation and inequalities. Significant movement into and out of NCL. Lifestyle choices put local people at risk of poor health and early death. Poor indicators of health for children. High rates of mental illness among both adults and children. Not enough focus on prevention Disease and illness could be detected and managed earlier Challenges in provision of primary care in some areas. Lack of integrated care and support for those with a long term condition. Many people are in hospital beds who could be cared for closer to home. Disease and illness could be detected and managed much earlier. Hospitals are finding it difficult to meet increasingly demanding emergency standards. Challenges in mental health provision. Current spend on health and care services in NCL is approx. 2.5bn. Health commissioners and providers are already approx. 120m in deficit in 2015/ 16. In the next 5 years, if nothing changes this will rise to approximately 875m deficit by 2020/ 21.
Vision For North Central London to be a place with the best possible health and wellbeing, where no one gets left behind N C L North Central London Sustainability and Transformation Plan This means we will: help people who are well to stay healthy work with people to make healthier choices use all our combined influence and powers to prevent poor health and wellbeing help people to live as independently as possible within their own homes and communities deliver better health and social care near to home wherever possible reduce the costs of the health and social care system, so that it is affordable for the years to come ensure services remain safe and of good quality
Our core principles are N C L residents and patients will be at the heart of what we do and how we transform NCL health and social care providers will work together across organisational boundaries to achieve better health and social care for all we will be radical in our approach and not be limited by the system that exists now we will work with local communities and organisations and their expertise we will be advised by clinicians and frontline staff who are close to residents and patients we will build on existing good practice in North Central London North Central London Sustainability and Transformation Plan
How we will do this N C L North Central London Sustainability and Transformation Plan Focus on prevention and self care Service Transformation Upgrading care provided closer to home Joining up mental and physical health services and supporting people to live well Improving care through integrated health and social care Focus on improving patient safety, quality and outcomes in hospitals Improving Productivity Enablers Delivering efficiencies through better alignment of health and care services Increasing productivity of current workforce Sharing back office services across different organisations Design of new workforce models to deliver transformed care Review the estates across NCL to improve facilities for delivering care Harness technology to provide new ways of managing and delivering care Development of strong commissioning through partnership working
N C L North Central London Sustainability and Transformation Plan den Local Care Strategy to the North Central London STP Aligning the STP to the Camden Local Care Strategy ENABLERS Health and care workforce Digital Health and care estates New delivery models Commissioning arrangements Productivity Business as usual commissioner QIPP System wide productivity Business as usual provider CIP STP CARE CLOSER TO HOME - CAMDEN LOCAL CARE STATEGY STP SERVICE TRANFORMATION INTERVENTIONS ALIGNED TO CAMDEN LCS D E M A N D Prevention Admissions prevention and reablement Health education and self management Health & wellbeing services: smoking, alcohol, nutrition Mental health Urgent and emergency care Co-ordinated access to emergency care Proactive case finding and risk stratification Multi-disciplinary teams Optimising the elective pathway F L O W Clear step-up and step-down pathways Consolidation of specialties Specialties in-reach in communities Information and advice Cancer High quality specialist services Health and care closer to home Care planning & co-ordination Extended primary care access More speciality support to community services D I S C H A R G E ALIGNED ENABLERS Workforce Leadership Technology & Systems Estates Quality & Safety Engaging Residents Commissioning & Contracts LOCAL WORK ON TRANSFORMATION ALREADY UNDERWAY Frailty Complete Care Management A&E delivery plan including GP at the Front Door Strategic Review of Local Care Integrated Practice Units 45 pathways developed for NCL Procedures of Limited Clinical Effectiveness (PoLCE)
What is the Camden Local Care Strategy? Aim: Health and care services will work together with local people to provide coordinated, proactive, accessible, good quality care in order to improve the health and wellbeing of people in Camden Why do we need a strategy? Need to bring together all key health and care organisations to agree a single model for the delivery of health and care services in the future Have an agreed approach on how we will achieve a sustainable system that provides high quality care To set out a shared programme of work to deliver the model using the agreed approach so that we can jointly work on implementing our vision by 2021 The strategy will complement and contribute to the NCL sustainability and transformation plan (STP). Camden Local Care Strategy
National challenges Health and wellbeing gap Care and quality gap Funding gap Camden Local Care Strategy
The partnership board is made up of the following organisations: Camden Local Care Strategy
Focus on outcomes: Whole system outcomes Reduce health inequalities Prevent early death Improve people s access to care Improve people s experience of care Enhance people s quality of life Population outcomes Outcomes for mental health, children and adults Population cohort outcomes Outcomes for sub-groups of population with similar needs and service use Camden Local Care Strategy
Where we want to be Enablers: Quality & Safety Workforce - Estates - Technology & Systems Leadership - Commissioning & Contracts - Engaging Residents Camden Local Care Strategy
Five key principles Accessible: Person-centred: Coordinated: Preventative: Effective: Camden Local Care Strategy
How will care be different for local people? Self care When I get ill, I know who to contact and where to go to get the right support I understand the importance of a healthy lifestyle and have lots of information on how to be healthy I feel like an expert in my health condition and know how to manage it so I don t get ill Voluntary sector I know where to find information on local services My GP told me about a local group of people with similar health issues who meet up I am part of a network of local people who share information, help me understand services and provide informal support Integrated primary and community services The people involved in my care are part of one team. They understand what works for me, and they communicate with each other I can sort all my appointments and prescriptions online Things are much easier now I don t have to travel to the hospital every week I can just pop into a nearby GP practice My doctor talks to me about my overall health and the things I need to do to stay healthy Hospital services With my complex needs I know I will get fast and responsive care in hospital, but I need it less often these days I thought I d have to be referred to hospital, but I was given an appointment with the specialist in a local GP practice When I need to see a specialist, I don t have to wait too long When I was ready to go home, the hospital worked with the nurses and carers to make sure I had the support I needed at home Camden Local Care Strategy
Our three horizons for successful implementation Soundings from local partners, during the development of our Local Care Strategy have indicated that there may be three organisational development horizons for successful implementation Horizon 1: Complete Horizon 2: Work in progress Horizon 3: Future What is the purpose? Deliver seamless integrated local health and care services - to improve outcomes, narrow health inequalities and achieve sustainable services Finalise Local Care strategy Develop a strategy and dedicated mobilisation plan by an integrated project team with buy-in from all stakeholders Integrate commissioning in a comprehensive way Develop and implement changes to joint commissioning arrangements to create a much more integrated health and social care commissioning Create new entity/entities for further changes in implementation Develop and implement innovative partnership models towards accountable care with a range of organisations influencing health and social outcomes of Camden s residents (commissioners, providers, third sector, employers, etc.) Camden Local Care Strategy