December Hertfordshire Health and Well Being Board

Programme objectivesA strategic review to determine sustainable services for the provision of health and social care in West Hertfordshire

In the context of the models of care for West Hertfordshire address the following domains:

1.How well (how effectively and efficiently) are patients’ needs met by the current health and social care system across West Hertfordshire?

2.What are the opportunities to meet future health and social care needs of the West Hertfordshire population more effectively and efficiently?

3.How should health and social care services across West Hertfordshire be configured to realise these opportunities?

4.What organisational form(s) and commissioning / contracting model(s) best support the delivery of the preferred future configuration of services?

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Guiding principles

As members of the Your Care, Your Future Programme we are working to an agreed set of principles:

1.Putting people not our organisations first when planning health and social care services for the future;

2.Ensuring quality and equality will be at the heart of all that we do, and in developing plans, organisations commit to upholding and improving the quality of care for people;

3.Ensuring that no decision is made on behalf of health and social care patients and customers without working with them to develop ideas and initiatives;

4.Planning, commissioning and delivering services, according to population needs and evidence-based practice, within the resources available to us as a health community;

5.Being honest and transparent with all stakeholders to build trust in the programme; this will include sharing the challenges we face and being open about our cost saving schemes (CIP and QIPP plans) for the West Hertfordshire health and social care system;

6.Working together constructively develop coherent plans for the West Hertfordshire health and social care system;

7.Not taking unilateral action that potentially affects our Strategic choices or results in a cost or workload shift to other organisations which would destabilise it without prior review and discussion at the Programme Executive and further if necessary;

8.Planning to operate within our collective financial means.

We are ‘a strong partnership committed to planning and delivering the best possible services and wellbeing for the people of West Hertfordshire’. We are ‘a strong partnership committed to planning and delivering the best possible services and wellbeing for the people of West Hertfordshire’.

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There is an intention to present these principles to the Stakeholder Advisory Group for confirmation

CEO Group (SPG)

Strategic Review

Living Well Group

System Resilience

Group

SystemBCF Group

Older People’s

Partnership

ICT Enabler Group

Estates Enabler Group

Engagement Group

Workforce Enabler Group

Sponsorship

CEO Sponsor: Nicola Bell

CEO Sponsor: Sam Jones

CEO Sponsor: Iain McBeath

CEO Sponsor: Nicola Bell

CEO Sponsor: David Law

CEO Sponsor: Tom Cahill CEO Sponsor: Sam Jones

CEO Sponsor: Nicola BellCEO Sponsor: David Law

Partners

•HVCCG – Nicola Bell•HCC – Iain McBeath•WHHT – Sam Jones•HPFT – Tom Cahil•HCT – David Law•EEAST – Dave Fountain

System leadership

Source: Draft system governance agreed by SPG as at Nov 2014

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Governance of the programme exists within the context of overall system leadership and will need to become fully integrated

Governance structure

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Clinical Advisory Group

(Chair: Dr Robert Ghosh)

Programme Executive

(Chair: Dr Nicholas Small)

Finance & Activity Reference Group

(Chair: Alan Warren)

Stakeholder Advisory Groups

(Chair: Dr Nicholas Small)

Programme Leads Group

(Chair: David Radbourne)

Individual organisation

Boards / governing bodies

HVCCG Commissioning

Executive

4 x localities

4 x clinical programmes

Existing work, groups and

forums, e.g.:

Living WellOlder People’s

PartnershipSystem BCF

System Resilience

Workforce enabler group

Estates enabler group

ICT enabler group

)Comms & Engagement

Group(Chair: David Radbourne)

Connection with system leadership building blocks

Health and care services• Carry out work through the LHEs four existing programme

groups, with all work to have an additional locality focus• Develop health and care economy baseline / case for change• Co-develop and agree models of care at an overall and

programme of care level• Develop local delivery plans for future models of care• Evaluate clinical information and IT systems requirements

Estates• Estates baseline covering West Hertfordshire estate

owned by HVCCG, HCC, HCT, HPFT, WHHT• Solutions developed in line with the preferred health

and care model• Solutions to be reviewed for restructuring Major and

Local hospital sites, as well as reviewing capacity within the community and GP estates

Finance and Modelling• Use current CCG and provider 5 year plans as a starting point

and align assumptions• Identify cross county (HCC, HPFT, HCT) activity and budgets

that relate to West Hertfordshire• Remove QIPP and CIP to arrive at a ‘pure’ year 0 gap• Identify potential efficiency improvements through VfM

benchmarking• Project forward for 5 and 10 years using demand assumptions• LTFM modelling and final impact of models of care / solutions

Overall approach

Comms and engagement• Develop and roll out comprehensive stakeholder

strategy, covering 3 months and beyond• Collect and evidence stakeholder feedback on the

baseline / case for change• Host stakeholder events to design models of care

building on work done to date• Engage patient and wider stakeholder views on

proposed models of care• Identify communication channels and stakeholder

messages going forwards

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Coordinationof Process

Workforce• Understand current position (e.g. skills, professions

and constraints) within the LHE workforce• Show how proposed changes to models of care will

affect the existing workforce and whether the required changes will be deliverable

• Identify opportunities for improvement, for example through VfM benchmarking and review of metrics

• Determine the impact of workforce changes to the financial and operational sustainability of the LHE

Core support is being provided in the following areas….

1. Baseline and case for change

2. Future models of care development

3. Detailed delivery plan

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The strategic review timeline is driven by the planned phases of engagement

4. Implementation

Dec14 Jan15 Feb15 Mar15 – Jun15Nov14Mar Board

reviews future models of care

Jan Board reviews case for

change

Baseline report, final case for change

Draft models of care

Milestones

Engagement & stakeholder strategy

Key recommendations (long list)

Jul Board reviews key

recommendations

Key Decisions – December 2015

Draft – subject to change

Values at the heart of our engagement:•Proportionate•Inclusive•Genuine•Open and transparent•Purposeful

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The expected phases of engagement:

Summary of Communications and Engagement Strategy

Public

•Engagement displays in main sites

•Drop in sessions

•Focus groups

•Existing meetings and forums

•Potential site visits with vulnerable audiences

Staff

•Intranet content

•Face 2 face meetings

•Co-creation workshops

•Advocacy programme

Stakeholders

•Initial written briefing

•Meetings on a 1-2-1 basis

•Health Scrutiny Meeting

All audiences

•E-newsletter

•Traditional media

•Website / Social Media

•Contact number

•Briefing document

A wide range of engagement and communications channels to involve and inform key stakeholders:

Draft – subject to change

Date Key activity21 November 2014

Your Care, Your Future begins

Winter 2014/2015

Data gathering and engagement

Spring 2015 Reflection and analysis Summer 2015

Potential options for change

Summer / Autumn 2015

Engagement on options for change