Call to Action
Andy Layzell
Chief Officer
NHS Southern Derbyshire Clinical Commissioning Group
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Pressures in the NHS
The money
Transformation Fund
Where we are
heading
• Implications for the
Voluntary Sector
NHS Southern Derbyshire Clinical Commissioning Group
Pressures in the NHS
Over the last 10 years:
– 50% increase in GP
consultations
– 35% increase in emergency
care admissions
– 50% increase in procedures
undertaken
– A&E Departments under
pressure
– ‘The worst winter I can
remember’
NHS Southern Derbyshire Clinical Commissioning Group
What causes the pressures?
Combination of factors:
– Demographic change
– 25% of the population with a long term
condition (70% of expenditure)
– Poorly joined up services between
primary, secondary and social care
– Technical advance
NHS Southern Derbyshire Clinical Commissioning Group
The money
• Tightest period of funding in the last
50 years of the NHS
• NHS funding has declined in real
terms and is below the level of
2009/10.
• Growth in real terms funding likely to
cease after 15/16
• Inflation of 2-3% per year still
expected to impact on the costs of
delivering health services
• Investment of £18m in Social Care by
15/16 (Integration Transformation)
NHS Southern Derbyshire Clinical Commissioning Group
SDCCG Estimated productivity Challenge
2014-2019
70,000
60,000
50,000
40,000
best £m
£m
Likely £m
30,000
Worst £m
20,000
10,000
0
2014/15
2015/16
2016/17
2017/18
2018/19
Years
NHS Southern Derbyshire Clinical Commissioning Group
Quality
• Quality suffers when systems are
under pressure
• Too many people in hospital
• People not supported to retain their
independence in the community
• Too many people entering long term
care too early or without proper
assessment
NHS Southern Derbyshire Clinical Commissioning Group
‘A Call to Action’
• Requires open dialogue
with the public,
providers and
stakeholders about the
future of the NHS
• Each CCG to develop
5 year commissioning
plans by June 2014
• To include use of the
Transformation Fund
NHS Southern Derbyshire Clinical Commissioning Group
The ‘Integration Transformation
Fund’
• Aim is to encourage integration, but no
new money
• £18m for SDCCG (3% of total funding)
• Focuses on preventing hospital
admissions and facilitating discharge
• Explicit about impact on acute services
• In the context of huge financial pressures
on local authorities
NHS Southern Derbyshire Clinical Commissioning Group
Where are we heading?
• Acute trusts working more closely together in strategic
partnerships
• Community services working closely with primary care
and social care to deliver integrated services
• Primary care developed as a robust provider of a wider
range of local services
• Care Homes developed as strategic partners in the local
health and social care economy
• Mental health provision integrated with community
provision
• Some shift from medical to social models of care
NHS Southern Derbyshire Clinical Commissioning Group
Assumptions
• The acute sector stops growing
• The evidence base around integration
NHS Southern Derbyshire Clinical Commissioning Group
Integrated Care – Where are we
now?
• Health and social care teams working locally
with practice populations of 20-25,000
• Focus on the elderly and people with a Long
Term Condition
• Single Points of Access
• Local teams have access to a range of support
services (therapies, specialist teams, local beds,
community physicians etc)
NHS Southern Derbyshire Clinical Commissioning Group
Integrated Care – what comes
next?
• Expansion of community approach to include
mental health and links to local community
networks
• More modern, flexible community estate, with
beds available locally to Community Support
Teams
• In-reach support to Care Homes
• Shared information
• Services available 7 days a week
NHS Southern Derbyshire Clinical Commissioning Group
Our priorities are still the same ….
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Urgent care
Mental health
Children
Planned care
Primary care
Long term conditions
Frail and elderly older people
NHS Southern Derbyshire Clinical Commissioning Group
… But our model of delivery
focuses on integration
Self Help
Advice,
information
& Advocacy
Social Capital
Social
philanthropy
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Primary/
Community
Delivered
locally
Early
Intervention
Prevention
Rehabilitation
Community
Care
Primary/
Community
Health at
“district”
level
Intermediate
Care
Social Work
Out of
hospital
Specialist
Services
Specialist
Hospital
Care
Care Homes
Primary care as key part of community services
Same model works for most client groups
Potential development of a Public sector Offer
Development of social capital
What are the public’s responsibilities in this model?
NHS Southern Derbyshire Clinical Commissioning Group
Implications for the Voluntary
Sector
• Funding will reduce
• Public sector will rationalise its working with the
voluntary sector
• There will be opportunities
– Prevention
– Social capital
– Has to integrate with the Public Sector
• What is the voluntary sector ‘offer’ to the
statutory sector?
NHS Southern Derbyshire Clinical Commissioning Group
Thank you
NHS Southern Derbyshire Clinical Commissioning Group