Planning for 2014/15 – 2018/19
• an overview of national planning
priorities
• CCG allocations
Planning Framework
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Planning Framework
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1 Vision
5 Outcome Domains
7 Outcome Measures
3 Key Measures
6 Characteristics of High Quality,
Sustainable Health and Care Systems
• 4 Essential Elements
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Vision
High quality care for all, now and for future generations
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Driven by quality in all we do
Equal access for all, especially the vulnerable and excluded
Spread existing excellence
Sustainable, high quality for the long term
5 Outcome Domains and
7 Measures (Ambitions)
Domain Outcomes
Measures
1) Preventing Premature Death
1) Securing additional years of life for
people with treatable mental and
physical conditions
2) Quality of Life for Long Term
Conditions
2) Improving health related quality of life
for people with long term conditions
3) Quick Recovery from Ill Health
3) Reducing avoidable time in hospital
4) Increasing elderly people living
independently at home on discharge
4) Great Experience of Care
5) Increasing positive experience of
hospital care
6) Increasing positive experience of care
outside hospital
5) Safe Care
7) Significant progress on eliminating
avoidable deaths
3 Key Measures
Key Measures
1) Improving Health
Promoting health, preventing ill
health in partnership
2) Reducing Health Inequalities Better care for the most
vulnerable
3) Parity of Esteem
For mental and physical health
6 System Characteristics
The 6 characteristics of high quality, sustainable health and care
systems in 5 years time are:
• Citizen inclusion and empowerment
• Wider primary care, provided at scale
• A modern model of integrated care
• Access to the highest quality urgent and emergency care
• A step-change in the productivity of elective care
• Specialised services concentrated in centres of excellence
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1.Citizen Inclusion & Empowerment
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Listening to patients’ views
– Patients to participate in planning, managing and deciding about their care
– Patient participation in the commissioning process
– “Transforming Participation in Health & Care” guidance, Friends & family test
expansion, Personal Health Budgets
Better care through the digital revolution
– Increased patient access to healthcare records
– Telehealth and telecare
Transparency and sharing data
– Publishing outcomes data
– Care.data – single data sets and transmission standards
– NHS number as primary identifier
– GMS contract requirements: online booking, prescriptions, records; summary
care record information
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2.Wider primary care, provided at scale
• All care for patients with moderate mental or physical LTC
(~20% of patients) provided in primary care, at home or in
community
• Stronger more integrated community services including general
practice, community pharmacy etc
• Consensus about general practice working at greater scale, in
closer collaboration with other health and care organisations
• Strategic Framework for commissioning general practice
services will be published in 2014
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3.A modern model of integrated care
• Integrated care model, with senior clinician responsible for actively
coordinating all care, for patients with multiple, complex mental and
physical LTCs, often compounded by age and frailty (~5% of patients)
• Accountable GP for over 75s; CCGs to support practices by commissioning
additional services required (~£5 per head)
• Care integrated around individual patients; responsible senior clinicians,
from initial presentation to episodic care, from life-style support to hospital
episode co-management
• Better Care Fund: supporting integration of health and social care; CCGs
need to identify 2014/15 actions to mitigate impact in 2015/16 (15%
reduction in hospital emergency activity)
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4.Highest quality urgent and emergency
care
• Longer term: Implementation of the model set out in the first phase report
from the Urgent and Emergency Care Review
• Completion of NHS 111 roll out
• On-going local resilience planning, led by Urgent Care Working Groups
(UCWGs); refreshed plans by summer 2014, building on 2013/14 plans
• UCWGs to agree investment of 70% emergency tariff marginal rate, prior to
contract signatures
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5.Step-change in elective care
productivity
• Elective services designed and managed to remove error, maximise quality
and increase productivity
• Centres delivering high quality, treating adequate volumes, expertly using
modern equipment
• Transforming out of hospital care and concentrating specialised services will
need us to review delivery of planned admissions for less complex
treatments
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6.Specialised services concentrated
in centres of excellence
• Currently too many sites, too much variety in quality, too high a cost
• Need to be concentrated in centres of excellence connected to research and
teaching, delivering sufficient volume
• Likely to be 15-30 centres for most specialised services, with AHSCs as the
focus of many of them
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4 Essential Elements
• Quality (Effectiveness, Experience & Safety)
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Francis, Winterbourne & Berwick reports implementation
Patient safety and collaborative programme
Compassion in practice (6Cs)
Seven day working – local action plans to deliver the clinical standards
Safeguarding – discharge of duties demonstrated in local plans
• Access
– Delivery of NHS Constitution standards demonstrated in local plans
– PM’s £50m challenge fund for 9 pilots to extend access to GP services
• Innovation
– Regional innovation fund to support staff to innovate
– Commissioners to seek and support research activity and opportunities
• Value for Money
– CCGs must be explicit about how the £30bn gap will be closed locally,
with no reduction in quality
Planning Fundamentals
• Strategic & Operational Plans must explicitly set out the
approach to:
– Improvements in the 5 outcome domains and 7 measures
– Delivering the 3 key measures
– Implementing the 6 system characteristics
– Delivering the 4 essential elements
• They should be:
– Bold and ambitious
– Developed in partnership with providers and LAs
– Locally led
• Operational and BCF plans must be driven by the Strategic Plan
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Local engagement
Build on previous and on-going conversations with
• Partnership Board
• COM
• Community Forum
• Health and Wellbeing Board
In order to ensure the local direction of travel is understood and
endorsed
Planning Timetable
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CCG Allocations
• The allocations for CCG’s for the next 2 years (2014/15 –
2015/16) have been announced
• A new funding formula has been adopted for Programme
Budgets to reflect population changes and includes a specific
deprivation measure. All CCG’s will receive funding to match
inflation, with the most underfunded areas & those with fast
growing populations receiving more
• The allocation for Administration Budgets will continue to be
based on £/head population and will be £24.78/head in
2014/15 and £22.11/head in 2015/16.
What this means for NEL
Programme Budgets
• NEL CCG will receive the minimum uplift of inflation only
(2014/15 – 2.14% & 2015/16 – 1.7%)
• No recommendations as yet with regard to 2016/17 onwards,
but anticipate further movement towards published
allocation target.
Better Care Fund (formerly the Integration Transformation Fund)
• Allocation of £11.246m – in line with expectations
Administration Budgets (Running Costs)
• Given NEL’s low population growth compared to the national
average, the CCG is likely to face savings excess of the
10% national savings requirement in 15/16.
Any Questions?