Mike Potts
Chief Executive
Local overview and key challenges across
the four themes set out in the Operating
Framework
Calderdale, Kirklees and Wakefield
District – the place
Todmorden
Calderdale
Calderdale
Halifax
Halifax
Batley
Dewsbury
Huddersfield
Huddersfield
Kirklees
Wakefield
Wakefield
Pontefract
Wakefield District
Wakefield
District
Hemsworth
About us …
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991,000 local people
582 staff
£1.68 billion budget
Significant health challenges
4 shadow CCGs
1 West Yorkshire Commissioning
Support Service
• 3 Health and Wellbeing Boards
About us … (Contd)
Main providers:
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2 acute (1FT, 1 aspiring FT)
1 mental health/care trust (FT)
1 ambulance service (aspiring FT)
2 social enterprises
138 GP practices
127 dental practices,
200 pharmacies
114 optometry providers
Wider system leadership:
• Emergency planning (West Yorkshire)
• 111 implementation (Yorkshire & the Humber)
Strong relationships with our
local authorities
Our role
3 PCTs - one cluster board and one executive team from
October 2011
Our role:
• lead the local NHS
• improve the health of local people
• commission high quality safe and sustainable
services within resources
• implement NHS reform
∙ manage transition to the new commissioning
system
∙ manage transition of PH to LAs and support
establishment of Health & Wellbeing Boards
∙ support provider development
Our focus
Control
Create
Close
• Maintaining quality & safety
• Delivering performance
• Managing the money
• Maintaining resilience
• Creating the new commissioning system CCGs, CSS, public health, H & WBBs
• New relationship with public
• Embed transformational change
• Formal Closure of PCTs
• Handing over our legacy
• Celebrating our achievements
Challenges for health and
social care
• Ageing population – increased pressure on health
and social care services.
• Do things differently – encourage innovation and
transformation.
• Embrace new technologies.
• Integrating care across agencies – move
from competition to co-operation/partnership.
• Improve health & health outcomes - ownership,
lifestyle choices, wider determinants of health.
• Meaningful engagement with our patients and local
communities.
• Limited resources – need for greater efficiency.
Operating Framework 2012/13
4 key themes:
• Getting the basics right
• Maintaining our grip on performance
• Meeting the quality and productivity
challenge
• NHS reform
Getting the basics right
Control
• Cluster quality governance
• Swift response to CQC inspections
• Performance: grip on key quality performance indicators
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Hospital acquired infections
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Patient safety
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Safeguarding
• Assuring and improving quality through transition
• Quality metrics across the system
• Quality impact assessments
Getting the basics right Contd
Create
• CCG quality governance/infrastructure
• National and local CQUIN development
• Focus on improving patient experience
Close
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Close down process in place
Legacy documents
Quarterly reporting to NHS North of England
Face to face handovers Q3 and Q4
Performance – the challenge
Keeping a grip on performance:
• A&E and Referral to Treatment (RTT) 18 weeks monthly delivery by speciality
• Increased pressure on delivery of zero Health
Care Acquired Infections (HCAIs)
• Continued focus on zero Mixed Sex Accommodation
(MSA) breaches
Focus on sustainability
Plans to Board in May
Quality, innovation, productivity,
prevention (QIPP)
• Strong record of managing within resources
and delivering QIPP targets.
• QIPP targets 12/13 to 14/15:
Calderdale
£m
Kirklees Wakefield CLUSTER
£m
£m
£m
2012/13
5.5
9.5
12.5
27.5
2013/14
4.8
10.0
11.4
26.2
2014/15
5.3
10.0
11.4
26.7
15.6
29.5
35.3
80.4
TOTAL
Our 5 transformational QIPP
Programmes (2012-15)
Preventing
unplanned
admissions
and
managing
long term
conditions
Changing
planned
care
pathway
Assistive
technology
and risk
stratification
Alternative
community
services
Stronger
mental
health and
learning
disability
services
Whole system integration
• Community care
teams .integrated
health and social care
on primary care
footprint
• Virtual ward
• A/E navigation
• Mobile response
• Emergency plans .
• Single point of access
• community care teams
Community
provider
LA
Person
first
Primary
care
• E consultation
• Personalised care
planning
• Case management
• Risk stratification
Acute
trusts
• E consultation
• Telemedicine
• Virtual ward
• Community consultants
System enablers
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Assistive technology
E-consultation
Integrated provision
Case management
Risk stratification
Leading Large Scale Change Support
Programme
Whole system health and social
care transformation
50% of QIPP savings delivered through two
Major transformation programmes:
• Calderdale & Huddersfield Health and Social
Care Transformation Programme
• Wakefield District and North Kirklees Health
and Social Care Transformation Programme
The transformation map
CCGs:
Greater Huddersfield &
Calderdale
Partner Trusts:
SWYPFT, Locala
CHFT Board
Calderdale
Council
Kirklees
Council
Calderdale and Huddersfield health &
social Care transformation
Urgent care:
Joint approach to
delivery of nonelective and urgent
care and QIPP
Health strategy refresh:
Future service vision
Transformation
Delivery of QIPP/CIPs
Cross Cutting: communications and engagement; clinical leadership; quality
and safety; workforce, PMO governance and risk management
Programme Office
Elective care:
Joint approach to
delivery of redesign
and QIPP
CKW Cluster
Board
Calderdale & Huddersfield health &
social care transformation
Aims:
• A strategy for the next 5 years to deliver high quality care
in the most appropriate setting.
• To be in top 10% nationally for safe, reliable patientcentred care.
• Maximise the benefits of the NHS reforms and respond
to demographic changes.
• Focus on the needs of people with LTC.
• Affordable and sustainable services, where local leaders
are recognised for their approach to partnerships and
integrating care.
CCGs:
Wakefield
North
Kirklees
NHS North
Partner Trusts:
SWYPFT, Locala
Recovery and service
improvement
• Financial recovery
• Service improvement
MY Hospitals
Trust Board
Wakefield
Council
Kirklees
Council
Wakefield District and North Kirklees
health and social care transformation
Programme executive
Transformation programme
• Care outside hospital
• Urgent care
• Clinical services strategy
• Primary medical services
Foundation Trust
application
Transactional
processes
Cross Cutting: Communications and engagement; clinical leadership; quality
and safety; workforce, PMO governance and risk management
Programme Office
Partner PCTs:
NHS Leeds
CKW Cluster
Board
QIPP schemes – some examples
Diabetes e consultation – linking GPs and secondary
care clinicians (early indicators 75% reduction in referrals)
Telehealth in Care Homes – supporting end of life care –
(10% – 15% reduction in emergency admissions)
Dementia Care – new model of specialist day care – 10%
increase in day care activity
Primary care transformation – to increase primary care
capacity – ( 8% reduction A&E attendances 5% reduction
in LTC admissions)
Implementing NHS Reform
NHS Commissioning Board
Chief Executive
Sir David Nicholson
Chair
Professor Malcolm Grant
Local clinical commissioning
groups (CCGs)
Practices
Chair
Applying for
authorisation
Calderdale
27 Dr Alan Brook
1st phase (July)
Greater
Huddersfield
40 Dr Steve
Ollerton
2nd phase
(Sept)
North Kirklees
Health Alliance
31 Dr David Kelly
3rd phase (Oct)
Wakefield
Alliance
40 Dr Phil
Earnshaw
1st phase (July)
RAG
rating
Commissioning support service
(CSS)
• West Yorkshire wide approach
• Already operational – from this month
• Business case submitted
• Expect to be fully operational
by end October.
• Currently consulting on senior
staffing structure
• MD appointed
Alison Hughes
Provider development
• All remaining NHS trusts move to Foundation
Trust status.
• New provider models e.g. social enterprises,
joint ventures.
• More choice, competition and co-operation
• Any qualified provider.
Public health transition
Public health – local
authority
• Public health functions to:
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Public Health England
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Local authorities
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NHS Commissioning Board
• Joint Directors of Public Health x 3
• Transition plans agreed.
• Plans assured by NHS North of England.
• Ready for start of shadow period: Oct 12.
Health & Wellbeing Boards
• Three shadow boards in place.
• Strong relationships developed with CCGs.
• Joint Health and Wellbeing Strategies being
Health & Wellbeing Boards
developed.
Group discussions
We want to hear from you
Your contribution is important