@nhsc_conference
#confed2015
The future provider landscape
Chair: Stephen Dalton, Chief Executive,
Mental Health Network
Katrina Percy, Chief Executive Southern
Health NHS Foundation Trust
Bev Humphrey, Chief Executive, Greater
Manchester West NHS Foundation Trust
Professro Ian Stewart, The City Mayor of
Salford
Sir David Dalton, Chief Executive, Salford
Royal NHS Foundation Trust

@nhsc_conference
#confed2015
The future provider landscape
Katrina Percy, Chief Executive Southern
Health NHS Foundation Trust

The future provider landscape:
Our perspective as a mental health and community provider
Katrina Percy, Chief Executive

Introduction to
Southern Health
Southern Health NHS FT formed on 1 April 2011 through merger of a community services and mental health provider
£350m budget, 8000 staff
Delivering community services, mental health, learning disability & some social care services

Our future
Developing a Multi-
Speciality
Community
Provider (MCP) – integrating primary care & community services
Developing our specialist Mental
Health and
Learning Disability
Services – and ensuring their sustainability

Developing an MCP
Your Health, In Your Hands, With Our Help.
Our new care model
Provider
Reform
Commissioner
Reform
A new care model with better access to care, extended primary care team proactively managing need, and specialist advice and support in the community.
Coming together to deliver the new model of care that has been co-designed with local people, is seamless across health and social care services and is cost effective
Pooling the combined resources for the local population and commissioning services using long term outcome and capitation based contracts

MCP Care Model
Wider primary care at scale
Improved access to care
An extended primary care team
De-layering specialist support

An extended primary care team
+ =

Delivering the model
East Hampshire
 10 practices / 70k patients
 Semirural “new town”
Gosport
 11 practices / 80k patients
 Urban deprived
New Forest
 7 practices / 70k patients
 Rural – older demographic

Specialist Mental
Health Services
Delivering recovery orientated services
Redesigning care pathways
Reducing reliance on inpatient care
Integrated health and social care model with local authorities

Specialised and forensic services
Adult low and medium secure services
Adolescent medium secure services
Tier 4 CAMHS
Services that require capital investment and scale to be sustainable

Delivering the new models – and implications for organisations such as ours

Building leadership capability

Organisational form?
With primary care, these services will form MCP(s)
These services increasingly need to operate at scale (whilst maintaining local focus)

Determining organisational form
An organisational form is required for the MCP to succeed, and for our specialist mental health and learning disability services
Our work is to determine the best solutions that enable success
Our Board clear that the Trust’s long term future is in the new organisational forms
Working to overcome the hurdles with regulators

Conclusions
Focus on the new model of care – this is what will improve care and enable financial sustainability
Building leadership capacity and capability is key
Our provider organisational forms will also change
Working with partners and regulators to ensure a smooth transition

@nhsc_conference
#confed2015
The future provider landscape
Sir David Dalton, Chief Executive, Salford
Royal NHS Foundation Trust

10 + 12 + 15
LAs CCGs Providers
1948
2016

Serving the needs of people,
- not Regulators or central funding bodies
Although each township is proud of its heritage we share a common view and have more that binds us than separates us.

or

Coherent Improvement Programme
Early Deliverables
Other
Deliverables
Enablers
Improving
Outcomes
& Access
7 day services
Specialist
Cancer
Services
Reduce GP variation in quality
Improving
Health
& Care
Diabetes
- Prevent
- Identify
- intervene
Dementia
Better Service
+ National
Institute
Improving
Wealth &
Employment
Improving
Models
Of Care
Support unemployed with mental health needs
Single
Shared
Hospital
Services
C&YP
Mental health wellbeing +
Eating disorders
Integrate
Pharmacy &
Dentistry 1°
Care Offer
Relationship with Industry
& Popⁿ Based
Trials
Adopt &
Spread
‘Vanguard’
Learning
GM
Workforce
Passport
Datawell
Intelligence
& Analytics
GM
Contracts for
GPs (GMS &
PMS)
Academic
Health
Science
System
Estates
Optimisation
Ed & Training
+ Skills & Job
Design

Collaborative assets:
Integrated health and Social Care
Academic & clinical excellence
Exemplary business development and environment infrastructure
Industry
Academia
FASTER
Unmet needs
F
U
S
FUS I ON
O
N
Solutions
BETTER
Collaborative resources:
Clinical trial infrastructure & facilities
Integrated Ehealth infrastructure
Business development
NHS adoption and procurement
Health economics
Entrepreneur development
Large, stable ethnically diverse population
NICE strategic relationship
Improved health & economic growth
IMPACT

Salford Vanguard
Single System of
P
Governance
P
P
Lead
P
P
P
• CCG, City Council, SRFT, GMW, Salix
• Health, social care & wellbeing for
65+ population
• Some services subcontracted
• Phased introduction 2014/15 onwards
BENEFITS
 Full range of services within a single management arrangement – more effective, efficient and coordinated care
 Collaborative environment without the need for new organisational forms
 Aligns interests of commissioners and providers, removing organisational and professional ‘silos’ that contribute to fragmented and sub-optimal care
 Collective ownership of opportunities and responsibilities; any ‘gain’ or ‘pain’ is linked to performance overall
 Supports a focus on outcomes and incentivises better management of population demand
23

• 16% differential in weekend mortality rates
• Saving 500 lives over 3 years by meeting trauma and emergency surgery standards
• Liberating 1500 hospital beds (with closer to home facilities or in home support)
• 20% reduction in urgent care admissions
• 25% reduction in care home admissions
• Supporting 000’s of people back to work

• NHS Constitution/Core National Standards
• ALB Regionalised Offices?
• GM Local Standards
• GM Improvement Programme metrics
• Employment Contracts (Primary Care)

(a personal view)
• 3 levels of decision making:
- local
- sector
- regional
• Must not travel at the ‘speed of the slowest’
• Decisions must ‘stick’ – limit power of veto/appeal

What might a GM Health Care Organisation look like in five years time?
Federated Back Office
With GM Providers ?
Management
Contract, or
Organisational Chain
Single Shared
Service with 2+
Providers serving 1m population
Integrated Care Models for
Long term conditions, Dementia
Mental Health and Urgent Care
Service Line
Contract for with Specialist
Providers
27
Dalton Review
#DaltonReview2014

@nhsc_conference
#confed2015
The future provider landscape
Ian Stewart, The City Mayor of Salford

@nhsc_conference
#confed2015
Bev Humphrey, Chief Executive, Greater
Manchester West NHS Foundation Trust