1. Healthier Together Joint Committee Wednesday 15 th June 2016

2. Programme Update Sophie Hargreaves, Programme Director

3. Joint Committee’s role is to assess whether adequate progress is being made towards implementation of Healthier Together This meeting is structured to provide an update on the GM and sector progress as well as key risks and dependencies The Committee will be asked to comment on this at the end of the agenda Purpose of meeting 3

4. Assurance: 3 of 4 sector stage 1 reviews completed HR and workforce: Recruitment principles agreed Baseline taken Finance: Finance ongoing discussions regarding capital Equalities: Standards baseline taken Access appraisal underway Clinical: Standards baseline taken Clarification of the general surgery model completed Quick win recommendations identified (item 7) NWAS audit underway Evaluation: Manchester University partnership established Highlights since March Joint Committee 4

5. Programme Status 5 Stage 1. Establish Sector Programme 2. Design of model of care and pathways 3. Completion of Business 4. Operational specification and detailed design 5. Preparation of Estate and facilities 6. Planning for Implementat ion IMPLEMENTATION 7. Post Implementa tion review MAT NE NW SE 60% 90% TBC Programme - AMBER NWAS – AMBER / GREEN

6. Programme Plan - Approach 6 Complex made up of many moving parts! Many dependencies and interconnected activities Risks and dependencies to be identified through Programme Board and managed through Risk/Dependency register Therefore reviewed on a rolling basis – and updated quarterly for Joint Committee

7. 7 Healthier Together Implementation Plan 20162017 MayJuneJulyAugSeptOct - DecJan - MarApr – JunAug - Sep Sector Stage Milestones Indicative – will vary by sector Clinical Pathfinder Radiology &Paediatric Surgery Finance HR & Workforce Equalities Benefits Management and Evaluation Stage 1 Stage 2 (Model of Care) Stage 3 (Bus.Case)Stage 4 (Operationalise) Stage 5 (Build) Stage 6 (Transition Planning) First Sector Goes Live Stage 7 (Evaluate) NWAS Forwards Audit Scope Business Case content requirements Capital agreed Assurance of business cases Confirm required GM workforce Develop GM principles Develop campaignGM recruitment Analyse and Report baseline Sector Action plans ScopeEvaluation Grants application National and automated benefit collection Confirm required GM workforce Business Case assurance process Trainee changes enacted Trainee changes notice given Plan trainee doctor changes requirements NWAS backwards audit (depending on outcome of audit) Plan Quick Wins Analyse and report baseline Full benefits data collection Develop automated / streamlined data collection processes

8. April to September 2016 Baseline audit returned and analysed Recruitment Framework complete Finance Framework complete Source of capital and transition funding agreed Paediatric surgery and radiology plans completed NWAS Pathfinder audit completed Doctors in Training - agreement of the impact September 2016 to March 2017 1 st wave of Recruitment to workforce Business cases completed and assured First clinical ‘quick wins’ delivered Agreement on requirements for NWAS Pathfinder tool Capital builds underway, where possible March 2017 Radiology Hubs in place First high risk general surgery patient movements (Sectors to have been through stages 1-6 of the Assurance Framework) Beyond March 2017 Implementation of outstanding sectors following required capital build and assurance Pan GM timeline (as of Wednesday 30 th March 2016)

9. 3 / 4 Stage 1 reviews complete Good progress in areas, common themes of areas to work on Agreement of model of care key on critical path Stage 1 themes paper sets out actions for sectors on these themes GM levers can also be used to support implementation Progress to date - assessment 9

10. 1.Understand current performance issues relevant to HT and develop action plans to address identified risks 2.Develop plans to support relationship building across clinical teams and to address the cultural changes 3.Review and share outputs from the Clinical Alliance in sectors 4.Development of ‘quick win’ plans for each specialty, supported by HT Clinical Champions 5.Identification of resource to commence modelling work and standardisation of baseline data 6.Sectors to establish Patient Participation Groups and integrate patient participation into their plans Joint Committee asked to support this and ensure actions are completed in sectors Recommendations for sectors 10

11. Demonstrate commitment to change through commissioning intentions: – Specifying single teams for general surgery in commissioning intentions from a set date – for example January 2017 – Specifying movement of high risk elective patients (~100 per site per year) in commissioning intentions from a set date – the date will need exploration but could be for example April 2017 Action: Joint Committee are asked to endorse this approach and reflect in local commissioning intentions. Action: CCGs to report proposed commissioning intentions for Healthier Together to September Joint Committee. Action: Sector to identify Head of Commissioning Lead to work with CFO lead on this Commissioning Levers 11

12. Supporting model of care agreement: – Stage 2 review meeting dates set – GM event is planned for sectors to share this in August – Support in finalising data Clinical Effectiveness: – Sharing of national data and the baseline – identifying leads for best practice from across GM – ‘Theme of the month’ Cultural challenges: – Engagement with GM Organisational Development Group to discuss the implementation challenge Healthier Together poses and draw on existing experience in managing change in GM – Collation of key clinical concerns and mitigations across sectors Other GM Levers 12