1. The future of the NHS in North Central London Islington Voluntary Sector Health Network 18 January 2011 Jacqueline Firth Engagement Manager, NHS Islington

2. All change Please understand that the NHS is undergoing a significant period of change. Two issues: 1.NHS White Paper, including GP commissioning 2.Efficiency savings Don’t have all the answers now Our transition plans are as flexible and adaptive as possible so that we can deal with uncertainty We await the new Health Bill Information in today’s update could change

3. July 2010 – White Paper Liberating the NHS: Equity & Excellence Patients to be placed at the heart of everything the NHS does The NHS to focus on improving what really matters to patients: the quality and outcome of their healthcare Clinicians to be empowered to innovate with the freedom to focus on improving healthcare services

4. GP Consortia Shift decision-making as close as possible to the patient build on the pivotal and trusted role already held by Primary Care professionals GPs best placed to co-ordinate commissioning and pathways of care Clinically-led redesign of pathways and services more effective working relationship between primary and secondary care clinicians bringing together responsibility for clinical decisions and the financial impact of those decisions GPs to work with local partners to commission the majority of healthcare services will not commission general practice, but will increasingly drive up the quality Practice level budgets to be allocated directly to consortia

5. To make future commissioning plans a success … GP consortia need to inherit a system which is performing well and in financial balance which means: –getting a grip on the current financial position –delivering savings on commissioning spend and savings on management costs

6. Management cost savings NHS London and its 31 PCTs must deliver management cost savings of £180 million by April 2013 savings to be reinvested in frontline services to ensure London’s patients receive better, more efficient and more effective care and also to support set up of GP consortia This means delivering management cost savings of 54% while maintaining the quality and safety of local services and supporting our people in planning their personal futures In North Central London, we cannot sustain five separate organisations and deliver those management cost savings Equates to some £28 million by the end of 2010/11

7. The transition plan A single transition team for North Central London to be operational from 1 April 2011 –do at a borough level what needs to be done locally –do at North Central London (sector) level what can be done centrally, once We are pooling our talent, resources and expertise to tackle our biggest problems Maintaining the relationship with GP community is crucial over the next two years Retaining local knowledge is also so important for the future We need to be as flexible and adaptive as possible so that we can deal with uncertainty

8. Principles for the new structure The purpose is to deliver the NHS North Central London Board objectives and lead transition programme up to 2013 Many functions can best be done centrally – some must be responsive to local needs There will need to be a strong and credible borough presence – the face of the NHS in each borough Value and build on existing local knowledge, skills and relationships GPs and local authorities will be part of the leadership shaping the future We will all need to work differently Services for patients will continue to be delivered locally

9. Proposed single management team structure and functions

10. Local functions Local, credible, authoritative presence Development of GP Consortia Liaison with the Local Authority –Public health functions –Local Strategic Plans and joint commissioning Relationship management and intervention with GPs Specific quality assurance and governance, e.g. safeguarding Financial support for Boards and Practice Based Commissioning / GP Consortia Delivery of local savings plans, a real focus for remainder of 2010/11 Delivery of service improvements

11. Retain focus on key priorities These proposals will help us to deliver our current priorities and work through the transition period improving health outcomes for our population financial recovery through effective service commissioning service change and transformation – with a focus on primary care assuring the quality and safety of services provided to patients in our communities managing an effective transition to new commissioning arrangements for the NHS in North Central London

12. Timeline New North Central London1 April 2011 NHS new borough presence (with fewer staff) 1 April 2011 GP consortium running in shadow form1 April 2011 Finally, all PCT functions will likely transfer to:April 2013 National Commissioning Board, or GP Consortia, or Local government

13. Thank you Questions? Contact me: jacqueline.firth@islingtonpct.nhs.uk telephone 020 7527 1333