1. NHS Southern Derbyshire Clinical Commissioning Group Call to Action Andy Layzell Chief Officer

2. NHS Southern Derbyshire Clinical Commissioning Group Pressures in the NHS The money Transformation Fund Where we are heading Implications for the Voluntary Sector

3. NHS Southern Derbyshire Clinical Commissioning Group Pressures in the NHS Over the last 10 years: – 50% increase in GP consultations –35% increase in emergency care admissions –50% increase in procedures undertaken –A&E Departments under pressure –‘The worst winter I can remember’

4. NHS Southern Derbyshire Clinical Commissioning Group What causes the pressures? Combination of factors: –Demographic change –25% of the population with a long term condition (70% of expenditure) –Poorly joined up services between primary, secondary and social care –Technical advance

5. NHS Southern Derbyshire Clinical Commissioning Group The money Tightest period of funding in the last 50 years of the NHS NHS funding has declined in real terms and is below the level of 2009/10. Growth in real terms funding likely to cease after 15/16 Inflation of 2-3% per year still expected to impact on the costs of delivering health services Investment of £18m in Social Care by 15/16 (Integration Transformation)

6. NHS Southern Derbyshire Clinical Commissioning Group SDCCG Estimated productivity Challenge 2014-2019

7. NHS Southern Derbyshire Clinical Commissioning Group Quality Quality suffers when systems are under pressure Too many people in hospital People not supported to retain their independence in the community Too many people entering long term care too early or without proper assessment

8. NHS Southern Derbyshire Clinical Commissioning Group ‘A Call to Action’ Requires open dialogue with the public, providers and stakeholders about the future of the NHS Each CCG to develop 5 year commissioning plans by June 2014 To include use of the Transformation Fund

9. NHS Southern Derbyshire Clinical Commissioning Group The ‘Integration Transformation Fund’ Aim is to encourage integration, but no new money £18m for SDCCG (3% of total funding) Focuses on preventing hospital admissions and facilitating discharge Explicit about impact on acute services In the context of huge financial pressures on local authorities

10. NHS Southern Derbyshire Clinical Commissioning Group Where are we heading? Acute trusts working more closely together in strategic partnerships Community services working closely with primary care and social care to deliver integrated services Primary care developed as a robust provider of a wider range of local services Care Homes developed as strategic partners in the local health and social care economy Mental health provision integrated with community provision Some shift from medical to social models of care

11. NHS Southern Derbyshire Clinical Commissioning Group Assumptions The acute sector stops growing The evidence base around integration

12. NHS Southern Derbyshire Clinical Commissioning Group Integrated Care – Where are we now? Health and social care teams working locally with practice populations of 20-25,000 Focus on the elderly and people with a Long Term Condition Single Points of Access Local teams have access to a range of support services (therapies, specialist teams, local beds, community physicians etc)

13. NHS Southern Derbyshire Clinical Commissioning Group Integrated Care – what comes next? Expansion of community approach to include mental health and links to local community networks More modern, flexible community estate, with beds available locally to Community Support Teams In-reach support to Care Homes Shared information Services available 7 days a week

14. NHS Southern Derbyshire Clinical Commissioning Group Our priorities are still the same …. Urgent care Mental health Children Planned care Primary care Long term conditions Frail and elderly older people

15. NHS Southern Derbyshire Clinical Commissioning Group Self Help Advice, information & Advocacy Social Capital Social philanthropy Primary/ Community Delivered locally Early Intervention Prevention Rehabilitation Community Care Primary/ Community Health at “district” level Intermediate Care Social Work Out of hospital Specialist Services Specialist Hospital Care Care Homes Primary care as key part of community services Same model works for most client groups Potential development of a Public sector Offer Development of social capital What are the public’s responsibilities in this model? … But our model of delivery focuses on integration

16. NHS Southern Derbyshire Clinical Commissioning Group Implications for the Voluntary Sector Funding will reduce Public sector will rationalise its working with the voluntary sector There will be opportunities –Prevention –Social capital –Has to integrate with the Public Sector What is the voluntary sector ‘offer’ to the statutory sector?

17. NHS Southern Derbyshire Clinical Commissioning Group Thank you