Our five year plan to improve local health and care services

Our vision for local health and care “Our plan is to work together as one area to improve public services and make sure we have sustainable, high quality health and care services for the long term.”

Why do we need a new plan? Health and social care services are under increasing pressure – locally and nationally The system isn’t working as well as it should - to continue to offer high quality services to local people we have to change Working together in this new partnership – bringing together health and care professionals across 11 organisations – offers us an exciting opportunity to plan in a new way To make sure all our residents have access to the best care and treatments And that these services are affordable into the future

850,000 people Combined health funding in 2016/17 of £1bn Combined social care and public health budget of £328m 3 Clinical Commissioning Groups 684 GPs in 95 practices H 4 acute hospital sites H 11 community hospital sites 2 community services providers 1 mental health provider working from 4 in-patient sites and delivering community services from 22 sites 1 local authority (Surrey County Council) providing adult & children’s social services 7 District/Borough Councils 3 A sensible size for working together Surrey Heartlands

In Surrey Heartlands we are facing four big pressures that we need to address We have an older population compared to national average, who often have many complex conditions Increasing demand is putting pressure on services, particularly urgent care Under-developed community and primary care services means people are often not treated in the best place. This is increasing pressure in our hospitals High cost of living and being close to London means we have significant recruitment pressures and rely too much on agency staff to fill gaps

We’re already made fantastic progress in developing new and innovative services and we can build on these We are already creating more joined up out of hospital care: – The Bedser Hub in Woking where older people have access to a range of services all in one place – Local organisations working together in the Epsom area (known as a provider alliance), working to a single budget – ‘My Care, My Choice’ in Guildford – a joint approach to providing more coordinated care for adults over 65 (at high risk of being admitted to hospital) – In mental health – specialist inpatient care supported by innovative out of hospital care (e.g. safe haven service, home treatment) Using technology to improve care – for example we are already developing a Single Care Record Better Care Fund – is already providing a strong basis for partnership working that we can build on

Our emerging vision: Four key strands which will make a big difference 1.To make sure all local residents have access to the same high quality standards of care – via a Surrey Heartlands clinical academy 2.To promote self-care and encourage local people to take more responsibility for their healthcare 3.To improve the way we provide services – with more care in the community, and single centres for some of the most specialist hospital services (creating expertise and improving patient outcomes) 4.Working as one – moving towards one budget and one overall plan for the Surrey Heartlands area

1. Access to the best care and treatments We want to establish a Heartlands Academy – to develop consistent clinical and professional standards so all patients receive the best quality care and treatments Ensuring clinical ownership of developing consistent standards and making sure this becomes part of day to day practice Empowering patients – using information to help patients make more informed decisions and take responsibility for their own healthcare

2. A citizen-led approach Putting more emphasis on ‘prevention’, promoting healthier lifestyles and choices Making sure we invest resources where they have most effect, e.g. population in later middle age who are at high risk of developing chronic diseases Improving early detection and prevention of long-term conditions (NHS Health Checks, national prevention programmes) Supporting more self management for people with long-term conditions (based on clear evidence) Working with our citizens to help them understand the complexities and trade-offs in planning and budget setting Communicating and engaging in a very different way – so local people are more equipped to take part in co-designing services

3. Improving health and care services (1) More focus on joining up out of hospital services, building on the work we are already doing e.g. locality/community hubs Improving the way we provide primary care services – with GPs taking responsibility for coordinating a person’s care - supporting a culture of personal responsibility and prevention Dedicated capacity in primary care to manage people that need to be seen on the same day Improving how we manage long-term conditions based on sound evidence (e.g. patients seeing a GP, pharmacist, nurse or physician’s associate depending on their need) – helping to keep people out of hospital And using technology (e.g. teleheath, telemedicine) where appropriate so patients have access to senior clinicians

3. Improving health and care services (2) For acute hospital and mental health services: – Creating centres of expertise for the most specialist services – Linking expertise across hospital sites so patients still have access to other specialties such as diagnostics and specialist opinions locally – Developing our Cancer Centre within a new Surrey/Sussex Cancer Alliance More joined up care for older patients, working closely with local community, primary, mental health and social care, with easy access to hospital care where necessary

Conclusions and next steps Our emerging vision and new partnership approach will help make sure local residents have the best care and treatments and that they are sustainable in the future Our vision includes having ‘one system, one plan’ – with a shared approach to an estates strategy, workforce plan, patient care record and so on Over the coming months we will be: – Widening our staff, stakeholder and citizen engagement – And developing more detailed plans for submission to NHS England later in the year