West Yorkshire Sustainability and Transformation Plan An overview September 2016

Summary What are we trying to achieve? Who is involved? A new way of working The triple aim Our approach Programme structure Impact Process to date and next steps

What are we trying to achieve?

Transformed health and care West Yorkshire is one of 44 footprints across the country working to address the three gaps set out in the NHS Five Year Forward View: Health and wellbeing Care and quality Finance and efficiency The footprints are developing plans known as sustainability and transformation plans (STPs). This is a medium-term plan for the next 5 years (until 2020/21). The timeline, process and assurance of the plans is provided by national organisations such as NHS England, NHS Improvement, Public Health England and the Local Government Association.

Every place will be a healthy place, focusing on prevention and health inequalities We will work with local communities to build community assets and resilience for health People will be supported to self-care as a standard offer Technology will be key to supporting people in their communities Care will be person centred, simpler and easier to navigate There will be joined-up community place-based services across mental and physical health and social care including close working with voluntary and community sector Acute needs will be met through services that are “safe sized” with an acute centre in every major urban area, connected to a smaller number of centres of excellence providing specialist care We will actively engaged people in planning, design and delivery of care We will move to a single commissioning arrangement between CCGs and local authorities We will share back office functions, where possible, to drive efficiencies to enable investment in services Local services = accountable care systems to help keep people well West Yorkshire will be an international destination for health innovation. The vision

Who is involved?

A new way of working

Partnerships and networks Partnership based on common values, shared decision making, mutual accountability and place based prioritisation. Network of organisations and relationships, including: West Yorkshire Association of Acute Trusts Mental health and community providers Single committee for 11 clinical commissioning groups Yorkshire Ambulance Service Local authorities Emerging primary care federations and GP groupings Collaboration through Vanguard programmes Healthwatch organisations across West Yorkshire

Governance structures Being led by our health and care leaders across West Yorkshire, who have developed: Single leadership group Steering group Joint committees of CCGs Clinical forum STPs do not replace statutory functions of individual organisations

The triple aim

Health and wellbeing gap Catchment population of 2.6 million Pockets of deprivation and affluence Health inequalities Higher than average smoking and obesity rates 1 in 5 children living in poverty People over age of 85 will double in 20 years in some areas Mortality higher than average for those with serious mental health concerns

Care and quality gap Variation in care and health outcomes across West Yorkshire High use of emergency care Pressure on delivery of existing and new national standards Ageing staff, slowing pipeline of key professionals, unstable care home workforce Social care – 70% of people were satisfied with support Over half of all people who use social care services reported they had as much social care as they would like 57% of carers surveyed said they felt consulted in discussions

Finance and efficiency gap Aim to achieve financial balance by 2020/21 Despite increased funding year-on-year for the next five years, there will still be a gap by 2020/21 if we continue to commission and provide services in the same way we currently do for the rising level of demand Finance and efficiency is a servant to the first 2 gaps

Our approach

Programme structure

1 STP for West Yorkshire, made up of: 6 local plans Bradford District and Craven Calderdale Harrogate and Rural District Kirklees Leeds Wakefield Health and Wellbeing Board oversight of all local plans. Most of the transformation required will be planned and delivered at a local level.

1 STP for West Yorkshire, made up of: 9 West Yorkshire-wide priority areas Acute collaboration Cancer Mental health Prevention ‘at scale’ Primary and community care Specialised commissioning Standardisation of commissioning policies Stroke Urgent and emergency care

1 STP for West Yorkshire, made up of: 7 enabling workstreams Workforce Digital Leadership and organisational development Communications and engagement Finance and business intelligence Best practice Commissioning

Impact

The proposals in our local place based plans and our collaborative workstreams identify how we could close the three gaps in West Yorkshire. This will: Improve the health and wellbeing of the whole population such as improving one year cancer survival rates and reducing suicides Ensure people receive quality care such as consistently meeting our targets for emergency (4 hours) and planned care (18 weeks) Deliver services within the financial envelope

Process to date and next steps

Submission timescales First draft ‘checkpoint’ submission on 15 April 2016 Second draft ‘checkpoint’ submission on 30 June 2016 Assurance meeting with national bodies on 13 July 2016 with key feedback to consider Submission of financial information on 16 Sept 2016 Final submission of draft West Yorkshire STP proposals on 21 Oct 2016 Draft submission of CCG and provider two-year operational plans 2017/18 and 2018/19 by end Nov 2016 CCGs and providers to finalise two-year operational plans by 23 Dec The STP sets the strategic framework for the operational plans.

Engagement Bottom-up development of plans in six local areas No foregone conclusions or decisions made Commitment to real and proper engagement with local people and all stakeholders West Yorkshire Healthwatch organisations working together to represent people’s views and make sure meaningful engagement takes place Draft proposals to be published following submission to NHS England on 21 Oct. date tbc Wide engagement to take place, with formal consultation where needed