Manchester Health and Care Commissioning Strategy BME Partnership 8th February 2017

Session Overview A single health and care commissioner for Manchester Overview of the draft Commissioning Strategy Table discussions: Draft commissioning strategy – strategic aims Partnership working: VCS and commissioners VCS and providers

Single Commissioning Function The journey so far

Context 1 - Manchester Locality Plan Transform / improve outcomes and sustainability 9 priorities 3 pillars: Single Commissioning Function Local Care Organisation Single Hospital System

Context 2 - Manchester Locality Plan Designing a 21st century health and social care system to help Manchester achieve its vision to be one of the world’s top flight cities Single commissioning function Description - setting out why / purpose LCO – why and purpose

Recommendations Single Commissioning Function, comprising: Single Manchester CCG Manchester City Council Partnership agreement Strategic focus Many existing functions undertaken by LCO Role of GM Agreement and implementation commenced – working title: Manchester Health and Care Commissioning

Strategic Commissioning Operational Commissioning Commissioning systems not services Manchester and Greater Manchester system leadership Setting outcome measures for the population of Manchester and defining the broad models of care required from providers Assuring the quality and safety of service provision delivered in Manchester Ensuring financial and performance targets are met – system wide Fulfilling statutory functions and duties e.g. safeguarding short, medium and long term financial balance against allocations Strategic market management Innovative in commissioning / contracting - prime contract / alliance model payment systems Support Asset based approach and co-production through commissioning Alignment with broader public services Operational Commissioning Commissioning health and care services Neighborhood focus – engaging with local people and practitioners to ensure local needs are understood and met Focus on achieving outcome measures - clear ‘logic’ of metrics at service level to high level outcomes Service and pathway redesign Functional support to contracting, business intelligence and finance. Commissioning of individual or small scale packages of care e.g. CHC and associated strategic commissioning Oversee and manage medicines optimisation across the system ( primary and hospital care)

Commissioning Strategy Overview

‘Straw man’- Commissioning Strategy Vision/Mission/Values Context Current state (assets and need) What we want to achieve / outcomes How we will work System Transformation Vision / values / mission – informed through the work that Mike is leading on Context National Policy – 5 Year Forward View0 GM Devolution – Taking Charge Our Manchester Manchester Locality Plan 3. Current state - Overview of the assets and how they are providing positive contribution across the city, The difference between this strategy and others, is that we want to start from the positive asset base that we have across Manchester and build on this. 4. What success will look like – what the outcomes we are working toward will be 5. How we will work - approach to commissioning as a strategic commissioner 6. System Transformation – 3 pillars, and how the formation of these will drive the transformation of the system.

Mission and values Our values: Positive Collaborative Fair Our ambition, what we do, how and why We are determined to make Manchester a City where everyone can live a healthier life. We will support you, and your loved ones, investing in what you tell us is important to you. We will make sure you receive the right care in the right place and at the right time, delivered by kind, caring people that you can trust. We will make the most of our money by reducing waste, testing new ways of working that improve outcomes and funding the things we know will work. We will forge strong partnerships with people and organisations, in the City and across the region, and put health and wellbeing at the heart of the plans for developing Manchester’s future as a thriving city. Our values: Positive Collaborative Fair

£133m Context #ClinLeaderMcr Finance - growth against funding gap Demand – demographic aging and growing population, cultural – 24/7, public expectation Poor outcomes – give examples of where manchester city Fragmented system – continuity of care across the system, variation between provision Strengths – community assets , partnership working across organisations and communities, Our Manchester Challenges – all of the above £133m #ClinLeaderMcr

Strategic aims and outcomes Working for a Healthier Manchester Improving health population outcomes e.g. Healthy life expectancy Fewer people dying of cancer, CVD, and respiratory disease Developing a thriving city, reducing dependency e.g. More families will be economically active and family incomes will increase More people supported to stay well and live at home as long as possible Achieve a sustainable system Finance, workforce …. Quality Safety, experience and effectiveness Reducing variation, CQC ratings Starter for 10 – following on from current plans, locality plan etc, pulled out what success would look like for Manchester. Setting up a task Group to take this forward: The purpose of this piece of work is as follows: Develop and articulate the strategic aims of the MHCC; Describe how the achievement of the strategic aims will be measured (using existing frameworks) over the timeframe of the strategy; Identify are priority outcomes under the strategic aims for the MHCC.   Progress to date in the development of the strategy has identified the ‘balanced scorecard’ approach (above) in describing the strategic outcomes of MHCC could be used, and these domes could translate into the strategic aims of the organisation. If that approach was taken, examples of the frameworks that would map are also provided. This commissioning strategy sets out how we will commission for the population to achieve our vision. How the achievement of that vision will be tracked and measured across the system through existing strategic outcome frameworks developed across the city:   Improving health population outcomes – GM Outcomes Framework Developing a thriving city – Manchester strategy Achieving financially sustainable system – CBA analysis linked to the H+WB activity shifts Quality – NHS Outcomes framework / constitutional measures – Co-production Patient experience – Constitution – Co-production

Strategic commissioner Strategic influencer / partner How we will work… Strategic commissioner Outcomes Commissioning and transforming systems, not services Assuring performance, quality and safety of commissioned services Driving collaboration and co-production Promoting strength and asset based approaches Ensuring equity – access, outcomes and experience Strategic influencer & partner Health and social care Public, voluntary, community sectors and beyond Wider determinants Manchester, GM and beyond Strategic commissioner + Strategic influencer / partner = System leader

Discussion points Are these the right strategic aims for a strategic commissioner? Partnership working: How do you think we can best work together to achieve these strategic aims? What support can commissioners provide to enable effective partnership working between the voluntary and community sector and the LCO?