Worcestershire Joint Services Review Extraordinary Tripartite Board Meeting 27 January 2012 Worcestershire Joint Services Review Working together to ensure high quality, safe and sustainable health services in Worcestershire

Context: the NHS challenge Growing gap between need for care and funding available Worcestershire share approx. £200M by 2014/15 Improving and sustaining quality in the face of reduced purchasing power Working together to ensure high quality, safe and sustainable health services in Worcestershire

Context: system transformation Enablers Clinical leadership Patient revolution Partnerships Innovation Features Care closer to home 24 hr primary & community services Integrated care pathways Self-care Reduced hospital capacity Optimal use of assets Fewer unplanned admissions Reduced variation Improved quality and patient experience Improved productivity and value for money Sustainable system Outcomes Working together to ensure high quality, safe and sustainable health services in Worcestershire

What is the Joint Services Review ? A review of health services to secure the best possible healthcare for county residents that is sustainable for the future Whilst the main focus is on acute hospital services and how they are organised, we will also look at how we improve the pathways of care between the acute hospitals and the community and general practices. Working together to ensure high quality, safe and sustainable health services in Worcestershire

Why are we doing it ? To ensure that we develop health services that are high quality, sustainable and affordable now and for future years. We believe that we can and must do more to improve the quality of care to achieve better outcomes for patients. We face the challenge of achieving this in the face of growing financial pressures – efficiency alone will not be enough Working together to ensure high quality, safe and sustainable health services in Worcestershire

Doing nothing is not an option. Getting care delivered in the right place A major focus on improving the way that our acute hospital services are provided, but should not be seen in isolation. We can do far more to look after patients at home and in the community Working together to ensure high quality, safe and sustainable health services in Worcestershire

Scope of the Review Will examine the full range of Acute Hospital Services Will examine the requirements for transformational change for Community and Primary Care services Will include a focus on the clinical pathways of care We are at the start of the process – there are no pre-determined answers Working together to ensure high quality, safe and sustainable health services in Worcestershire

Vision and Outcomes of Review A blueprint for developing a stronger health economy, equipped to provide and sustain quality health services for people of Worcestershire and able to withstand the financial pressures placed upon NHS organisations. A clear vision and plan for acute services which ensures high quality, safe and sustainable services for county. A business case which sets out a programme of strategic change for Acute Services and requirements for transformational change in wider community and primary care system. Working together to ensure high quality, safe and sustainable health services in Worcestershire

Guiding Principles The Review will be governed by 5 key principles: Clinically led Rigorous Inclusive Open and Transparent Managed and Resourced Working together to ensure high quality, safe and sustainable health services in Worcestershire

Clinically Led Clinical leaders from local NHS have come together to jointly lead this review They will lead the discussion on future options with patients and the public They will make the formal recommendations on how we organise care and services against agreed criteria and quality metrics Working together to ensure high quality, safe and sustainable health services in Worcestershire

Rigorous All options for service reconfiguration fully assessed against best clinical evidence Application of agreed criteria for generation and appraisal of options which fully assess the improvement in quality and safety Expert Independent Clinical Scrutiny via an Independent Peer Review Panel chaired by Professor Bernard Crump Working together to ensure high quality, safe and sustainable health services in Worcestershire

Inclusive The review will involve, patients, the public, staff, partners and the media throughout. Commitment is for a process carried out with integrity – open, honest, inclusive and timely A Stakeholder Reference Board will give additional quality assurance on how we are engaging patients and the public throughout - chaired by Professor Rod Griffiths Working together to ensure high quality, safe and sustainable health services in Worcestershire

Open and Transparent Challenges facing our services and options for reconfiguration will be made public within our Engagement and Consultation Strategy We are committed to meaningful engagement with the public throughout the whole process - giving opportunities to contribute and comment on the development of the options We will ensure that our public consultation meets all the statutory requirements and prevailing guidance Working together to ensure high quality, safe and sustainable health services in Worcestershire

Section 242 of the NHS Act 2006 in respect of Public Consultation Health Secretary ‘Four Tests for Service Change’ Clarity about the clinical evidence based underpinning the proposals Must have the support of the GP commissioners Must genuinely promote choice for their patients Process must have genuinely engaged the public, patients and the local authorities Working together to ensure high quality, safe and sustainable health services in Worcestershire

Managed and resourced The review is important and has a robust governance structure and decision-making process The review is complex and involves many work streams and will be managed via a Programme Management Office and standardised Project management methodology Partner organisations are committed to ensuring it has adequate clinical and management resources and support. Working together to ensure high quality, safe and sustainable health services in Worcestershire

Project Plan – Phases and Timetable Milestones Timetable Approval to Proceed SHA December 2011 Approval to Proceed 3 Boards January 2012 Phase 1 Set up January / Feb Phase 2 Modelling and Analysis Early March Phase 3 Clinically led Option Generation & Appraisal End April Phase 4 Draft Strategic Outline Case for Change Early May Phase 5 Independent Peer Review End May Phase 6 Finalise SOC, Develop OBC, Approval for Consultation End June Phase 7 Public and Stakeholder Consultation July - Sept Phase 8 Refinement of Options Finalise Outline Business Case October / Nov Involve & engage

Opportunities to work together We recognise the need for the review and support the process; We are keen to work closely with acute and primary care colleagues to improve the treatment, care and experience of local people and to consider community based alternatives where this is appropriate; We will ensure our clinical leaders are involved in the discussions about possible developments and solutions that best meet the needs of local people Working together to ensure high quality, safe and sustainable health services in Worcestershire

Priority pathways for further development Improving health and promoting recovery; Supporting people with dementia; Supporting people with a long term condition; Supporting older people with complex needs; Supporting people with urgent care needs; Supporting people with palliative care needs. Working together to ensure high quality, safe and sustainable health services in Worcestershire

Summary Our clinicians believe we can do more to improve quality and achieve better clinical outcomes for patients We face the challenge of achieving this in the face of growing financial pressures Doing nothing is not an option: productivity and efficiency alone will not be sufficient to address this challenge We need a fundamental rethink about how we provide care We are working in partnership and are committed to Involve and engage staff, patients and the public throughout Working together to ensure high quality, safe and sustainable health services in Worcestershire

Worcestershire Joint Services Review Working together to ensure high quality, safe and sustainable health services in Worcestershire