Neurological Services Deep Dive Workshop Understanding “what to change” using the NHS Right Care methodology Part of the NEW Devon Way

Deep Dive Workshop Structure Activity timing Introduction and Purpose of Today 25 mins The purpose of today’s workshop Why NEW Devon CCG has adopted NHS Right Care How NEW Devon CCG uses NHS Right Care in QIPP planning Deep Dive Feedback 50 mins Presentation of the findings of the deep dive review Q&A on deep dive findings QIPP Theme Selection 1hr 30 mins Work in groups to define: Selected themes for QIPP projects to be turned into a mandate Design Principles Data requirements Outline plans and objectives Workshop Feedback 10 mins Feedback to make workshop a better learning experience Questions 5 mins Final opportunity for questions

Deep Dive Workshop Introduction & Purpose of Today 25 minutes

Deep Dive Workshop Purpose To introduce the use of NHS Right Care for NEW Devon CCG To understand the theory behind NHS Right Care To understand the findings of the service deep dive To design a QIPP programme around the service deep dive including: Design Principles Data requirements Outline plans and objectives To learn a standardised approach to evidence based change in the NHS

Systematic QIPP Development Adoption of NHS Right Care NHS NEW Devon CCG must maintain a continuous list of improvement opportunities to ensure that QIPP requirements can be met each year To do this we must adopt a standardised approach to QIPP development that will bring clarity and assurance to the QIPP proposals NHS Right Care is designed for CCGs to tailor to their purposes using the overall methodology as a blueprint NHS NEW Devon CCG will develop its use of the Right Care system in outline and refine it as the QIPP programmes develop, effectively testing it with delivery and improving as we go 5YFV “closing the gap” target for NEW Devon is to be upper quintile across the board, therefore all opportunities will be valued at a top 20% indicator The deep dive packs we are about to review show opportunity ranges between peer and national average to peer and national upper quintile We are here to identify a series of projects that will move the service to the upper quintile in quality, cost and performance while contributing a targeted value to system recovery

Systematic QIPP Development NHS Right Care Overall Methodology We are here “What to change”

Systematic QIPP Development Phase 1 - Where to look Where to look will happen once each year to produce a high level ranked list of opportunity to pursue We do this using a series of nationally available indicative data comparing our performance against a selected peer group of health economies The output of this phase is a scoped and ranked list of opportunity Commissioning for Value Atlas of Variation Programme Budgeting Local Interpretation Benchmark, value, rank and prioritise themes using agreed national and local data. Identify opportunity of top ranked themes. Produce a scope per theme. Present scope to steering group for go/no go decision. Themes ranked With a scope per theme www.rightcare.nhs.uk Programme budgeting

Systematic QIPP Development Phase 1 - Where to look (2013/14 data) We have ranked all services by value (a combination of demand, outcomes, cost and performance) For 2015/16 NHS Right Care shows a total value against peer of £116M and against the national upper quintile position of £268M 16 of the 22 categories have been selected for deep dive review in 4 waves in 15/16 These are not the QIPP targets but an indication of where our services are sub optimal compared with other health economies

Systematic QIPP Development Phase 2 part 1 - What to change – today’s workshop What to change starts with a deep dive exercise focusing on the selected theme The deep dive pack is analysed (today’s exercise) and QIPP plans are defined with sufficient evidence to produce a project mandate. The output of this phase is a project mandate NHS Right Care deep dive is completed (6 weeks) Detailed deep dive is analysed and prioritised and planned targets defined (3 days ) Implementation plans are drafted, business cases defined and project mandate produced (2 days) Mandate assessed at steering group for go/no go decision Note: An example mandate is in your handouts

Systematic QIPP Development Phase 2 part 2 – What to change Once the mandate is approved we can undertake deeper analysis of the selected QIPP projects (next step) This deeper analysis culminates in an optimal service design workshop including providers, patients and CCG members The output of this phase is a project initiation document including the new service design, strategy and implementation plans Assess gaps to best in class Clinically led pathway redesign Strategy for theme Complete Strategy to action plans, full business case & full PID Test against target and initial objective Full PID assessed at steering group for go/no go decision

Systematic QIPP Development Phase 3 - How to Change Once the PID is approved we can start to implement the planned changes Implementation will follow the NHS NEW Devon CCG turnaround methodology and will seek to deliver benefits as fast as possible Projects will be delivered and sustained under the Turnaround governance structure

Deep Dive Workshop Systematic QIPP Development Questions?

Deep Dive Workshop Deep Dive Pack Review 50 minutes

Deep Dive Workshop Deep Dive Pack Review Questions?

Deep Dive Workshop QIPP Theme Selection 90 minutes overall

Deep Dive workshop QIPP Theme Selection In your groups: What: Determine the themes suitable for improvement Identify any further data or analysis needed Determine “design principles” for that theme Identify evidence of the opportunity How: Discuss the findings of the deep dive and identify 3 key themes and title a flip chart page for each theme Produce a list in 2 columns of further data needed and the design principles for the project Capture the benefit in a one line benefits statement Nominate a spokesperson to brief the room at the end 60 minutes

Deep Dive workshop Plan and Approach to QIPP Theme All Together What: Select the themes to progress Identify how each Theme will be approached: Commissioner delivered Commissioner led Determine timings to get each theme to optimal pathway redesign How: Produce summary post it for each theme Rank theme by benefit (or time to deliver) Identify cut-off point to select themes Determine if theme is commissioner delivered or led Outline key dates: Plan (analysis, redesign, commissioner delivery) Stakeholder engagement (provider , patient etc) Ranked Themes Delivered or Led Outline plan Theme: physio referrals to outpatients Benefit : £1.2M, 12,300 referrals Time to deliver: immediate Theme Cut off 30 minutes

Deep Dive Workshop QIPP theme selection Questions?

Deep Dive Workshop Workshop feedback 10 minutes

Deep Dive Workshop Next Steps 5 minutes

Deep Dive Workshop Thank You