Worcestershire Joint Services Review 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 and ensure it 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 ? Demand for healthcare is rising year on year with our population living longer with chronic illnesses On-going care needs must be met within existing resources Providers being more efficient and productive is important but these measure alone will not be enough to manage the scale of financial challenge We can do far more to look after patients at home and in the community Challenging workforce issues facing the Acute Hospitals 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 2015 Improving and sustaining quality with increasing demand and financial pressures 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 Self-care Fewer unplanned admissions 24 hr primary & community services Reduced hospital capacity Integrated care pathways Reduced variation Optimal use of assets 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

Health select committee The Challenge can only be achieved by fundamental changes in the way care is delivered …..and a wide process of service change on both a small and large scale. We are concerned that NHS organisations are according the highest priority to short term savings ….. at the expense of planning service changes which would allow them to meet their financial and quality objectives in later years. These changes should not be deferred: they must happen early to release the recurring savings that will be vital to meeting the Challenge 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

The Review will be governed by 5 key principles: Guiding Principles The Review will be governed by 5 key principles: Clinically led Rigorous Inclusive Open & transparent Managed & 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 & 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 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 (Section 242 of the NHS Act 2006) and prevailing guidance - including the Health Secretaries ‘Four Tests for Service Change’ Working together to ensure high quality, safe and sustainable health services in Worcestershire

Managed & 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 Draft Outline Business Case 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

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 and workforce 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 a We are working in partnership and are committed to involve and engage staff, patients and the public throughout.

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