1. Service Development Plan Rosemary Williams Director of Practice Engagement & Service Development 1 st May 2013

2. OUTLINE  CCG brief up-date  Context of the plan  Key projects within the plan  Opportunities for partnership working 1 1

3. SWCCG – UP-DATE  Authorised without conditions  Fully staffed  Moved to Coach House, Perdiswell 2 2

4. RATIONALE FOR THE SERVICE DEVELOPMENT PLAN  SWCCG responsibility to ensure that the population of South Worcestershire enjoy lives that are as health as possible  Annual budget of £307m for 2013/14 to commission services  Commission in the context of our 5 year strategy 3 3

5. Non negotiables against which every plan must outline their contribution: No never events 4 hour standard for A&E is achieved No >12 hr post admission decision trolley waits No MRSA cases and Cdif is below the LHE target LHE only needs to escalate to EMS L4 in response to major incidents, not just because of normal demand People will be supported to return to their “old normal” or their “new normal as soon as clinically safe 5 year strategy : underpinning principles, delivery plans, non negotiables and target end state South Worcestershire Clinical Commissioning Group Five year strategy and Everyone Counts –”On a Page” Everyone Counts : Priorities and trajectories for the first year Dementia: To achieve diagnosis rates - 2013/14 : 47.1% (1,976 / 4,195), 2014/15 : 50.1% (2,184/4,282) IAPT: Achieve the proportion accessing Psychological Therapies - 2013/14 : 5.0% (2,450 / 49,190). Please note that this is a Worcestershire wide figure. Emergency Admissions in Children U15: To return to emergency admission rates seen in 2011/12 (72.29). This requires a 12.6% reduction from the 82.76 per 1000 rate expected in 12/13. Emergency Admissions in People >75: To achieve an 5.1% reduction in emergency admissions, resulting in 13/14 target at 258.3 per 1,000, compared to the 278.7 per 1000 rate expected in 12/13. End of Life Care: Increase the % of people who are enabled to die in their preferred place of care, reducing hospital deaths from 39% to 36.3% over the year, an annual average of 37.2% (1887/5068) Our Plans Finance and QIPP Activity Trajectories Self Certification We certify that our plans ensure that the performance standards in the NHS Constitution will be delivered throughout 2013/14. We certify that our plans ensure that the performance commitments in the Mandate will be delivered throughout 2013/14 We are not yet able to certify that we have assured provider CIPs are deliverable without impacting on the quality and safety of patient care, but we have a plan to do so. We plan to manage HCAIs so that our local population have a maximum number of C.Difficile infections as set by our local CDI objective. Fewer serious incidents and no never events Fewer healthcare acquired infections Improved patient experience of care More people who die in their chosen place of care Our plan for Everyone Counts is an integral part of our five year strategic framework which will be published in April 2013. The framework will bring together our key delivery plans across the following areas and is not designed to cover everything we do, only the areas we want to make transformational change in. Everyone Counts is very much part of this delivery plan. STRATEGIC AIM: Improved quality and patient safety STRATEGIC AIM: Reduced health inequalities STRATEGIC AIM: More Independence STRATEGIC AIM: Better and faster access to urgent care More people helped to live independently, when they can safely manage their own health needs People helped to return to their previous “normal”, or where that is not possible their “new normal”, more quickly after an episode of illness or injury Fewer urgent care admissions Faster access to the best emergency healthcare option Shorter lengths of stay Improved healthy life expectancy for all Narrower gaps between the best and worst health outcomes Quality and patient safety strategy Urgent Care Strategy Integrated Care Strategy Primary Care Strategy Medicines Strategy Joint Commissioning Strategy Domain 1 Preventing people dying prematurely Domain 2 Enhancing quality of life for people with long term conditionsDomain 3 Helping people to recover from episodes of ill health or injuryDomain 4 Ensuring people have a positive experience of careDomain 5 Treating and caring in a safe environment and protecting from harm                                   Finance : CCG Financial plan delivers: 1% Surplus (£3m), 2% Transformation Reserve, 1% Operational and 1% Insurance Risk Reserve, 1.4% Demography fund to support redesign. QIPP: We have identified schemes to deliver an £8.0m QIPP programme. This contains existing schemes rolled forward (£3.3m) and new schemes developed for 2013/14 (£4.6m). Further schemes to create headroom being developed are not shown here. Strategic Themes to be demonstrated in every plan Quality, safety and clinical effectiveness comes first Prevention is better than cure Care is coordinated across the health and social care economy Independence is promoted and health is made personal for each individual Maximum value is gained from every health pound spent NHS Outcome Framework   1.2% reduction in Elective FFCE’s will be achieved through QIPP schemes in orthopaedics and outpatient follow ups. 8.4% reduction in non-elective FFCEs will be achieved through annualising the winter schemes of 2013/14 which have shown substantial impact to date. 5.5% reduction in outpatients will be delivered through our “Clustering” approach to demand mgmt. 2.3% reduction in A&E att’s will be achieved by rolling out improved primary care access schemes.

6. IT’S ALL ABOUT PRIORITIES!  Most services will be re-commissioned, based on previous year’s activity  Service Development Plan is mechanism for achieving change - driven by opportunities to commission better / different services  We have a £8m Quality, Innovation, Productivity & Prevention (QIPP)saving to achieve during 2013/14  Any investment has to be generated through making savings elsewhere in the system  So, in this climate, how did we derive our priorities? 5 5

7. SERVICE DEVELOPMENT DRIVERS  National Guidance  CCG Initiatives  Practice and Community Membership  Working with Partners 6 6

9. PROJECT HIGHLIGHTS – NATIONAL GUIDANCE  Emergency admissions for children < 15  Emergency admissions for people >75  End of life  Dementia diagnosis  Improving access to psychological therapies 8 8

10. PROJECT HIGHLIGHTS – CCG INITIATIVES  Improving patient flow  Implementation of integrated neighbourhood teams  Risk stratification  Care Home support services 9 9

11. PROJECT HIGHLIGHTS – PRACTICE AND COMMUNITY MEMBERSHIP  Strengthening healthy communities  Locality projects  Clinical improvement proposals from internal & external stakeholders 10

12. PROJECT HIGHLIGHTS – WORKING WITH PARTNERS  Integrated care programme  Assistive technology  Mental health liaison service 11

13. KEY MESSAGES  Service development plan is the schedule of projects to achieve change  It must work within existing resources  It is flexible and evolving  There is a mechanism to put forward project proposals 12