1. 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

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

17. 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

18. 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

19. 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

20. 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

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