1. Strategic Review Update
Calderdale and Greater Huddersfield Integrated Health and Social Care Strategic Review
Strategic Review Update
March 2014
Status : Issued Version: v2 Date: 5th March, 2014

2. Agenda
Background to the Strategic Review
What our engagement to date has told us
Our vision for our future system
Commissioners’ responsibilities
The providers’ Strategic Outline Case
High level timetable and next steps

3. Background and Context
Seven partner organisations
2 years - shared vision - innovate and transform services.
Transformation is needed to address the significant challenges facing the health and social care system now and in the years ahead.
Ageing population with increasing needs
Increase of long-term health / social care needs
High quality, sustainable healthcare
Responding to the needs expressed by patients
Limited and diminishing resources.

4. Background and Context
Key overarching aims taken from the priorities in both JSNAs
All partners share the vision to change the way health and social care is provided to enable:
Easy access to the right information and guidance for people to make informed choices for themselves and their families
People only have to tell their story once and are supported to make positive choices
As much care as possible is provided close to home to keep people safe, well and as healthy as possible for as long as possible
Every child has a healthy start with opportunities to achieve their full potential
High quality, safe and effective specialist care is available when needed
Different agencies make best use of shared resources

5. Engagement activity to date
More than 2,500 people directly engaged
300 young people
44 people at planned care event
1,700 people unplanned care survey
500 staff
All national and local surveys, PALS, complaints, patient opinion and NHS choices information from the past 3 years collated.
Unplanned care engagement – 2,500 views
Call to Action – 280 public views

6. What you told us you want
Timely and consistent access to services
Co-ordinated and integrated care
Services closer to home
Involve us in decisions about our care and in planning care
Better use of technology

7. Call to Action – 13 Themes
Education and information – all information should be available in easy to understand formats
Invest in community and primary care as well as local community and voluntary groups
National solutions and campaigns are needed for changes on a national scale
Self Care – or self help/self management
Improve access to health services. Opening times and appointment availability, particularly GP practices
Staff training including changing the culture of the NHS, communication and transparency.
Working together, all agencies, not just health, should work together to improve health and wellbeing

8. Call to Action – 13 Themes
Regular check-ups including annual check ups or possibly more frequent depending on the age / condition
Discharge planning and better hospitals including discharge plans with 24/7 support and hospital services in community settings.
Manage risk and safeguarding – keeping people safe when they were unwell.
More services in the community
Invest in technology – especially for monitoring and sharing information between services and patients.
Be accountable – clear measures, learn from mistakes, educate people on their rights and responsibilities and base contracting decisions on research and guidance.

9. Our Future Care System Total Care Safety Net Safety Net Specialist
Locality
Safety Net
Safety Net
Money
Control
Safety Net

10. Why are we here / Why Now? Time to start talking
National Clinical Advisory Team report from last summer
Parliamentary interest in September 2013 and adjournment debate in December 2013.
Media interest over the last three months
Time to start talking

11. The Strategic Outline Case
The Strategic Outline Case is a provider response to the Strategic Review

12. Commissioners’ Responsibilities
We need to make YOU feel part of designing the future
Engage the population
Statutory duty to lead the consultation
Make the final decision about services for our population.

13. Key points
No decision has been taken about which hospital would be the planned care site and which the unplanned site
Whatever happens, there will be some level of unplanned care provision at each hospital
We are about to undergo a mutually agreed thorough pre-consultation engagement process to identify options for consultation
Recent media coverage has not, in many instances, reflected the true position

14. Key points
The strategic review is about much more than the configuration of acute (including A&E) services
It is about the transformation of virtually all health and social care
We want to talk about this wider transformation with patients, public and staff - not just the scenarios identified by providers
Only then will firm proposals for consultation be identified

15. Scope of the Strategic Outline Case
Jointly developed by CHFT, Locala, & SWYPFT
Intention to work with general practice, YAS, social care and voluntary organisations to deliver integrated care in a community setting.
Some (currently) hospital based services would move to Community
Acute and emergency services provided on 1 specialist hospital site
Planned services on 1 specialist planned care hospital site.
The changes proposed will require public consultation.
The proposals must demonstrate that the four Department of Health tests for major service reconfiguration have been met.
(PPE, choice, evidence, CCG backing)

16. Scenarios for discussion with staff, key stakeholders, public, patients, carers and their representatives
Scenarios
Description 1.
Continue with the existing hospital and community service model and configuration. 2.
Implement the community and hospital service model proposed in this presentation with Huddersfield Royal Infirmary as the site for acute and emergency care and Calderdale Royal Hospital as the site for planned hospital care. 3.
Implement the community and hospital service model proposed in this presentation with Calderdale Royal Hospital as the site for acute and emergency care and Huddersfield Royal Infirmary as the site for planned hospital care. 4.
Continue with the existing community service model and change emergency hospital care provided locally so that those people needing specialist treatments are transferred to a major emergency centre outside the local area. Huddersfield Royal Infirmary and Calderdale Royal Hospital would offer ‘see and initiate treatment’ services with people needing specialist treatments transferred to specialist centres. 5.
Other scenarios which may emerge from the planned engagement activity with staff, public, patients, carers and their representatives.

17. Commissioners’ Questions – 1 of 2
Finance Estate requirements, affordability &
confidence to achieve savings
Clinical Stds What are they? Risks to current &
clinical evidence base
Location Support from YAS, journey times, parking, gritting & community offer
Primary Care Resource, activity shift, engagement
Staff Commitment, & impact on workforce.
Phasing Community before acute services

18. Commissioners’ Questions – 2 of 2
Design Impact of ‘no change’ & other options Fit with Mid Yorks,
Skills in ambulance & local paramedic cover
Coms/Eng Public, patients, carers, staff – done/planned
Eq & Diversity Protected Characteristics, Equality of Access
Procurement Satisfy fair contract route / lawful

19. High Level timetable What By When Providers develop OBC May
Preparation and planning for engagement
March
Pre-engagement
June
Analysis and report
Preparation and planning for consultation
 June
Consultation (13 Weeks)
Post consultation feedback (6 Weeks)
Potential Sec of State Review (3months)
Summer 2014

20. Next Steps - Engagement already in place
Local Councillors and MPs
Overview and Scrutiny Committees and Health and Well Being Boards
A dedicated website
A Reference Group – 90 organisations
PALS and complaints services
Healthwatch
Staff and member practices
Existing consumer websites

21. Next Steps – Engagement what we need to do
Drop in sessions x 9
Road show activity – 10 central locations
Comments cards & boxes for anonymity
Media & communications – posters, contact points, social media feeds, media releases
Existing networks

22. Question Time