1. Our population is growing and most of us are living longer
We often develop long term conditions that need on-going medical care like diabetes or a heart condition; more care and expertise is needed to treat these types of conditions so we can stay as well as possible
We need to be better at preventing poor health in the first place and encouraging people to take responsibility for staying well and making healthy life choices
We need to improve standards of care, using the latest technology and improvements in medicines to help us
It is better, where possible, to treat people as close to their home as possible and only see people staying in hospital when it is absolutely necessary
The way we currently deliver health and social care is unaffordable in the long term given the rising demand for services

2. Due to the size of the challenge, health and social care bodies in Herefordshire and Worcestershire (and across the country) are working together to help make sure the NHS is safe and sustainable for the future. This is called the Sustainability and Transformation Plan (STP) but it is really about implementing the NHS Five Year Forward View, published by NHS England Chief Executive Simon Stevens. The Herefordshire and Worcestershire STP is currently a draft outline plan, submitted to NHS England in June Following review by NHS England, a full plan will be submitted. Proposals based on STP priorities will be developed with the public over the course of the year.

3. Herefordshire and Worcestershire STP
Big geography, small population
785,000 people (smallest in WM)
2 HWBs
Relatively simple footprint
Worcestershire County Council
Redditch and Bromsgrove CCG
South Worcestershire CCG
Wyre Forest CCG
Worcestershire Acute Hospitals NHS Trust
Worcestershire Health and Care NHS Trust
4 Primary Care Collaborations
Birmingham
Shropshire
Dudley
Wales
Warwickshire
Gloucestershire
Herefordshire Council
Herefordshire CCG
Wye Valley NHS Trust
2gether NHS Foundation Trust
Taurus GP Federation

4. Finance and Efficiency
The Triple Aim
Explore the opportunities and benefits of planning at scale to:
Improve health outcomes across our whole population, including addressing health inequalities.
Improve Care and Quality by:
Addressing areas where there is unwarranted variation
Ensuring access to the safest care possible
Improving experience of care
Securing performance improvements from providers in the delivery of care
Deliver Financial Sustainability:
Better value in how resources are utilised and deployed
Optimise performance across the whole system
Health and
Well Being
Care and Quality
Finance and Efficiency

5. Across Herefordshire and Worcestershire, health and care organisations are committed to always providing safe and effective services, but the way some services are run may need to change. This is because we have a growing population and rising demands on services, and we have to make sure we can do the best we can with the resources available. 
This means: 
Reducing duplication and make services easier to navigate and access,
All of us doing more to support healthy living, or to self-care and manage aspects of our conditions, 
Providing more care at home or closer to home, reducing avoidable hospital admissions
Potentially travelling further for more specialist services so we can ensure they are safely and appropriately staffed with the right level of expertise.  

6. Wherever we can we want to put the voice of patients, service users, families/carers and our communities at the heart of any changes. While there may be constraints on what is possible, we will always try to ensure proposals reflect what people tell us is most important. To support this work we are developing the #YourConversation initiative, which will develop discussion points and encourage feedback from the wider community on some of the high level principles initially, and then more specific engagement and consultation as things develop.