1. March 2019 Realising the potential of a single Commissioning Group:
Working together:
NHS Eastern Cheshire Clinical Commissioning Group
NHS South Cheshire Clinical Commissioning Group
NHS Vale Royal Clinical Commissioning Group
NHS West Cheshire Clinical Commissioning Group
Realising the potential of a single Commissioning Group:
How can the voluntary sector make an impact?
March 2019

2. Agenda for today Our Working Together across Cheshire (WTaC) programme
Update on transformation of Cheshire CCGs
Cheshire West Integrated Care Partnership
How the Voluntary Sector can help us deliver our plans – what are the opportunities?
Working together across Cheshire:
NHS Eastern Cheshire Clinical Commissioning Group (CCG), NHS South Cheshire CCG, NHS Vale Royal CCG and NHS West Cheshire CCG

3. Working Together Across Cheshire
Is a programme of work to:
Develop a (potentially) merged Cheshire CCG
Support the development of 2 Place based Integrated Care Partnerships (ICPs)
Bring about greater integration and collaboration resulting in maximum efficiency in commissioning and service delivery
Working together across Cheshire:
NHS Eastern Cheshire Clinical Commissioning Group (CCG), NHS South Cheshire CCG, NHS Vale Royal CCG and NHS West Cheshire CCG

4. Cheshire Working together across Cheshire:
NHS Eastern Cheshire Clinical Commissioning Group (CCG), NHS South Cheshire CCG, NHS Vale Royal CCG and NHS West Cheshire CCG

5. ‘Place’ in Cheshire 1) Cheshire West Place 2) Cheshire East Place
NHS West Cheshire CCG
NHS South Cheshire CCG
NHS Vale Royal CCG
NHS Eastern Cheshire CCG
Cheshire West and Chester Council
Cheshire East Council
1) Cheshire West Place
2) Cheshire East Place
Proposed Cheshire CCG
Cheshire West and Chester Council
Cheshire East Council
Cheshire West Integrated Care Partnership
Cheshire East Integrated Care Partnership

6. Why are we coming together?
We want to work together to improve outcomes for the population and reduce the risk of a ‘postcode lottery’ across Cheshire
We want to improve the quality of care that the people of Cheshire have every right to experience – currently we’re not meeting all of the NHS Constitutional standards
We are continuing to see growing levels of demand for services as the population ages and complexity increases
People tell us that they continue to experience care that is fragmented and disjointed
Available funding does not meet the growing demand for health and care services
We are working closely with our Local Authority commissioning partners and providers to develop two ‘Integrated Care Partnerships’ (West and East) to improve the integration of health and social care
Working together across Cheshire:
NHS Eastern Cheshire Clinical Commissioning Group (CCG), NHS South Cheshire CCG, NHS Vale Royal CCG and NHS West Cheshire CCG

7. Benefits of a single Cheshire CCG
- More powerful national and regional voice
- Commissioning at scale
- Efficiencies so that staff can align with ICP
- Standardise and improve care offer
Vale Royal
102,500 population
12 practices
East Cheshire
201,000 population
23 practices
South Cheshire
173,000 population
18 practices
West Cheshire
257,408 population
36 practices
Working together across Cheshire:
NHS Eastern Cheshire Clinical Commissioning Group (CCG), NHS South Cheshire CCG, NHS Vale Royal CCG and NHS West Cheshire CCG

8. Benefits of doing this
A more powerful voice for Cheshire in championing the needs of local people at regional and national level – advocate for the 750,000 residents
Ability to plan in a more “joined up” manner especially in relation to Cheshire as a whole and with respect to the flows of patients
Standardise, as far as possible, pathways and approaches to care to improve outcomes for everybody
Release clinical and managerial capacity to support the development of Integrated Care Partnerships
Better use of CCG workforce - improving efficiency and sharing of best practice, reducing duplication
Maximise opportunities for commissioning at scale across Cheshire, with the 2 local authorities and across Cheshire & Merseyside
Working together across Cheshire:
NHS Eastern Cheshire Clinical Commissioning Group (CCG), NHS South Cheshire CCG, NHS Vale Royal CCG and NHS West Cheshire CCG

9. The Route to Potential CCG Merger
Oct 2016
Initial Discussions
2017
Cheshire Joint Commissioning Committee Formed
2018
Agreement to consider merger of CCG teams/formal merger
Appointment of Single Accountable Officer for 4 x Cheshire CCGs
2019
Appointment of Single Executive Team for 4 x Cheshire CCGs
CCG Functions to align with ICPs so that resources, decision making ability and responsibility for delivery transfers
Memberships to be assured on:
- Clinical representation
- Financial aspects
- Existing services
July – Sept 2019
CCG Memberships to agree / not to CCG merger application
April 2020
Single Cheshire CCG could be formed
All has / will only take place with CCG membership and Governing Body approval
Working together across Cheshire:
NHS Eastern Cheshire Clinical Commissioning Group (CCG), NHS South Cheshire CCG, NHS Vale Royal CCG and NHS West Cheshire CCG

10. Strategic Clinical Commissioning Group
Develops in parallel to two ICPs: Cheshire East & Cheshire West
Development of two integrated health and social care commissioning boards on local authority footprints
Supports place-based approach to integrated care in Cheshire
Maximises opportunities to commission at scale
Common outcomes framework for integrated care
Optimises resources & reduces variation
Improved outcomes for population and provides opportunity for greater involvement
Working together across Cheshire:
NHS Eastern Cheshire Clinical Commissioning Group (CCG), NHS South Cheshire CCG, NHS Vale Royal CCG and NHS West Cheshire CCG

11. Integrated Care Partnerships
Shared cross-system ambition to join up health and social care
Place-based approach i.e. two Integrated Care Partnerships co-terminous with the Local Authority footprints
Partnership of health and care organisations to improve the outcomes for the population
Collective accountability for improving outcomes within available funding over a longer term
Focus on integration; single assessment process, single personalised care record, multidisciplinary teams wrapped around the person at the centre
Development of 17 ‘care communities’ providing primary and community care
Able to co-ordinate care for individuals along whole pathway of care
Proactive case management focused on using data to target effective care earlier
Integrated IT solutions that are accessible to patients
Increased involvement of patients and users in service design and delivery
Aim to join up hospital and primary care, health and social care, voluntary sector, mental and physical health and the NHS and local communities.
Working together will create the best environment to achieve this
Working together across Cheshire:
NHS Eastern Cheshire Clinical Commissioning Group (CCG), NHS South Cheshire CCG, NHS Vale Royal CCG and NHS West Cheshire CCG

12. The Journey
Timeline to April 2020 – ambition agreed by all 4 Cheshire CCGs
Appointment to a single Executive Team by April 2019
Stakeholder engagement commencing May 19th 2019
Strengthening collective and collaborative commissioning arrangements
ICP’s development & governance - overseen by Cheshire West (ICP) Partnership Board & Executive
Map CCG functions and services – some likely to form part of a strategic commissioner, others ICPs
Phased transfer of some CCG functions & associated resources to ICPs – starting March 2019
Working together across Cheshire:
NHS Eastern Cheshire Clinical Commissioning Group (CCG), NHS South Cheshire CCG, NHS Vale Royal CCG and NHS West Cheshire CCG

13. Voluntary Sector Context
No longer possible to view the public sector simply as a ‘provider’ of public services
Needs of the population in the 21st century, along with the most challenging of economic circumstances mean that we need to fundamentally reshape this paradigm
Move towards a position of shared power, collaborative leadership, robust engagement and co-production
Recognises the significance of the VCFSE as central to this shift, and as an equal partner in meeting the challenges our populations face
Proposal to develop a ‘Compact’ to underpin a new and progressive relationship with the VCSFE
Use the term ‘Compact’ illustratively - historically ‘Compacts’ have often been viewed as passive agreements between the commissioner and the VCFSE
Going forward we develop new language which is reflective of the fact that we have ambitions that extend beyond the traditional
Working together across Cheshire:
NHS Eastern Cheshire Clinical Commissioning Group (CCG), NHS South Cheshire CCG, NHS Vale Royal CCG and NHS West Cheshire CCG

14. Voluntary Sector Opportunities
Work with us to utilise your vast expertise in effective involvement of service users to improve service delivery
Key delivery partner
Provide feed back from service users on what is/isn’t working well
Consultation (with Healthwatch) on development of Place based 5 year plan
Robust and consistent approach to public engagement
Use your ability to be flexible and adapt to changing need quickly
Share best practice and innovation
Potential role in personal health budgets; tailoring offer to individual
Active partner in the care communities – what is your relationship with the Integrated Care Partnership?
Joint commissioning between CCGs and Local Authority – single approach budget
19/21 commissioning and contracting via Cheshire West ICP?
Working together across Cheshire:
NHS Eastern Cheshire Clinical Commissioning Group (CCG), NHS South Cheshire CCG, NHS Vale Royal CCG and NHS West Cheshire CCG

15. Voluntary Sector Challenges
How are you working across Cheshire and across Cheshire & Mersey?
Review number of separate organisations – align more closely?
Reduce competition amongst yourselves?
Key strategic partner - Do you have the right relationships? Right offer?
Fit for purpose? Fit for business?
Are you getting the best from Chester Voluntary Action? What is your partnership agreement?
Working together across Cheshire:
NHS Eastern Cheshire Clinical Commissioning Group (CCG), NHS South Cheshire CCG, NHS Vale Royal CCG and NHS West Cheshire CCG

16. Summary Are you up for it? Update on proposed CCG changes
Update on Cheshire West ICP
Opportunities for the Voluntary Sector
Challenges for the Voluntary Sector
Are you up for it?
Working together across Cheshire:
NHS Eastern Cheshire Clinical Commissioning Group (CCG), NHS South Cheshire CCG, NHS Vale Royal CCG and NHS West Cheshire CCG