1. East Anglia area team Staff development session Sheila Bremner East Anglia Area Director Adrian Marr Director of Finance

2. 2 Purpose of the session To provide an update on latest national policy and to consider what this means for our roles To provide an update on local development of the NHSCB East Anglia office To provide an opportunity to reflect on the past and look forward to the future To wish you a HAPPY CHRISTMAS! To provide an update on latest national policy and to consider what this means for our roles To provide an update on local development of the NHSCB East Anglia office To provide an opportunity to reflect on the past and look forward to the future To wish you a HAPPY CHRISTMAS!

3. What’s new 3 From Secretary of State for Health to NHSCB Outlines expectations of NHSCB for the next two years Underpinned by NHS Constitution Outcomes approach based around the five domains of the NHS Outcomes Framework Based on NHSCB supporting local autonomy of Clinical Commissioning Groups, Health and Wellbeing Board and local providers. From Secretary of State for Health to NHSCB Outlines expectations of NHSCB for the next two years Underpinned by NHS Constitution Outcomes approach based around the five domains of the NHS Outcomes Framework Based on NHSCB supporting local autonomy of Clinical Commissioning Groups, Health and Wellbeing Board and local providers.

4. How will we deliver 4

6. 6 Patient-centred, customer focused The planning guidance addresses two key challenges:  Guaranteeing no community is left behind or disadvantaged – focusing on reducing health inequalities and advancing equality in its drive to improve outcomes for patients; and  Treating patients respectfully as customers and putting their interests first – transforming the service offer of the NHS to take control and make more informed choices. The planning guidance addresses two key challenges:  Guaranteeing no community is left behind or disadvantaged – focusing on reducing health inequalities and advancing equality in its drive to improve outcomes for patients; and  Treating patients respectfully as customers and putting their interests first – transforming the service offer of the NHS to take control and make more informed choices.

7. Everyone Counts: 4 inter-related sections 7 Context  5 offers from Board  3 lenses to view planning & delivery Improving outcomes & quality  NHS Outcomes Framework  NHS Constitution  Financial Control  QIPP Tools & levers  NHS Standard Contract  Quality Premium  CQUIN  Financial / business rules Planning timetable  Who needs to do what by when  Supporting Area Director assurance of plans

8. 8 Five offers from the Board  NHS services, seven days a week  More transparency, more choice  Listening to patients and increasing their participation  Better data, informed commissioning, driving improved outcomes  Higher standards, safer care  NHS services, seven days a week  More transparency, more choice  Listening to patients and increasing their participation  Better data, informed commissioning, driving improved outcomes  Higher standards, safer care

9. 9 The three lenses There are three inter-related lenses through which planning can be viewed:  Local area based planning;  Clinical commissioning group organisational planning; and  Direct commissioning by the NHS Commissioning Board There are three inter-related lenses through which planning can be viewed:  Local area based planning;  Clinical commissioning group organisational planning; and  Direct commissioning by the NHS Commissioning Board

10. 10 A patient centred approach Area :  CCGs and the Board (through Area Teams) as key partners on the Health & Wellbeing Board  Board is well placed to provide information and support to determine local priorities based on local need  But we won’t performance manage the outcomes of these discussions nationally – we will be a strong player (with CCGs) Area :  CCGs and the Board (through Area Teams) as key partners on the Health & Wellbeing Board  Board is well placed to provide information and support to determine local priorities based on local need  But we won’t performance manage the outcomes of these discussions nationally – we will be a strong player (with CCGs) Viewed through three lenses: The CCG :  As well as local priorities, each CCG asked to deliver its statutory responsibilities around quality improvement (ie delivery of the NHS Outcomes Framework and NHS Constitution) within financial allocations  Assured by the Area Team  Clinically led and locally responsive The CCG :  As well as local priorities, each CCG asked to deliver its statutory responsibilities around quality improvement (ie delivery of the NHS Outcomes Framework and NHS Constitution) within financial allocations  Assured by the Area Team  Clinically led and locally responsive Direct Commissioning :  How the Board ensures the best return for patients from its £26 billion of commissioning  Primary and dental care, optical services  Specialised services  Some public health services  Offender health  Veterans’ health Direct Commissioning :  How the Board ensures the best return for patients from its £26 billion of commissioning  Primary and dental care, optical services  Specialised services  Some public health services  Offender health  Veterans’ health Key role for the Board’s Area Teams to secure the best outcomes for patients through each of the lenses

11. 11 Planning to meet responsibilities Each clinical commissioning group will need to satisfy itself that it is maintaining its statutory duties to improve quality of services by:  reducing inequalities;  obtaining appropriate professional advice;  ensuring public involvement;  meeting financial duties; and  taking account of the local Joint Health and Wellbeing Strategy. Each clinical commissioning group will need to satisfy itself that it is maintaining its statutory duties to improve quality of services by:  reducing inequalities;  obtaining appropriate professional advice;  ensuring public involvement;  meeting financial duties; and  taking account of the local Joint Health and Wellbeing Strategy.

12. 12 Improving outcomes, reducing inequalities: our responsibilities To support clinical commissioning groups and our own commissioning to improve outcomes. We have identified a number of outcome and delivery measures that commissioners can use. This approach is informed by the mandate that asks us to oversee improvements against:  NHS Outcomes Framework;  maintaining the right and pledges under the NHS constitution within allocated resources; and  with a view to meeting the QIPP challenge. To support clinical commissioning groups and our own commissioning to improve outcomes. We have identified a number of outcome and delivery measures that commissioners can use. This approach is informed by the mandate that asks us to oversee improvements against:  NHS Outcomes Framework;  maintaining the right and pledges under the NHS constitution within allocated resources; and  with a view to meeting the QIPP challenge.

13. Improving outcomes unites us as commissioners: 13 NHS Outcomes Framework

14. 14 Patients rights: the NHS Constitution  We expect the rights and pledges from the NHS Constitution 2013/14 (subject to current consultation) including the thresholds the NHS Commissioning Board will take when assessing organisational delivery.  The delivery of NHS Constitution rights and pledges on waiting times will be taken into account in determining Quality Premium payments for clinical commissioning groups.  We expect the rights and pledges from the NHS Constitution 2013/14 (subject to current consultation) including the thresholds the NHS Commissioning Board will take when assessing organisational delivery.  The delivery of NHS Constitution rights and pledges on waiting times will be taken into account in determining Quality Premium payments for clinical commissioning groups.

15. 15 Planning to improve outcomes Eliminating long waiting times – zero tolerance on 52+ week waits Urgent & emergency care – better turnaround times for ambulances Reducing cancellations – penalties in contract Mental health – completion of improving access to psychological therapies (IAPT) rollout Eliminating long waiting times – zero tolerance on 52+ week waits Urgent & emergency care – better turnaround times for ambulances Reducing cancellations – penalties in contract Mental health – completion of improving access to psychological therapies (IAPT) rollout

16. QIPP 16  Clinical commissioning groups must take ownership of local plans.  Cost improvements in providers must have explicit clinical agreement from the Trust’s Medical and Nursing Directors.  Area Directors must be active in overseeing clinical commissioning group agreement to cost improvements.  We must use all the tools available to us: National Quality Dashboard, NHS Safety Thermometer, staff and patient views – and act quickly where there is doubt. Quality and patients’ safety must not be compromised as we seek out efficiencies.  Clinical commissioning groups must take ownership of local plans.  Cost improvements in providers must have explicit clinical agreement from the Trust’s Medical and Nursing Directors.  Area Directors must be active in overseeing clinical commissioning group agreement to cost improvements.  We must use all the tools available to us: National Quality Dashboard, NHS Safety Thermometer, staff and patient views – and act quickly where there is doubt. Quality and patients’ safety must not be compromised as we seek out efficiencies.

17. 17 Tools and levers to support commissioning To secure better outcomes for patients we will provide a number of financial and related levers that commissioners can use in their overarching strategies:  the NHS Standard Contract;  Quality Premium;  Commissioning for quality and innovation (CQUIN); and  Financial and business rules. To secure better outcomes for patients we will provide a number of financial and related levers that commissioners can use in their overarching strategies:  the NHS Standard Contract;  Quality Premium;  Commissioning for quality and innovation (CQUIN); and  Financial and business rules.

18. 18 Planning and assurance We will support clinical commissioning groups to ensure that every plan is as strong as it can be. The approach aims to:  strike a balance between local determination and priorities; and  to ensure that statutory requirements around improving quality and financial duties are being met. No specific targets are being set for improvement of those indicators contained in the NHS Outcomes Framework, other than a defined level of reduction in Clostridium difficile infections. We will support clinical commissioning groups to ensure that every plan is as strong as it can be. The approach aims to:  strike a balance between local determination and priorities; and  to ensure that statutory requirements around improving quality and financial duties are being met. No specific targets are being set for improvement of those indicators contained in the NHS Outcomes Framework, other than a defined level of reduction in Clostridium difficile infections.

19. Next Steps 19  First cut of clinical commissioning group plans in January  Iterative discussion between clinical commissioning groups and Area Teams  Area Directors are the Board – to lead the planning process locally and provide definitive advice to clinical commissioning groups  Final plans by end of March 2013  CCGs to publish Prospectus for local population by end of May 2013  Annual assurance cycle  First cut of clinical commissioning group plans in January  Iterative discussion between clinical commissioning groups and Area Teams  Area Directors are the Board – to lead the planning process locally and provide definitive advice to clinical commissioning groups  Final plans by end of March 2013  CCGs to publish Prospectus for local population by end of May 2013  Annual assurance cycle

20. QUESTIONS? 20

21. Local update

22. What’s new – all leadership appointments in place 22 Sheila Bremner – Local Area Director Margaret Berry – Director of Nursing Tracy Dowling – Director of Operations and Delivery Sallie Mills Lewis – Director of Commissioning Adrian Marr – Director of Finance Susan Stewart – Medical Director Sarah Jane Relf – Interim Director of Transition and Development Sheila Bremner – Local Area Director Margaret Berry – Director of Nursing Tracy Dowling – Director of Operations and Delivery Sallie Mills Lewis – Director of Commissioning Adrian Marr – Director of Finance Susan Stewart – Medical Director Sarah Jane Relf – Interim Director of Transition and Development

23. Recruitment update 23 Structures finalised – 144 posts in total First stages of restricted recruitment completed by 21 December 80+ offers made Appointments letters to be issued as soon as possible Moving to open recruitment after Christmas for any unfilled posts – preference will still be given to those at risk within the system Support programmes for staff that have not secured positions at this stage Structures finalised – 144 posts in total First stages of restricted recruitment completed by 21 December 80+ offers made Appointments letters to be issued as soon as possible Moving to open recruitment after Christmas for any unfilled posts – preference will still be given to those at risk within the system Support programmes for staff that have not secured positions at this stage

24. Key appointments – some highlights 24 Medical Assistant Director of Revalidation – Sarah Rann and Mark Sanderson Network and Senate Director – Ruth Ashmore Nursing Assistant Director Quality & Safety – Birte Harlev-Lam Assistant Director Patient Experience – Mavis Spencer Finance Head of Finance – Ann Hogarth Assistant Head of Finance Corporate – Mike Pym Assistant Head of Finance CCG Assurance – Rachel Pilsworth Head of Finance (Specialised) – Justine Stalker Booth Medical Assistant Director of Revalidation – Sarah Rann and Mark Sanderson Network and Senate Director – Ruth Ashmore Nursing Assistant Director Quality & Safety – Birte Harlev-Lam Assistant Director Patient Experience – Mavis Spencer Finance Head of Finance – Ann Hogarth Assistant Head of Finance Corporate – Mike Pym Assistant Head of Finance CCG Assurance – Rachel Pilsworth Head of Finance (Specialised) – Justine Stalker Booth

25. Key appointments – some highlights 25 Operations and Delivery Head of Assurance and Delivery – David Matthews Commissioning Head of Primary Care – Andrea Patman Head of Public Health – Tracy Cogan Head of Offender Health – Rob Jayne Head of Specialised Commissioning – Carole Theobald Operations and Delivery Head of Assurance and Delivery – David Matthews Commissioning Head of Primary Care – Andrea Patman Head of Public Health – Tracy Cogan Head of Offender Health – Rob Jayne Head of Specialised Commissioning – Carole Theobald

26. Estates and IT update 26 Main base at CPC1 at Fulbourn Satellite hot desk “outposts” – ten desks in the following locations: Suffolk – Rushbrook House Norfolk – Lakeside Essex – Collingwood Road, Witham Development session in January to design the “guidelines” for use of the outposts. IT “vision” for the NHSCB is for all staff to have up to date IT hardware that enables you work from home and to set up base in any NHSCB premises. Main base at CPC1 at Fulbourn Satellite hot desk “outposts” – ten desks in the following locations: Suffolk – Rushbrook House Norfolk – Lakeside Essex – Collingwood Road, Witham Development session in January to design the “guidelines” for use of the outposts. IT “vision” for the NHSCB is for all staff to have up to date IT hardware that enables you work from home and to set up base in any NHSCB premises.

27. CCG authorisation update 27 All site visits completed – nationally and locally Great Yarmouth and Waveney CCG authorised with no conditions All site visits completed – nationally and locally Great Yarmouth and Waveney CCG authorised with no conditions

28. Moving forward 28 Recruitment processes to continue after Christmas New Year planning session for Directors and Assistant Directors to map the transition of functions and staff to the NHSCB Finalising the office infrastructure Team “away days” for each new function Induction sessions for staff Recruitment processes to continue after Christmas New Year planning session for Directors and Assistant Directors to map the transition of functions and staff to the NHSCB Finalising the office infrastructure Team “away days” for each new function Induction sessions for staff

29. QUESTIONS? 29

30. CELEBRATING THE PAST AND MOVING FORWARD TO THE FUTURE What are you most proud of in your current role? What would you like to take forward to the new world? What would you like to leave behind? 30

31. sarahjane.relf@nhs.net 31

32. 32 HAPPY CHRISTMAS