1. Monday 17 September (Materials presented to the Mayoral Team on 28 August 2012)

2. Intended outcomes of today’s session: Provide an overview of the Healthier Together work programme to members of the Salford Mayoral Team

3. The Task To develop a clinically and professionally-led strategy that puts forward options for new ways of providing health care services in Greater Manchester in a number of priority areas

4. The Legacy Lack of a cohesive GM wide strategy for the development of services Significant variation in services and outcomes across Greater Manchester Changing demography Stroke, Making it Better & Healthy Futures

5. Improve the health and wellbeing of people in Greater Manchester - safe services based on best practice, clinical standards and better specialist care in our hospitals Reduce inequalities of access to high quality care - improved, timely access to appropriate staff, facilities and equipment across the whole of Greater Manchester Improve people’s experience of healthcare service - integrated care provided in the most appropriate setting to provide better outcomes and experience for patients Make better use of healthcare resources - care provided by sustainable organisations that allow best possible use of the total resource available to the health and social care system in Greater Manchester Healthier Together Outcomes

6. Public Health Local Authority Healthier Together Partnership Voluntary Sector

8. Why change is needed

9. Our vision....... ‘For Greater Manchester to provide the best health and care in the country’

10. Why now? - Demand is rising

11. Changing needs 29% of the population have Long Term Conditions. They use 50% of all GP appointments and 70% of all in-patient hospital bed days

12. Need to make best use of resources?

13. Challenge to improve quality & outcomes against a context of significant financial challenge Need whole system change to do things differently to improve quality and improve outcomes

14. Some good progress Greater Manchester-wide centralisation of services seen massive improvements in outcomes Centralisation of stroke services across GM has resulted in 250 lives saved. However further improvements needed as inequities still evident and further centralisation and improvements to the whole pathway of care will save more lives and reduce disability. Opportunities to proactively plan impact of changes on NHS and social care services

15. 550 lives a year in Greater Manchester (& Cheshire) could be saved if the UK meets the European average survival rates – about 1 per practice - late presentation a key factor Emergency general surgery is carried out in 10 acute hospitals in Greater Manchester, but not always with consultant staff present and not always with routine admission to a critical care bed after surgery, even for high risk cases - leads to inconsistent quality of care and poorer patient outcomes The number of emergency medical readmissions within two days of discharge has gradually increased over the last two years But more change is needed Variation in practice & outcomes

16. The rate of Greater Manchester residents with diabetes receiving all 9 care processes known to improve outcomes varies from 20% - 70% Most District Acute Stroke centres failing to deliver key performance indicators Patients admitted to cardiology wards have a 20% lower mortality rates compared to those admitted to general wards

17. Current Progress Ongoing communication and engagement with key partners to co- design the framework and amend the proposed programme activities Development of 8 Cases for Change including detailed data analysis and intelligence Appointment of leadership team for each workstream: -CCG Chair -Clinical Champion -Local Authority Director -Public Health Director -NHS Associate Director

18. Anticipated Timeline  Spring – Summer 2012 – case for change development  Summer-Autumn 2012 – public engagement on principles for change  Autumn 2012 – Spring 2013 - development of model of care, options for service configuration & ongoing engagement  Spring 2013 – readiness for public consultation

19. Public Information & Discussion Period of public discussion scheduled from August 2012 Discussion period is prior to development of options for formal consultation post April 2013 Aim to fit with local engagement mechanisms & activity, eg Health & Wellbeing, CCG authorisation External Reference Group being established

20. Stakeholder briefing

21. A conversation about.... Why change is needed Our commitment to our GM residents What does best care look like? Creating a shared vision We can’t achieve this without you We all need to take responsibility to create better services Everyone needs to take an active contribution to health What changes may be needed to achieve the best?

22. An opportunity for discussion and questions …. Thank You