1. Integrated Care Market Engagement Event Vale of York Clinical Commissioning Group Monday 2 nd February 2015 09.30 – 12 noon

2. Agenda Agenda ItemLeadTimings Purpose and format of todayFiona Bell09.30 - 09.40 Background/VisionAndrew Phillips09.40 - 10.00 Q&AAll10.00 - 10.15 Initial ScopeFiona Bell10.15 - 10.30 Breakout SessionsFiona Bell10.30 - 11.30 FeedbackAll11.30 - 11.50 Next steps and closeAndrew Phillips11.50 - 12.00 Networking Opportunity-12.00 - 12.30

3. To commence a process of community services co-production To identify and engage with potential providers of community services To share our vision for whole system change and the future commissioning of community services To stimulate the market to think differently regarding community services provision To utilise providers feedback to shape and refine our high level plans To understand any concerns/queries market providers may have To identify opportunities for integration and capture innovative practice To understand system change timelines Purpose and Format of Today Commissioners will strategically lead the collaborative co- production of a new and innovative community service model

4. Background and Vision

5. Why Change? Local Context Opportunities for joint commissioning under BCF National pilot for New Models of Care Opportunity for system integration Opportunity to increase access to community services Opportunity to commission for outcomes Opportunity to minimise duplication Opportunity to address commissioning gaps Opportunity to eliminate boundary issues National Context NHS 5 Year Forward View Integration Agenda Better Care Funding Patient centred services Efficiency / Economies Pooled Budgets

6. The Opportunity This programme allows the opportunity to: Optimise resources with Local Authorities Reduce duplication and address gaps in service provision Fund social care services with a health benefit Explore innovative new models of provision, commissioning and contracting Consistent with direction set out in the NHS 5 year forward view

7. Our System Wide Vision Transformational system wide change NOW Large acute based provision Multiple contracts for community services 2016 + Patient centred Community Hubs Aspiration Optimising provision of services in the community Under developed Voluntary sector Social care system is separate Collaborative Commissioning across the system Commissioning for outcomes

8. Community Hubs Single Contact Point WHAT A range of health and care professionals working together to meet all of the health and care needs of the population Actively liaising with professionals where onward referral for specialist support is needed. Accountable for outcomes and funding across all settings in and outside of the ‘Hub ’ HOW Doctors (family health and medical), Nurses, Social Care, AHPs and Pharmacists Working from health and care facilities integral to the Hub Linking into support services e.g. voluntary and third sector, community groups etc.

9. Emerging Themes Integrated community system Single vision, aligned delivery plans and allocation of resources Shared leadership – commissioners / providers Risk sharing and Incentives that promote outcome delivery and collaboration Sharing of patient level information for risk stratification and care management Use of combined records and assessments across health and social care Single point of access to services Opportunity to use staff and resources differently Care co-ordination Community as the default setting of care

10. Long-term Outcomes Our aspiration is to ensure people can live independently for as long as possible We will ensure this by commissioning providers to deliver co-produced outcomes for our population For Example More people in good health and living independently More people living with complex conditions and frailty, in their own homes Optimising the number of people able to live in their home

11. Questions?

12. Initial Scope

13. Current Contract Community Services Services within the current contract District Nursing Community Hospitals Fast Response Community Rehab (PT/OT) Specialist Nursing o Cardiac Rehab o Respiratory o Heart Failure o Tissue Viability o Continence o Diabetes o MND Community Matrons Case Managers Intermediate Care Minor Injury Units / Walk-In Units Palliative Care Paediatric Community Nursing SALT (Adult & Children) Community therapies Dietetics Community Diabetes Team Podiatry Community Wheelchair Services Community Equipment Pulmonary Rehabilitation Neighbourhood Care Services Looked After Children COPD Bowel and Bladder Service Infection Prevention Complex wound care Are there any other services which you feel are provided currently but are not referenced here? c.25M Currently 3 main providers

14. Other Community Services Areas for current considerationService ExclusionsFor future consideration Transport Community Midwives Hospice care Macmillan nursing Community Health Trainers Chronic Pain Services Community IV Community diagnostics Children's Diagnostics including endoscopy Epilepsy Community specialist services e.g. dermatology/rheumatology Phlebotomy Complex wound care (GP LES) Mental Health (procurement) MSK Planned Care (procurement) Social Care Reablement Step Up/Step down beds Domiciliary Care Telehealth/Care Are there any other services which you feel are provided currently but are not referenced here?

15. Breakout Sessions Facilitated round table discussion

16. DO…DON’T… Keep the patient in mind Be forward thinking and challenge the status quo Accept the fact that there will be differences of opinion Be free to speak minds Utilise today to explore networking opportunities Think about functions rather than services Be constrained by current service configurations Be constrained by current models of care Attribute ideas to individuals Ground Rules

17. Format and Questions To help us influence our system level thinking and develop our outline community services specification: 1. What do you feel should be in/out of scope and why? 2. What are the current service gaps/opportunities in existing services? 3. What do you find attractive/challenging about our integration programme? 4. Who are the key partners and agencies who might need to be involved in developing/ delivering this vision? 15 minutes per question followed by 15 minute feedback session

18. Supplementary Questions (If req’d) 1.What innovative contracting models would you like to see as part of this programme? 2.What innovative financial models would you like to see considered as part of this programme? 3.What kind of provider models might you explore as part of response to this programme?

19. Feedback

20. Next Steps

21. Engagement Outputs Market (providers) Clinical VoY Community Development of outcomes Specification Development

22. Where to Find Information Contracts finder https://online.contractsfinder.businesslink.gov.u k/ NHS Vale of York Website http://www.valeofyorkccg.nhs.uk/

23. Questions and Networking