1. Ambition, Action, Achievement Leading your local NHS

2. Our Vision: Havering will be a healthy place to live for all To commission best in class services that give people personal choice and control of their healthcare needs in the most appropriate settings Working with our partners we will radically redesign our Primary Care Provision, align the targeted and open access services with the Borough and operate jointly 7 days a week Delivering best in class services will mean that we will make informed evidence based investment decisions, delivering clearly defined outcomes We will empower our residents to access health and wellbeing, education and training opportunities Ambition, Action, Achievement

3. Key points from JSNA Oldest population in London and numbers are growing expected 29% increase people aged 65 or over 57% increase aged 85 or over with long term limiting illness by 2025 Diabetes levels predicted to rise 48% by 2025 and stroke levels predicted to rise 31% over the same period. 2 nd highest in London % of obese adults (22%) Cancer mortality higher than expected for bowel/breast at 1 year 2 nd highest rate in London of overweight children at age 5 (ticking timebomb) Havering deprivation (IMD) 200 th out of 354 PCTs

4. Actions are needed to deliver the outcomes for our population Increase – Improved identification/diagnosis of dementia – % of deaths that occur at home – Breastfeeding at 6-8 weeks – Uptake of DTP at age 5 (proxy for MMR) – Self reported experience of patients/users Our eight local outcomes: REDUCE – COPD mortality – Stroke deaths within 30 days – Premature cancer mortality

5. Key Actions speak louder than words – must be realistic Polysystem model implement during 2010/11 LTC care transformed with 50+ strategy actions & modernised community services Health4NEL shifts linked to CSP initiatives Organisational including Board development Clinical & Public engagement strategies delivered

6. What’s a Polyclinic/Community Hospital  Post acute stroke beds  Step down and palliative care beds  Advanced physiotherapy services  Day Hospital  Plus services available in the Hub  DDA Compliant  Induction Loop fitted to reception  Treatment room  At least one consulting room  Minimum of 1 disabled parking space per clinical room  Baby Changing Facilities  Breast-feeding friendly  Secure pram/pushchair/cycle storage  Satisfactory Infection control report  IT compatible with hub to allow reciprocal appointment booking and records access  Confidential reception facilities  Energy efficiency audit action plan completed  On-line booking facilities for patients Ambition, Action, Achievement Features for all new facilities

7. Polyclinics and spokes across Havering Ambition, Action, Achievement

8. Polyclinic Hub Min 12hr x 7 days a week, Urgent Care Centre, with direct links to A/E X-ray, ultrasound, possibly mobile MRI and mobile breast screening Full range of near patient testing Dedicated disability facilities Access to health information available in leaflet or electronic form Range of Borough service Voluntary sector services Community based services e.g. physiotherapy, audiology, sexual health, pharmacy Consultant led outpatients Direct links with Out of Hours services All GPs offering full range of enhanced services Range of services for children and young people with direct links to the Children’s Centre Mental health including dementia support Long Term Conditions working through multi-disciplinary groups End-of-life support network Maternity with close links to BHRT and children’s centres Diabetes – up to level three services Ambition, Action, Achievement

9. Spoke GP Practice Tier 1  Min 12hr x 7 days  Blood tests & ECG  Access to health information available in leaflet or electronic form  Full range of Enhanced GP services  Walk in GP services  Consultant led outpatients  Minimum of 8 wte GPs  Premises that can be expanded  Long Term Conditions  Diabetes – up to level two services Ambition, Action, Achievement

10. GP Practice Tier 2  Min 12hr x 6 days  Blood tests & ECG  Access to health information available in leaflet or electronic form  Full range of Enhanced GP services  Minimum of 4 wte GPs  Long Term Conditions  Diabetes – up to level one services Ambition, Action, Achievement

11. GP Practice Tier 3  Core Primary Care Services  Range of agreed additional services  Long Term Conditions where appropriate  Single handed practices up to 4 wte GPs Ambition, Action, Achievement

12. Community/Home Tailored education to support patients and carers in managing long term conditions and end of life care supported from the Hub/Spoke Rehabilitation services for stroke patients Mental health assessments e.g. dementia Children and young people with complex health needs Ability to single point of access for information and advice to self manage - e.g. telephone, web, tele health, NHS Direct Home births Ambition, Action, Achievement

13. Urgent Care Centres Ambition, Action, Achievement

14. Urgent Care Centres Our plan for Urgent Care Centres is: North-west System Urgent Care Centre will be based at Queen’s Hospital North-east System Urgent Care Centre will be based at Harold Wood Polyclinic South System Urgent Care Centre will initially be provided at South Hornchurch operating from 6am to midnight, but the services will be moved to St. George’s Hospital site when appropriate Urgent Care Centre will be provided at Cranham operating from 6am to 9pm. All 3 Polysystems will have one Urgent Care Facility fully operational by December 2010. Future Urgent Care Centres will be considered at Collier Row, Maylands and Harold Hill. Ambition, Action, Achievement

15. Joint Priorities with Council Advice Services (including dementia) Keeping people out of hospital (includes intermediate care, integrated case management, DTOC and falls prevention) Polysystems (to ensure maximum reach and success of moving services into the community) Speech and language therapy (for children)

16. Partnership working - the key to a healthy Havering What’s in it for the voluntary sector? How can the NHS and Borough ensure the voluntary sector is bidding on a level playing field What are the timescales – this year?

17. World Class Provider Fit for Purpose Good governance Financial Stability Meet our vision, goals, priorities, actions and outcomes Mirror image of World Class Commissioning competencies