1. NHS Vale of York Clinical Commissioning Group Draft Strategic Plan 2014-2019 Thursday 3 rd April

2. NHS Planning Requirements ‘Everyone Counts: Planning for Patients 2014/15-2018/19’ Guidance and templates provided by NHS England. 5 year Strategic Plan covering the ‘unit of planning’ – deadline 20 th June Supporting 5 year Financial Plan – deadline 20 th June Better Care Fund submissions 2 year Operational Plan (national template) – deadline 4 th April Activity plans – deadline April 12th

3. Developing the Strategic Plan Planning started in October 2013 and has focussed on listening to the views of the community, clinicians and local partners. This has included Governing Body workshops on current position and future challenges Review of consultation information, performance, comparative spend and quality review and national policy Initial priorities shared with Health and Well-Being Boards, Governing Body and Council of Representatives Stakeholder Event and Provider meetings Better Care Fund programme activity to develop the Care Hub approach Public Engagement Events on priorities and proposed areas of work (Selby, Easingwold and York) and online consultation

4. Objectives and Ambitions for the Vale of York Listening to the public and responding to the sustainability challenge for the NHS, we have developed the following objectives: People will be supported to stay healthy through promoting healthy lifestyles improving access to early help and helping children have a healthy start to life People will have more opportunities to influence and choose the healthcare they receive and shape future services. People will continue to have good access to safe and high quality healthcare services When people become ill, they are treated in a timely manner with access to expert medical support as locally as possible Where people have long-term conditions they are supported to manage those conditions to give them the best possible quality of life When people are terminally ill, the individual and their families and/or carers are supported to give them the best possible quality of life and choice in their end of life care.

5. Objectives cont. A move to ‘Care Hubs’, providing increased access to health promotion, care and support services, including GPs, pharmacies, diagnostics (e.g. scans/ blood tests), community services, mental health support and social care and community and voluntary services. High quality mental health services for the Vale of York, with increased awareness of mental health conditions, improved diagnosis and access to complex care within the local area. A sustainable and high quality local hospital providing a centre for urgent and emergency care and planned care for a wide range of conditions and elective operations, maternity and other specialisms within the Vale of York. Access to world class highly complex and specialist care provided through specialist centres across the country. Opportunities for accessing and leading research to improve healthcare systems for all

6. Levels of Ambition We will measure our impact using the national levels of ambition, as well as delivery against the NHS Constitution and quality outcomes. Ambition over the next five yearsBaselineTarget Reduce the potential years of life lost (PYLL) from causes considered amenable to healthcare by 21% 1950.61545.8 Improve the health related quality of life of the 15 million+ people with one or more long-term condition, including mental health conditions to equal the best amongst our peers 76.7377.95 Reduce the amount of time people spend avoidably in hospital by 14% through better and more integrated care in the community, outside of hospital. 1990.01712.9 Increase the proportion of older people living independently at home following discharge from hospital from a baseline of 76.7 76.7 Increase the number of people with mental and physical health conditions having a positive experience of hospital care by 12% 123.8108.6 Increase the number of people with mental and physical health conditions having a positive experience of care outside hospital, in general practice and in the community by 12% 5.074.76 Make significant progress towards eliminating avoidable deaths in our hospitals caused by problems in care. n/a

7. Care Hub Implementation Heart of the plan – transforming the system to enable us to continue to deliver high quality, safe and local services Integration of Care – moving away from traditional boundaries of ‘primary, secondary, community and social care’ Phased approach over the plan period, focussing initially on frail elderly and long term conditions; and expanding to a broader range of services including mental health

8. Improving Quality and Outcomes Improving health (health promotion, cancer prevention and diagnosis) Reduce health inequalities Parity of esteem – mental health reforms Quality – quality agenda, safeguarding, workforce reform and medicines management

9. Continuous Improvement and Transformation Our approach to innovation Use of technology Promotion of research

10. Improvement Interventions These are based on the initial priorities for transformational work shared with Governing Body, stakeholders and the public. Following the analysis of feedback these have been finalised. Each ‘Improvement Intervention’ is supported by work programmes (QIPP projects and strategy development) to deliver the expected outcomes. The CQUIN and Quality Premium measures for 2014-15 have been set to complement the delivery of these programmes of work.

11. Improvement Interventions Improvement InterventionWork programmes Integration of Care Better Care Fund programme Mental Health Street Triage Hospice at home Psychiatric liaison Single point of contact Rapid assessment team Community Services review Community equipment review Person Centred Care Public Health Strategies Cancer Pathway Review Primary Care promotion of healthy lifestyles Personal budgets Communication, Engagement and Involvement Strategy Health Service Directory Self-Management Strategy Carers Support Strategy

12. Improvement Interventions Improvement InterventionWork programmes Urgent Care Reform Demand and Capacity planning Emergency Care Practitioners Under 5’s admission review Patient Transport Services Review Out of Hours service review DVT Pathway Transforming mental health services Review of mental health provision and estate Active placement management Psychological Therapies Service Dementia Friendly Communities Memory clinics and care navigator Physical health standards in in-patient mental health facilities Access to health and dental checks

13. Improvement Interventions Improvement InterventionWork programmes Primary Care Reform Primary Care Strategy Practice engagement strategy Risk profiling and proactive case management E-Consultations Doctor First appointment triage Transforming mental health services Outpatient Follow-Ups Referral Support Service Dressings management Diabetes pathway review Renal pathway review Dermatology pathway review Ophthalmology pathway review Neurology pathway review Children and Maternity Implementation of the Children and Families Act Review of Child and Adolescent Mental Health services Autism Pathway Maternity Commissioning Strategy Looked After Children health reviews Review of emergency admissions for children with lower respiratory tract infections

14. Keeping the NHS Sustainable and Governance Financial Plan Sustainability Strategy Governance and monitoring arrangements for the plan

15. Operational Plan Standard national template – developed to support the 5-year plan Levels of Ambitions: measures provided nationally in the ‘Atlas’ – looked to move performance to the top quartile or to be comparable with the best performing of our peers. These are supported by the BCF initiatives National measures – Quality premium, IAPT, Dementia, A&E activity Local Quality premium – injuries relating to falls (aligned to the BCF programme)

16. MeasureObjectives – 5 year planImprovement Interventions/ Strategies Levels of AmbitionAllQuality Strategy Care Hub/ Integration of Care Person Centred Care Urgent Care Reform Transforming mental health Primary Care Reform Planned Care Medication Error ReportingPeople will continue to have access to safe and high quality healthcare services Quality Strategy Friend and Family reporting People will have more opportunity to influence and choose the healthcare their receive and shape future services Quality Strategy

17. MeasureObjectives – 5 year planImprovement Interventions/ Strategies QP: Reduction in injuries relating to falls (5% reduction) Where people have long term conditions they are supported…to give them the best possible quality of life Integration of Care (BCF) Urgent Care Reform C.Diff (target 90)People will continue to have access to safe and high quality healthcare services Quality Strategy Dementia Diagnosis (to reach national target) High quality mental health services for the Vale of York Transforming mental health IAPT (to reach national target) High quality mental health services for the Vale of York Transforming mental health