1. December Hertfordshire Health and Well Being Board

2. Programme objectives A strategic review to determine sustainable services for the provision of health and social care in West Hertfordshire In the context of the models of care for West Hertfordshire address the following domains: 1.How well (how effectively and efficiently) are patients’ needs met by the current health and social care system across West Hertfordshire? 2.What are the opportunities to meet future health and social care needs of the West Hertfordshire population more effectively and efficiently? 3.How should health and social care services across West Hertfordshire be configured to realise these opportunities? 4.What organisational form(s) and commissioning / contracting model(s) best support the delivery of the preferred future configuration of services? 2

3. Guiding principles As members of the Your Care, Your Future Programme we are working to an agreed set of principles: 1.Putting people not our organisations first when planning health and social care services for the future; 2.Ensuring quality and equality will be at the heart of all that we do, and in developing plans, organisations commit to upholding and improving the quality of care for people; 3.Ensuring that no decision is made on behalf of health and social care patients and customers without working with them to develop ideas and initiatives; 4.Planning, commissioning and delivering services, according to population needs and evidence-based practice, within the resources available to us as a health community; 5.Being honest and transparent with all stakeholders to build trust in the programme; this will include sharing the challenges we face and being open about our cost saving schemes (CIP and QIPP plans) for the West Hertfordshire health and social care system; 6.Working together constructively develop coherent plans for the West Hertfordshire health and social care system; 7.Not taking unilateral action that potentially affects our Strategic choices or results in a cost or workload shift to other organisations which would destabilise it without prior review and discussion at the Programme Executive and further if necessary; 8.Planning to operate within our collective financial means. We are ‘a strong partnership committed to planning and delivering the best possible services and wellbeing for the people of West Hertfordshire’. 3 There is an intention to present these principles to the Stakeholder Advisory Group for confirmation

4. Partners HVCCG – Nicola Bell HCC – Iain McBeath WHHT – Sam Jones HPFT – Tom Cahil HCT – David Law EEAST – Dave Fountain System leadership Source: Draft system governance agreed by SPG as at Nov 2014 4 Governance of the programme exists within the context of overall system leadership and will need to become fully integrated

5. Governance structure 5 Clinical Advisory Group (Chair: Dr Robert Ghosh) Programme Executive (Chair: Dr Nicholas Small) Finance & Activity Reference Group (Chair: Alan Warren) Stakeholder Advisory Groups (Chair: Dr Nicholas Small) Programme Leads Group (Chair: David Radbourne) Individual organisation Boards / governing bodies HVCCG Commissioning Executive 4 x localities 4 x clinical programmes Existing work, groups and forums, e.g.: Living Well Older People’s Partnership System BCF System Resilience Workforce enabler group Estates enabler group ICT enabler group ) Comms & Engagement Group (Chair: David Radbourne) Connection with system leadership building blocks

6. Health and care services Carry out work through the LHEs four existing programme groups, with all work to have an additional locality focus Develop health and care economy baseline / case for change Co-develop and agree models of care at an overall and programme of care level Develop local delivery plans for future models of care Evaluate clinical information and IT systems requirements Estates Estates baseline covering West Hertfordshire estate owned by HVCCG, HCC, HCT, HPFT, WHHT Solutions developed in line with the preferred health and care model Solutions to be reviewed for restructuring Major and Local hospital sites, as well as reviewing capacity within the community and GP estates Finance and Modelling Use current CCG and provider 5 year plans as a starting point and align assumptions Identify cross county (HCC, HPFT, HCT) activity and budgets that relate to West Hertfordshire Remove QIPP and CIP to arrive at a ‘pure’ year 0 gap Identify potential efficiency improvements through VfM benchmarking Project forward for 5 and 10 years using demand assumptions LTFM modelling and final impact of models of care / solutions Overall approach Comms and engagement Develop and roll out comprehensive stakeholder strategy, covering 3 months and beyond Collect and evidence stakeholder feedback on the baseline / case for change Host stakeholder events to design models of care building on work done to date Engage patient and wider stakeholder views on proposed models of care Identify communication channels and stakeholder messages going forwards 6 Coordination of Process Workforce Understand current position (e.g. skills, professions and constraints) within the LHE workforce Show how proposed changes to models of care will affect the existing workforce and whether the required changes will be deliverable Identify opportunities for improvement, for example through VfM benchmarking and review of metrics Determine the impact of workforce changes to the financial and operational sustainability of the LHE Core support is being provided in the following areas….

7. 1. Baseline and case for change 2. Future models of care development 3. Detailed delivery plan 7 The strategic review timeline is driven by the planned phases of engagement 4. Implementation Dec14Jan15Feb15Mar15 – Jun15 Nov14 Mar Board reviews future models of care Jan Board reviews case for change Baseline report, final case for change Draft models of care Milestones Engagement & stakeholder strategy Key recommend ations (long list) Jul Board reviews key recommendations Key Decisions – December 2015 Draft – subject to change

8. Values at the heart of our engagement: Proportionate Inclusive Genuine Open and transparent Purposeful 8 The expected phases of engagement: Summary of Communications and Engagement Strategy Public Engagement displays in main sites Drop in sessions Focus groups Existing meetings and forums Potential site visits with vulnerable audiences Staff Intranet content Face 2 face meetings Co-creation workshops Advocacy programme Stakeholders Initial written briefing Meetings on a 1-2-1 basis Health Scrutiny Meeting All audiences E-newsletter Traditional media Website / Social Media Contact number Briefing document A wide range of engagement and communications channels to involve and inform key stakeholders: Draft – subject to change DateKey activity 21 November 2014 Your Care, Your Future begins Winter 2014/2015 Data gathering and engagement Spring 2015Reflection and analysis Summer 2015 Potential options for change Summer / Autumn 2015 Engagement on options for change