1. NHS | Presentation to [XXXX Company] | [Type Date]1 Senates - the interface with SCNs and AHSNs Nigel Acheson Medical Director NHS England (South)

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3. SCNs and Clinical Senates 4 in the South South West Wessex Thames Valley South East Coast NHS | Presentation to [XXXX Company] | [Type Date]3

4. Cardiovascular (cardiac/stroke/diabetes) Maternity/children and young people Mental health/dementia/neurological conditions Cancer [ Respiratory] NHS | Presentation to [XXXX Company] | [Type Date]4

5. SCN 2014/15 priorities Themes: Early diagnosis Parity of esteem Optimisation of pathways Reducing avoidable admissions Reducing variation NHS | Presentation to [XXXX Company] | [Type Date]5

6. AHSNs 5 in the South: South West Peninsula West of England Wessex Oxford Kent, Surrey and Sussex NHS | Presentation to [XXXX Company] | [Type Date]6

7. AHSN licence agreement focus upon: Wealth creation Spread and adoption of innovation Building upon a culture of collaboration between stakeholders NHS | Presentation to [XXXX Company] | [Type Date]7

8. AHSN 2014/15 priorities Clinical workplans include: Pharmacy Mental health Long term conditions Enhanced recovery Urgent care Informatics/telehealth Patient safety collaboratives NHS | Presentation to [XXXX Company] | [Type Date]8

9. New financial year, new NHS England Chief Executive – Simon Stevens NHS | Presentation to [XXXX Company] | [Type Date]9

10. Simon Stevens speech 3 rd April 2014 Out of hospital care Personalisation (eg using genomics) Reducing variation and assurance of quality Early diagnosis, prevention and intervention Co-production and self care NHS | Presentation to [XXXX Company] | [Type Date]10

11. Some “big” issues Smoking/Hypertension/Obesity/Diabetes Parity of esteem Primary care transformation Variation in quality Urgent care End of life care NHS | Presentation to [XXXX Company] | [Type Date]11

12. Some issues to address… Dogma You can’t close my….. NHS | Presentation to [XXXX Company] | [Type Date]12

13. New England Journal of Medicine, 2014 Paper from Ontario, Canada relating to the surgical safety checklist – little impact on mortality Atul Gawande – “government mandate without serious effort to change the culture and practice of surgical teams results in limited change” NHS | Presentation to [XXXX Company] | [Type Date]13

14. Specialised commissioning 143 new service specifications and adopted 60 highly specialised service specifications Only the beginning – equity of access, quality of services (clinical and cost-effectiveness, patient experience, patient safety) NHS | Presentation to [XXXX Company] | [Type Date]14

15. Need to develop pathways and networks to ensure both quality and access to specialised service This will require changes in how and where specialised services are provided NHS | Presentation to [XXXX Company] | [Type Date]15

16. Engaging patients, staff, the wider public and other stakeholders will be critical if high quality services are to be developed and improved Senates will play important roles in improving the quality of care through such transformation NHS | Presentation to [XXXX Company] | [Type Date]16

17. The Four Key Tests (in 14/15 Mandate) Strong public and patient engagement Consistency with current and prospective need for patient choice A clear clinical evidence base Support for proposals from clinical commissioners NHS | Presentation to [XXXX Company] | [Type Date]17

18. What guidance has been published? Sets out a broad framework of roles and responsibilities for commissioners in how they should plan for major service change, work with providers, local authorities, patients and the public

19. How are proposals assured? 19

20. The aim of clinical assurance through the Senate is to establish whether the proposed changes are supported by a clear clinical evidence base and will improve the quality of the service provided NHS | Presentation to [XXXX Company] | [Type Date]20

21. National Clinical Advisory Team (NCAT) assurance of service change proposals: 1 Independent clinical assurance of reconfiguration 2 Early advice 3 Review and investigation of clinical services (eg re safety) 4 Evidence collection 5 post-hoc advocacy NHS | Presentation to [XXXX Company] | [Type Date]21

22. Senates will undertake functions 1 and 2 Independent clinical assurance of reconfiguration Early advice NHS | Presentation to [XXXX Company] | [Type Date]22

23. Investigation of issues of clinical safety (function 3) lies with other bodies Evidence collection (function 4) is undertaken by a range of organisations including NICE, Royal Colleges and NHS Evidence NHS | Presentation to [XXXX Company] | [Type Date]23

24. The post-hoc advocacy role (function 5) is not a function for Clinical Senates to undertake in isolation Any communications or advocacy requirements should be considered by NHS England as part of its broader assurance process NHS | Presentation to [XXXX Company] | [Type Date]24

25. Senate roles 1 Clinical advice to commissioners to help inform proposals (by ?SCNs or Senate if outwith SCN groups) Strategic clinical advice to commissioners on relevant clinical guidance/best practice Advice to support commissioners in developing a case for change, options appraisal and proposed clinical models NHS | Presentation to [XXXX Company] | [Type Date]25

26. A proportionate approach 26

27. 2 Independent clinical advice as part of the NHS England service change assurance process Independent clinical advice by means of a formal report to be considered as part of the NHS England assurance process for service change proposals NHS | Presentation to [XXXX Company] | [Type Date]27

28. Service change assurance exists to give confidence to patients, staff and the public that proposals are well thought through, have taken on board their views and will deliver real benefits NHS | Presentation to [XXXX Company] | [Type Date]28

29. Next steps Development of common products for use by Clinical Senates (principles for managing reviews, ToR, review report pro-forma) Associate Directors for SCNs and Clinical Senates and Clinical Senate Managers to examine the potential for shared working Service change proposals are shared regularly with clinical senates