1. MY LIFE A FULL LIFE Isle of Wight Loretta Outhwaite Interim Programme Director & Chief Finance Officer (IW CCG) Loretta.outhwaite@iow.nhs.uk

2. MY LIFE A FULL LIFE Isle of Wight What is My Life a Full Life ?

3. PARTNERS: the list is growing… Isle of Wight Council (incl. fire & children’s srvs) Isle of Wight Clinical Commissioning Group Voluntary Sector Independent Sector (Care Homes & Home Care) Isle of Wight NHS Trust One Wight Health (All 17 GP Practices) Earl Mountbatten Hospice Hampshire constabulary Housing associations

4. AIMS Person-centred, allowing & enabling individuals to take control of their lives & their care Services based in the community/at home, delivered by integrated teams Prevention-based, promoting health & wellbeing Quality of life & keeping well Linking together & building on schemes already up & running/being planned across our communities

5. “I” Statements I’ll no longer be a patient or client – I’ll be a person I have access to easy to understand information about health, wellbeing, care & support I am able to get skilled advice to plan my care & support I can plan ahead & keep control at times of crisis I have considerate support delivered by competent people

6. MY LIFE A FULL LIFE Isle of Wight, PACS Vanguard Why are we doing this ?

7. ISLE OF WIGHT OVERVIEW Accessible only by sea/air (weather dependent) 23 miles wide by 13 miles long Single system, single boundaries Increasing elderly population; 26% over 65 (17% England av) & over 75 12% (8% England av) Recruitment & retention issues Low earnings; higher than av. long term unemployment; 20% children live in poverty; low GCSE attainment (45%) Population of 142,000; est’d £300m health & social care budget 2.5m visitors p.a.; 2 large music festivals

8. SERVICING THE ISLAND’S NEEDS: CHALLENGES Off-island destination TransportTravel time (mins) Southampton General Air8 Southampton General Sea100 Queen Alexandra Portsmouth Air8 Queen Alexandra Portsmouth Sea85 Front line Transport Annual activity Coastguard47 Air ambulance 83 Ferries392 Type of patient % treated off Island Elective22.9% Non-elective7.2%

9. AGE PROFILE Over 65s expected to increase by 47% & will account for 36% of the total population by 2037 (vs England 24%)

10. Health Needs: Multiple Chronic Conditions By Age –The majority of over-65s have 2 or more conditions, and the majority of over-75s have 3 or more conditions –54% of patients have at least one chronic condition requiring management Source: ACG Risk Stratification tool, July 2015

11. GETTING IT RIGHT: ALLOCATION & COST Need Allocation Island Premium Cost Tariff/benchmarked cost Inefficiencies Island Premium Mitigate with system redesign Unavoidable

12. ACTIVITY BENCHMARKING: HES DATA New To Follow Up Ratio (All Specialties) 2014/15 Elective Admissions per 1000 population (standardised) 2014/15 Emergency Admissions per 1000 population (standardised) 2014/15 A&E Attendances per 1000 population (standardised) 2014/15

13. MY LIFE A FULL LIFE Isle of Wight, PACS Vanguard What are we going to do ?

14. VANGUARD BID Why we are the perfect Vanguard Care on the Island will be shaped around people’s individual needs and managed by them. Our model focuses on keeping people happy and healthy through self- care and self- management. Working together is nothing new for us. My Life, A Full Life is already working across organisational boundaries, sharing resources and expertise. We’re already on the way – but we can go further and faster with your help! The age and wellbeing of the Island’s current population is a reflection of how the rest of England’s population will be in 20 year’s time. If we can get care right here, we can lead the way for the rest of the country. We have an incredibly active voluntary sector on the Island, along with strong communities. Both are at the core of the My Life, A Full Life model. Our starting point for going forward Self Care – Accessing information and support Crisis intervention reducing hospital admission The formation of 3 integrated locality teams Our three key projects (so far…) 1 2 3  Strong My Life, a Full Life brand  Single system, single boundaries (NHS Trust, CCG, Local Authority)  Strongly engaged community

15. Partners’ current examples Crisis Response

16. Information is not easily available Separate leadership Organisational boundaries Technology potential not maximised Funding not aligned with person centred care Our Current Model & Issues Access to services are often uncoordinated Services are working separately Does not give flexibility for where people are treated It is financially unsustainable Reliance on health and social care services Health and social care services (statutory) Friendships and support services Voluntary and support services Voluntary & independent sector

17. OUR ‘MY LIFE’ MODEL http://www.nurturedevelopment.org/ Based on ABCD approach – Cormac Russell Our integrated ‘My Life’ model is: Prevention-based Health and wellbeing promoting Built on experience-based co-design Founded on self care and empowered communities. At the centre of our model is the person My Life coordination supports the individual to navigate the community and system. This single point of access triages, reduces the perceived system complexity, increases awareness of services, and maximises efficiency. The Integrated Locality Teams deliver person centred care and support in the community, with GP clinical leadership and multi-specialist teams. Intimate / Family Key enablers My Life, A Full Life – care services Associated Life Friendships Support Groups Home One information One Leadership One empowered people and workforce One Technology-enabled Care System One Island £ Hospital Services Integra ted Localit y Teams Ambulanc e Service Public Health Commissione d voluntary sector Adult social care Children’s social care Integrat ed single point of access Commu nity Faith Groups Voluntary Sector Isle Help Town and Parish Councils Fami ly Frie nds Colleagu es My Life Coordinat ion Informal commu nity links Transport Education Housing Association Environment Health- watch People Matter Crisis Respons e Team Domicili aryCare Out of Hours Independe nt Sector Pallia tive Care 10.06.2015 Home 09.06.2015 Community Health Services MH & LD Services

18. MY LIFE A FULL LIFE Isle of Wight, PACS Vanguard How are we going to do it ?

19. 09.06.2015

20. PROGRAMME STRUCTURE Strategic Commissioning, Contracting and One Island £ Organisational Integration & Form Communications, Engagement and Project Management Office Evaluation and Measurement One Information & Technology Enabled Care, Infrastructure and Estates One Leadership & One Empowered Workforce Prevention and Early Intervention Integrated AccessIntegrated Locality Teams Whole Integrated System Review Prevention & Early Intervention Integrated Access Integrated Locality Teams Whole Integrated System Review

21. MY LIFE A FULL LIFE Isle of Wight Loretta Outhwaite Interim Programme Director & Chief Finance Officer (IW CCG) Loretta.outhwaite@iow.nhs.uk