Learning Disabilities Division Business Planning Heath Gunn – Divisional Director

Key Strategic Headlines – commissioning intentions Oxfordshire County Council and Oxfordshire CCG have announced consultation on the Big Plan for learning disabilities which is due to be implemented from December 2015, when our contract ends. There are some strong matches with our 4-tier model of care but a much greater emphasis on people with a learning disability accessing mainstream health services Hampshire CCG and Southampton CCG have not issued commissioning intentions this year. Hampshire have indicated that they will not block purchase beds but will spot purchase through a “framework” of providers for inpatient services. Hampshire County Council intend to reduce funding for campus re-provision as the need for the service is expected to reduce. Buckinghamshire have not issued their commissioning intentions this year and we continue to have negotiations with commissioners about the current contract and provision NHS England’s Local Area Team are investing in forensic learning disability services, increasing low secure beds from six to ten and planning to have forensic LD community services in the Thames Valley

Changes in context since last strategy Financial constraints are even tighter in our and partner organisations Commissioners are determining how to make use of the Better Care Fund through service integration Report on the death of Connor Sparrowhawk issued – impact in our services Changing needs of service users – age related conditions, autistic spectrum disorders, personality disorders

Summary of clinical model To insert 4 tier spectrum of care Would appreciate skilled power pointer to reproduce please

Improvements and quality initiatives Leadership and management changes –interim senior appointments to manage change in Oxon and Bucks; support from quality turn-round team Changes in the governance structure; assignment of responsibilities; clear accountability Focus of assessment and treatment inpatient services in the Ridgeway Centre ( Bucks) and Willow Ward (Hants) to increase quality and reduce overspend. STATT, JSH and Postern House (26 beds) closed. Oxon and Bucks also concentrating on 6 areas of clinical practice, following positive review of the model in Hampshire. Honing admission criteria ( not just filling beds) Governance risks for SHFT in Swindon and Wiltshire to be avoided by transfer of community psychiatric and psychology services to Avon and Wiltshire Mental Health Partnership (Jan 2015)

High level workforce review Charlotte to add

Finance Luke and Andy to add

Estates and IT priorities Disposal of Postern House Establishment of non-Hants HQ and options for the Slade site Location and accommodation for Thames Valley forensic community team Re-location and accommodation of Bucks community teams Disposal or re-use of Westview Relocation of low secure and forensic rehabilitation services within Woodhaven Video and teleconferencing facilities; extension of Lync 2010 Digital dictation into RiO Options for making RiO work in LD Development of an app for service users accessing health and social facilities IT support for staff transferring to AWP Continued support for Flexible Systems Access in Hampshire

Changes to structure and governance Move to Integrated Service Division with Mental Health and TQtwentyone Quality & governance and business development & contracts and performance to be restructured into cross-Divisional functions

Key risks to delivery Unable to identify and realise sufficient savings to recover overspend and meet Cost Improvement Targets Failure to secure contract in Oxfordshire after December 2015 Unable to redeploy staff following commissioning shift from specialist healthcare to mainstream healthcare; high staff or redundancy costs of senior (B7 and above) and long serving staff Unable to fill vacancies and continued use of agency staff presents quality and financial risks

Priority Actions Ascertain commissioning intentions in all areas Ensuring CIP plans are realistic and achievable Prepare for and respond to the Big Plan in Oxfordshire Workforce review – right professions, right level and band, right location, right employment status Skilled staff for changing needs