Sustainability and Transformation Plan (STP) progress update and next steps Council of Governors 9 th June 2016

Purpose of STP Sub-regional strategic plan to address 3 key gaps – health improvement, quality, financial (44 STPs nationally) Key strategic planning document to deliver ‘Five Year Forward View’ for NHS Required to trigger release of 16/17 STP funding (£4.9m for STFT) NHS, Local Authority and key partners all involved

Northumberland Tyne and Wear STP footprint Name of footprint and no: Northumberland Tyne and Wear Region: Cumbria and the North East Nominated lead of the footprint including organisation/function: Mark Adams, Chief Officer, NHS Newcastle Gateshead CCG Contact details ( and phone): 0191 The Northumberland Tyne and Wear STP footprint is a new collaboration covering a total population of 1.5 million residents across three Local Health Economies (LHEs): Newcastle Gateshead North Tyneside and Northumberland South Tyneside and Sunderland Organisations delivering Health and Social Care within the STP footprint are detailed on the map. NTW STP footprint overview Map produced Apr'16 by NECS Information Services Boundaries from ONS Settlements from OSM Used under licence The NTW footprint has broadly similar age and sex demographic characteristics with the biggest variances occurring in Newcastle and Gateshead which has a larger year old population and Northumberland which has a larger year old population. Large numbers of students bring the age population down in Newcastle, with increased number of people retiring to Northumberland having the opposite effect. 3

The 3 NTW area planning footprints in more detail STP footprint: NTW LHE Plan South Tyneside & Sunderland Acute collaboration & associated community services changes LHE Plan South Tyneside & Sunderland Acute collaboration & associated community services changes Sunderland– out of hospital strategy South Tyneside Plan (Integration & Primary Care) Touchpoints between CCG work programmes Who: South Tyneside only Who: STCCG and SCCG Who: Sunderland only Who: Northumberland, North Tyneside, Newcastle Gateshead, South Tyneside, Sunderland LHEs Who: STFT, CHS, STCCG, SCCG MUST DO TOGETHER Learn/share Could do together Learn/share

Timeline for STFT involvement Week commencing 9 May16 May23 May30 May6 June13 June20 June27 June AcuteMA/SWa CommunityBB Support servicesAR-D/BB EstatesMA / SJ Financial / CIPHP / AR-D Draft S&ST STPGroup Board 24/5 Final draft NTW STP 30 th May STFT Board engagement Workshop 10/5 BoD w’shop 7 June STP leadership Board final NTW STP plan 22 JunSubmit 30 Jun Council of Governors CoG meeting 9 June

NHS Improvement planning guidance Demonstrate a shared understanding of the three gaps Single coherent strategy for the area, identifying key decisions – single organisation and system-wide factors considered Setting out health, quality and financial benefits to 2020/21 Assess level of consensus for change and plans for engagement Workforce impact review Dialogue with NHSI and NHSE throughout the summer Likelihood of a timeline to sign-off and approve plans by October

Key initial areas of transformation – NTW Newcastle Gateshead LHE 1.Acute Hospital collaboration across clinical pathways 2.Out of hospital collaboration Re design of intermediate care system Mobilisation and transformation of community services Extended Primary care 3. Prevention and wellbeing Actions Explore and test clinical models across acute providers and develop implementation proposals Analyse current intermediate care system capacity and capability and develop business proposals Mobilisation and transformation of community services Continue to implement the General Practice Strategy ensuring alignment with community model of care Develop community led approaches to health and well being Timeframe for delivery April 2017 North Tyneside Northumberland LHE 1.Development of the ACS / ACO models 2.Interaction of new model with partners across the STP footprint 3.Financial stability of the LHE footprint Actions Strategic commissioning functions to be agreed Financial modelling and due diligence Capitated budget and transition arrangement Schemes of delegation - proportionality New vehicle construct – procurement options Business case submission and ongoing engagement Timeframe for delivery April 2017 South Tyneside Sunderland LHE 1.Reconfiguration of services across the two acute providers 2.Ensuring this fits with currently developing out of hospital model of care 3.Health and wellbeing and prevention Actions Review “in hospital” clinical schemes Learn from developing out of hospital models across the LHE (MSCP Vanguard and Pioneer) Deliver general practice strategies Reduce primary care variation Deliver Digital Roadmap Right Care / Map of Medicine/ Health Pathways Timeframe for delivery In hospital reconfiguration Jul 2016 – Jul

STP footprint South Tyneside and Sunderland local health economy South Tyneside Sunderland

Areas of Transformation AIM: South Tyneside & Sunderland – System wide collaboration to deliver better health and wellbeing, care, quality and financial stability 1.Radical reconfiguration and transformation of services across the two acute providers to create a single clinical operating model 2.An increasingly shared approach to out of hospital transformation across Sunderland and South Tyneside, with a joint workforce development programme 3.Re-designed pathways with an increasing focus on prevention and management of conditions through to End of Life 4.A radically different approach to prevention and self care, embedding deep rooted behavioural change in communities Underpinned by one system of thinking and leadership Themes Supporting delivery of in hospital 7 day working with reduced duplication, decreasing spend on hospital beds, rationalising out estate Every service across the two hospital site reviewed and reconfigured within two years Pathway reviews informed by NHS Right Care and enabled by HealthPathways and Map of Medicine Take the best from the Sunderland Vanguard model and from South Tyneside integration pioneer to develop a “blended” out of hospital model Deliver general practice strategies and reduced primary care variation Deliver Digital Roadmap Timeframes for delivery In hospital reconfiguration: Jul 2016 – Jul 2018 NHS RightCare, HealthPathways and Map of Medicine : 2016/17 – 2019/20 Delivery of out of hospital/integrated care models & primary care strategies : as above 9

Draft system Model to be enhanced subject to agreement of its key fundamentals Systems View – What does it look like in 5 years time?

Our approach to STP development The South Tyneside and Sunderland LHE footprint enables us to plan and work together across organisational boundaries, in order to transform the way that health and care is planned and delivered for the populations within a geographic footprint. The larger LHE planning footprint will maximise opportunities to implement the vision of the Forward View of better health and wellbeing, improved quality of care and stronger NHS finance and efficiency. Our approach and our plan will build upon positive partnership work within South Tyneside and Sunderland. Section 1: Leadership, governance & engagement 1 Hospital collaboration Sunderland / South Tyneside System Leadership Board CCGs, FTs and Councils (Proposed) Sunderland / South Tyneside System Leadership Board CCGs, FTs and Councils (Proposed) Out of Hospital models e.g. MSCP Integrated care model Primary Care Strategies e.g. primary care at scale Out of Hospital models e.g. MSCP Integrated care model Primary Care Strategies e.g. primary care at scale South Tyneside Partnership Alliance Sunderland Transformation board Out of Hospital collaboration (Proposed) Out of Hospital collaboration (Proposed)

Standards that providers must meet when considering Local Health Economy working (NHSI guidance, May 2016) Scope – there should be clear and appropriate scope of issues under consideration Level – decisions should be taken at the most appropriate level (e.g. provider, group of providers, commissioners) Engagement – the manner of engagement must be constructive and effective Rationale – there should be clear consideration and articulation of why decisions are in the best interests of patients and organisations Accountability – there must be clear lines of accountability for decisions and actions taken