Sustainability & Transformation Partnerships Clare Hawkins Deputy Chief Executive, Director of Quality/Chief Nurse Hertfordshire Community NHS Trust 19th July 2017

Aims of the STP Improve the Health and Well-Being of the population Improve the quality of the services provided Efficient and affordable care

Our vision Our approach We want people from Hertfordshire and west Essex to live as healthily and independently as possible, supported by caring, effective and affordable health and care services Our approach Working together with our residents to support healthy and independent lifestyles Working together with our staff so that they can provide high quality care in the right place at the right time Working together between organisations to ensure that the care and support we provide is delivered effectively and efficiently

The new Hertfordshire and West Essex health and care planning ‘footprint’ has a population of around 1.5 million people. It’s a complex health and social care landscape… There are: 160 GP practices, Two county councils Two Health & Wellbeing Boards Two branches of Healthwatch 13 district and borough councils Three acute hospitals Two mental health providers Two community healthcare providers One ambulance trust and a significant number of other health and social care partners, including numerous voluntary and ‘third sector’ organisations.

Context Financial pressures Pressure on the health and care system Hertfordshire and West Essex Sustainability and Transformation Plan Context Financial pressures Current system spend is approximately £3.1bn Forecast deficit of £94m for 2016/17 rising to £401m (£552m Inc. Social Care) by 2020/21 if we don’t take action Increasing demand Population expected to increase by over 10% from 2011 to 2021. Number of over 85s expected to increase by approximately 45% from 2011 to 2021 Pressure on the health and care system Primary care capacity Acute care performance and quality challenges Social care funding National drivers NHS Five Year Forward View NHS GP Five Year Forward View NHS Constitution commitments National service strategies, e.g. mental health, cancer and maternity

Herts and West Essex Financial Overview Hertfordshire and West Essex Sustainability and Transformation Plan Herts and West Essex Financial Overview £ millions Deficit Recovery /Control Totals: Current Deficit , Requires Cash Releasing Solutions req -c£90m Estimated Cost of future pressures Cost Avoidance Req -c£401m

Proposed STP Governance Structure DRAFT Proposed STP Governance Structure External stakeholders include: Patient and public engagement forums Health and Well Being Boards Health Overview and Scrutiny Committees Independent and third sector organisations District Councils LMC Healthwatch GP Federations Regulators Sovereign bodies Health and well being boards External stakeholders STP Oversight Board STP Oversight Board – to lead on alignment of sovereign bodies with STP vision, to ensure Boards are committed to the transformation and to support in the management of external stakeholders (as appropriate). Chief Executives Board Chief Executives Board – strategic direction of the STP and to oversee the delivery of STP through the Programme Board and System/Local Delivery Groups. Local Delivery Partnerships Herts Valleys East and North Hertfordshire West Essex Engagement Key: Reporting 5

Our Approach to Delivery Turnaround Finance Directors - Align CIPP/QIPP Task and Finish Groups - POLCE / Exclusions - Meds Management - Back Office - Procurement - Agency - Outpatients Transformation Clinical Workstreams Enabling Workstreams Reconfiguration Model Changes - Activity - Workforce - Investment - Finance Organisational form

STP Priorities Prevention / self management Demand management Hertfordshire and West Essex Sustainability and Transformation Plan STP Priorities Prevention / self management Demand management Commissioning thresholds Increase capacity & access in Primary care Place based care, population approach Managing Urgent & Emergency Care Planned Care Frailty Cancer & Mental health Efficiency of support and back room functions

Proposed STP System Leadership Arrangements DRAFT Proposed STP System Leadership Arrangements STP Enabling transformation Urgent and Emergency Dr Andy Morris Katie Fisher Barbara Harrison Planned Care Michael Van De Watt Deborah Fielding Support Mental Health and Learning Disabilities Dr Prag Moodley Karen Taylor Simon Pattison Cancer Clinical Lead Nick Carver Sarah Brierley Clinical transformation Prevention Jim McManus Linda Mercy / Maggie Pacini Primary Care Dr David Buckle Beverley Flowers Denise Boardman Clinical Support Services Trevor Smith Workforce Jinjer Kandola Andrew Boasman Technology Dr Paul Bradley Trudi Mount Estates, Facilities & Capital Professional Lead Helen Brown Diane Brent Women’s & Children Jenny Coles Kate Barker Population Based & Int’d Care Clinical Lead David Law Support Collaborative Comm’g Clinical Lead CCG CEOs Ed Knowles Comms & Engt Beverley Flowers Nuala Milbourn Frailty Dr Rachel Joyce Kathryn Magson Iain MacBeath / Suzanne Westhead Task and Finish Groups

Future Plans for the STP Focus on delivery of priority projects Ensure transformation is embedded Increase clinical engagement Develop vision for Hertfordshire and West Essex with regard to new models Workforce for the future

How can you be involved ? Contribute and lead workstreams and task & finish groups. Identify opportunities for quality improvement and be efficient. Think about how you can , should do things differently Make every contact count - is it of value? Support engagement with stakeholders, patients and the public.