Dr Wirin Bhatiani, Bolton CCG Cllr Linda Thomas, Bolton Council On this opening slide: Thank you to all the staff in Bolton who have worked so hard during the pressure of winter demand

Welcome to Bolton Aim is to just quickly flash this slide up and say Bolton is a town of inequalities – no time to do more! 284,000 residents 12 year difference in life expectancy BME population growing (over 20%) 50 Practices (indicated on map)

This is Bolton’s plan – and where we intend to invest in transformation in order to encourage more community based care and a more resilient health and care system This is a truly place-based model, focusing on communities

Our building blocks to integration Examples for today: Bolton Quality Contract New Contract between CCG and Trust Intermediate Tier Integration Here’s what we are going to tell you about today

Bolton Quality Contract: 50 Practices meeting standards more equitable funding, more capacity, better quality. Access Standard: 10 bookable sessions (am / pm) Access to both male and female clinician (not all 10 sessions) 8.00 – 6.30pm, Monday to Friday At least 75 contacts per 1000 population every week Pre-bookable 1 month in advance Process for unplanned/urgent appts (extras determined by a clinician) Offer telephone consultations Children under 12 assessed by a clinician same day Accept deflections from A&E / NWAS / Community Services Improve on patient survey measures = 60,000 extra appointment slots delivered in a year

We understand our Practice populations and deliver detailed performance data: Invested £3 million in the contract, saved £3million in its first year.

£3 million invested, £3 million saved in year 1 Safe and effective prescribing with reduced waste has been a big part of this.

New Contract with Bolton FT Aligned incentives: Focus everyone on the Bolton £, not their organisation £ Focus on hospital activity reduction Removed PBR (Payment by Results) tariff Risk sharing “We are all in this together” Successes: Ownership of effective use of resources policies shifted to Trust Reducing spend on high cost drugs & Estates together Bolton FT and Bolton CCG won Joint HFMA (Healthcare Financial Management Association) Award for innovation for this contract

Intermediate Tier Services... Joint work across Bolton to re-focus services to “Think Home First”. Intermediate Tier Services include: Rapid Response Admissions Avoidance Service Home-based Intermediate Care & Reablement Bed-based Intermediate Care Integrated Hospital Discharge Service Reconfigured intermediate care beds, invested in home based care and encouraging use of beds as ‘step up’, not just ‘step down’ Very proud of our admissions avoidance service which provides an urgent, reactive service to GPs, to NWAS, to Careline The integrated hospital discharge service is now fully in place

Service jointly commissioned by Council & CCG through Section 75 Service jointly delivered by Bolton Council and Bolton FT for 2 years, with single management

On this opening slide: Thank you to all the staff in Bolton who have worked so hard during the pressure of winter demand