Choice – 6 Steps, 6 Actions, 6 Weeks Step 1 – Conduct self assessment / baseline exercise of current position H Step 2 – Highlight and communicate aims and goals O Step 3 – Obtain training and resource pack I Step 4 – Initiate 6 Actions Step 5 – Collect evidence E Step 6 – Evaluate progress and review wider options and longer term plans

6 STEPS 6 ENABLERS Consider Current Position Highlight Aims and Goals Obtain Training/ Support package Initiate 6 Actions Collect Evidence and sources of assurance Evaluate Impact / agree next steps 1) Patients aware of their Choices What is the current level of awareness ? Set awareness goal (Minimum standard 1) Patient Awareness Pack 1.1 to 1.6 eRS survey data about levels of awareness Improved Patient experience and Patient Activation Scores 2) GPs Aware and want to support Choice What is the current utilisation of eRS ? Set engagement goal GP Awareness Pack 2.1 to 2.6 eRS utilisation data Reduced levels of referrals and DNAs 3) Information for Shared Decision Making What information is currently available ? Set shared decision making goal (Minimum standard 2) Choice Information Bank and GP Training Pack 3.1 to 3.6 eRS survey data about shared decision making Improved RTT and reduced referrals 4) Build Choice into Contracting and Commissioning Plans What do current plans say about choice ? Set commissioning goals (Minimum standards 3,4 and 5) CCG Training Pack 4.1.to 4.6 Changes in contracting and commissioning plans and intentions Improved levels of supported self management 5) Choice embedded within referral models, protocols and clinical pathways Baseline current services and referral patterns Set RTT goals (Minimum standards 6,7,8, and 9) Demand Management Guides 5.1 to 5.6 eRS referral data Reductions in demand and improved RTT performance 6) CCG Assurance systems are in place for choice What systems are already in place ? Set increased level of assurance goals Choice Assurance Pack 6.1 to 6.6 CCG Internal Audit and statements of internal assurance Has Controls Assurance level improved ? 6 STEPS 6 ENABLERS

1) Actions for raising Patient awareness of Choice 1.1 Draft Patient Choice policy statement (good practice version available) 1.2 Creation of Patient Awareness Pack ( using editable materials provided for use in clinics, surgeries and practice websites) 1.3 Obtain CCG Board support of policy and approach – (draft board paper provided) 1.4 Distribute Patient Awareness Packs to GP surgeries – using materials created in 1.2 above 1.5 Distribute Patient Awareness Pack to patient groups and other partners – using above materials (see suggested distribution list) 1.6 Conduct social media campaign / local awareness events to promote Patient Awareness Pack

2) Actions for raising GP / referrers awareness and use of Choice 2.1 Identify CCG GP lead ( Choice Champion ?) 2.2 Present ‘choice benefits and opportunities paper’ to local GP network meeting (draft paper to be provided) 2.3 Prepare GP Awareness Pack (including links to enhanced use of eRS, latest Directory of Services (including which one require approval), Shared Decision Making, and navigator programmes) 2.4 Test and refine GP Awareness Pack 2.5 Approval / sign off of GP Awareness Pack 2.6 Distribute GP Awareness Pack to all GP Practices

3) Actions for providing relevant Information for choice and shared decision making 3.1 Ensure NHS Choices and eRS DOS are up to date with local provider services and notify GPs of any change of providers or services 3.2 Creation of Choice Information Bank – (pre populated template provided linked to NHS Choices / Patient.co.uk and local provider websites and including what choices are available by specialty) 3.3 Sign off / approval of Choice Information Bank 3.4 Roll out to GP Shared Decision Making Training Packs 3.5 Creation of Choice Information Bank in multiple formats 3.6 Distribution / Launch of Choice Information Bank

4) Actions for building Choice into Commissioning plans CCG Training Pack covering… 4.1 Assess availability of choice (by specialty ?) 4.2 Analysis of changes in referral patterns 4.3 Investigate any changes in referral patterns 4.4 Identify capacity gaps in provider landscape where patients would benefit 4.5 Address gaps by decommissioning and recommissioning as appropriate 4.6 Establish Advice and Guidance services from named consultants for mental and inclusion of mental health care referrals on to e-RS

5) Actions to embed Choice into referral models, protocols and Clinical Pathways With focus on Demand Management and RTT performance 5.1 Identify elective demand pressure points and red / green RTT providers 5.2 Assess and quantify ‘smoothing’ opportunities for targeted services including Independent Sector 5.3 Contact relevant GP practices /referrers and providers and review accuracy of relevant Directory of Services (eRS DOS) for relevant services 5.4 Provide Demand Management Guides and training for GPs 5.5 Provide Demand Management Guides and Training to Referral Management Centres where appropriate 5.6 Switch on eRS capacity flags (in agreement with RCO team)

6) Actions for assuring and enforcing Choice Supported by Choice Assurance Pack 6.1 Identify individual who has lead responsibility for choice on CCG Governing Body 6.2 Monthly board reporting of eRS utilisation and availability of appointments (automated feed) 6.3 Add choice as a standard agenda item for contract management meetings 6.4 Report patient awareness of choice on CCG website (provided routinely as eRS survey extract) 6.5 Review NHS Improvement investigation reports relating to Choice (relevant copies provided) 6.6 Publish legal rights to Choice on CCG website

Personalisation and the Future of Primary Care Better Access Information Integration More Control Convenience GP contact time Less Appointments required Waiting time £££ on acute and urgent care Disruption and inconvenience for patients

Personalisation and Choice in Primary Care 1 Front of House Choices- Improved signposting and navigation- using standardised GP Practice websites with link to community health services, social prescribing and self care support 2 Personalised Planning and Scheduling – Booking appointments, ordering prescriptions , access to medical records +test results and person centred care planning / IPC personal health budgets 3 Convenient Access- Multiple forms of access and new consultation types (video /email/instant messaging / translation services) available any time and any place 4 Shared Decision Making and Choice of Referral - Directories of Services / eRS / Capacity Flags / Advice and Guidance Services / Social Prescribing 5 Consent and Control - of personal information and shared health records 6 Offline Choices - when the human touch is needed - eg Pharmacy First

Patient Choice and GP Access 38% would like appointments before 8am 76% would like appointments after 6.30pm 79% would like appointments on a Saturday 50% can not access an appointment on the day they wanted