East Sussex Better Together Alliance 28/04/2017 East Sussex Better Together Alliance East Sussex Strategic Partnership Update 6th July 2017 3 May 2017

and experience of patient care Improve health outcomes 28/04/2017 Background – triple aims Personal Enhance the quality and experience of patient care (the care and quality gap) Population Improve health outcomes of populations (the health and well being gap) System Reduce the per capita cost of care (the funding and efficiency gap) 3 May 2017

ESBT: more integrated services becoming available for local people Crisis Response Service fully operational Frailty Service fully operational Recruited 41 Integrated Support Workers 15 Proactive Care Practitioners have been recruited Falls assessors and falls prevention classes as part of Falls and Fracture Prevention Service

ESBT Alliance ‘Shadow Year’ Progress 28/04/2017 ESBT Alliance ‘Shadow Year’ Progress Formal Alliance Agreement in place Integrated governance structure New Strategic Commissioning Board Integrated pilot Outcomes Framework Integrated Strategic Investment Plan for 2017/18 and system-wide financial and performance reporting Agreed how patients, clients and citizens will be a part of the governance arrangements Exploring what locality planning and leadership could look like East Sussex Better Together is our bold and transformative approach to developing a fully integrated health and social care economy in East Sussex 150 week plan started in August 2014 Our shared ambition is to make sure every patient and service user receives proactive, joined up care that supports them to live as independently as possible and achieve the best possible outcomes. It’s about making sure we use our combined £850 million annual budget to achieve the best results 3 May 2017

The role of localities in our ESBT Alliance 28/04/2017 The role of localities in our ESBT Alliance Opportunity to ensure the voice of localities are at the heart of how we plan and how we act as a system A potential change in the way professionals and partners across the system locally come together to work around the best interest of the population they serve? This would involve the full range of relevant partners and professionals within a locality identifying priorities and collectively making best use of resources Evolving - the aim is to get to a greater collective understanding of local need and cost effective solutions 3 May 2017

Integrated Outcomes Framework 28/04/2017 Integrated Outcomes Framework 3 May 2017

28/04/2017 2017/18 – a learning year Part of our longstanding objectives for integration to achieve the triple aims - we’re aren’t starting from a blank sheet As our ESBT ‘place’ we have agreed that we need a new model of care; redesigning care pathways isn’t enough to deliver sustainability We now need to choose the best vehicle to deliver this Learning environment to think about the ‘how’ not the ‘what’ East Sussex Better Together is our bold and transformative approach to developing a fully integrated health and social care economy in East Sussex 150 week plan started in August 2014 Our shared ambition is to make sure every patient and service user receives proactive, joined up care that supports them to live as independently as possible and achieve the best possible outcomes. It’s about making sure we use our combined £850 million annual budget to achieve the best results 3 May 2017

Our options* Prime provider/prime contractor ‘integrator’ 28/04/2017 Our options* Prime provider/prime contractor ‘integrator’ Corporate Joint Venture Alliancing commissioners and providers Forms of merger or new organisation *New models of care: emerging innovations in governance and organisational form (Kings Fund, October 2016) East Sussex Better Together is our bold and transformative approach to developing a fully integrated health and social care economy in East Sussex 150 week plan started in August 2014 Our shared ambition is to make sure every patient and service user receives proactive, joined up care that supports them to live as independently as possible and achieve the best possible outcomes. It’s about making sure we use our combined £850 million annual budget to achieve the best results 3 May 2017

Options appraisal Panel process and design criteria discussed in May: 28/04/2017 Options appraisal Panel process and design criteria discussed in May: Arrive at a consensus view across our ESBT Alliance about the preferred direction of travel for our Alliance in the future, and; Understand and agree the key steps and the timetable involved to get there, and; Inform our priority actions for implementation from April 2018 Arriving at a consensus view across our ESBT Alliance about the preferred direction of travel for our Alliance, and; Understanding and agreeing the key steps and the timetable involved in getting there, ensuring priority actions agreed for implementation from April 2018. Need a new model of care, know that – how we organise ourselves to deliver Four options High level levers Legislative context What’s in the pack Decision-making process and timetable  Not a debate about the merits of Accountable Care  High level roadmap session September 2017 April 2018/19 April 2019/20 3 May 2017

Criteria Criteria Transformation (for sustainable services) 28/04/2017 Criteria Criteria Transformation (for sustainable services) Governance and accountability Quality and safety Clinical and professional sustainability Access and choice Deliverability Financial Sustainability 3 May 2017

Overall consideration 28/04/2017 Overall consideration How does the option help us to improve System-wide leadership The levers for change we have to transform delivery for sustainable services Collaboration and collective decision-making Long-term sustainability - for the workforce and financially; and to support transformation for sustainable services 3 May 2017

East Sussex Better Together Alliance Next steps Recommendations on the preferred model (the legal delivery vehicle) to the relevant CCG, County Council, ESHT and SPFT decision-making bodies – July 2017 Share outcomes widely July and August 2017 Further engagement to discuss and firm up implementation details August – September 2017 Quality and Safety

28/04/2017 Thank you 3 May 2017