1 Oxfordshire PCT Ambitious about improving the health and wellbeing of local people. Developing the PCT Strategy Local Medical Committee October 18th 2007

2 Why we are here PCT is seeking feedback on its draft 5 year strategy from a wide range of organisations and individuals Attending range of meetings with different stakeholders, including LRCs & PBC Holding 5 meetings for patients, public and voluntary organisations across the County Holding a theme based meeting on each of our 3 commissioning priorities Inviting written comments via Using all comment to inform redraft for formal adoption by the Board 29 th November First draft

3 Outcomes we’re trying to achieve – our Vision Oxfordshire PCT will work with its partners to deliver a transformation in local health services, so that by 2012 the people of Oxfordshire will: §Be healthier – particularly if they live in our most deprived communities. §Be working with the PCT to promote well being and prevent ill health. §Be actively supported to manage their own health and care needs at home, when this is appropriate. §Have access to a choice of high quality, safe and appropriate health services. §Get excellent value for money from their local health services.

4 Starting point We need to: §Focus on a few things that will make the biggest difference to health in Oxfordshire §Get better at forecasting and planning ahead, for example anticipating the impact of changing demography on health spend §Improve our ability to analyse health spend v. health gain/outcome §Adopt a strategy for the whole PCT that covers what we commission and the services we provide directly

5 Commissioning priorities for 08/09 Breaking the cycle of deprivation §Partnership based activity to tackle physical and mental health inequalities and improve outcomes for deprived children in targeted geographical areas. Better deal for older people §Focus on older people’s physical and mental health services by: tackling avoidable admissions to hospital, providing more services in the community and improving our understanding of the economic impact of the growing population and how we might get a better return on investment by shifting spend. Commissioning excellence §Implement the diabetic pathway work as a model to test out: ways to improve long term condition management, care pathway redesign, shifting to outcome based commissioning and getting a better return on investment.

6 What we know now is: §Health outcomes are good, except in deprived areas – and the best way to try and start breaking the cycle of deprivation is through targeted partnership work on early intervention, prevention and mental health services with children and families §Over 85s will increase by 126% by and we know health spend is highest on this age group, and that some of this spend is avoidable or could deliver better outcomes §Partnership working between all those involved in commissioning and delivering services to older people with mental health problems needs to improve §Prevalence of long term physical and mental health conditions is increasing and this will present us with service redesign and resource challenges §Redesign work for diabetes gives us a model for a way of working that, if successful, we can apply to a range of other conditions §Diabetes is a LTC where we are appear to be delivering below average outcomes for above average investment and growth in prevalence is expected §Breaking the cycle of deprivation, providing a better deal for older people and commissioning excellence – particularly for LTCs like diabetes – are priorities shared by our local partners.

7 What about the rest of the PCT’s work? We will continue to deliver: §Community health services §Locally agreed service improvement programmes (eg MSK, heart failure and COPD) §Mental health priorities as set out in the agreed mental health strategy §Commitments made in partnership with the Children and Young People’s Partnership Board –safeguarding, teenage pregnancy §Public health programmes such as GUM programmes, obesity, screening, infectious diseases and breastfeeding §Faster access to treatment and improved choice §Planning for the development of care outside hospital

8 Our approach to financial planning §We will plan to create a recurrent surplus that can be used to invest in our priorities. §Cost drivers (eg demographic change, technological advances) and agreed cost improvement targets will be factored in at the start of the budget setting contract negotiation stage. §Future financial planning will consider potential disinvestment where evidence of poor return on investment exists.

9 Questions 1.Do you have any initial feedback the strategy and specifically our three proposed strategic priorities § Breaking the cycle of deprivation §Better deal for older people §Commissioning excellence 2.How do you think the strategy could be improved?