Status : Issued Version: v2 Date: 5th March, 2014 Calderdale and Greater Huddersfield Integrated Health and Social Care Strategic Review Strategic Review Update March 2014

Agenda Background to the Strategic Review What our engagement to date has told us Our vision for our future system Commissioners’ responsibilities The providers’ Strategic Outline Case High level timetable and next steps

Background and Context Seven partner organisations 2 years - shared vision - innovate and transform services. Transformation is needed to address the significant challenges facing the health and social care system now and in the years ahead. Ageing population with increasing needs Increase of long-term health / social care needs High quality, sustainable healthcare Responding to the needs expressed by patients Limited and diminishing resources.

Background and Context Key overarching aims taken from the priorities in both JSNAs All partners share the vision to change the way health and social care is provided to enable: –Easy access to the right information and guidance for people to make informed choices for themselves and their families –People only have to tell their story once and are supported to make positive choices –As much care as possible is provided close to home to keep people safe, well and as healthy as possible for as long as possible –Every child has a healthy start with opportunities to achieve their full potential –High quality, safe and effective specialist care is available when needed –Different agencies make best use of shared resources

More than 2,500 people directly engaged 300 young people 44 people at planned care event 1,700 people unplanned care survey 500 staff All national and local surveys, PALS, complaints, patient opinion and NHS choices information from the past 3 years collated. Unplanned care engagement – 2,500 views Call to Action – 280 public views Engagement activity to date

Timely and consistent access to services Co-ordinated and integrated care Services closer to home Involve us in decisions about our care and in planning care Better use of technology What you told us you want

Education and information – all information should be available in easy to understand formats Invest in community and primary care as well as local community and voluntary groups National solutions and campaigns are needed for changes on a national scale Self Care – or self help/self management Improve access to health services. Opening times and appointment availability, particularly GP practices Staff training including changing the culture of the NHS, communication and transparency. Working together, all agencies, not just health, should work together to improve health and wellbeing Call to Action – 13 Themes

Regular check-ups including annual check ups or possibly more frequent depending on the age / condition Discharge planning and better hospitals including discharge plans with 24/7 support and hospital services in community settings. Manage risk and safeguarding – keeping people safe when they were unwell. More services in the community Invest in technology – especially for monitoring and sharing information between services and patients. Be accountable – clear measures, learn from mistakes, educate people on their rights and responsibilities and base contracting decisions on research and guidance. Call to Action – 13 Themes

Safety Net Total Care Specialist Locality Safety Net Our Future Care System Safety Net Money Control

National Clinical Advisory Team report from last summer Parliamentary interest in September 2013 and adjournment debate in December Media interest over the last three mo nths Time to start talking Why are we here / Why Now?

The Strategic Outline Case is a provider response to the Strategic Review The Strategic Outline Case

We need to make YOU feel part of designing the future Engage the population Statutory duty to lead the consultation Make the final decision about services for our population. Commissioners’ Responsibilities

Key points No decision has been taken about which hospital would be the planned care site and which the unplanned site Whatever happens, there will be some level of unplanned care provision at each hospital We are about to undergo a mutually agreed thorough pre-consultation engagement process to identify options for consultation Recent media coverage has not, in many instances, reflected the true position

Key points The strategic review is about much more than the configuration of acute (including A&E) services It is about the transformation of virtually all health and social care We want to talk about this wider transformation with patients, public and staff - not just the scenarios identified by providers Only then will firm proposals for consultation be identified

Jointly developed by CHFT, Locala, & SWYPFT Intention to work with general practice, YAS, social care and voluntary organisations to deliver integrated care in a community setting. Some (currently) hospital based services would move to Community Acute and emergency services provided on 1 specialist hospital site Planned services on 1 specialist planned care hospital site. The changes proposed will require public consultation. The proposals must demonstrate that the four Department of Health tests for major service reconfiguration have been met. (PPE, choice, evidence, CCG backing) Scope of the Strategic Outline Case

Scenarios for discussion with staff, key stakeholders, public, patients, carers and their representatives ScenariosDescription 1.Continue with the existing hospital and community service model and configuration. 2.Implement the community and hospital service model proposed in this presentation with Huddersfield Royal Infirmary as the site for acute and emergency care and Calderdale Royal Hospital as the site for planned hospital care. 3.Implement the community and hospital service model proposed in this presentation with Calderdale Royal Hospital as the site for acute and emergency care and Huddersfield Royal Infirmary as the site for planned hospital care. 4.Continue with the existing community service model and change emergency hospital care provided locally so that those people needing specialist treatments are transferred to a major emergency centre outside the local area. Huddersfield Royal Infirmary and Calderdale Royal Hospital would offer ‘see and initiate treatment’ services with people needing specialist treatments transferred to specialist centres. 5. Other scenarios which may emerge from the planned engagement activity with staff, public, patients, carers and their representatives.

Finance Estate requirements, affordability & confidence to achieve savings Clinical StdsWhat are they? Risks to current & clinical evidence base LocationSupport from YAS, journey times, parking, gritting & community offer Primary CareResource, activity shift, engagement StaffCommitment, & impact on workforce. PhasingCommunity before acute services Commissioners’ Questions – 1 of 2

Design Impact of ‘no change’ & other options Fit with Mid Yorks, Skills in ambulance & local paramedic cover Coms/EngPublic, patients, carers, staff – done/planned Eq & Diversity Protected Characteristics, Equality of Access ProcurementSatisfy fair contract route / lawful Commissioners’ Questions – 2 of 2

High Level timetable WhatBy When Providers develop OBCMay Preparation and planning for engagement March Pre-engagementJune Analysis and reportJune Preparation and planning for consultation June Consultation (13 Weeks) Post consultation feedback (6 Weeks) Potential Sec of State Review (3months) Summer 2014

Next Steps - Engagement already in place Local Councillors and MPs Overview and Scrutiny Committees and Health and Well Being Boards A dedicated website A Reference Group – 90 organisations PALS and complaints services Healthwatch Staff and member practices Existing consumer websites

Next Steps – Engagement what we need to do Drop in sessions x 9 Road show activity – 10 central locations Comments cards & boxes for anonymity Media & communications – posters, contact points, social media feeds, media releases Existing networks

Question Time