Welcome to NHS Wirral Kathy Doran Chief Executive

Welcome to Wirral - setting the scene An overview of our strategic plan - ‘plan on a page’ Our key achievements since November 2008 Looking ahead: what do we still need to do? * Our progress since November 2008

Wirral has a wide variation in terms of health outcomes 11 year gap in life expectancy between most and least affluent wards

The challenge to the partners is… Children experiencing twice as much dental decay and five times as many accidental injuries High rates of people claiming sickness benefit because of mental health problems Far higher rates of type 2 diabetes, COPD, cancer and CVD Higher rates of teenage pregnancy and higher rates of births to lone mothers Far higher levels of smoking, inactivity, poor diet and alcohol/drug misuse Poorer access to services owing to lack of transport, poor literacy levels, acceptance of a poorer state of health

Working Together for a Healthier Future Local Authority WUTH Cheshire & Wirral Partnership Third sector Public

Welcome to Wirral - setting the scene An overview of our strategic plan - ‘plan on a page’ Our key achievements since November 2008 Looking ahead: what do we still need to do? * Our progress since November 2008

“All round commissioning capability” “Broad range and granularity of information” “Clinical leadership and engagement” “Extensive healthcare reform” “Substantial improvement in patient experience” “Partnerships with meaning are now in place” Quotes from 2008 panel

Strategic Plan Refresh: the process Initial partnership working First draft of strategic plan 2007 Consultation with partners, the public and clinicians 2008 Development of strategic plan goals initiatives Prioritisation of initiatives Launch of evaluation process Reassessment 2009/10

Evaluation criteria Assessed needs Effect on Inequalities Access Evidence based Strategic Fit Cost effectiveness Financial Impact Achievability Acceptability Governance legal/clinical

Mental Health and Learning Disability 23 providers Community and Intermediate Services 47 providers (voluntary/third sector 37 providers) Primary Care 232 independent contractors Total number of providers 332 Acute Sector 30 providers River Mersey River Dee Irish Sea The Provider Landscape

Balancing collaboration and plurality New services New providers Home from Hospital (Voluntary & Community Action Wirral) Hospice at Home for Children (Claire House) Carers outreach (Alzheimer’s Society) Ophthalmology (Spa) Dermatology/ENT (Peninsula Health) Early onset dementia service (Cheshire & Wirral Partnership) Multi-systemic therapy for young people (CAMHS at Cheshire & Wirral Partnership) Lifestyle and weight management service (NHS Wirral provider arm) Stroke Support Service (WUTH) Integrated respiratory service (WUTH & Primary Care) Existing providers

Welcome to Wirral - setting the scene An overview of our strategic plan - ‘plan on a page’ Our key achievements since November 2008 Looking ahead: what do we still need to do? * Our progress since November 2008

Prioritised Investments Health Trainer Network Fall prevention service Community detoxification service Weight management service Health in schools service Social Marketing End of Life programme Home oxygen service Hyper acute stroke service Primary Care mental health service Clinical EngagementPatient and Public Involvement Enabling strategies Evaluation development Evidence based Market management Risk People and Organisational development Premises Quality Promoting Key Health Needs Health Needs Focus on children and older people Alcohol Obesity Sexual Health Smoking Cancer COPD CVD Mental Health Health Inequality Life Expectancy Reducing the gap Increased life expectancy Rate of hospital admissions per 100,000 for alcohol related harm Childhood obesity at reception Under 18 conception rate Smoking quitters All causes of cancer mortality Spirometry testing in primary care Percentage of stroke admissions given a brain scan within 24 hours Hospital admissions caused by intended or deliberate injuries Overall Impact/Outcomes Outcomes To ensure excellence in our health services To target inequalities through effective partnerships To involve and empower people Vision To be a high reputation, high performance organisation

Welcome to Wirral - setting the scene An overview of our strategic plan - ‘plan on a page’ Our key achievements since November 2008 Looking ahead: what do we still need to do? * Our progress since November 2008

Involving and Empowering People: a new phlebotomy service A centralised service, not offering much flexibility for patients with long waiting times November 2008 March 2010 Patient and GP feedback drives service review A practice and community based service offering greater patient flexibility Quick scheduling of appointments, results within 48 hours Better quality = Lower cost

Targeting Inequalities: achievements in Cardiovascular Health 60,000 Wirral residents = CVD Health Check 19,000 Wirral residents = CVD risk registers A community programme to support lifestyle change Heart Centres provide diagnostic services and cardiac care closer to home Year on Year of revascularisations Early Supported Discharge Team Specialist Stroke Support 50 lives saved over the next 5 years

Ensure excellence in our health services: an integrated alcohol pathway Reintegration Community Aftercare Projects x 5 Voluntary Sector Daycare & Aftercare Projects Wirral Advocacy Services Homeless outreach project Specialist Care Rehab Community and Residential Detox Specialist Residential Rehab Dependent Drinkers Team Hospital liaison nurses Hospital based engagement workers Harm Reduction Harm Reduction team Rapid Response service (PCAU) Criminal Justice Programme Archway Resource Centre Identification and Engagement Social marketing campaign GPs and Pharmacy screening Advice line and website Community engagement team (screening and brief intervention) Private sector Primary care Mental Health FT Voluntary sector Local council Acute FT

Be a high performance, high reputation organisation: achieving the A&E 4-hour target 4-hour waiting time data inaccurate June 2009 Performance at 85% the challenge

The current situation Across the Health Economy 97.2% Annual result for 2009/ % Q4 across the Health Economy

Be a high performance, high reputation organisation: reducing A&E attendances The current situation as at end of March 2010 attendances 6% against plan attendances 5.8% against 2008/9

Single door triage at A&E… … live from 10 May 2010 Initial results from pilot programme 4% of patients diverted to Primary Case Assessment Unit 28% of patients diverted to All Day Health Centre61% of patients diverted to A&E Minors4% of patients diverted to A&E Majors 3% of patients diverted direct to speciality 35% of patients diverted away from A&E

Welcome to Wirral - setting the scene An overview of our strategic plan - ‘plan on a page’ Our key achievements since November 2008 Looking ahead: what do we still need to do? * Our progress since November 2008

Wirral Leadership Group Older People Director of Adult Social Services Wirral Borough Council 5 Planned Care Chief Executive NHS Wirral 3 Urgent Care Chief Executive Wirral University Teaching Hospital 2 4 Mental Health Chief Executive Cheshire & Wirral Partnership Children and Maternity Director of Children’s Services Wirral Borough Council 6 Communications and Engagement Chief Executive Clatterbridge Centre for Oncology 7 Public Health & Back Office Chief Executive Wirral Borough Council 1

A good starting position to deal with the financial challenges ahead A successful history of achieving statutory duties Use of Resources ‘Managing Finances’ = score 3 QIPP plans in place for short and medium term Identification of management and administrative support costs advanced

NHS Wirral leadership role in… C&M Renal Network Diabetes Network National PBR External Advisory Group Merseyside & Cheshire Research Alliance Network Board (co-ordinating network activities) Directors of Public Health group C&M Director of Commissioning Group Audit Commission Data Assurance City Region Healthier, Safer Communities Board Host for PH Network - Greater Merseyside CMP NPDT Collaboratives Continuing Health Care Critical Care Network Map of Medicine C&M Public Health Network National Financial Issues Group Cancer Network National Institute of Health Research Advisory Board National Advisory Role to C&M czar DH Policy Groups for Primary Care National Assistive Technology Advisory Group Mersey Sports Partnerships C&M lead obesity & well-being

Welcome to NHS Wirral Kathy Doran Chief Executive