Lunch & Learn – Session 5 Plan and Contracts Overview 19 th March 2014

Aim To provide attendees with an overview of key messages contained in the NHS planning guidance, the Strategic Plan, Operational Plan and Financial Plan submission and contracts, thus assisting with the ongoing development of programme/project plans. Previously….on Lunch & Learn #1 Keep it Simple Keep it Proportionate Remove the Bureaucracy Feedback from previous Lunch & Learn events: “great to have opportunity to input” “good to have engaged input from leads to enable them to feel they are part of the process. Everyone will have the same understanding” “I really value the introduction of the PMO, I think it will help Programme Leads manage and prioritise their work and help us to know what is expected and when”

Agenda Part 1: Overview of NHS Planning Guidance Part 2: 5 Year Strategic Plan: Highlights and key messages 2 Year Operational/Activity Plan: Highlights and key messages Finance Plan: Highlights and key messages Part 3: Contracts Overview

Part 1: Overview of NHS Planning Guidance A little test!!!

Part 1: Overview of NHS Planning Guidance 1.Complete NHS England’s vision statement: High quality care for - - -, now and for generations 2. There are four fundamental outcomes detailed in the NHS planning guidance: Delivery across the five domains and seven outcome measures Improving health Reducing health inequalities Parity of esteem Can you identify which of the following improving outcomes ambitions are the real SEVEN?

Part 1: Overview of NHS Planning Guidance Securing additional years of life for the people of England with treatable mental and physical health conditions. Improving the health related quality of life of the 15 million+ people with one or more long- term condition, including mental health conditions. Securing ‘more for less’: ensuring that the NHS continues to provide high quality services using less resources and a greater use of technology. Reducing the amount of time people spend avoidably in hospital through better and more integrated care in the community, outside of hospital. Increasing the proportion of older people living independently at home following discharge from hospital. Increasing the number of people having a positive experience of hospital care. Improving clinical leadership and reducing the number of managers wasting NHS money. Increasing the number of people with mental and physical health conditions having a positive experience of care outside hospital, in general practice and in the community. Making significant progress towards eliminating avoidable deaths in our hospitals caused by problems in care.

Part 1: Overview of NHS Planning Guidance 3.NHS England has introduced six transformational service models that they believe will determine any high quality, sustainable health and care system in England in the next five years. Can you fill in the gaps? A completely new approach to ensuring that citizens are fully included in all aspects of _______ _______ and ______ and that patients are fully _________ in their own care. Wider _______ care, provided at scale. A modern model of __________ care. Access to the highest quality ______ and _________ care. A step-change in the productivity of ________ care. ___________ services concentrated in centres of excellence.

Part 1: Overview of NHS Planning Guidance 4. When do NHS England expect CCGs to have: a) determined the footprint of their urgent and emergency care network? b) begin the process of designating facilities within the network? 5.One of the six transformational models of care requires a ‘step change in the productivity of elective care’. What is the level of improvement required within the next 5 years?

Part 1: Overview of NHS Planning Guidance 6. According to the NHS England Allocation process ND CCG has a greater share of CCG resources than is equitable in 2014/2015, but by how much? 7.What are the total Programme Resources available to the CCG in 2014/2015? 8.What are the following percentages in 2014/2015: a) Minimum risk reserve b) Minimum Control total c) Minimum Transformation monies 9. When we have to have the BCF in place in 2015/2016 how much will it be?

Part 1: Overview of NHS Planning Guidance And the answers…………

Part 1: Answers

1.Complete NHS England’s vision statement: High quality care for ALL, now and for FUTURE generations 2. There are four fundamental outcomes detailed in the NHS planning guidance: Delivery across the five domains and seven outcome measures Improving health Reducing health inequalities Parity of esteem Can you identify which of the following improving outcomes ambitions are the real SEVEN?

Part 1: Answers Securing additional years of life for the people of England with treatable mental and physical health conditions. Improving the health related quality of life of the 15 million+ people with one or more long-term condition, including mental health conditions. Reducing the amount of time people spend avoidably in hospital through better and more integrated care in the community, outside of hospital. Increasing the proportion of older people living independently at home following discharge from hospital. Increasing the number of people having a positive experience of hospital care. Increasing the number of people with mental and physical health conditions having a positive experience of care outside hospital, in general practice and in the community. Making significant progress towards eliminating avoidable deaths in our hospitals caused by problems in care.

Part 1: Answers 3.NHS England has introduced six transformational service models that they believe will determine any high quality, sustainable health and care system in England in the next five years. Can you fill in the gaps? A completely new approach to ensuring that citizens are fully included in all aspects of SERVICE REDESIGN and CHANGE and that patients are fully EMPOWERED in their own care. Wider PRIMARY care, provided at scale. A modern model of INTEGRATED care. Access to the highest quality URGENT and EMERGENCY care. A step-change in the productivity of ELECTIVE care. SPECIALISED services concentrated in centres of excellence.

Part 1: Answers 4. When do NHS England expect CCGs to have: a) determined the footprint of their urgent and emergency care network? ‘During 2014/15’ b) begin the process of designating facilities within the network? ‘In 2015/16’ 5.One of the six transformational models of care requires a ‘step change in the productivity of elective care’. What is the level of improvement required within the next 5 years? ‘20% productivity improvement within 5 years, so that existing activity levels can be delivered with better outcomes and 20% less resource’

Part 1: Answers 6.According to the NHS England Allocation process ND CCG has a greater share of CCG resources than is equitable in 2014/2015, but by how much? 8.8% 7.What are the total Programme Resources available to the CCG in 2014/2015? £ m 8.What are the following percentages in 2014/2015: a) Minimum risk reserve 0.5% b) Minimum Control total 1.0% c) Minimum Transformation monies2.5% 9. When we have to have the BCF in place in 2015/2016 how much will it be? £19.439m

Part 2: Overview of Strategic Plan NDCCG Strategic Vision: Work together across health, social care, housing, voluntary sector and with the public itself to enable people to retain independence supported by their local community. When publicly funded services are required they will be responsive, safe, caring and provide a good experience of care still within the local community in the majority of cases. Where exceptionally people need to access more specialised services outside of their community this will happen easily and they will be supported to return to their local community as quickly as possible.

5 Year Strategic Plan – NDCCG Plan on a Page

Part 2: Overview of Operational Plan Targets: As per NHS Constitution/CCG Assurance Framework IAPT: % of need in population served by IAPT: 15% % of people completing treatment and moving to recovery: 50% Local priority:80% of clinical navigation referrals into the SPA will avoid acute admission or be maintained in the community Dementia diagnosis rate: 2014/15: 67% 2015/16: 68% C-Diff: Trajectory now received from NHS England: ceiling of 138 cases (vs 85 cases)

Part 2: Overview of Operational Plan Improving Outcomes Ambitions Ambition AreaMetricProposed Attainment in 18/19 Unit of planning Average % change between baseline and 18/19 1. Securing additional years of life for the people of England with treatable mental and physical health conditions PYLL for causes considered amenable to healthcare - ALL % 2. Improving the health related quality of life of the 15 million+ people with one or more long term condition, including mental health conditions Health related quality of life for people with Long term conditions (12/13) % 2.1% 3. Reducing the amount of time people spend avoidably in hospital through better and more integrated care in the community outside of hospital. Composite of all avoidable emergency admissions (12/13) % 5. Increasing the number of people having a positive experience of hospital care. Patient experience of hospital care - av. number of negative responses per 100 patients (2012) % -6% 6. Increasing the number of people with mental and physical health conditions having a position experience of care outside hospital, in general practice and in the community. Patient experience of hospital care - av. number of negative responses per 100 patients (2012) % -7%

Part 2: Overview of Activity Plan Operational, activity and finance plans must triangulate Growth set at: NEL: 5.7% (offset by 3.2% QIPP) OP & EL: 1% A & E:2% QIPP: NEL:3.2%=reduction of c. 700 NEL admissions (per year) OP:0.3%= reduction of c. 300 attendances More work to do before final submission on 4 th April

Part 2: Overview of Finance Plan Resources in 2014/2015: Programme£369,807,000 Admin£7,077,000 The first priority is to: Recurrently fund all budget shortfalls Fund all recurrent expenditure funded in 2013/2014 from non-recurrent sources of funding Fund 2013/2014 outturn Whilst maintaining realistic and achievable levels of: QIPP and efficiencies Growth in secondary care activity Contingencies to mitigate risk

Part 3: Contracts Overview DCHS Continuation of the contract rebasing Reapportion the contract over CCG’s Chesterfield Royal FT Work toward the closure of a Non elective ward by 1 st September Work on the frailty unit Contract penalties Standard contract penalties national and local.

Any Questions?

Next Steps

Lunch & Learn – Session 5 Next Lunch & Learns Thursday 20 th MarchPMO A Basic Introduction to PMO Wednesday 26 th MarchLast Chance Saloon: Open space for questions, specific project support and development

Thank you for coming and please provide us with your feedback! Is there anything you felt was missing from this presentation? How could we do this better next time?