Best Health for Everyone NHS Warwickshire’s strategy with South Warwickshire Foundation Trust

Strategy Overview

5 Reducing Variations in Care: OP cardiology variation in referrals: In grouping the five ‘high’ and five ‘low’ utilising practices to increase the patient counts in the denominators, we observe significantly higher Year2 secondary care costs for the practices with high Year1 OP utilisation

Investment / Disinvestment planned over period to 2013/14 Disinvestment anticipated across the acute sector (£69m compared with 2009/10). Supports new investments in Primary Care (£55m) and Community services (£17m). 2010/11 change is small - but important for preparing for the following years. It is essential that we are all clear on the changes that will need to be made and of our individual and shared responsibilities for delivery. Source: NHS WM, Analytical summary of the Healthcare Strategy for Warwickshire PCT, 13/4/2010

High level view of Acute spending across NHS Warwickshire This bridge shows the overall financial strategy of the PCT for Acute sector spend to 2013/14 – it is based on aggregate spending on Outpatients, Elective, Non-elective & Day cases. Shows an unfunded increase in demand of £36.3m, offset by initiatives which are targeted to deliver savings totalling £88m. But excludes provider efficiency requirements. These savings are expected to be realised by exploiting opportunities to: 1.Better manage the health of our population; 2.Improve supporting patient independence to reduce demand for high cost care; 3.Manage a substantial proportion of interventions more efficiently – eg: embracing ‘best practice’ care pathways and substitute care packages within community settings. 4.Target services to patients based on proactively managing risk

SWFT Strategic Financial Plan for period to 2013/14 Source: NHS WM, Analytical summary of the Healthcare Strategy for Warwickshire PCT, 13/4/2010 The current SWFT strategic view sees income remaining flat over the period with a small increase in total expenditure over the period. These assumptions are inconsistent, in the long-term, with NHSW’s financial planning

High level view of NHS Warwickshire future spend with SWFT This bridge shows the overall financial strategy of the PCT for SWFT The impact on SWFT as a result of the proposed Initiatives is for a net reduction of £15m income - although this follows an anticipated increase in unfunded demand of £17.2m. This is a forecast and so naturally reflects the underlying assumptions – whilst individual figures may change the scale and direction of the challenge is clear.

How will we work together to find the right path? We need to develop a joint approach to managing the strategic healthcare challenge, both with SWFT, and across our local health economy (LHE). In particular, we want to: 1.Share our respective plans and assumptions and work to develop a consensus for an overall plan that provides ‘Best health for everyone’; 2.Reach agreement in principle regarding the shared elements of our respective change agendas and agree how we can best support each other to deliver; 3.Establish a shared view about the SWFT’s role in the LHE, in the context of NHSW’s service model of: Defining Needs, Choice, & Integrated Services; 4.Revise the contractual incentives for SWFT to more easily enable our shared agenda and the service model to be delivered; 5.Ensure that we have the right frameworks in place across the LHE to ensure that we develop appropriate levels of partnership and relationships at all levels. As the first step we need to agree the strategic agenda between NHSW and SWFT and suggest that we establish a working group with a representatives of your board who we will work with to progress this.