Bishop’s Castle Patient Group Thursday, 9 July 2015

Programme Update The story so far….. Acute Option Development Rural Urgent Care Affordability Timeline & Risks Linked Projects Engagement & Consultation

The story so far…… Call to Action Nov ‘13 Case for Change Jan ‘14 Clinical Design Jun ‘14 Long list of acute scenarios Jun ‘14 Activity & Capacity Modelling Aug ‘14 Short list of acute options Feb ‘15 Strategic Outline Case Aug ‘15 Preferred option Sept ‘15 Rural urgent care provision Sept ‘15

Clinical Model – networks of care Urgent & Emergency Care Network Planned Care Network Maternity Network Consultant-led Obstetrics and Neonates Midwifery Led Units MLU Obs

Emergency Centre Urgent Care Centre Consultant-led Obstetrics Diagnostic & Treatment Centre Local Planned Care SHORTLIST OF ACUTE HOSPITAL OPTIONS

Option Appraisal ECONOMIC APPRAISAL Which option provides the best value for money? Financial Appraisal How do the costs of options compare? Non-Financial Appraisal What non-financial impact will each option have? Accessibility Quality of care Workforce Deliverability

Potential Locations for Urgent Care Centres

Urgent Care Centres  Urban UCC (RSH & PRH) included within acute options  Work under way to explore the most appropriate rural urgent care solutions in partnership with local communities and considering current facilities/services  1 st round of locality meetings completed  2 nd round now scheduled  Will consider all existing Minor Injuries Units & Community Hospitals as potential sites for Urgent Care Centres  No locality would experience a reduction in urgent care provision  Subsequent work will need to explore potential for rural planned care activity by sub-specialty. Bishops CastleThur WhitchurchMon LudlowThu BridgnorthMon OswestryThu

Urgent Care Centres First Round To develop a baseline understanding of urgent care, and what we anticipate will be the minimum system requirements for all UCCs in Shropshire, Telford & Wrekin. Second Round Summary presentation on information gathered and analysed from first round. Further inputs (e.g. travel times, projected footfall, estates review, estimated cost envelope). Inviting representatives of other professional groups (therapists, practice nurses, ambulance service, social care, third sector), aiming for around a 60:40 split between public/ patient representatives and professional clinicians / managers. Key themes to be identified to inform recommendation to Programme Board.

Affordability Work now being completed on: The building and running costs for each of the shortlisted acute options The potential cost of Urgent Care Centres Commissioners to assess affordability of activity implications within 5 year plans SaTH to set out affordability of each option within the funding envelope NHS Trust Development Authority to advise on affordability assessment

MAY 2015 JUNJULAUGSEPOCTNOVDECJAN 2016 FEBMARAPRMAYJUN Acute SOC (EC, DTC & Urban UCCs) TDA and DH/HMT parallel approvals Acute OBC development Rural Urgent Care solutions PCBC development Preferred Option – Rural urgent Care Offer - 4 Tests Gateway– Senate – Affordability - Consultation Plan NHSE Assurance Panel Gate 1 Review DMBC development Senate Stage 2 Review Public Consultation Preparation for Consultation - plans & draft document Final Preparation Prototyping - Business Case development (tbc) Board/ CCG approvals CCG affordability decision SaTH approval Board/CCG approvals Option Appraisal Preferred Option Equality Impact Engagement Development of Full IIA Plan Integrated Impact Assessment FINAL COMMISSIONER DECISION MAKING Consultation Report HOSC/CHC Engagement Gate 2 Review Welsh Election SaTH approval SCHT approval PROGRAMME HIGH-LEVEL CRITICAL PATH Compressed variant of original timetable Risk of failing to deliver the critical path due to interdependency with other workstreams and/or dependency on approvals outside the programme. High RiskMedium RiskLow Risk IIA Report & Mitigation Planning

Linked Projects ‘Community Fit’ Describe patient oriented activity in primary care and estimate how this might change as a result of changes in demography. Use a full range of available data sources to identify patient’s wider community health and social care usage and classify patients based on utilisation patterns. Nature of subsequent work to be defined re: development of primary and community services Stakeholder meetings to start from September (Third Sector, Mental Health, Primary Care Services, Social Care & Community Services) to review data Information Technology Local Health Economy IT Forum reported progress to Programme Board Integrated Care Record project to be established

Communication & Engagement POP UP CAMPAIGN o Grassroots engagement in 13 community venues - 60,000 leaflets. PRESENTATIONS o Over 50 presentations to Councils and social & community groups from January to May. RURAL URGENT CARE CENTRES o Planning workshops at five localities TELEPHONE SURVEY o Representative sample of c.3,000 people across Shropshire, Telford & Wrekin and Powys to inform option appraisal. IMPACT ASSESSMENT o Targeted engagement with groups representing people with Protected Characteristics, and planning for full Integrated Impact Assessment alongside Public Consultation. CONSULTATION PREPARATION o Due to commence and to include early engagement with Health Overview & Scrutiny Committee and with Powys Community Health Council. COMMUNITY FIT o Initial communications on purpose and scope being prepared.