1. CHC ANNUAL CONFERENCE Wednesday 27 th June 2012 Andrew Carruthers, National Director, Together for Health

2. Agenda National Director role Progress to date Why now – some perspective Some closing thoughts

3. National Director Role To work with the Director General/Chief Executive NHS Wales and the NHS Wales Chief Executives Focus on delivering the Specific requirement for Health Boards to develop plans that ensure sustainable services for NHS Wales – the service change plans! Co-ordinating the 3 regional plans and 7 Local Health Board Plans Supporting the National Clinical Forum

4. Progress to date ………. Hywel Dda/Betsi Cadwaladr Engagement/listening programme complete Reflecting on feedback to inform formal consultation development South Wales Programme Complexity and scale of 6 Health Boards Working Together Engagement underway- 4 clinical events held

5. Progress to date ………. (cont) National Case for Change Launched in April 2012: The Best Configuration of Hospital Services for Wales: A Review of the Evidence – Professor Longley Service Terminology – a consistent approach across Wales

6. Why Now – Some Perspective Based on his review of evidence: “ Across Wales, some major service re-configuration is required: some people are facing serious, unnecessary risks, and parts of the service may collapse” Professor Marcus Longley, April 2012

7. Why Now – Some Perspective The Golden Jubilee of the DGH ‘Here now is the opportunity to build a hospital service equal to any in the world and matched, I would think, by very few… This Plan is nothing less than a plan for the modernisation of our hospital system… to make clear the sort and size of hospitals which we ought to have if we are to make the best use of the specialist techniques of our time, together with the general practitioner services and the domiciliary services’ Lord Newton, Hansard HL Deb 14 February 1962 vol 237 cc472-581

8. What has happened since 1962? 1962 – The first hip replacement 1965 – Patient monitoring systems introduced 1967 – Colour TV programmes on BBC 2 1968 – The first heart transplant 1969 – Neil Armstrong landed on the moon

9. What has happened since 1962? (cont) 1971 – Pocket calculator and the floppy disk 1972 – CT Scanners Introduced 1973 – Personal computers and handheld mobile phones 1978 - First “Test Tube” baby 1980 - MRI scanning and laparoscopic surgery 1988 - Breast screening introduced

10. What has happened since 1962? (cont) 1990 – Day case surgery 1991 – World Wide Web 1998 -NHS Direct launches 2000’s -the development of drugs/interventions to manage cardiac disease (Primary PCI/Thrombolysis) 2000- Broadband becomes mainstream in UK 2007 – Robotic surgical intervention introduced 2011 - Technology exists now that enables 3D printing from a 3D printer

11. In case you don’t believe me!

12. A challenge………….. Is it right that 50 years later, with all the technological and medical advance there has been in that time, and the evidence we know exists, that our pattern of hospital services looks similar? If in 1962 Enoch Powell had available to him the same opportunities in terms of health care provision, treatments, technologies and evidence, would the Hospital Plan have looked the same?

13. Making change is never easy….. It will challenge us all Difficult decisions will have to be made: “Acceptable trade off’s” (Professor Longley) We need to be consistent in our message Lose any self interest – the greater good Work together closely Have strength and resolve

14. Because it can be done……….

15. Closing Thoughts “Services best suited to Wales but comparable with the best anywhere” (Bevan Commission) The evidence indicates where we need to look to improve We owe it the population (and ourselves!!)

16. The real challenge Is it right that 50 years later, with all the technological and medical advance there has been in that time, and the evidence we know exists, that our pattern of hospital services looks similar? If in 1962 Enoch Powell had available to him the same opportunities in terms of health care provision, treatments, technologies and evidence, would the Hospital Plan have looked the same? More Importantly…………

17. What will we do?

18. Thank You andrew.carruthers2@wales.nhs.uk