1. Ian Ayres Accountable Officer West Kent Clinical Commissioning Group

2. The new NHS Architecture 1 HQ 4 Regional Teams 27 Local Area Teams Clinical Commissioning Group Foundation Trusts Private Providers 3 rd Sector providers Set Targets Allocate £s Accountable Authorise Contract with 1 NCB 212 CCGs 000s of providers Parliament & Secretary of State £sMandate Social Enterprises Patients Local People and Local Authorities Provide care Work together

3. Draft Mission A safe, sustainable and affordable patient focused healthcare service that provides quality patient experience and improved outcomes for local people.

4. Draft three year aims A thriving local NHS provider landscape for the West Kent population which delivers safe and high quality urgent and non-urgent care, in particular: – To work with MTW to support them to be a Foundation Trust in the top quartile in terms of productivity and safety Improved patient and carer experience for End Of Life Care, in particular: – To develop a quality of care focus with increased levels of advanced care planning Improved and integrated health and social care packages for the elderly population, in particular: – To align community health and social care team around clusters of practices to improve the integration of care and keep people out of hospital

5. Draft three year aims Improved satisfaction, reduced variability, and improved access in Primary Care, in particular: – To develop a collaborative commissioning contract with primary care and community services, that reduces health inequalities, and achieves better outcomes. Engaged and empowered patients who are able to manage their own health and make informed decisions, in particular: – To develop peer support for long term carers and PPGs to work with schools and the media Improved Value for Money and outcomes for Mental Health conditions including dementia, in particular: – Developing improved community based services that support individuals manage their mental health problems without the need to be admitted to an inpatient bed.

6. The NHS focus on quality

7. The efficiency challenge May 2010May 2015 May 2020 An aging population needs more healthcare Level funding for this parliament Funding for the next parliament? Healthcare Costs NHS Funding

8. The efficiency challenge in £s The Nicholson Challenge for this Parliament – NHS funding c£100bn – 4% cost pressure each year for 5 years – Up to 4bn additional efficiency needed each year – Total £20bn annual efficiency needed by year 5 The Nicholson challenge for the next parliament – The same again or more? The local challenge – Local funding c£0.5bn – 4% cost pressure each year for 5 years – Up to £20m additional efficiency needed each year – Up to £100m annual efficiency needed by year 5

9. Hard Decisions Doing more of the same is not an option Two ways to bridge the gap – Do less – stop funding some services – Do it cheaper (reduce costs not price) Healthcare costs are mostly people, buildings and drugs These are hard choices that effect us all – We will find the best answers if we work together With local people Led by clinicians