1. Integrated Care Organisation 24 June 2015 1

2. Challenges in the current system Some services are based around organisation structures, not whole population health & care needs Multiple providers and commissioners with misaligned financial incentives Expenditure driven by acute activity levels rather than most appropriate solutions Scarce availability and poor morale of some key staff groups Organisations facing financial problems, potentially leading to focus on the individual organisation rather than whole population solutions 2

3. New Policy Framework Five Year Forward View – National Co-Commissioning – National Health and Care Review – Suffolk All focusing on ‘joined up’ services 3

4. Five Year Forward View – New Models of Care Breaking down barriers between primary, acute care, community services and social care New organisational forms possible: - Primary Care at scale - Primary and Acute Care organisations - Federated hospitals One size doesn’t fit all 4

5. NHSE IHT GP practices (GP Fed) SCH 111 OOH Leadership and resource Functions Board PMO Communications and engagement OD and workforce planning IM&T System-wide activity and financial modelling Indicative capitation funding Joint redesign Functions Board PMO Communications and engagement OD and workforce planning IM&T System-wide activity and financial modelling Indicative capitation funding Joint redesign CCG NSFT SCC Shadow ICO Service based contractual relationships IP3/4 and Sudbury Connect early adopter sites Test and learn Phase 1 - 2015/16 1+1 contract arrangements provide space for development of integration plans

6. NHSE CCG SCC Outcome based contractual relationships IP3/4 and Sudbury Connect early adopter sites Test and learn Phase 2 Outcome based contractual relationships Per capita based funding ICO GP practices Acute hospital Community health care OOH 111 NSFT Social care providers VCS EEAST Independent providers

7. Opportunities for Ipswich & East Suffolk Primary Care Better patient care Improved working - Direct influence over hospital & community services - Co-ordination of care - Portfolio careers System resilience - More attractive recruitment prospects - Stability for community service staff - Support for challenged practices Finance - Investment into local services - Potential direct employment options