1. Highly
Preliminary
Building a sustainable health and care system for the people of Sussex and East Surrey

2. National context Drivers for Change
Population increasing
People living longer with long-term conditions
Health inequality gap
Health and care funding not increasing in line with increasing demand
The Five Year Forward View sets out how health services need to change over the next five years in order to improve public health and service quality while delivering financial stability by 2020/21.

3. Local context Long waits for planned care services
Pressures on A&E, 18 weeks and Primary Care
Pressures on Workforce
Poor health outcomes (Cancer, stroke, mental health)
Challenged health and care system finances

4. Our priorities have been built to address the system gaps
In our early stages of exploring the issues we face we have identified 3 priority frontline improvement areas:
New models of care for population-based catchments
Public health, prevention and self-care
New models of care for acute service delivery and networking

5. Our priorities fit into a new integrated model of care that will be key to long term sustainability
Overview
Our new mode of care will:
Deliver community-based prevention and population wellness
Incentivise collaboration between providers to coordinate care along pathways
Form a simpler, more integrated health and care system

6. New models of care for population-based catchments

7. Place-based models of care aim to improve health, care quality and cost of care simultaneously
Sussex and East Surrey is experiencing the same pressures as are being felt nationally and globally: there are more people, and we are living longer and with more complex conditions, the cost of healthcare is rising, and patient and public expectation is increasing
We believe that a prevention-led, whole-person focus, that crosses traditional health and care siloes will address the triple aims:
The health and wellbeing gap (Improving health outcomes of populations)
The care and quality gap (Enhancing the quality and experience of patient care)
The funding and efficiency gap (Reducing the per capita cost of care)

8. Our new model of care will:
Place-based models of care will be built around natural communities to support their health and wellbeing
Our new model of care will:
Deliver community-based prevention and population wellness
Incentivise collaboration between providers to coordinate care along pathways
Form a simpler, more integrated health and care system

9. We have developed a set of key characteristics that define how these place-based care models will operate
Prevention-led approach to reduce demand for services and allow care to be delivered increasingly out of hospital
All health and social care services should be in scope
‘Whole person’ care needs to be supported by a whole population approach rather than segmenting or subdividing the population by conditions or age
The model will have a positive impact and deliver outcomes that are important to local people
The outcomes based contract and capitated budget will be sufficiently large to achieve the economies of scale needed
There will be a focus on reducing the costs of commissioning
Strong culture of whole system working on the ground that actively empowers staff to be able to ‘do the right thing’, putting patients’ and clients’ needs first
Maximum levels of clinical and staff engagement and leadership
Collective leadership and have governance and operational mechanisms that enable learning and development to take place in stages to share and manage risks between commissioners and providers

10. Public health, prevention and self-care

11. We are developing an ambitious Prevention and Self-Care plan that will deliver significant health and wellbeing improvements
In order to address the most significant factors that drive poor health across the footprint, this we will focus on the following 5 areas:
Smoking
Diet
Exercise
Alcohol
Emotional Wellbeing & Loneliness
Evidence shows that these are the areas that have the greatest impact on ill health, disabilities, and early death.
A population based approach will be taken for children, working age adults and the frail and elderly.

12. We have developed themes to our prevention programme to enable more effective focus on the needs of our communities
Corporate Responsibility – “A healthier way to work and live”
Our health and care services will create healthy environments for patients, carers and staff
“Making Every Contact Count” MECC –
We will effectively use the millions of day to day interactions we have with the public to support their physical and mental health and wellbeing
Engagement with the Public -“The Big Conversations” and “Self-Care”
We will develop innovative approaches to promote and support self-care to help people stay healthy
An integrated, holistic approach to prevention
We will collaborate across the 23 partners to implement preventative initiatives at scale

13. New models of care for acute service delivery and networking

14. Waiting time improvements through sharing resources
Our hospitals are working together in new ways to ensure we provide the best care possible to the populations we serve
We are identifying significant opportunities to improve hospital care by working as a network:
Waiting time improvements through sharing resources
Standardising and simplifying urgent care through our network
Improving efficiency by learning from each other and sharing back office functions
Enhancing clinical networks to improve quality and efficiency
Making the best use of estate