1. Governing Body 1st November 2016
Planning Update
Governing Body
1st November 2016

2. Purpose
Update on planning changes since last Governing Body including:
Sustainability and Transformation Plan
Operational Planning assurance themes & challenges
Committees in Common updates: Stroke and Children’s Community Services
Collaborative Arrangements: Mental Health
Presented to NOTE no decisions are required from Governing Body

3. Frimley Health and Care STP
Final draft submission was sent to NHSE on 21st October as required
No changes in priorities since September GB update but more detail provided on key initiatives
Additional information added on:
Transformational enablers ( Whole population focus, developing communities, workforce, technology and developing our estate)
Mental health and learning disabilities
Communication and engagement
Aiming for early public launch events following NHSE approval

4. Operational Plans
NHSE assurance areas/themes becoming clearer (slides 3-7)
Operational challenges for
Affordable activity plans within contracts that will deliver across all Constitutional Standards owned by both commissioner and providers
Risk areas: RTT, A&E and ambulance services
CCG Integrated Assessment Framework
6 areas “Needs Improvement” assessment rating for cancer & diabetes. Will need clear improvement plans.
Clearly articulate our urgent care model ( NHS 111, GP urgent care in & OOH, clinical hubs)
Clear narrative on how health & social care integration, Accountable Care Systems & STP wide projects will improve outcomes & sustainability

5. Assurance Themes Plans
Operational plans that deliver STP objectives in year 1 and 2
Achieving the best possible performance within financial limits
Commissioning enough activity to meet demand, that can be paid for and there is capacity to deliver
Delivering constitutional standards
Meeting business rules
Process
Plan submissions according to national deadline
Contracts agreed by national deadline
Plans that can be used to monitor delivery
Clear outputs for moderation of plans and in year monitoring
Assurance
Action plan where the plan objectives can’t be met
Evidence that plans are credible and deliverable
Evidence of robust planning assumptions
Plans agreed across the system and actions that will enable delivery of the plan
Strategic and quantitative alignment with STP
Adding value to CCGs where possible

6. Key assurance questions
Activity
Is there enough activity to meet demand?
Can planned performance be delivered?
Is there capacity to deliver planned activity?
Is the planned activity affordable?
Is the planned activity represented in contracts?
Will the plans deliver the STP?
Constitutional standards
System
Affordability
Contracts
STP alignment

7. Indicative KLOEs Activity – Does it align with STP IHAMs growth
Evidence to support move from do nothing to expected
Mapped to capacity
Jointly managed risk
Constitutional Standards
Trajectories meet standards in 17/18
Realistic reflecting history
Risks and mitigations
Steps to deliver in failing systems
Quality and Safety
Workforce planning
Safeguarding
SI learning
Impact assessments in place for pathway changes

8. Indicative KLOEs STP Evidence of open STP process
Is it year 2 and 3 of STP
Milestones
Evidence of joint working and contribution to STP
Reducing unwarranted variation
Cancer/Mental Health
Delivery of revised stretch targets and annex requirements
Maternity
Better Births implementation plan
Diabetes
Plans to tackle obesity and diabetes
Urgent Care
Planned reduction in attendance/conveyance evidenced
7 day services
Implementations of Urgent and Emergency Care review

9. Indicative KLOEs Elective Care Logic from referral through PODs
Required demand commissioned (IHAMS)
Secured capacity with NHS and IS providers
It is a CCG responsibility to commission capacity to meet constitutional targets
Logical flow through to trajectories
Primary Care
How is CCG using £3 a head to transform primary care
Progress to 7 day working
Workforce strategy to enable sustainability in primary care
Technology, Research, Innovation & Growth
Link to LDR
Benefit realisation from Digital programs and enablers
Screening & Immunisation
Does plan show working with NHSE Public health to increase uptake of screening and immunisation
Transforming Care
How are the needs of people with LD/autism included

10. NHSE Formal Review Assurance Multi Disciplinary Team (MDT) Review
Assurance MDT review of narrative and KLOE and finance and activity feedback
Finalise the risk rating feeding back findings and recommendations to CCGs
MDT will consist of Relationship Managers, Finance, Director of Assurance Delivery and Head of Assurance Delivery.

11. Risk Ratings Operational plans will be rated as:
Low risk plans that are achievable with finance and activity reconciling and require no further explanation
Medium risk those that require further clarification and adjustments to their finance and activity trajectories
High risk significant issues raised and finance and activity trajectories requiring full revision.

12. Feedback Timetable Actions Deadline CCGs submit draft Op Plan and KLOE
24-Nov-16
Share draft submissions with expert review team
25-Nov-16
Commence expert assessment
25/11/2016 to 01/12/2016
Operations and delivery MDT review
02/12/ /12/2016
Summary of key planning risks and issues
06-Dec-16
CCG feedback and discussions of identified gaps and risks
07-Dec-16
CCGs submit final Op Plan
23-Dec-16
28-Dec-16
28/12/2016 to 06/01/2017
09/01/ /01/2017
10-Jan-17
11-Jan-17

13. Committee In Common Update
Stroke
Work continues to progress with an update and next steps to be discussed at the next meeting in early November
Community Services for Children
Commissioners have identified a preferred bidder and are awaiting confirmation of when the procurement standstill ends and the preferred bidder can be announced publically.

14. Mental Health Collaborative Arrangements
Surrey CCGs moving from 1 to 2 collaborative commissioning groups to enable greater local focus whilst simultaneously strengthening health and social care collaboration
NEHF CCG and SHCCG form one collaboration with NEHF as lead commissioner
Oversight of changes through Mental Health Collaborative transition Board. NEHF & SHCCG share an interim Programme Director.

15. Assurance for GB
SH/NEHF will still benefit from economies of scale by:
Accessing specific expertise from Heartlands & East Surrey Collaborative via formal agreement
Intention to negotiate some single contract structures (if not all) eg single CQRM, serious incident panel etc
Aim to retain staff expertise within Surrey system. Consultation in progress
Process is in place to ensure contract negotiations happen within planning timescales

16. Local benefits
Strong alignment between NEHF and SHCCG on values and partnership approach to working with providers
Fewer commissioners could support more rapid decision making & strong joint working across 2 CCGs
Opportunity to share managerial and clinical leadership for specific areas of work