1. Dr Wirin Bhatiani, Bolton CCG Cllr Linda Thomas, Bolton Council
On this opening slide:
Thank you to all the staff in Bolton who have worked so hard during the pressure of winter demand

2. Welcome to Bolton
Aim is to just quickly flash this slide up and say Bolton is a town of inequalities – no time to do more!
284,000 residents 12 year difference in life expectancy
BME population growing (over 20%) 50 Practices (indicated on map)

3. This is Bolton’s plan
– and where we intend to invest in transformation in order to encourage more community based care and a more resilient health and care system
This is a truly place-based model, focusing on communities

4. Our building blocks to integration
Examples for today:
Bolton Quality Contract
New Contract between CCG and Trust
Intermediate Tier Integration
Here’s what we are going to tell you about today

5. Bolton Quality Contract: 50 Practices meeting standards more equitable funding, more capacity, better quality.
Access Standard:
10 bookable sessions (am / pm)
Access to both male and female clinician (not all 10 sessions)
8.00 – 6.30pm, Monday to Friday
At least 75 contacts per 1000 population every week
Pre-bookable 1 month in advance
Process for unplanned/urgent appts (extras determined by a clinician)
Offer telephone consultations
Children under 12 assessed by a clinician same day
Accept deflections from A&E / NWAS / Community Services
Improve on patient survey measures
= 60,000 extra appointment slots delivered in a year

6. We understand our Practice populations and deliver detailed performance data:
Invested £3 million in the contract, saved £3million in its first year.

7. £3 million invested, £3 million saved in year 1
Safe and effective prescribing with reduced waste has been a big part of this.

8. New Contract with Bolton FT
Aligned incentives:
Focus everyone on the Bolton £, not their organisation £
Focus on hospital activity reduction
Removed PBR (Payment by Results) tariff
Risk sharing
“We are all in this together”
Successes:
Ownership of effective use of resources policies shifted to Trust
Reducing spend on high cost drugs & Estates together
Bolton FT and Bolton CCG won Joint HFMA (Healthcare Financial Management Association) Award for innovation for this contract

9. Intermediate Tier Services...
Joint work across Bolton to re-focus services to “Think Home First”.
Intermediate Tier Services include:
Rapid Response Admissions Avoidance Service
Home-based Intermediate Care & Reablement
Bed-based Intermediate Care
Integrated Hospital Discharge Service
Reconfigured intermediate care beds, invested in home based care and encouraging use of beds as ‘step up’, not just ‘step down’
Very proud of our admissions avoidance service which provides an urgent, reactive service to GPs, to NWAS, to Careline
The integrated hospital discharge service is now fully in place

10. Service jointly commissioned by Council & CCG through Section 75
Service jointly delivered by Bolton Council and Bolton FT for 2 years, with single management

11. On this opening slide:
Thank you to all the staff in Bolton who have worked so hard during the pressure of winter demand