1. STP – how can doctors in medicine be part of it?
Robert Woolley,
Chief Executive of University Hospitals Bristol NHS Trust & BNSSG STP Footprint Lead
RCP: The NHS in 2016 is underfunded, underdoctored and overstretched.

2. Sustainability & Transformation Partnerships
New approach to planning health and care services in England
44 STP footprints with average footprint population of 1.2m
Collaborative, place-based
Inclusive and engaging
Principal aims
Improve the health and wellbeing of local people
Improve the quality of local health and care services
Deliver financial stability in order to be able to continue to meet local health needs
Provide background of our STP footprint area: geography, some of the high-level facts/ stats

3. Bristol, N. Somerset & S. Gloucestershire STP
3 community providers
3 acute hospital Trusts
3 CCGs
3 LAs – both PH and SS
MH Trust
Ambulance
NHS England spec comm

4. The BNSSG STP care model
My needs are complex
Self-Management, Care Management and monitoring
Intensive integrated care
My situation and/or condition
is stable/safe
My situation and/or condition
is unstable/unsafe
Urgent Review and Early Intervention
Prevention, Self Care and Planned Care
Our current vision/ care-model in process of review – going through an iterative process
I am happy and well

5. STP planning content framework
System Strategy Design and review
Case for change
System financial framework
Population Health improvement priorities
System Productivity
Effective Planned care
Prevention & Early Intervention
Primary Care reform (GPFV)
Integrated care
Mental Health & Learning disabilities
North Somerset Sustainability
Acute Services collaboration
STP framework
Outcome based Strategic priorities
Transformed care model
Public facing narrative
System design
Future organisation form
System Contractual levers and incentives
System development
System leadership support
STP System priorities
Children’s & maternity services
In-year delivery plans
Enabling plans
Workforce & Organisational Development
Digital / IM&T
The is a revised suggestion for setting out our STP work programme. It is likely to be more acceptable publically because it is more comprehensive in its coverage than the 3 clinical priorities we are currently working on. This is only a way of organising our work – This framework does not have to articulate a comprehensive plan in all areas. – Our plans will continue to be emergent. - There won’t be a “big reveal” – we will need to work on a limited number of high impact transformation programmes at any one time and we will need to continually evaluate progress and develop insight into what needs to happen next – this is the nature of strategic planning.
Thinking about how we develop our public narrative, does this representation of the planning content across the system, is this a more acceptable way describing the breadth of our planning content?
How much of this do we want to do together?
This is just a framework to help describe how our planning content relates to what we are delivering at a given time. It is not intended to be fully populated at STP level – The system will be working on all of this somewhere. The partnership needs to be clear which areas of this framework need transformation plans that deliver the triple aim
Communications & Engagement
Estates

6. We know clinicians are key to our success…
Who’s involved?
We know clinicians are key to our success…
Broad overview of our stakeholders which we will be developing further. Clinicians are a critical audience and influencer

7. Clinical leadership Sponsoring board
In Bristol, North Somerset and South Gloucestershire we have clinical leadership and engagement at every level:
Sponsoring board
Chair of the Clinical Cabinet is a member
Assurance through Clinical Cabinet
A broad range of clinical leaders from across the system involved in reviewing and checking quality, safety, evidence and involvement in programmes and projects
Clinicians leading and engaged in every transformation and programme
Each programme has a clinical leader and clinical engagement involved in the design of the programme and the development of any proposed changes

8. An example of a pathway programme…
Musculoskeletal (MSK)
The scope has included pain, rheumatology, orthopaedics, physio, podiatry
We currently have six providers involved in the delivery of patient care all operating to different waiting times, different clinical protocols and pathways. This makes it really complex for clinicians and patients to navigate.
Clinical Researcher
Clinical GP Fellow
Clinical Lead Rheumatologist
Consultant Rheumatologist
GP Clinical Lead
Orthopaedic Clinical Lead
Director of Pain HIT and Consultant in Pain
Commissioning Manager
Community services Lead
GM MSK and Neurosurgery
Physiotherapy Lead
Lead Radiographer
Specialist Physiotherapist
Clinical nurse specialist
Specialist Pharmacist
Explain the MSK current challenge. Blue box gives a flavour of the type of clinicians/ colleagues engaged in the programme

9. A local system example: ‘Healthy Weston’
Source: ‘Healthy Weston: joining up services for better care in the Weston area’, North Somerset CCG, Sept 2017

10. Illustrative care campus model at Weston

11. This is only the start… Commissioning pathways Locality rollout
outcomes-based pathways of care
tight service specifications
new contracting approaches
best value for taxpayer
early priorities:
Diabetes
Respiratory
Deep vein thrombosis
Skin
Eye care
Musculo-skeletal
Out of hospital services
Stoma prescribing
Continence prescribing
111 and out of hours services
Locality rollout
North Somerset
South Bristol
Remaining 5 localities in BNSSG

12. Questions?
Thank you