1. Next steps Alison Gilbert Director of Delivery and Partnerships
Hertfordshire and West Essex
Sustainability and Transformation Partnership
Before we let you go and have your well-earned cup of tea or coffee – I just want to take 10 minutes or so to wrap up today’s learning and look to the future.

2. Impact so far
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No-one was able to attend every workshop today, so here’s a summary of some of the outcomes our care home improvement project has achieved so far. There’s more information on all of these schemes in your packs.
The figures are impressive, I hope you’ll agree – but what’s really important is the changed lives that lie behind these statistics.
We are safeguarding residents in Vanguard care homes from the daily pain and discomfort of pressure ulcers, thanks to additional training.
We are slowing the depressing merry-go-round of hospital admissions and discharges for some of our most vulnerable, confused patients.
And we are improving the job satisfaction of hundreds of care-home employees.
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3. What we learnt – and how we adaptedDo
Don’t
‘Scope creep’ - during pilot schemes, add in controlled iterative phases, don’t just ‘bolt on’ features.
Use data to inform the development of your model
Work with others – communicate clearly and agree clear processes
Design in isolation – involve all levels of staff to ‘co-produce’ models and don’t avoid difficult conversations
Offer on-going support, not just one-off training
Overwhelm staff with training that is not relevant or essential
Throughout the project – some over-arching lessons have emerged which we would urge you to bear in mind if you’re planning on introducing your own care home improvement projects.
(TALK THROUGH BULLET POINTS)
From my own experiences in transformation programmes I would add another ‘don’t’ – don’t expect change to happen quickly, or easily. However if you invest time understanding the pressures experienced by the people you are working with, and what motivates them, as well as the needs of your patients or residents, you can work to develop models that meet all of your objectives.

4. Vanguard learning and the STP
STP PMO
Clinical transformation Workstreams
Enabling transformation Workstreams
Task and finish groups
Urgent & Emergency
Primary Care
Clinical Support Services
Prevention
Procurement
Back Office
Planned Care
Mental Health and Learning Disabilities
Medicines Optimisation
Place Based and Integrated Care
Reduce Agency Spend
POLCE and Exclusions
Frailty
Cancer
Estates, Facilities and Capital
Technology
As I said right at the start of the day, it’s vitally important for me that the impact of this project isn’t restricted to the East and North Hertfordshire Clinical Commissioning Group area.
East and North Hertfordshire CCG is now part of a wider Sustainability and Transformation Plan ‘footprint’, which includes two other local CCGs, Herts Valleys CCG and West Essex CCG.
Altogether the health and care organisations within our STP area serve a population of around 1.5 million people – and my colleagues in the STP project management team are keen to ensure that we take the best of what the Vanguard project has to offer and share that across this wider population.
This has already started to happen – for example the ‘impartial assessor’ role which has been successfully improving the discharge process at one of our acute hospitals – The Lister in Stevenage - is going to be introduced at the other two, Watford General Hospital and Princess Alexandra Hospital in Harlow, from next week onwards.
The Vanguard project’s preventative, health-improvement work – using a combination of wearable technology and exercise classes to reduce falls risks and improve the quality of life for older people, is being further explored in the Prevention workstream – which is being led by Hertfordshire’s Director of Public Health.
And the potential to improve health and save money through medicines optimisation and reduced wastage is one of the ways in which the STP hopes to make significant savings to the wider NHS budget – starting with a medicines waste public information campaign this winter. The messages about waste are resonating with care home staff – there’s no reason to think that they won’t make an impact on the general public.
Of course, there are obvious links too to the Frailty workstream, Urgent and Emergency Care and the Reduced Agency Spend and Technology workstreams.
Women’s and Children
Communications and Engagement

5. Visit our website for more resources www.enhertsvanguard.uk/showcase
Job descriptions
Lessons learnt
Processes
Business cases
Case studies
Standard operating procedures
KPIs
‘How to’ guides
Finances
Return on investment information
Activity dashboards
Evaluation reviews
There’s a wealth of information about all of this work on the vanguard website. Information specifically created to support today’s events, including the workshop slides, will be available on the site from next Friday, 10 November.
We’ll send an to the address that you registered with, which will link you directly to the website and the special event pages. Please feel free to forward the information to your colleagues. You can also contact us through the website – the Vanguard project team would be delighted to hear from you.

6. Thank you
Have a safe journey home Please help yourself to a cup of tea or coffee from the dining room before you leave Don’t forget your evaluation sheet!