1. Healthy Lives Healthy Futures NLAG Trust Board Tuesday 26 th May 2015

2. Out of Hospital Area of clinical focus In Hospital Fully engaged public and patients Generalis t Specialist OUT OF HOSPITAL IN HOSPITAL HLHF Key Work Streams – Clinical Focus

3. HLHF Definitive List of Schemes NLAG Advanced Community Teams NELEndoscopy Integrated Locality Teams NL Ambulatory Care Service NL ENT Max Fax Service Review Assisted Living Centre NEL & NL FEAST (Frail and Elderly Assessment Support Team - Scunthorpe) including Integrated Discharge Team Ophthalmology Breast Services Review Frail and Elderly Assessment Unit (Grimsby) RATL (Rapid Assessment Time Limited Service) Cardiology CDCU (Grimsby)Goole HLHF - Campus Reduction in review Outpatients (NL & NEL) Cardiology Review - Phase 2 Goole HLHF - Elective Respiratory Review - Phase 2 Childrens Surgery Goole HLHF - Medicine Inpt beds Stroke Review - Phase 2 Critical Care Strategy - Phase 1Goole HLHF - MIU Urgent Care Services Dermatology NEL & NLHaematology/oncologySite Potential (All) NLNEL 7 Day hospital social work team NLEnd of Life Services Care Home Liaison Service NLExtra Care Housing Carers Support NLFrequent Service Users Chronic Wound NLGP Front Ending Diabetes (Super 6)NLHome from Home NEL Discharge to Assess NLSingle Point of Access (H&SC) LTC ModelSupport into Nursing & Residential Care Homes MSK Older Peoples Mental Health Liaison NL Wellbeing Hubs NL

4. Year One – Draft Implementation Timeline Name of Scheme2014-15 Year 1 Implementation Year 2 2016-17 Qtr 1Qtr 2Qtr 3Qtr 4 Advanced Community Teams - NEL Ambulatory Care Service – NL Assisted Living Centre Breast Services Review Cardiology Day Case Unit Cardiology Review - Phase 2 Childrens Surgery Critical Care Strategy - Phase 1 Dermatology Diabetes / Super 6 – NL Discharge to Assess – NL Endoscopy ENT Extra Care Housing FEAST Goole HLHF – Campus Goole HLHF – Elective Goole HLHF - Medicine Inpt beds Haematology/Oncology Home from Home – NEL Integrated Locality Teams – NL RATL (Rapid Assessment Time Limited Service)

5. Primary Care Practitioners Proactive Care Community Health and Social Care Prevention, & supported self care Falls Prevention Mental Health Health Promotion Out of Hours End of Life Care Podiatry Continence Carer Support Hospitals and Care Homes Rapid Response Day Support Care and Rehabilitation Support for Independenc e and Isolation Enablement and Re- ablement Assistive Technology Family Carer Community Drug and Alcohol services Single Point Access Community Hubs are the first order of transformation WHAT A range of health and care professionals working together to meet all of the health and care needs of their residents Actively liaising with professionals where onward referral for specialist support is needed HOW Doctors (family health and medical), Nurses, Social Care, AHPs and Pharmacists Working from health and care facilities integral to the Hub Accountable for outcomes and funding across all settings in an outside the ‘Hub’

6. Next steps Create outcomes framework with KPIs – Quality, Money and Activity – by end June Progress implementation of the transformation schemes for 2015/16, including Better Care Fund Schemes - ongoing Produce the Operating Framework for Community Hubs via Clinical Leaders Group – by end July Develop the pipeline of additional out of hospital schemes aligned with Hubs - through summer