1. WHOLE SYSTEMS CHANGE: CO PRODUCING NEW MODELS OF HEALTH AND CARE IN LONDON Sam Everington 16 th April 2015

2. National Context

3. NHS Five Year Forward View The NHS Five Year Forward View was published on 23 October 2014 One of its great successes was that it is a shared vision for the future of the NHS across six national NHS bodies The challenge is now implementation; we know: It will not be easy We need to learn from the past We’re going to need a different approach We’re up for it 3

4. The future NHS 4 The core argument made in the Forward View centres around three ‘gaps’: Radical upgrade in prevention Back national action on major health risks Targeted prevention initiatives e.g. diabetes Much greater patient control Harnessing the ‘renewable energy’ of communities Health & wellbeing gap 1 1 New models of care Neither ‘one size fits all’, nor ‘thousand flowers’ A menu of care models for local areas to consider Investment and flexibilities to support implementation of new care models Care & quality gap 2 2 Efficiency & investment Implementation of these care models and other actions could deliver significant efficiency gains However, there remains an additional funding requirement for the next government And the need for upfront, pump-priming investment Funding gap 3 3

5. New Models of Care 5 Initially the new models of care programme will focus on: Multi-agency support for people in care homes and to help people stay at home Using new technologies and telemedicine for specialist input Support for patients to die in their place of choice Enhanced health in care homes Coordinated care for patients with long-term conditions Targeting specific areas of interest, such as elective surgery Considering new organisational forms and joint ventures New approaches to smaller viable hospitals Integrated primary, hospital and mental health services working as a single integrated network or organisation Sharing the risk for the health of a defined population Flexible use of workforce and wider community assets Integrated primary and acute care systems Blending primary care and specialist services in one organisation Multidisciplinary teams providing services in the community Identifying the patients who will benefit most, across a population of at least 30,000 Multispecialty Community Providers

6. Principles of the New Care Models programme Clinical Engagement Patient Involvement Local Ownership National Support The programme will be developed with a co-design approach – built with patients and the health and care system It will seek to identify replicable standards, tool and methods so that scale can be reached; It will use the transformation fund to maximise progress and pace through centralised support, especially in technical areas as well as leadership support and development for those local health and social care systems; The national package of support to prototype sites will be offered with an agreed Memorandum of Understanding and mutual commitment to delivery on the ground, and a commitment to value for local people It will establish an evaluation process to support testing and rapid learning It will share early and continuous learning with the whole national health and care system through a wider community of support.

7. Local context in Tower Hamlets

8. THPCT legacy: Primary care networks Outcome based contract linked to improving population health Page 2

9. Finance and Risk Group Operations Team Clinical Governance Diabetes MDTs monthly meetings Imms &Vacs MDT CVD MDT Sexual Health MDTs Community Partners Group Poplar & Limehouse H&W Network Governance Structure June’10 Director Co-ordinator Finance Officer HT Co-Ord Director Clinical Leads Director Practice Managers or Practice Rep Chair Partner/Rep from each Practice Community Rep Director Connection with- 3 rd sector r Healthy Lifestyles Co-ord Director Residents Chair Director LAP Rep Various 3rd Sector Representation Main Board CIC To follow COPD, NIS etc. Poplar & Limehouse Health & Wellbeing Network CIC

10. Connecting up with what’s out there! Senior Youth Service ESOL Health Visitors Playgroups Creches Karate/ M Arts Employment Advice Line Dancing Junior Youth Clubs Cycling Groups Cultural Groups Social Services Welfare Advice Elders Groups Majorettes Mental Health Groups Tai Chi Aerobics/Keep fit Parent & Toddler Churches & Mosques Community Cafes Football Clubs Children’s Centres Primary Schools 3rd SECTOR PARTNERS Job Centre + Healthy eating classes Seniors Shopping Trips Girls Clubs Gardening Clubs Coffee Mornings Walking Groups GP Practices Yoga Singing groups Dance STATUTORY SERVICES Sport Secondary Schools Midwifery Specialist Nurses Home Helps Drug Outreach Team RSLs School Nurses Family Intervention Project Exercise on Referral Classes

11. 1111 Community Partners Added Value Community Partners Added Value Engagement with our locally diverse community Quality control Wide use of venues (schools, Childrens Centres, community groups…etc.) Community Champions buy-in Partnership working Poplar & Limehouse Health & Wellbeing Network CIC Portas – Chrisp St market Well London My Weigh Primary Care Schools Project Link Age Plus Fit4Sport Cancer Screening Programme

12. Looking forward: integrating care across the system 12

13. WELC Integrated Care Programme Page 5

14. Creation of one provider Roles Supports integrated care Vehicle to commission from Platform for co-commissioning 36 practices 8 networks 1 provider Page 3

15. Development of THIPP

16. Strategic context Demographics and productivity challenges Over 15 years NEL will have an extra 270,000 residents – equivalent to another London borough. Framework could provide enablers/infrastructure for delivery of 5 year plans in Transforming Services Together New models of care are critical to long term sustainability plans Integrating health and social care Key part of Better Care Fund plans Support LA implementation of Care Act Person centred – empowering people to self manage Linking together capitated budgets work with IPC and personal health budgets Emphasis on preventative agenda – commissioning for population health Page 4

17. Thank you and questions