1. Welcome to the Swindon Strategic Partnership Conference 18 th March 2011

2. Tom Charnock Chair of Swindon Strategic Partnership Overview & Monitoring Group

3. Pat Geenty Assistant Chief Constable Wiltshire Police

4. Lyn Hill-Tout Chief Executive Great Western Hospital NHS Foundation Trust

5. Some Facts About The Trust 3,300 staff Serving 340,000 people across Swindon, Wiltshire, parts of Oxfordshire, Gloucestershire and West Berkshire 9,200 members (Over 5,000 are members of the public) Annual income of £200 million Authorised by Monitor (the Foundation Trust Regulator) as an FT in December 2008 Licensed by the Care Quality Commission (April 2010) Provide services at Great Western Hospital, Brunel Treatment Centre, Fairford Hospital, Savernake Hospital and various GP practices in Wiltshire

6. GWH Income 2010/11 = £200.2m

7. Context Less care in hospital, more care provided in the community Choice – where and how care is provided by GPs, hospital, any willing provider (private or voluntary sector) Greater regulation by the Care Quality Commission Safety, quality and growing patient satisfaction (and expectations) Although the NHS is receiving the same level of funding, nationally savings of £20bn are required These savings need to deal with increasing health needs White Paper published – radical reforms Concerns about changes and effect on NHS

8. How The NHS Operates … Currently Parliament Department of Health Strategic Health Authorities Primary Care Primary Care Trusts (PCTs) General Practitioners (GPs) Dentists Opticians Pharmacists Walk in Centres Secondary & Tertiary Care Acute Hospitals Ambulance Trusts Mental Health Trusts Care Trusts Foundation Trusts Monitor (Regulator of Foundation Trusts) Contract

9. How The NHS Will Operate Parliament NHS Commissioning Board ? Regional Commissioning Boards Foundation Trusts Any Willing Provider Monitor (Regulator of Foundation Trusts) GP Consortia Contract Regulated for Quality by Care Quality Commission Contract

10. What could the national £20bn savings mean for GWH 1. FINANCE11/1212/1313/14 £m Cost pressure to be funded internally4.03.753.5 Tariff reduction3.23.02.8 Total GWH savings requirement7.26.756.3 Proposed income reductions Swindon PCT7.337.848.25 Wiltshire PCT0.825 8.1558.6659.075

11. How Will This Be Managed NHS SwindonNHS Wiltshire Reduce emergency admissions (improve urgent care) Shifting settings of care and optimising urgent care Improve management of long term conditions (end of life care, virtual wards, assisted technology) Long term conditions Elective care (stop procedures of limited clinical benefit, telephone advice to GPs) Elective care pathways Primary and community care (review all primary care contracts) Improving primary and community care Medicines management (reduce prescribing costs) Improve prescribing Mental health (reduce out of area placements)Mental health Learning disabilities (reduce out of area placements) Learning disabilities Non clinical productivities (organisation structure, estate disinvestment) Non clinical productivities

12. GWH Approach 1. Partnership Working – With Swindon Borough Council, NHS Swindon and Wiltshire to reduce duplication/improve quality/add value – Wiltshire Community Health Services will merge with GWH on 1 st June – Work with other providers – e.g. Independent Sector Treatment Centre, Prospect Hospice 2. Service Change – Provide more local care – Less care and treatments in hospital – reducing cost to Primary Care Trust – Reduce length of stay in hospital = less beds – Work with commissioning intentions, e.g. no longer provide treatments of low clinical benefit – Treat patients locally – Innovate – use of technology to improve care and reduce cost 3. Staff – Engage staff so they understand the issues, help reduce waste and improve productivity and be proud/promote the care we provide – Review who and how care is provided – Agency staff – only use in exceptional circumstances – Integrate GWH and Wiltshire Community Health Services staff

13. Gavin Jones Chief Executive Swindon Borough Council

14. The fundamental issue time demand resources Stem demand, More effective use of resources Build new capacity

15. Drives a fundamental rethink of what we are here to do, how we should do it and how we are organised Why we have to change further and faster Rapidly diminishing revenue Some public services can prolong dependency The volume and complexity of demand is increasing Major national policy changes including a drive for localism Public Health role for LA’s

16. Working alongside communities to better understand and prioritise needs, create capacity and broker local solutions ( Securing services) Strategy & Commissioning Ensuring Service Delivery is effective Local People & Communities Shaping and defining outcomes for local people, and building the framework for delivery CE Cabinet Local People & Communities Mixed market of community, voluntary, private and public providers From… What does this mean …. Direction of travel? Local Engagement Functional Services To…

17. Commercial PublicSocial People & Place Infrastructure Business - Transport - Land Use - Digital infrastructure - Support Services - Education &Skills - Housing - Community infrastructure - Engaged and active communities Grow : Technology Environmental Start-ups and SME’s Retail & Leisure Retain: Manufacturing Insurance Distribution Outcomes Xx new jobs Yy Growth sector increase ££ new private investment ?? Social Value One Swindon : Resilient Economic Growth

18. © Participle Ltd. // www.participle.netwww.participle.net Throughout 2010

19. © Participle Ltd. // www.participle.netwww.participle.net Judgement Agencies’ agendas Be the parent/power & control Enforcement Professionalism and alienating language Service design not relevant to people’s lives Rescuing not empowerment Lack of trust, honesty, transparency Hopelessness, believe that change is not possible Defensiveness & fear Oppression End up with parent/child relationship Isolation Exhausted with fighting system No safe space to ask for help Lack of trust, honesty, transparency Hopelessness, believe that change is not possible AGENCIESFAMILIES Insight 4: Barriers

20. Facilitators: Matt Gott & Ruth Kennedy

21. Commitments :

22. One Swindon in Practice Twigs – Alan Holland Broadgreen Mental Health Project – Sheena Dean Football in the Community – Tim Hall Neurological Alliance – David Wray Promoting Positive Outcomes for 13-19 year olds – Kate Steel Groundworks – Kerry Wray & Mike Pringle

23. Coffee Please be back at 11:25 to start the next session

24. Nick Stanhope, Managing Director, ‘We Are What We Do’

25. One Swindon Facilitators: Matt Gott & Ruth Kennedy

26. One Swindon Principles Local and Lasting : We will encourage local people to get involved in decisions affecting their lives, to make the most of the opportunities available to them, and to help themselves, so they in turn can contribute to the place they live. Stronger together : Organisations in Swindon like the Council, Police, NHS Swindon, Voluntary and Community sector are working together more effectively than ever before – but have to get even better and we need to work more with businesses, communities and people in Swindon. Prioritisation & Leadership : There are leaders in all areas of our communities and we must enable them to flourish. Leadership will be about being open minded, flexible, showing humility and knowing when to let go as well as when to get involved. Trust & Bravery : We will all need to trust each other and create a common purpose and shared endeavour. We need to share our ambitions, respect our differences and build on the things that bind us together.

27. One Swindon in Practice Bulb Planting Project – Paul Russell ‘Northview’ – Keith Smith & Maureen Penny Stay Safe – Peter Robinson

28. Lunch Please be back at 1:45 to start the afternoon session If needed a Quiet room has been set aside on the first floor for prayer and quiet contemplation

29. Welcome to the Swindon Strategic Partnership Conference 18 th March 2011

30. Nick Stanhope, Managing Director, ‘We Are What We Do’

31. Leadership Facilitators: Matt Gott & Ruth Kennedy

32. Local leadership: How will it need to be different? How will we bring people with us? What will it look/feel like? How will decisions get made? How will we decide what’s important? What’s the role of elected members?

33. Plenary Session & Next Steps Ruth Kennedy

34. Conference Close Cllr Roderick Bluh Leader of the Council