1. Commissioning for a New Era

2. The challenges we face…

3. Economic Factors  Lowest average wage levels  Inadequate housing and overcrowding  Low educational attainment  6 th most deprived local authority in England  High levels of: o Unemployment o Benefit claimants o Deprivation o Crime o Domestic abuse o Transience

4. Impact on Health  Worst life expectancy rates for men in England  Third worst for women  Significantly higher number of Children Looked After in comparison with similar areas  Highest rates of liver and lung disease in England  High prevalence of cancer, heart disease and stroke  Add to that high rates of mental illness, suicide, teenage pregnancy and drug abuse

6. Funding Gap

7. 7 Any questions? Commissioning more of the same …..?

8. What the data is telling us

9. Out of Hospital Strategy

10. New Models of Care

11. Neighbourhoods Clinical Engagement- Mapping practices and resources Mosaic Groups of population Practice location and size Existing services Libraries, churches etc.

12. CENTRAL EAST (25K) SOUTH CENTRAL (22K) SOUTH (38K) CENTRAL WEST (26K) NORTH (30K ) FAR NORTH (20K) Blackpool Neighbourhoods

13. Infrastructure

14. Proactive New Models for Primary Care Extensivist Service focused on High Risk frail elderly Patient cohorts Re-orienting capacity in General Practice to implement Extended Primary Care Model Ambition is to materially improve the Quality and Clinical outcome for this patient group Driving up the quality of patient satisfaction Reduced usage of Secondary Care - 23-45% reduction in admissions - 20-30% reduction in unscheduled attendances for targeted population

15. Partnership with Third Sector Fulfilling Lives £10 million over 7 years Complex mental health, substance misuse, homeless or criminal justice Partner - Addaction Better Start £45 million over 10 years 0-3 year olds Partner - NSPCC How good is your memory Memory tests for 50-90 year olds