1. Welcome to February’s ETAG Su Long, Chief Officer

2. Improved community based care  We’ve talked to you about integration, your priories over the past new months and changes to NHS.  Improving quality of care and improving access to GP services are your priorities.  NHS Greater Manchester have published community based care clinical standards.  These are minimum standards of care you can extend across all of Manchester – in Little Lever or Little Hulton.

3. What are they?  Quality and safety  Wellness and prevention – Extended hours for screening  Self care, independence and choice  Care planning and multidisciplinary care – All people with a long-term condition will have access to their own care record and shared care plan – Multi-disciplinary teams meeting care needs  Access and responsiveness – To urgent community, social care and primary care within 2 hours

4. Bolton’s offer  Bolton CCG’s responsibility to work with GPs and the public on the Bolton community based care offer.  Planning a public event for April to deliberate the options.  Make trade offs on what’s really important –  telephone appointments with GP v face to face appointments or seeing a GP from a neighbouring practice at 9pm v seeing your own GP.  Expect an invite soon

5. Home based mental health care

6. Why change is needed  CCG priority is for more high-quality services provided away from hospitals in community based settings.  Often system’s failed a patient if they are admitted to hospital in an emergency admissions to hospital. Many people admitted to hospital because the right services in the community are not available.  Talked to you about integration. Supported the idea but you were concerned about quality of home-based care and whether it will save money.  Patients and GP fed back issues with crisis care and poor out of hours care in mental health  Stories of patients being admitted to hospital on Friday evening by GPs because no weekend community care is available.  Bolton has a high number of beds and admissions compared to England average.  Rising demand on health and social care services, and Bolton doesn’t have the money to provide services in the same way.  Services need to be better – better is different!  Started to improve services - already invested in RAID and single point of access.

7. Proposed solutions  First big move to integrated services  Designed by GMW clinicians  NHS will invest in improving home based care to avoid unnecessary hospital admissions  Redesign community services with extended hours  Once we’ve done all this, then  Redesign inpatient services as fewer beds will actually be needed.

8. Change details  Invest £576k in improving home based and community care.  Invest in building a specialist centre at Woodlands – increase beds from 35 to 65.  Close Oak Ward (adults) and Linden Ward (older people) in October 2014.  This will be reduction of adult beds from 57 to 42 in Bolton.  Patients with dementia admitted to Woodlands from November 2014.  All older people’s inpatient services provided from Woodlands from November 2015.  Change in older people beds to 35 in Bolton to 65 (at Woodlands).

9. What does this mean for Bolton people?  If have urgent or emergency mental health need, home based and community support will be available at weekends and evenings for first time. – Home based care – 24/7 – Community care – 9am to 8pm/ 9am to 5pm at weekends  Care coordinator will work with patients and carers to organise their care – and be their key contact.  If admitted to hospital, due to daily ward rounds and multi- disciplinary teams, patients will be discharged home earlier.  Many services will remain at Royal Bolton Hospital site  NHS will save money to help protect future of services and allow investment into other areas.

10. What happens next?  It’s consultation on a proposal.  No decision has been made.  Listening the public, Bolton GPs and councillors on the proposal.  Tell us today. What do you like? Any concerns What impact will it have on you or your family?  Come to any of your meetings  Going to send out a survey to seek more views  Consider all views and understand impacts before CCG decides to support the proposal or not at our board in April.

11. Update on Equality Delivery System  What is the Equality Delivery System? A tool that helps the NHS to improve services and meet the requirements of the Equality Act 2010.  What has been done do far? Thank you to everyone who took part in the questionnaire, workshop and discussions last year.  What has happened as a result? External grading took place in December which looked at all the evidence gathered. As a result an Equality Action Plan will be written.  What is the Equality Delivery System? A tool that helps the NHS to improve services and meet the requirements of the Equality Act 2010.  What has been done do far? Thank you to everyone who took part in the questionnaire, workshop and discussions last year.  What has happened as a result? External grading took place in December which looked at all the evidence gathered. As a result an Equality Action Plan will be written.

12. Update on Equality Delivery System  What were the key themes? Key themes that you told us will form our Equality Objectives. Themes include improving access to health services, reducing health inequalities and  How does ETAG fit in? We will keep ETAG updated with progress and developments. ETAG is very important in shaping services provided. We will continue to feedback to ETAG and listen to everyone's views.  What were the key themes? Key themes that you told us will form our Equality Objectives. Themes include improving access to health services, reducing health inequalities and  How does ETAG fit in? We will keep ETAG updated with progress and developments. ETAG is very important in shaping services provided. We will continue to feedback to ETAG and listen to everyone's views.