1. Local General Hospitals Dr Steve Laitner and Jacqui Bunce Hertfordshire PCTs

2. PUBLIC HEALTH (Health Promotion, Vaccination, Screening…) SELF-CARE (Home or “Over the Counter” remedies TRIAGE (Assessment of health needs, telephone or “face to face” PRIMARY CARE (GP surgery, dentist, optometrists, minor injuries INTERMEDIATE CARE ( Home/ NH/ C. Hosp) INTERFACE (CASS/ CATS) and Urgent Care Centre SECONDARY CARE ( Hosp.) Health Care Pyramid Dr S Laitner 2007

3. Meeting health needs in Hertfordshire Health inequalities to be addressed Access Nearest hospital may not be in Hertfordshire so working with all providers on care pathways Utilisation of community hospitals and other health facilities to enable care closer to home

4. Feedback from consultation Everything as clinically safe and as local as possible Diagnostics Outpatients A&E Urgent care Surgery Maternity services Intermediate care services

5. Decision from 19 th December The PCTs are committed to maintaining and developing a vibrant mix of health services in Hemel Hempstead and Welwyn Garden City as the non-acute hospital sites

6. Core services Outpatients Urgent care Diagnostics Plus key opportunity for local health campus development Pathology Minor surgery Ante-natal and post-natal care

7. Local General Hospital Local General Hospital Therapy services Mental health services Palliative care DiagnosticsUrgent Care Maternity services Ante Natal Post Natal Outpatients Adults & Children Social services Local authority services Support Groups Intermediate Care Services & beds? Minor Surgery

8. Intermediate care Next steps Short term provision at Hemel Hempstead and existing facilities Review of existing facilities throughout the county Integration with social care Local provision

9. Intermediate care Additional requirement East and North HertfordshireWest Hertfordshire BedsHome CareBedsHome Care 2008/09 820916195 2009/10 9209 3195 2010/2011 17417 5390 Total 3483524780

10. Master plan LGH development linked to changes in services at acute hospitals inc Barnet & Chase Farm New care pathways being developed across primary and secondary care Services will change – buildings will come later Dual running is planned where appropriate to ensure effective transition i.e. Urgent Care at Hemel Hempstead

11. Financial modelling Costs to build new facilities – £30m per PCT Service shifts – £65m investment over 6 years in community services, primary care and transport

12. PCTs Affordability FUNDS AVAILABLE: –One-off benefit from debt repaid in 2007/08 approx £52m –Growth – 2% p.a. (approx £28m each year)= £169m by 2013/14 –Savings on acute care currently provided in secondary care setting = £14m RESERVES: uncommitted estimated at £46m

13. How we will manage the process Service model finalised with Practice Based Commissioning Groups Confirmation with other stakeholders of services to be on the campus and at other community facilities Capacity planning of sites Outline business case & planning permission

14. Future vision Vibrant health campus development vision – not a poor second best but a real community resource Phased development hand in glove with acute hospital changes We want to involve the community in making these changes happen We have the resources to make these changes happen