1. Our five year strategy 1

2. The health and social care system in NE Hampshire and Farnham faces an unprecedented challenge Greater demand as a result of:  Increasing proportion of older people  Increasing prevalence of Long Term Conditions  Increasing prevalence and impact of dementia Limited resource growth due to the economic environment So what is the CCG vision for the future health & social care system in this area that delivers excellent quality care to the population and addresses this financial gap? 2

3.  This position is comparable to that in Hampshire, Surrey & SW London; this CCG is not an outlier – but is there a better and more cost effective model of primary, community, mental health, social and acute care for these patients?  2 out of 5 admissions are for patients who have been in hospital before, within 12 months What is the opportunity for a different model of care? 8% of patients in the system who are admitted to hospital as emergencies stay for 15+ days, but this group occupy 58% of the beds 3

4. Is it realistic? What would be the impact on where we spend our resources? Estimated breakdown of £420m expenditure in 2013/14 Desired breakdown of £460m expenditure in 2017/18? ? 10% less? 25% more? 4

5. A paradigm shift from reactive to proactive care: Emphasis on prevention and earlier early identification  Earlier ‘early identification’ – aiming to identify children, adults and older people at risk of becoming unwell. Involves sophisticated risk stratification  A development of the prevention/ wellness model, in line with County Council  Individuals more involved in managing their own care – with agreed personalised care plans in place for every individual at risk  Supporting people to stay healthy and well  Greater use of technology including tele- health to provide remote monitoring to identify potential problems  More support for patients and their carers, harnessing the potential of third sector 5

6. Transforming Community Care: Comprehensive local care as the first choice for referrals  Rapid access to 24 hour community focussed services which offer credible safe alternatives to emergency hospital admission  Community focussed services as the first choice for referral for GPs and ambulance crews for all but those with the most acute and complex needs  Services traditionally provided in hospital now delivered in primary and community settings – secondary care input to rapid assessment and diagnostic services, diagnostics, blood transfusions, IV medications all delivered locally or at home. Rapid access for GPs to consultants for advice and support  Much greater emphasis on community care as an alternative to hospital care at the end of life  Community based rehabilitation to break the vicious circle of admission, discharge and readmission  Key workers supporting patients and carers with their ongoing needs and personal budgets 6