Bishop’s Castle Patient Group Thursday, 9 July 2015

Programme Update

• The story so far…..

• Acute Option Development

• Rural Urgent Care

• Affordability

• Timeline & Risks

• Linked Projects

• Engagement & Consultation

The story so far……

Call to ActionNov ‘13

Case for ChangeJan ‘14

Clinical DesignJun ‘14

Long list of acute scenarios

Jun ‘14

Activity & Capacity Modelling

Aug ‘14

Short list of acute optionsFeb ‘15

Strategic Outline Case

Aug ‘15

Preferred optionSept ‘15

Rural urgent care provision Sept ‘15

Clinical Model – networks of care

Urgent & EmergencyCare Network

Planned Care NetworkMaternity Network

Consultant-led Obstetricsand Neonates

Midwifery Led Units

MLU

Obs

Emergency Centre Urgent Care Centre Consultant-led Obstetrics

Diagnostic & Treatment Centre Local Planned Care

SHORTLIST OF ACUTE HOSPITAL OPTIONS

Option Appraisal

ECONOMIC APPRAISAL

Which option provides the best value for money?

Financial Appraisal

How do the costs of options compare?

Non-Financial Appraisal

What non-financial impact will each option have?

• Accessibility• Quality of care• Workforce• Deliverability

Potential Locations for Urgent Care Centres

Urgent Care Centres

Urban UCC (RSH & PRH) included within acute options

Work under way to explore the most appropriate rural urgent care solutions in partnership with local communities and considering current facilities/services

1st round of locality meetings completed

2nd round now scheduled

Will consider all existing Minor Injuries Units & Community Hospitals as potential sites for Urgent Care Centres

No locality would experience a reduction in urgent care provision

Subsequent work will need to explore potential for rural planned care activity by sub-specialty.

Bishops Castle Thur 16.07.15

Whitchurch Mon 20.07.15

Ludlow Thu 6.08.15

Bridgnorth Mon 10.08.15

Oswestry Thu 13.08.15

Urgent Care Centres

First Round • To develop a baseline understanding of urgent care, and what we

anticipate will be the minimum system requirements for all UCCs in Shropshire, Telford & Wrekin.

Second Round • Summary presentation on information gathered and analysed from

first round.• Further inputs (e.g. travel times, projected footfall, estates review,

estimated cost envelope).• Inviting representatives of other professional groups (therapists,

practice nurses, ambulance service, social care, third sector), aiming for around a 60:40 split between public/ patient representatives and professional clinicians / managers.

• Key themes to be identified to inform recommendation to Programme Board.

Affordability

• Work now being completed on:

• The building and running costs for each of the shortlisted acute options

• The potential cost of Urgent Care Centres

• Commissioners to assess affordability of activity implications within 5 year plans

• SaTH to set out affordability of each option within the funding envelope

• NHS Trust Development Authority to advise on affordability assessment

MAY2015

JUN JUL AUG SEP OCT NOV DEC JAN2016

FEB MAR APR MAY JUN

Acute SOC(EC, DTC & Urban UCCs)

TDA and DH/HMT parallel approvals Acute OBC development

Rural Urgent Care solutions

PCBC developmentPreferred Option – Rural urgent Care Offer - 4 Tests

Gateway– Senate – Affordability - Consultation Plan

NH

SE Assurance Panel

Gate 1 Review

DMBC development

Senate Stage 2 Review

Public ConsultationPreparation for Consultation - plans & draft document Final Preparation

Prototyping - Business Case development (tbc)

Board/ CCG approvals

CCG affordability decision

SaTH

approval

Board/CCG approvals

Option Appraisal

Preferred O

ption

Equality Impact Engagement

Development of Full IIA Plan

Integrated Impact Assessment

FINAL CO

MM

ISSION

ER DECISIO

N M

AKING

ConsultationReport

HOSC/CHCEngagement

Gate 2 Review

Welsh Election

SaTH

approvalSCH

T approval

PROGRAMME HIGH-LEVEL CRITICAL PATH 2015-16Compressed variant of original timetable

Risk of failing to deliver the critical path due to interdependency with other workstreams and/or dependency on approvals outside the programme.

High Risk Medium Risk Low Risk

1

2 3

4

5

6

7

8 IIA Report & Mitigation Planning

Linked Projects

• ‘Community Fit’

• Describe patient oriented activity in primary care and estimate how this might change as a result of changes in demography.

• Use a full range of available data sources to identify patient’s wider community health and social care usage and classify patients based on utilisation patterns.

• Nature of subsequent work to be defined re: development of primary and community services

• Stakeholder meetings to start from September (Third Sector, Mental Health, Primary Care Services, Social Care & Community Services) to review data

• Information Technology• Local Health Economy IT Forum reported progress to Programme

Board • Integrated Care Record project to be established

Communication & Engagement

• POP UP CAMPAIGNo Grassroots engagement in 13 community venues - 60,000 leaflets.

• PRESENTATIONSo Over 50 presentations to Councils and social & community groups from January to

May.• RURAL URGENT CARE CENTRES

o Planning workshops at five localities• TELEPHONE SURVEY

o Representative sample of c.3,000 people across Shropshire, Telford & Wrekin and Powys to inform option appraisal.

• IMPACT ASSESSMENTo Targeted engagement with groups representing people with Protected Characteristics,

and planning for full Integrated Impact Assessment alongside Public Consultation.• CONSULTATION PREPARATION

o Due to commence and to include early engagement with Health Overview & Scrutiny Committee and with Powys Community Health Council.

• COMMUNITY FITo Initial communications on purpose and scope being prepared.