Mike Potts Chief Executive

Local overview and key challenges across Local overview and key challenges across the four themes set out in the Operating the four themes set out in the Operating

FrameworkFramework

Calderdale, Kirklees and Wakefield District – the place

Wakefield Pontefract

Hemsworth

Huddersfield

Batley

Dewsbury

Halifax

Todmorden Calderdale

HuddersfieldWakefield District

Wakefield

Batley

Dewsbury

Halifax

Todmorden Calderdale

Huddersfield

Pontefract

Hemsworth

Wakefield District

WakefieldBatley

Dewsbury

HalifaxTodmorden Calderdale

Huddersfield

Kirklees

About us …

• 991,000 local people• 582 staff• £1.68 billion budget• Significant health challenges• 4 shadow CCGs • 1 West Yorkshire Commissioning

Support Service• 3 Health and Wellbeing Boards

About us … (Contd)

Main providers:• 2 acute (1FT, 1 aspiring FT)• 1 mental health/care trust (FT)• 1 ambulance service (aspiring FT)• 2 social enterprises• 138 GP practices• 127 dental practices, • 200 pharmacies • 114 optometry providers

Wider system leadership:• Emergency planning (West Yorkshire) • 111 implementation (Yorkshire & the Humber)

Strong relationships with our local authorities

Our role

3 PCTs - one cluster board and one executive team from October 2011Our role:

• lead the local NHS• improve the health of local people• commission high quality safe and sustainable services within

resources• implement NHS reform

∙ manage transition to the new commissioning system∙ manage transition of PH to LAs and support establishment of

Health & Wellbeing Boards∙ support provider development

Our focus

• Maintaining quality & safety• Delivering performance• Managing the money• Maintaining resilience • Creating the new commissioning system - CCGs, CSS, public health, H & WBBs• New relationship with public• Embed transformational change

Control

Close

Create

Challenges for health and social care

• Ageing population – increased pressure on health and social care services.

• Do things differently – encourage innovation and transformation.

• Embrace new technologies.• Integrating care across agencies – move from

competition to co-operation/partnership.• Improve health & health outcomes - ownership, lifestyle

choices, wider determinants of health.• Meaningful engagement with our patients and local

communities.• Limited resources – need for greater efficiency.

Operating Framework 2012/13

4 key themes:

• Getting the basics right

• Maintaining our grip on performance

• Meeting the quality and productivity challenge

• NHS reform

Getting the basics right

Control• Cluster quality governance• Swift response to CQC inspections• Performance: grip on key quality performance indicators

• Hospital acquired infections • Patient safety• Safeguarding

• Assuring and improving quality through transition• Quality metrics across the system• Quality impact assessments

Create• CCG quality governance/infrastructure• National and local CQUIN development• Focus on improving patient experience

Close• Close down process in place• Legacy documents• Quarterly reporting to NHS North of England• Face to face handovers Q3 and Q4

Getting the basics right Contd

Performance – the challenge

Keeping a grip on performance:

• A&E and Referral to Treatment (RTT) 18 weeks - monthly delivery by speciality

• Increased pressure on delivery of zero Health Care Acquired Infections (HCAIs)

• Continued focus on zero Mixed Sex Accommodation (MSA) breaches

Focus on sustainability

Plans to Board in May

Quality, innovation, productivity, prevention (QIPP)

• Strong record of managing within resources and delivering QIPP targets.

• QIPP targets 12/13 to 14/15:

Calderdale£m

Kirklees£m

Wakefield£m

CLUSTER£m

2012/13 5.5 9.5 12.5 27.5

2013/14 4.8 10.0 11.4 26.2

2014/15 5.3 10.0 11.4 26.7

TOTAL 15.6 29.5 35.3 80.4

Our 5 transformational QIPP Programmes (2012-15)

Changing planned

care pathway

Preventing unplanned admissions

and managing long term conditions

Assistive technology

and risk stratification

Alternative community

services

Stronger mental

health and learning disabilityservices

• E consultation • Telemedicine• Virtual ward• Community consultants

Whole system integration

Person first

System enablers

• Assistive technology• E-consultation• Integrated provision• Case management• Risk stratification• Leading Large Scale Change Support

Programme

Whole system health and social care transformation

50% of QIPP savings delivered through twoMajor transformation programmes:

• Calderdale & Huddersfield Health and Social Care Transformation Programme

• Wakefield District and North Kirklees Health and Social Care Transformation Programme

The transformation map

Program

me O

ffice

Calderdale and Huddersfield health & social Care transformation

CKW Cluster Board

Calderdale Council

Kirklees Council

Urgent care:Joint approach to delivery of non-elective and urgent care and QIPP

Health strategy refresh:Future service visionTransformationDelivery of QIPP/CIPs

CHFT Board

Cross Cutting: communications and engagement; clinical leadership; quality and safety; workforce, PMO governance and risk management

Partner Trusts: SWYPFT, Locala

CCGs:Greater Huddersfield &

Calderdale

Elective care:Joint approach to delivery of redesign and QIPP

Calderdale & Huddersfield health & social care transformation

Aims:• A strategy for the next 5 years to deliver high quality care in

the most appropriate setting.• To be in top 10% nationally for safe, reliable patient-

centred care.• Maximise the benefits of the NHS reforms and respond to

demographic changes.• Focus on the needs of people with LTC.• Affordable and sustainable services, where local leaders

are recognised for their approach to partnerships and integrating care.

Program

me O

ffice

Wakefield District and North Kirklees health and social care transformation

Foundation Trust applicationTransactional processes

Partner PCTs:NHS Leeds

CKW Cluster Board

NHS North Wakefield Council

Kirklees Council

Recovery and service improvement

• Financial recovery• Service improvement

Transformation programme• Care outside hospital• Urgent care• Clinical services strategy• Primary medical services

MY Hospitals Trust Board

Cross Cutting: Communications and engagement; clinical leadership; quality and safety; workforce, PMO governance and risk management

Partner Trusts: SWYPFT, Locala

CCGs: Wakefield

North Kirklees

Programme executive

QIPP schemes – some examples

Diabetes e consultation – linking GPs and secondary care clinicians (early indicators 75% reduction in referrals)

Telehealth in Care Homes – supporting end of life care – (10% – 15% reduction in emergency admissions)

Dementia Care – new model of specialist day care – 10% increase in day care activity

Primary care transformation – to increase primary care capacity – ( 8% reduction A&E attendances 5% reduction in LTC admissions)

Implementing NHS Reform

NHS Commissioning Board

Chief ExecutiveSir David Nicholson

ChairProfessor Malcolm Grant

Local clinical commissioning groups (CCGs)

Practices

Chair Applying for authorisation

RAG rating

Calderdale 27 Dr Alan Brook 1st phase (July)

Greater Huddersfield

40 Dr Steve Ollerton

2nd phase (Sept)

North KirkleesHealth Alliance

31 Dr David Kelly 3rd phase (Oct)

Wakefield Alliance

40 Dr Phil Earnshaw

1st phase (July)

Commissioning support service (CSS)

• West Yorkshire wide approach• Already operational – from this month• Business case submitted• Expect to be fully operational by end October. • Currently consulting on senior

staffing structure • MD appointed

Alison Hughes

Provider development

• All remaining NHS trusts move to Foundation Trust status.

• New provider models e.g. social enterprises, joint ventures.

• More choice, competition and co-operation

• Any qualified provider.

Public health transition

• Public health functions to:• Public Health England• Local authorities• NHS Commissioning Board

• Joint Directors of Public Health x 3• Transition plans agreed. • Plans assured by NHS North of England.• Ready for start of shadow period: Oct 12.

Public health – local authority

Health & Wellbeing Boards

• Three shadow boards in place.• Strong relationships developed with CCGs.• Joint Health and Wellbeing Strategies being developed.

Health & Wellbeing Boards

Group discussions

We want to hear from you

Your contribution is important