South West London Collaborative Commissioning

Croydon, Kingston, Merton, Richmond, Sutton and Wandsworth NHS Clinical Commissioning Groups and NHS England  

‘Working together to improve the quality of care in South West London’

South West London Sustainability and Transformation Plan

Kingston Health and Wellbeing Network12th April 2016

South West London Collaborative Commissioning

What is a sustainability and transformation plan?

• A plan to improve the way that health care services are delivered in south west London to ensure that:– the quality of services meets national standards;– we address future challenges such as obesity and diabetes by delivering services 

in the right way;– inequalities are reduced across the area;– we work within the available budget 

• Every health and care system will be required to work together to produce this - covering the period October 2016 to March 2021.

• This is an opportunity to build or strengthen relationships - across health, social care and local government – but also with patients, communities, staff and the voluntary sector

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South West London Collaborative Commissioning

Our plan should:

• be based on the geographical area of south west London - include all services across this area

• reflect local Health and Wellbeing Strategies• return the system to financial balance• address the sustainability and quality of general practice•  reduce waiting times for A&E, cancer and mental health•  improve quality of care

Source: Delivering the Forward View: NHS planning guidance 2016/17 – 2020/21;   Joint letter re: Developing Sustainability and Transformation Plans to 2020/21, 16 Feb 2015 3

Develop local leadership and  collaboration

Establish common purpose

Define early vision and priorities

Ongoing planning, implementation and learning

Engagement of staff and communities at every stage

30 June submission

Build the leadership       Develop the vision and take early action Continued implementation

Collective leadership

agreed

Full Plan submitted to national bodies

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Overview of the process and timeline

Identify and quantify  opportunities and develop 

plan

Take early action,  get runs on the board

South West London Collaborative CommissioningThree planning levels that contribute to the STP

Responsible for the development of condition/pathway specific quality improvement plans, productivity plans, and plans for enablers.

These groups will involve input from commissioners and providers across SWL.

Responsible for the development of local cross partner preventions plans.

Responsible for the development of sub-regional out of hospitals plans.

Existing SWL workstreams, e.g.

Urgent and Emergency Care

Network

4 x sub-regional planning groups:

Croydon, Kingston & Richmond, Sutton & Merton, W/worth &

Merton

6 x CCGs working with local authorities

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Four sub-regional planning footprints aligned to acute providers

South West London Collaborative Commissioning

Our three gaps (to be met through the STP)

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• Health and wellbeing • Care and quality• Financial

South West London Collaborative Commissioning

Gap 1: Improving health and wellbeing

Challenges to health and wellbeing in south west London

• Growing and ageing population, but also an unusually young population. • Inequalities with pockets of deprivation that are linked to poorer health and wellbeing 

outcomes• Prevention in early years could be improved (focus on childhood obesity) • The number of people living with dementia is rising and embedding high quality dementia 

care into services is key.  

Developing cross partner prevention plansThe development of this plan has been welcomed as an opportunity to improve collaboration between the NHS and local authorities.  

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South West London Collaborative CommissioningGap 2. Improving care and quality Our care and quality base case demonstrates:

• We are failing to meet minimum standards for acute urgent and emergency care• More could be done in the community to reduce the amount of care delivered in 

hospitals• We can do more to improve the quality of general practice• We are not consistently meeting the needs of people who have mental health needs or 

dementia

Underlying factors Two main factors underpin these gaps in the quality of our services:

– The lack of an available workforce to provide safe, effective care in the existing configuration of services 

– The provision of preventative and proactive care, including primary care and services supporting earlier discharge from hospital, is inadequate

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South West London Collaborative Commissioning

Gap 3: Improving our financial position

• The Partnership has estimated that under the ‘Do Minimum’ scenario, the underlying deficit in the SWL & Surrey Downs health economy could rise to approximately £600m in-year by 2020/21.

• Under this scenario, with activity continuing to grow the demand for beds would increase by an estimated 454 by 2020/21, requiring additional capacity across the provider sites. 

9Source: DRAFT South West London and Surrey Downs Healthcare Partnership - Baseline Review of Activity, Capacity and Finance - 18 March 2016 

Acute providersNon-acute providersCommissionersSpecialised commissioning provisional estimateAdditional commissioner chal-lenge to 1% surplusCost of capital to fund ad-ditional bed requirement

South West London Collaborative Commissioning

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What we want to achieve through the our plan

Therefore, the Programme needs to focus on options in light of: • Prevention • The configuration of acute sites in SWL• The productivity challenge• The transformation of out of hospital services

opriate• People-centred services.  • We have some excellent services but we know we can do better.  • We will invest much more in mental health and in services based in the community as this improves outcomes.  

• We want to help local people live healthier lives.  • We need to transform the way we deliver services to make sure people get the best care and taxpayers get value for money.

• We have already achieved a lot. 

South West London Collaborative Commissioning

Croydon, Kingston, Merton, Richmond, Sutton and Wandsworth NHS Clinical Commissioning Groups and NHS England  

‘Working together to improve the quality of care in South West London’

Thank youAny questions?