Slide 1

The future provider landscape Chair: Stephen Dalton, Chief Executive, Mental Health Network Katrina Percy, Chief Executive Southern Health NHS Foundation Trust Bev Humphrey, Chief Executive, Greater Manchester West NHS Foundation Trust Professro Ian Stewart, The City Mayor of Salford Sir David Dalton, Chief Executive, Salford Royal NHS Foundation Trust @nhsc_conference #confed2015

Slide 2

The future provider landscape Katrina Percy, Chief Executive Southern Health NHS Foundation Trust @nhsc_conference #confed2015

Slide 3

The future provider landscape: Our perspective as a mental health and community provider Katrina Percy, Chief Executive

Slide 4

Introduction to Southern Health Southern Health NHS FT formed on 1 April 2011 through merger of a community services and mental health provider 350m budget, 8000 staff Delivering community services, mental health, learning disability & some social care services

Slide 5

Our future Developing our specialist Mental Health and Learning Disability Services and ensuring their sustainability Developing a Multi- Speciality Community Provider (MCP) integrating primary care & community services

Slide 6

Developing an MCP Your Health, In Your Hands, With Our Help. Commissioner Reform Provider Reform Our new care model Pooling the combined resources for the local population and commissioning services using long term outcome and capitation based contracts Coming together to deliver the new model of care that has been co-designed with local people, is seamless across health and social care services and is cost effective A new care model with better access to care, extended primary care team proactively managing need, and specialist advice and support in the community.

Slide 7

MCP Care Model Improved access to care An extended primary care team De-layering specialist support Wider primary care at scale

Slide 8

An extended primary care team +=

Slide 9

Delivering the model East Hampshire 10 practices / 70k patients Semi-rural new town Gosport 11 practices / 80k patients Urban deprived New Forest 7 practices / 70k patients Rural older demographic

Slide 10

Specialist Mental Health Services Delivering recovery orientated services Redesigning care pathways Reducing reliance on inpatient care Integrated health and social care model with local authorities

Slide 11

Specialised and forensic services Adult low and medium secure services Adolescent medium secure services Tier 4 CAMHS Services that require capital investment and scale to be sustainable

Slide 12

Delivering the new models and implications for organisations such as ours

Slide 13

Building leadership capability

Slide 14

Organisational form? With primary care, these services will form MCP(s) These services increasingly need to operate at scale (whilst maintaining local focus)

Slide 15

Determining organisational form An organisational form is required for the MCP to succeed, and for our specialist mental health and learning disability services Our work is to determine the best solutions that enable success Our Board clear that the Trusts long term future is in the new organisational forms Working to overcome the hurdles with regulators

Slide 16

Conclusions Focus on the new model of care this is what will improve care and enable financial sustainability Building leadership capacity and capability is key Our provider organisational forms will also change Working with partners and regulators to ensure a smooth transition

Slide 17

The future provider landscape Sir David Dalton, Chief Executive, Salford Royal NHS Foundation Trust @nhsc_conference #confed2015

Slide 18

10+ 12 + 15 LAs CCGs Providers 1948 2016

Slide 19

Coherent Public Services Serving the needs of people, - not Regulators or central funding bodies Although each township is proud of its heritage we share a common view and have more that binds us than separates us.

Slide 20

or

Slide 21

Coherent Improvement Programme 7 day services Specialist Cancer Services Diabetes - Prevent - Identify - intervene Dementia Better Service + National Institute Support unemployed with mental health needs Single Shared Hospital Services C&YP Mental health wellbeing + Eating disorders Reduce GP variation in quality Integrate Pharmacy & Dentistry 1 Care Offer Relationship with Industry & Pop Based Trials Adopt & Spread Vanguard Learning GM Workforce Passport GM Contracts for GPs (GMS & PMS) Datawell Intelligence & Analytics Academic Health Science System Estates Optimisation Ed & Training + Skills & Job Design Early Deliverables Other Deliverables Enablers Improving Outcomes & Access Improving Health & Care Improving Wealth & Employment Improving Models Of Care

Slide 22

Industry Improved health & economic growth Unmet needs Collaborative resources: Clinical trial infrastructure & facilities Integrated Ehealth infrastructure Business development NHS adoption and procurement Health economics Entrepreneur development Large, stable ethnically diverse population NICE strategic relationship Solutions Collaborative assets: Integrated health and Social Care Academic & clinical excellence Exemplary business development and environment infrastructure FUSONFUSON FASTER BETTER Academia FUS I ON IMPACT

Slide 23

Single System of Governance P P P P Lead P P BENEFITS Full range of services within a single management arrangement more effective, efficient and coordinated care Collaborative environment without the need for new organisational forms Aligns interests of commissioners and providers, removing organisational and professional silos that contribute to fragmented and sub-optimal care Collective ownership of opportunities and responsibilities; any gain or pain is linked to performance overall Supports a focus on outcomes and incentivises better management of population demand CCG, City Council, SRFT, GMW, Salix Health, social care & wellbeing for 65+ population Some services subcontracted Phased introduction 2014/15 onwards 23 Salford Vanguard

Slide 24

GM Improvement Dividend 16% differential in weekend mortality rates Saving 500 lives over 3 years by meeting trauma and emergency surgery standards Liberating 1500 hospital beds (with closer to home facilities or in home support) 20% reduction in urgent care admissions 25% reduction in care home admissions Supporting 000s of people back to work

Slide 25

Regulation NHS Constitution/Core National Standards ALB Regionalised Offices? GM Local Standards GM Improvement Programme metrics Employment Contracts (Primary Care)

Slide 26

Governance (a personal view) 3 levels of decision making: - local - sector - regional Must not travel at the speed of the slowest Decisions must stick limit power of veto/appeal

Slide 27

27 Dalton Review #DaltonReview2014 What might a GM Health Care Organisation look like in five years time? Federated Back Office With GM Providers Integrated Care Models for Long term conditions, Dementia Mental Health and Urgent Care Single Shared Service with 2+ Providers serving 1m population Service Line Contract for with Specialist Providers ? Management Contract, or Organisational Chain

Slide 28

The future provider landscape Ian Stewart, The City Mayor of Salford @nhsc_conference #confed2015

Slide 29

Bev Humphrey, Chief Executive, Greater Manchester West NHS Foundation Trust @nhsc_conference #confed2015