chair appointments bnssg
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NHS England and NHS Improvement
Chair Appointments – BNSSGJune 2021
Healthier Together was established as a partnership to improve health and wellbeing for the people of Bristol, North Somerset and South Gloucestershire (BNSSG)
2016
Partnership formed
2020
ICS
designation
2019
Long term plan
Sept 2021
ICS Memorandum of
Understanding
The 10 Healthier Together ICS partners are:
Clinical Commissioning Group:
• BNSSG CCG
Local Authorities:
• Bristol City Council
• North Somerset Council
• South Gloucestershire Council
Healthcare Providers:
• Avon & Wiltshire Mental Health Partnership
NHS Trust
• North Bristol NHS Trust
• One Care (BNSSG) Ltd
• Sirona Care and Health
• South Western Ambulance Service NHS
Foundation Trust
• University Hospitals Bristol and Weston NHS
Foundation Trust
We are developing integrated care partnerships (ICPs) in six localities:
We were designated as a ‘maturing’ Integrated Care System in December 2020, in recognition of what we have achieved together…. The next phase of
journey involves transition to a new statutory form by April 2022
April 2022
ICSs operating in new
statutory form
Feb 2021
White Paper
published
Trusts (Acute and MH): 3
Local authorities: 3
PCNs: 18
Population: 1m
Place: 6
CCGs: 1
CCGs, Local Authorities, and Providers and CQC Ratings
CCG Local Authority (LA)
NHS Bristol, North Somerset and
South Gloucestershire CCG
• Bristol City Council
• North Somerset Council
• South Gloucestershire Council
CCGs and LAs
Provider Current CQC rating
North Bristol
Hospital NHS Trust
• Overall: Good
• Safe: Good
• Effective: Good
• Caring: Outstanding
• Responsive: Requires improvement
• Well-led: Outstanding
University Hospital
Bristol and Weston
Foundation
Trust (UHB &
Weston acute sites)
• Overall: Outstanding
• Safe: Requires improvement
• Effective: Good
• Caring: Outstanding
• Responsive: Good
• Well-led: Outstanding
Avon and Wiltshire
Mental Health
Partnership Trust
• Overall: Requires improvement
• Safe: Requires improvement
• Effective: Good
• Caring: Good
• Responsive: Requires Improvement
• Well-led: Requires improvement
Providers and CQC ratings
CCGs, Providers and Local Authority – Accountable officers & leadership
CCG
Organisation Chair Accountable
Officer
NHS Bristol, North
Somerset and
South
Gloucestershire
CCG
Jonathan Hayes Julia Ross
Providers
Organisation Chair CEO
North Bristol
Hospital NHS
Trust
Michele Romaine Maria Kane
University Hospital
Bristol and Weston
Foundation Trust
Jeff Farrar Robert Woolley
Avon and Wiltshire
Mental Health
Partnership Trust
Charlotte Hitchings Dominic Hardisty
Local Authorities
Local Authority Leader Chief Exec DASS DPH Combined
Authority
Elected
Mayors
Bristol City Council Marvin Rees Mike
Jackson
Hugh Evans Christina
Gray
Dan Norris,
West of
England
Combined
Authority
Mayor
North Somerset
Council
Don Davies Jo Walker Sheila Smith Matt Lenny
South Gloucestershire
Council
Toby Savage Dave Perry Chris Sivers Sara
Blackmore
Gold
Silver
Bronze
Partnership Board
Executive Group
System Oversight
Planning & Oversight
Operations Performance
Performance subgroups
Finance Planning
System planners
& DDOFs
DOFs Deputy
DOFs
Business Intelligence
PMO System Transformation
Integrated care
Acute care collaboration
Urgent care
Population Health, Prevention & Inequalities
Mental health & LD
Children & Families
People Digital Estates
Clinical Cabinet
Strategic comms
System transformation• Core ICS function• Overseen by Steering Groups• Each Steering Group is Chaired by an
Executive Group member/sponsor
System planning• Cyclical function• Overseen by Planning and
Oversight Group• Coordinated by PMO and system
planners• Each cycle requires Executive
oversight
System oversight• Core ICS function• Overseen by Planning and
Oversight Group• Supported by system
planners and Deputy DOFs (DDOFs) group
• Supported by system performance subgroups on
• Planned Care• Urgent Care• Integrated Care• Primary Care• Mental Health
EPRR• Incident control function• Manged through
command and control structures
Function leads groups• Informal structures, not currently part of system governance• Facilitates cross system collaboration between functional leads• Helps to align organisational and system level working• Supports system performance and transformation functions
System enabler functions• Business intelligence and PMO capabilities• Supports system oversight and transformation functions
System governance groups
Covid-19 incident control functions
Functional leads groups
ICS functions
Key
Key focus areas for System Oversight function
System enabler functions
COOs group System planners group
System change group
HRDs group
Directors of Finance• Financial planning and reporting• Risk and control total management• Financial advice on transformation
(costs, savings and affordability)
Localities
Inner City & East Bristol
North & West Bristol
South Bristol
Weston, Worle & Villages
Woodspring
South Gloucestershire
BNSSG Gold command has the same membership as the Executive Group
BNSSG Locality footprints
BNSSG ICS Governance Arrangements (Current)
ICPsInner City & East Bristol
North & West Bristol
SouthBristol
Weston, Worle & Villages
Woodspring South Glos
North Somerset HWB South Glos HWBBristol HWB
ICS Partnership
People in their communities
Agrees Integrated Care Strategy
Delegates functions, decisions, funding; defines leadership
and governance ICPs accountable to ICS for NHS-funded care
ICPs report to HWB and have regard to the JSNA and JHWS
Local HWBs: • Set local priorities for
ICPs• ensure health
inequalities focus• enable integration of
health and social care at LA boundary
HWBs produce JSNA and JHWS for ICS to regard
Joint HWB
Responsible for developing an integrated care strategy that addresses the wider health, public health, and social care needs of the system
Responsible for the day to day running of the ICS; lead and oversee planning and delivery of NHS services across the system
Acronyms: • HWB: Health and Wellbeing Board• JSNA: Joint Strategic Needs Assessments • JHWS: Joint Health and Wellbeing Strategies
‘At Scale’ Provider Collaboratives
Work in progress – does not currently include key functions, such as: • Clinical and professional leadership• System planning and performance oversight• Quality improvement and oversight • Health and wellbeing transformation and enabling programmes
BNSSG ICS Governance Arrangements (Future) Work in progress
Key principles for how we work together as an ICS:
➢ Individuals @ the centre
➢ Subsidiarity
➢ Collaboration
➢ Mutual accountability & equality
➢ Transparency
BNSSG ICS NHS Body
Our shared vision for the people of BNSSG
Our vision for delivering our ambitions is to join up care at locality level and across our hospital systems to respond to what people with complex needs tell us matters to them
Healthier Together is the health and care partnership for people in Bristol, North Somerset and South Gloucestershire. We work together to improve the health of our population and make sure services work for everyone.
Our vision is for people in Bristol, North Somerset and South Gloucestershire to have the best start in life, and for the places where we live to be healthy and safe.
Everyone will have the opportunity to live longer in good health. When people need support from our services, they will be high quality and easy to access.
People will be better supported to take control of their own health and wellbeing, and become equal partners in care. Working alongside our communities, we’ll build on strengths and tackle inequalities together.
We’ll make it simple for health and care staff to work better together for the benefit of the people we care for – nurturing talent, removing barriers and acting on views and concerns.
BNSSG Strategic Priorities
1. Developing our Partnership and transitioning to a statutory ICS: evolving our ways of working as an ICS to ensure our system is fit for purpose to achieve our goals for the people we serve and support our staff in the transition
2. Developing ICPs (x6): transform experience of health and care (starting with community mental health) through fully integrated preventive, proactive/anticipatory and personalised services:• Focused on local people’s health and wellbeing• Building on the asset base of individuals and communities• Embedding the voluntary sector and working with community and faith groups…• …to make the community the default setting of care 24/7, 365 days a year
3. Recovering from the covid pandemic: increasing access to our services through online, telephone, and face-to-face appointments; reducing waiting lists and supporting our staff
4. Adopting a new value-based health and care approach to meet the aims of population health by focusing on achieving the outcomes that matter to people, services that work for them and are culturally appropriate, and making the best use of resources• Working with the community to optimise access to services and prevention/early intervention • Promoting wellbeing for the whole population, and not just those who present to services • Ensuring equitable and efficient resource allocation • Progressing to long term financial stability
5. Improving our performance: driven by the outcomes we want to see for our population; raising standards, e.g., faster diagnosis and treatment for cancer and improved access to physical healthcare for people living with learning disabilities and serious mental illness
6. Redesigning pathways to transforming health and care services for the people we serve (e.g., stroke, mental health, learning disabilities, autism, children's health)
7. Provider collaboration across the sector to improve outcomes and consistency of care, transform patient experience, and delegate and optimise use of resources• Acute care reconfiguration • Community provider collaboration • Mental health collaboration
8. Developing our People: collaborating on recruitment, retention, and learning and development and increasing diversity to make BNNSSG the best place to work
9. Developing our role as an anchor organisation – investing in and working with communities to impact the wider factors that make us healthy, addressing root causes of health inequalities and promoting social and economic development
SW Strategic Priorities
• Reduce health inequalities
• Work in partnership
• Become digitally enabled
• Address mental health needs
• Put in place regional diagnostic hubs
• Make the SW the best place to work
• Develop improvement capability
Strategic Priorities 2020-2025
In-year objectives 20/21• Regional co-ordination of COVID, winter and EU Exit operational
responses
• Delivery of flu and COVID vaccination programmes
• Recovery and restoration of services
• Maintain business critical and statutory regional functions to keep patients and staff safe
• Make the South West the best place to work
View of the South West Region
6m
Population
(9.7%)
SW England
9,200 square
miles (18%)
20/21 Allocation
£11.2bn125,000
NHS Workforce
The South West in numbers
5/5 life expectancy
and causes of death
indicators better than
average
4/5 Child Health
indicators are better
than average and
some the best in the
country
2nd/3rd lowest
under 75
mortality rates
for CHD/cancer
2nd worst
diabetes
detection rates
2nd highest
suicide rate
9.3 year
difference in
male life
expectancy
Lowest number
of G&A and CC
beds per 100k
popn
11 |
Features of our South West Operating ModelThese are areas of work that can be led by relevant directorates
NHSE/I Operating Model
SW Regional ICS Development Programme
Na
tio
na
l
A1 ICS
Governance &
accountability
A4 People &
Culture
A3 Digital,
Technology, Data
& Intelligence
ICS Policy Design Workstreams
ICS Implementation Programme
ICS Development Steering Group
Bi-Weekly – Attended by Regional Directors, ST&T National Directors, ST Directors
A5: Provider
CollaborativesDesign Test Site
(Glos)
A2 ICS Financial
Framework
Somerset +
CornwallBSWDorset TBCDevon
Syste
m
Collaborative
Commissioning
Group
Strategic
Commissioning
Workstream
A6: Direct
Commissioning
TBC
S7a
Commissioning
workstream
Specialised
Commissioning
workstream
Primary Care
Commissioning
workstream
People & Culture
Working Group
Re
gio
n
SPOC
3-Weekly System
Check-in
Development
PlansDelivery Plans
SW ICS
TeamSW PD forum
System Leaders twice weekly sessions
SW WLT ICS Development
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