Co-commissioning a 0-19 service in Newcastle upon Tyne

Jane Johnston (Public health commissioning manager CNTW area team).

Helen Robinson (Interim senior public health specialist Newcastle city council)

NHS/ LA | Presentation to EXPO CNTW/NCC 3/3/142

Section sub-headingTo share a process that demonstrates co production .

Service remodel that developed from co commissioning

Resulted in improved health outcomes

Reflecting through the NHS change model.

NHS/ LA | Presentation to EXPO CNTW/NCC 3/3/143

• Home to 279,000

• Diverse community changing ethnic mix

• 64,000 children

• 1/3rd live in poverty

• High rates of childhood obesity, teenage pregnancy.

• Underachievement of public health outcome framework

• Concern around emotional well being “ party city”

•

Newcastle Upon Tyne

Health visiting and school nursing• High turnover

• Low moral

• No clarity in commissioning

• Limited public health delivery

• Transforming Community Services - low visibility in acute service

• Conflict and mixed views

• Focus on HV call to action.

• School nursing - small service

NHS/ LA | Presentation to EXPO CNTW/NCC 3/3/144

Commissioning arrangements • NHS England area team – Healthy child programme 0-5,

Health Visitor and Family Nurse partnership and school based immunisation programmes

• Newcastle City Council public health – school nursing services, breast feeding peer support, childhood obesity pathway.

• Newcastle City Council – Children’s Centres, children's social care

• Clinical Commissioning groups – children community nursing services

• Voluntary sector- children services, young people services and parenting support. NHS/ LA | Presentation to EXPO CNTW/NCC 3/3/145

What was different this time• Local shared vision based on improved health

outcomes.

• Engagement and commitment of multi agency commissioners

• Active participation of providers including higher education.

• A commitment from all to the public health early intervention and prevention agenda

• The use of evidence base and data to shape commissioning process.

NHS/ LA | Presentation to EXPO CNTW/NCC 3/3/146

The outcomes • Commissioning intensions clear –informed by all

stakeholders

• Service specification local -then national for HV developed for school health

• Local performance framework which supports full service delivery of the healthy child program and local priorities.

• Provider actively engaged and now leading the change agenda

• Innovative delivery model emerging within the financial allocations.- Hello goodbye/Men C delivery

NHS/ LA | Presentation to EXPO CNTW/NCC 3/3/147

The outcomes • Improved public health outcomes:

Immunisations

Sustaining breast feeding – 4%increase from March 2013. (co commissioned)

• Evidenced delivery of the revised model of HV (shared production)

• Co commissioned school based immunisation programmes, healthy child programme and local priorities.

• Retention of Health Visitors ( 4.8% turnover this year)

NHS/ LA | Presentation to EXPO CNTW/NCC 3/3/148

How • Development of shared vision

• Leadership

• Engagements

• Using the system drivers

• Transparent measurement

• Evidence based Service improvement methodology –RIPW (immunisation) LEAN (Service delivery redesign)

• Sharing the innovation

• Measurable outcomes

NHS/ LA | Presentation to EXPO CNTW/NCC 3/3/149

NHS Change Model

www.changemodel.nhs.uk

NHS Change Model

• This was created to support the NHS to adopt a shared approach to leading change and transformation.

• The NHS change model is a framework for making change happen that can be used from a commissioning perspective

• 8 components

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The future • Move to LA of HV and FNP commissioning –

possible threat?

• Academies

• Tender process.

• Loss of existing structures

• Efficiency savings in LA

NHS/ LA | Presentation to EXPO CNTW/NCC 3/3/1412