Northern LincolnshireHealthy Lives Healthy Futures Programme

North Lincolnshire CCG Governing Body Update

February 2014

Vision

Community based care

Self care &independent

livingLocal

services Centralised care

Comprehensive

Affordable

Healthcare providers should provide a comprehensive service, from supporting prevention and self-care, through community provision, to specialist and tertiary care.

Providers of these services should take an integrated approach, so that local people have access to a seamless service

The result will be higher-quality care, with more lives saved and more people returned to full health

A further result will be a service that is affordable in the years to come

Integrated

Higher quality

Care in your home

As a result of patient and public feedback, and commissioners plans we have separated out self-care and independence from the home care element.

Operationalising the visionCo

mm

issio

ning

Inte

ntion

s / V

ision Major service

change

Minor / incremental

service change

Engage & Implement

1. Long Term Strategic Partnership Discussions (HEY, NLaG, York)

2. Medium Term Commissioners Vision / Big Picture• Shift to the left – more community & home based care• Centralisation of some services where there are quality

benefits (paediatric surgery, ENT surgery)• Agreement of final solution for Hyper-acute stroke

3. Implementation of enabling works• QIPP and CIP schemes• Keogh recommendations• Elderly care & dementia strategies• LTC initiatives (COPD, Diabetes, CVD)• 7 day working initiatives

Consult

Our Key Messages

Our Priorities Self Care • Enabling people to make positive lifestyle decisions, better access to

information and advice and promoting screening and preventative services

Care in your Home • Our aim is to deliver care in the home wherever safe, possible and

practicable. Where possible, we want to reduce the need for patients and carers to travel for their care

Care in your Community • Most health and care services do not need to be delivered in hospitals.

We believe a majority of care can be delivered out in the community, either in or close to people’s homes in a community setting.

Hospital Services • No decisions have been made yet about major service changes, however we know

that a small number of services are likely to require large scale change in order to make the quality and safety improvements that we want to achieve

Some examples of what we are engaging on

Promote the use of the local pharmacy as a first point of contact for minor ailments such as coughs and

colds

Introduction of information points or

“support hubs” or “health and wellbeing

centres” in public areas such as GP clinics

or health centres

Outpatient appointments - Many appointments do not

require specialist equipment or tests. These can be offered in the community to

avoid visits to hospitals

Use of technology such as tele-health systems

can be used to undertake simple

monitoring procedures such as blood

pressure, medicines usage or weight checks

Hyper-acute stroke services. These have

already been centralised on the Scunthorpe

General Hospital site as a temporary measure. Patients have already benefitted from this temporary solution

Children’s Surgery -We are considering

whether this service should be delivered

from one hospital site rather than at both

Access to Services - We have established

an integrated transport group to

understand what the current issues are, and what may need to be

done differently if services are moved

Ear, Nose and Throat services(ENT). Clinical teams have suggested

there will be some benefits to ENT patients if we have one site for inpatients and people requiring care out of

normal working hours

Delivering the message

Engagement Events

Updates with community and

voluntary groups

Roadshows

Engagement materials

(booklet, posters)Press releases

Organisational websites

(intranets)

1:1’s with Key Stakeholders

Engagement Documentation

Phase 1: Introducing the case for change & review criteria

Phase 2: Moving the conversation on

Adobe Acrobat Document

Adobe Acrobat Document

Engagement events in NL • A series of Road Shows have taken place in North Lincolnshire, including:

– Kirton Lindsey, Crowle, Winterton, Barrow, Goxhill, Brigg, Scunthorpe and one to take place on 13th February in South Killingholme.

– The number of contacts and engagement material distributed at the Roadshows in North Lincs can be seen below:

Location Direct Contact with public

Booklets handed out Leaflets handed out Comments card filled in

Kirton Lindsey 33 27 19 17

Crowle 14 11 8 8

Winterton 26 28 14 15

Barrow 17 16 8 6

Goxhill 5 4 3 2

Brigg 56 48 14 14

Scunthorpe High St 78 73 25 6

Total 229 207 91 68

Engagement Events in NL

• We are holding three formal engagement events in North Lincolnshire:

General programme activities so far

• Developed the case for change and criteria for reviewing services• Undertaken engagement activities on the case for change and review criteria,

including stakeholder 1:1s and engagement with OSC• Completion of EQIA and Risk Matrix, • Agreement of Evaluation Criteria for decision making• Commissioners worked through thinking around service provision • Providers worked through responses to vision and emerging thinking• Agreement of high level principles for bringing commissioner and provider work

together• Outline and articulation of jointly agreed possible service models (for public

engagement)• Launch of 2nd phase public engagement• Agreement of high level content for major service change and possible

consultation (if required)• Agreement of programme assurance mechanisms with the Area Team, Clinical

Senate and Gateway Team

Next stepsWe need to move the conversation on:

• To build on the feedback we received in the 1st engagement phase• To focus on a higher level of participation in the service model

development work and provide opportunities for more detailed discussion and consideration of themes and issues

This will be delivered through:• Stakeholder summit 13th February 2014• A series of roadshows across the area from the 3rd Feb – 14th March

2014• Open space events within the North and North East Lincs area• Online engagement • Use of social media and advertising• Public consultation to run from June 2014

We also need to complete the modelling work & financial assessments for the changes we are proposing, and prepare implementation plans

Timeline

Apr

Refine high level themes /

service models for public

engagement

Today

Sept Oct Nov Dec Jan Feb Mar

Zero-based commissioners

solution

Engagement Public consultation

Option refinement & assessment

Consultation preparationProvider-led solution

Stakeholder summit Stakeholder summit

May June

Engagement

Jul Aug-Oct

Work to assess/incorporate

outputs of consultation

Preparation for implementation

Implementation Oct 2014

20142013

Implementation of safety & quality imperatives, and those elements not requiring consultation

Communications & Engagement Activities, Key Stakeholder 1:1s,