Planning for 2014/15 – 2018/19 an overview of national planning priorities CCG allocations

1. Planning for 2014/15 – 2018/19 • an overview of national planning priorities • CCG allocations

2. Planning Framework NHS | Presentation to [XXXX Company] | [Type Date]

3. Planning Framework • 1 Vision • 5 Outcome Domains • 7 Outcome Measures • 3 Key Measures • 6 Characteristics of High Quality, Sustainable Health and Care Systems • 4 Essential Elements NHS | Presentation to [XXXX Company] | [Type Date]

4. Vision High quality care for all, now and for future generations • Driven by quality in all we do • Equal access for all, especially the vulnerable and excluded • Spread existing excellence • Sustainable, high quality for the long term

5. 5 Outcome Domains and 7 Measures (Ambitions)

6. 3 Key Measures

7. 6 System Characteristics The 6 characteristics of high quality, sustainable health and care systems in 5 years time are: • Citizen inclusion and empowerment • Wider primary care, provided at scale • A modern model of integrated care • Access to the highest quality urgent and emergency care • A step-change in the productivity of elective care • Specialised services concentrated in centres of excellence NHS | Presentation to [XXXX Company] | [Type Date]

8. 1.Citizen Inclusion & Empowerment • Listening to patients’ views • Patients to participate in planning, managing and deciding about their care • Patient participation in the commissioning process • “Transforming Participation in Health & Care” guidance,Friends & family test expansion, Personal Health Budgets • Better care through the digital revolution • Increased patient access to healthcare records • Telehealth and telecare • Transparency and sharing data • Publishing outcomes data • Care.data – single data sets and transmission standards • NHS number as primary identifier • GMS contract requirements: online booking, prescriptions, records; summary care record information NHS | Presentation to [XXXX Company] | [Type Date]

9. 2.Wider primary care, provided at scale • All care for patients with moderate mental or physical LTC (~20% of patients) provided in primary care, at home or in community • Stronger more integrated community services including general practice, community pharmacy etc • Consensus about general practice working at greater scale, in closer collaboration with other health and care organisations • Strategic Framework for commissioning general practice services will be published in 2014 NHS | Presentation to [XXXX Company] | [Type Date]

10. 3.A modern model of integrated care • Integrated care model, with senior clinician responsible for actively coordinating all care, for patients with multiple, complex mental and physical LTCs, often compounded by age and frailty (~5% of patients) • Accountable GP for over 75s; CCGs to support practices by commissioning additional services required (~£5 per head) • Care integrated around individual patients; responsible senior clinicians, from initial presentation to episodic care, from life-style support to hospital episode co-management • Better Care Fund: supporting integration of health and social care; CCGs need to identify 2014/15 actions to mitigate impact in 2015/16 (15% reduction in hospital emergency activity) NHS | Presentation to [XXXX Company] | [Type Date]

11. 4.Highest quality urgent and emergency care • Longer term: Implementation of the model set out in the first phase report from the Urgent and Emergency Care Review • Completion of NHS 111 roll out • On-going local resilience planning, led by Urgent Care Working Groups (UCWGs); refreshed plans by summer 2014, building on 2013/14 plans • UCWGs to agree investment of 70% emergency tariff marginal rate, prior to contract signatures NHS | Presentation to [XXXX Company] | [Type Date]

12. 5.Step-change in elective care productivity • Elective services designed and managed to remove error, maximise quality and increase productivity • Centres delivering high quality, treating adequate volumes, expertly using modern equipment • Transforming out of hospital care and concentrating specialised services will need us to review delivery of planned admissions for less complex treatments

13. 6.Specialised services concentrated in centres of excellence • Currently too many sites, too much variety in quality, too high a cost • Need to be concentrated in centres of excellence connected to research and teaching, delivering sufficient volume • Likely to be 15-30 centres for most specialised services, with AHSCs as the focus of many of them NHS | Presentation to [XXXX Company] | [Type Date]

14. 4 Essential Elements • Quality (Effectiveness, Experience & Safety) • Francis, Winterbourne & Berwick reports implementation • Patient safety and collaborative programme • Compassion in practice (6Cs) • Seven day working – local action plans to deliver the clinical standards • Safeguarding – discharge of duties demonstrated in local plans • Access • Delivery of NHS Constitution standards demonstrated in local plans • PM’s £50m challenge fund for 9 pilots to extend access to GP services • Innovation • Regional innovation fund to support staff to innovate • Commissioners to seek and support research activity and opportunities • Value for Money • CCGs must be explicit about how the £30bn gap will be closed locally, with no reduction in quality

15. Planning Fundamentals • Strategic & Operational Plans must explicitly set out the approach to: • Improvements in the 5 outcome domains and 7 measures • Delivering the 3 key measures • Implementing the 6 system characteristics • Delivering the 4 essential elements • They should be: • Bold and ambitious • Developed in partnership with providers and LAs • Locally led • Operational and BCF plans must be driven by the Strategic Plan

16. Local engagement Build on previous and on-going conversations with • Partnership Board • COM • Community Forum • Health and Wellbeing Board In order to ensure the local direction of travel is understood and endorsed

17. Planning Timetable

18. CCG Allocations • The allocations for CCG’s for the next 2 years (2014/15 – 2015/16) have been announced • A new funding formula has been adopted for Programme Budgets to reflect population changes and includes a specific deprivation measure. All CCG’s will receive funding to match inflation, with the most underfunded areas & those with fast growing populations receiving more • The allocation for Administration Budgets will continue to be based on £/head population and will be £24.78/head in 2014/15 and £22.11/head in 2015/16.

19. What this means for NEL Programme Budgets • NEL CCG will receive the minimum uplift of inflation only (2014/15 – 2.14% & 2015/16 – 1.7%) • No recommendations as yet with regard to 2016/17 onwards, but anticipate further movement towards published allocation target. Better Care Fund (formerly the Integration Transformation Fund) • Allocation of £11.246m – in line with expectations Administration Budgets (Running Costs) • Given NEL’s low population growth compared to the national average, the CCG is likely to face savings excess of the 10% national savings requirement in 15/16.

20. Any Questions?