Sustainability and transformation plan for Northumberland , Tyne & Wear and North Durham

1. Sustainability and transformation plan for Northumberland, Tyne & Wear and North Durham Presentation for patients and the public

2. The NHS Five Year Forward View (5YFV) • Published by NHS England in 2014, the 5YFV set out a vision for continuing to improve the NHS. • By 2020-21 it aims to: • Improve the quality of care people receive • Improve health and wellbeing • Ensure services are efficient. • .

3. The NHS Five Year Forward View (5YFV) • The 5YFV recognised that: • The way health and social care is provided has improved dramatically over the past 15 years • However the quality of care people receive can vary from place to place • Preventable illness in our communities is all too common • The growing demands on health and social care has put financial pressure on local organisations.

4. Sustainability and transformation plan for Northumberland, Tyne & Wear and North Durham Presentation for patients and the public

5. The NHS Five Year Forward View • Other things have changed too: • The needs and expectations of the public is increasing • We are living longer, often with a range of conditions that require different, more complex care • New treatments and medicines are being developed • People want better care in or close to their homes and less care in hospitals.

6. The NHS Five Year Forward View • To create a better future for the NHS we need to adapt the way we do things  • This does NOT mean doing less for patients or reducing the quality of care • It means more preventative care - finding new ways to meet people’s needs • Identifying ways to do things more efficiently.

7. What are Sustainability andTransformation Plans? •     In December 2015 NHS England asked all health and care systems in the country to develop their own blueprints to speed up delivery of the 5YFP locally. •     These blueprints are known as Sustainability and Transformation Plans (STPs). •     STPs will be delivered by partnerships of health and care organisations working together across 44 geographic "footprints" primarily based on the way people use local services.

8. What are Sustainability and Transformation Plans? • In the past all organisations have had their own plans – they will continue to do so. No organisation will lose their individual autonomy or identity • But STPs are the first time shared plans have been developed across a geographical footprint • STPs set out how the NHS, local authority and other organisations will work together to improve health, care and finance for their local population.

9. What are Sustainability and Transformation Plans? • STP footprints are not new statutory organisations • They are a decision making forum - bringing people and organisations together to develop a shared plan for better health and social care for local populations  • They act as an ‘umbrella’ plan - holding underneath it a number of different specific plans to address certain challenges eg improving cancer diagnosis, mental health care, or transforming urgent and emergency care services.

10. What does this mean for the NorthEast of England? • There are two STP footprints in the region: • Northumberland, Tyne and Wear, and North Durham • South Durham, Darlington, Tees, Hambleton, Richmondshire and Whitby • As many people in Cumbria travel to the North East for some treatment we are also working closely with the STP for Cumbria. 

11. What does this mean for the NorthEast of England? • The NHS in the region has a long history of clinical partnership and joint working to develop and provide services – our STPs build on that track record • Draft STPs have been drawn up by partnerships of organisations in both footprints in the North East • The majority of the plans are based on work already underway in the footprints and is in line with what local people say is important to them about services. 

12. Northumberland, Tyne & Wear, and North Durham STP • A draft STP for the area was submitted to NHS England at the end of October and published on 9 November • The publication signals the start of a period of engagement to seek views on the proposed way forward for local health and social care services. • Engagement will continue until the end of January 2017 and feedback will help to shape the final STP.

13. What's in the STP? • The STP sets out a simple vision for the area: • Everyone who lives, works, learns in or visits the area will realise their full potential and equally enjoy positive health and well being • Safe and sustainable health and care services that are joined up, closer to home and economically viable • Local people are empowered and supported to play a role in improving their health and well being.

14. What's in the STP? • Delivery of the STP will mean that by 2021: • The health inequalities in our area will have reduced to be comparable to the rest of the country • We will have thriving out of hospital services that attract and retain the staff they need to best support their patients • There will be high quality hospital and specialist care across the whole area, seven days a week.

15. What's in the STP? •     The draft STP is designed to address three main gaps in the 5YFV: • Health and well being • Care and quality • Funding • 80% of STP are established programmes of work underway in each local health and social care economy area

16. Health and Well being •     There have been improvements in the health of local people but there is still more to do: • 27% of people live in 20% of the most disadvantaged areas in England • Smoking related admissions to hospital – almost 250,000 per year – are 50% higher than the national average • 68% of our adult population is obese or overweight • The early death rate from cancer is 20% higher than the average for England • The health life expectancy is 59.6 years – more than four years less than the national average.

17. Care and quality • We have strong services but there is variation in the quality, safety and experience of patients across the area • Not all services are joined up to provide the best support for people • Increasing demand for hospital and bed based services – 20% higher than the average for England • Increasing pressure on staff with real difficulties to recruit to some services. • As a result some of our services are unlikely to be sustainable in the future in their current form.

18. Funding •     We have some of the best performing service providers in the country and the health system is currently financially stable. • But: • Demand for care is increasing • NHS budgets are only expected to rise in line with inflation and not to cover cost of new treatments and developments • Increasing financial pressure on local authority social care services. • If we don't make changes we could be facing a funding gap in health of £641m by 2021 and could be as high as £904 million including social care.

19. Plugging the gaps •     The draft STP identifies three action areas to plug the identified gaps: • Scaling up work on ill-health prevention and improving well being • Improving the quality and experience of care by increasing collaboration between organisations that provide out of hospital care and making the best use of our acute or hospital based services • Closing the gap in our finances.

20. Health and well being •     Accelerate delivery of existing health and well being strategies to: • Promote healthy behaviours and target high risk areas eg reducing smoking, obesity, and alcohol related hospital admissions • Increase the number of people supported to manage their long term conditions • Reduce the number of early deaths • Increase flu immunisation and breast feeding rates • Reduce sickness levels among health and care staff

21. Out of hospital collaboration and hospital services • Learn from current work to improve the way organisations work together to provide out of hospital care and so reduce the need for hospital based care • Improve community and GP services • Increase weekend and out-of-hours GP appointments • Reduce attendance at A&E departments and emergency hospital admissions • Review hospital based services, speciality by speciality, to make sure the same quality of care is provided across the area.

22. Closing the financial gap • Each organisation has an efficiency plan that together should address 60% of the gap • Looking at rolling out a model of out of hospital care that could reduce costly non-planned hospital care by up to 15% by 2021 • Looking to scale up prevention across the footprint • A range of smaller efficiency schemes eg sharing back office functions, greater collaboration on pathology services

23. What does this mean to me? • NHS and local authorities are working together to integrate health and social care in a better way meaning better care experience for patients and service users • More health care will take place outside of hospital, either in local communities or in patient’s own home • Local people are empowered and supported to have a more active role in improving their health and wellbeing • More access to high quality hospital and specialist care, seven days a week

24. Future Work • Key drivers having an input on the provision of care – availability of trained health and social care staff • Need to work together to understand how services can be delivered in the future • Should future plans suggest any potential service change then the provider organisations eg, NHS trusts, clinical commissioning groups, or local authorities, will be responsible for fully engaging and consulting with local people before any decision on any future proposed changes are made.

25. How to get involved? • There will be lots of opportunities for local people to get involved and have their say in the development of the STP and the way their services are delivered in the future. • All clinical commissioning groups in the region have "My NHS" - a way for local people to register their interest in receiving information about opportunities to get involved. • The website of your local CCG has information on how to sign up to MY NHS. You'll also find there the full draft STP and an on-line survey to gather views on the plan.