North West London Five Year Strategic Plan update – Westminster Health & Well-being Board

1. North West London Five Year Strategic Plan update – Westminster Health & Well-being Board 24 April 2014

2. NHS England has asked commissioners to develop ambitious plans that look forward to the next five years • NHS England has asked each local health economy, including North West London, to develop genuinely transformative plans to meet the strategic challenges facing the NHS. • These plans are intended to address the challenges set out in a ‘Call to Action’, and are based on a set of core principles and considerations. • Core Principles: • Clinically led – aligned with national clinical strategies • Outcome focused - priorities set to optimise outcomes and quality within financial constraints • Affordable – built on robust and consistent financial basis 5 Year Strategic Plans 2 Year operational Plans • Core Considerations: • A Call to Action (£6bn required in 2015/16) • Alignment of planning across CCG, Direct commissioning and providers. • Co-ordination with Local authorities. • Patient and carers • The Spending Review Commitment (£3.8bn 2015-16) • The review of Urgent and Emergency Care • National and regional priorities Patients & Quality “Patients and Quality must be at the core of everything we do” ‘The NHS belongs to the people: a call to action’: http://www.england.nhs.uk/wp-content/uploads/2013/07/nhs_belongs.pdf 2

3. A Strategic Planning Group has oversight of the development of the North West London Five Year Strategic Plan • The North West London (NWL) five year strategic plan is supported by the operational and financial plans at CCG, provider and NHS England Area Team level, and also aligns with the Better Care Fund plans at the Health & Wellbeing Level. • Membership of the NWL Strategic Planning Group (SPG) includes CCG Chairs, Accountable Officers, Finance Directors, lay members, Local Authority Directors of Adult Social Care and Public Health, and NHS England. NWL Strategic Planning Group (SPG) Strategic plan CCGs Providers Health & Wellbeing Boards Area Teams Direct Commissioning plan Financial plan Provider plan Better Care Fund plan Operational plan Local authority planning Strategic Plan and other NHS England planning templates: http://www.england.nhs.uk/ourwork/sop/templates/

4. The draft Strategic Plan consolidates NWL’s existing plans, including Shaping a healthier future and Whole Systems • Developing the draft Strategic Plan • The NWL Strategic Plan builds on the existing strategic plans and transformation programmes that have been developed across NWL, including: • Whole Systems Integrated Care • Shaping a healthier future (SaHF) acute reconfiguration • Health and Well-being Strategies • It is a consolidation of existing plans, with the addition of NHS England’s direct commissioning plans (e.g. primary care, specialised commissioning). • Patient and public engagement in developing the contents of the Plan has included the SaHF public consultation, Whole Systems and Out of Hospital strategy engagement, co-design and consultation, and Health & Well-being Strategy consultation at Borough level. • The Plan is structured so as to address the ‘Key Lines of Enquiry’ set out in the NHS England strategic plan template, using the guidance provided in ‘Everyone Counts: Planning for Patients 2014/15 to 2018/19’. • Next steps • There will be further opportunities to contribute to the Plan as it progresses from the draft submission (4th April) through to final submission on the 20th June, including: • Opportunities to review and comment on the Plan between April and June • Stakeholder engagement event (to coincide with the launch of the WSIC toolkit: 15 May • HWB to consider and approve the final Five Year Strategic Plan prior to submission • A major pan-NWL stakeholder event will also be held in June. Everyone Counts: Planning for Patients 2014/15 – 2018/19: http://www.england.nhs.uk/wp-content/uploads/2013/12/5yr-strat-plann-guid-wa.pdf

5. Executive summary: vision and principles • Introduction • Our five year strategic plan sets out how we will work collaboratively to transform the health and care landscape across NWL in order to achieve our shared vision, deliver improved health outcomes and patient experience, ensure a financially sustainable system, and meet the expectations of patients and the public. • Our shared vision for North West London • Our overarching vision, co-produced with the people of North West London, is: • Four principles underpin our vision – that health services need to be: . • In addition, we recognise our broader role in society (both as employers and commissioners), and will address the determinants of health. Localised Centralised Integrated “ We want to improve the quality of care for individuals, carers and families, empowering and supporting people to maintain independence and to lead full lives as active participants in their community ” Personalised Integrated

6. Executive summary: case for change and outcome ambitions • Case for Change • The health needs of the people of North West London are changing, the demands on our health services are increasing, and the way we have organised our hospitals and community-based services in the past will not meet the needs of the future. • From a commissioner perspective, if we do nothing we estimate we would need £365m more to keep pace with demand. Hospitals in NWL will also face significant financial challenges even if they become as efficient as they can be. This means services need to be redesigned to be more affordable. • NWL’s five year strategic plan will deliver two key outcomes: • Improved health outcomes and patient experience, as captured within the 7 NHS Outcome ambitions • A financially sustainable health system • All of the programmes and plans set out in our five year plan have been developed to achieve these ambitions.

7. Executive summary: key transformation programmes • Key North West London transformation programmes • Key programme enablers include: Workforce; Informatics; Communications; Engagement, co-design, travel and equalities; Clinical; Finance; and Research and Innovation.

8. Executive summary: maintaining a focus on the essentials, and how we work • Maintaining our focus on essentials: quality, safety and access • While North West London is implementing an ambitious set of transformation programmes, at the CWHHE collaborative and BHH federation level essential work continues to improve quality and performance through the commissioning cycle. • How we work: embedding partnerships at every level • Citizen empowerment and patient engagement: there are four aspects to our approach: • Patient self-management and self-care: • Public participation in the commissioning process • Access to data and information about health and services • Delivering better care through the digital revolution - harnessing technology

9. Executive summary: key outcomes • (1) Health outcome, quality and patient experience outcomes (aggregated across NWL CCGs)1: • (2) Financial outcomes: • The CCG projections are to ensure a sustainable position is attained, which is consistent with NHS England Business Rules (i.e. a 1% surplus) and includes contingency (at 0.5%) to respond to risks. • CCG financial plans include the outcome ambitions. • Non-recurrent implementation costs are assumed to be funded through the NWL financial strategy agreement to pool CCG / NHSE non-recurrent headroom (2.5% in 2014/15). 1: Details on the outcome measure indicators: http://www.england.nhs.uk/wp-content/uploads/2013/12/stra-op-how-to-guide1.pdf