NHS North East Essex Vision for Improving Health Strategy

1. NHS North East EssexVision for Improving Health Strategy Dr Mike Gogarty

2. Our mission is to commission world class healthcare for local people. We aim to make long term improvements to local health services and to people’s well being. To do this we will make sure we work with our partner organisations. We will involve patients, carers and local people in what we are doing. We will promote healthy living and make sure people receive quality services. • Our vision is to improve life expectancy in our local communities. We will also improve quality of life especially for people living with long term conditions throughout Tendring and Colchester. We will improve life expectancy from 78.1 years in 2005-7 to 81.5 years in 2012-14 (male) and 82.5 years in 2005-7 to 84.3 years in 2012-14 (female). We will reduce the difference in life expectancy between the most and least deprived areas from 8.1 years in 2004-8 to 6.9 years in 2009-13 (males), and 5.4 years in 2004-8 to 4.4 years in 2009-13 (females).

3. Achieving the Vision – Strategic Goals To achieve this vision the PCT have agreed the following Strategic Goals:- • To improve Health & Well Being • To reduce Health Inequalities • To improve Patient experience • To commission safe and effective services • To make best use of public money

4. Rationale for Strategic Goals • Improving health & well being and reducing inequalities are agreed by all stakeholders locally and regionally to be crucial. • The population we serve suffer considerable unacceptable differences in life expectancy (13.1 years between wards) • Current patient experience is sub optimal when benchmarked. • Local stakeholders, in line with National drivers agree high quality services especially safe services are essential. • From Year 2, all public sector partners are challenged in terms of optimal use of resources as value for money is essential.

5. Context of Strategy • Increasing aged population with high health needs • Scope to improve services to prevent and manage long term conditions including heart disease, stroke, diabetes, respiratory disease, falls and dementia • High levels of health inequalities • Poor patient satisfaction in primary and secondary care • High level risk behaviour around smoking, alcohol and obesity • High levels of carers with potential to benefit from support • Suboptimal end of life care • Suboptimal planned and unscheduled care with scope for resource release and quality gains • Suboptimal patient safety scores • Increasingly challenging financial environment

6. WCC Commissioning Outcomes selected • Health inequalities (split by gender) • Life expectancy (split by gender) • Smoking quitters • Self-reported experience of patients & users • End of Life deaths occurring at home • Rate of hospital admissions per 100,000 for alcohol related harm • For IAPT services the number of people entering IAPT treatment • COPD prevalence • Diabetes controlled blood sugar • CHD controlled cholesterol • and local targets • Safeguarding children; percentage of assessments undertaken by Health Services • Patient safety score

7. WCC Outcome Trajectories

8. WCC Outcome Trajectories

9. WCC Outcome Trajectories

10. WCC Outcome Trajectories

11. WCC Outcome Trajectories

12. WCC Outcome Trajectories

13. MISSION To be a World Class Commissioner working with partner agencies and local people, to make sustained comprehensive Region leading improvements in health and healthcare for the population we serve. VISION Over the next five years we will improve both quality of life and life expectancy and will reduce the burden of long term conditions in all local communities GOALS Safe & Effective Services Improve Health and Well Being Health Inequalities Better Use of Public Money Better Patient Experience INITIATIVES ACTIONS Delivery of the Strategy

14. Workstreams Initiatives will be delivered by workstreams • Unscheduled Care • Planned Care • Long Term Conditions • Health & Well Being • Mental Health & Learning Disabilities • Children’s Services • Maternity Services • End of Life Care • Patient Satisfaction • Patient Safety

15. Initiatives and links to Strategic Goals

17. Strategic Goals • Outcome • Trajectory • How we will deliver

18. Goal 1 - To Improve Health and Well Being Outcome Measure • Under the Base Case (Scenario 0), we will achieve an increase in life expectancy from 78.1 years in 2005-7 to 81.5 years in 2012-14 (male) and 82.5 years in 2005-7 to 84.3 years in 2012-14 (female). Under Scenario 1, improvements in life expectancy will be more modest, but our targets will be higher under Scenario 2.

19. Goal 1 - To Improve Health and Well Being How we will reach our goal • Improve primary & secondary prevention of long term conditions • Improve ascertainment and treatment of people at risk of vascular diseases • Address lifestyle risk factors including smoking, alcohol and obesity

20. Goal 2 - To reduce Health Inequalities Outcome Measure • Reducing the difference in life expectancy between the most and least deprived Lower Super Output Areas (LSOAs), from 8.1 years in 2004-8 to 6.9 years in 2009-12 (males) and 5.4 years in 2004-8 to 4.4 years in 2009-12 (females). Under Scenario 1, the reduction in the life expectancy gap will be more modest, but will be greater under Scenario 2.

21. Goal 2 - To reduce Health Inequalities How we will reach our goal • Targeted healthy lifestyle initiatives • Targeted clinical risk reduction in high risk groups including outreach • Targeted ascertainment of risk in hard to reach groups • Focus on carers, people with mental health issues, unemployed people and older people

22. Goal 3 - To Improve Patient Experience Outcome Measure • Patient/user experience is defined by 5 key dimensions: Access and waiting; Safe, high quality coordinated care; Building closer relationships; Clean, friendly comfortable place to be; and Better information, more choice. We will work with CHUFT to improve their score from 71.9 in 2008-9 to 79.9 in 2013-14.

23. Goal 3 - To Improve Patient Experience How we will reach our goal Our strategy is to move to being a service that works with patients in supporting them with their health needs. The PCT is committed to making commissioning decisions that reflect the needs, priorities and aspirations of the local population. This means we will have to be proactive in understanding their views and experiences, as a patient’s experience can have a significant impact on their wellbeing and recovery.

24. Goal 4 - To Commission Safe High Quality Services Outcome Measure • The Dr Foster Patient Safety Score includes Hospital Standardised Mortality Ratios (HSMR) and other measures of Patient Safety. We will work with Colchester Hospital University NHS Foundation Trust (CHUFT) to increase the Trust’s Score from 34.93 in 2008-9 to 100% in 2013-14.

25. Goal 4 - To Commission Safe High Quality Services How we will reach our goal A patient safety incident is any unintended or unexpected incident which could have or did lead to harm for one or more patients receiving NHS care. The vision of the National Patient Safety First Campaign is an NHS with no avoidable death and no avoidable harm.

26. Best Use of Available Resources • Rigorous Prioritisation • Robust financial management and predictive modelling • Rigorous contract management • Programme Budgeting • Innovative commissioning for productivity • Benchmarking e.g. BCBV • Analyse and understand costs • Identify areas for service redesign • Partnership with providers around information • Decommission less effective services

27. Initiatives to Deliver Savings • Unscheduled Care Workstream • Planned Care Workstream • Mental Health & LD

28. Summary of funds needed to deliver PCT Goals

29. Summary of savings and productivity over next 4 years

30. Base Case Assumptions