Health Improvement Plan for Community Well-being

1. Operational Plan 2009/10 Health Overview and Scrutiny Panel February 2009

2. What does it include? • Context including JSNA, national targets, operating framework • Programmes of work and implementation plans for Improvements in the quality of care for patients • Progress on ambitions in our Strategic Framework • Plans for the use of system reforms such as patient choice, PBC, contestability, WCC • Supporting strategies such as workforce and OD, IM&T, estates development • Financial framework and our investment plans • Risk assessment and management plans

3. Strategic Objectives 2008-2011, organisational goals for PCT Strategic Framework 3-5 year plan, long term ambitions, big strategic issues Medium term financial plan 3-5 year plan Organisational development plan 3-5 year plan Operational Plan (LDP) 1 year plan Commissioning Strategy How we commission Practice based commissioning plans Plans to meet health needs of local communities Operational Plans (LDP) 1 year plan, detailed actions Practice based commissioning plans Plans to meet health needs of local communities Operational Plans (LDP) 1 year plan, detailed actions Practice based commissioning plans Plans to meet health needs of local communities The Operational Plan in Context

4. Prioritisation

5. National Operating Framework 2009/10 High quality care for all remains as guiding principle for the Operating Framework and underpinning every stage of development and reform are: • safety of patients and staff • effectiveness of care • experience of patients

6. National Operating Framework 2009/10 Opens with confident assessment that: “we have never been in a better place to deliver these ambitions” Focus continues to shift from better health care to better health

7. National Operating Framework 2009/10 Priorities • improving cleanliness and reducing HCAIs • 18 weeks Referral to Treatment (RTT) target • improving health and reducing health inequalities • improving patient experience and satisfaction • preparing to respond in a state of emergency such as pandemic flu outbreak National priorities essentially the same as 2008/09:

8. National Operating Framework 2009/10 Setting standards Continued focus on ‘Vital Signs’ framework: • Tier one:“must do” indicators,apply to all Primary Care Trusts • Tier two:national priorities for local delivery • Tier three:Primary Care Trusts can use with Partners and local communities

9. Our Primary Goals • Reduce health inequalities in all areas of our work by targeting effort in the areas with greatest deprivation • Address the inter-related issues of care for older people, long term conditions and increasing independent living at home • Work across boundaries to improve joint working……in order to find new and radical solutions to systemic problems • Get it right first time – deliver safe, effective care, by ensuring that systems and processes are efficient and reflect best practice

10. Our Strategic Objectives • To improve quality and earn autonomy by meeting necessary targets • To meet our challenges through innovative service redesign – to meet identified needs. • To reduce health inequalities and promote health and wellbeing based on an understanding of health needs • To be a competent commissioner and ensure the development of a fit for purpose provider service • To be a good partner to work with – building public, stakeholder and staff confidence

11. Healthy Living and Health Improvement • Work to reduce childhood obesity • Targeted cardiovascular screening • Increase help for people who want to stop smoking • Additional health trainers • Promoting physical activity • Brief interventions for alcohol in A&E services • Intensive support for vulnerable families in deprived areas

12. Long Term Conditions • Single point of access to community services • Develop and progress North Somerset Self-Care Policy • Implementation of the North Somerset Carers Strategy • Implementation of a new Rehabilitation Care Pathway • Meeting target for diabetic retinopathy screening • Development of best practice care pathways for a range of neurological conditions • Implementation of the national stroke strategy • Continue the development of Dignity in Care Challenge

13. Cancer Services • Continue the implementation of Improving Outcomes Guidance specifically: • Expansion of bowel screening • Expansion of breast screening • Further reduction of wait times • Implementation of an intermediate level skin care service • Improved access to diagnostics

14. Mental Health • Further develop the primary mental health services by taking forward improvements in access to psychological therapies • Implement the Joint Commissioning Strategy for people with dementia • Developing psychiatric liaison services both in adult and older people services • Review acute care pathways with providers to create a focus on recovery • Develop training on understanding eating disorders and a range of educational leaflets for primary care

15. Learning Disabilities • Develop and implement plans in response to ‘Valuing People Now’ • Deliver recommendations contained within ‘Healthcare for All’ • Continue pilot of health checks with GP practices • Improve Speech and Language therapy services • Support the joint action plan to respond to the needs of people with Autism and Aspergers • Continue to improve access to services by ensuring information is produced in an accessible format

16. Planned Care • Reduce waiting times to 13 weeks from referral to treatment across all specialties • Extend opening hours in all GP practices • Deliver a year on year increase in patients accessing dentistry • Implement the new GP practice in Worle • Implement the new GP Led Health Centre and satellite unit in central Weston • Open the new Marina Healthcare Centre in May 2009

17. Urgent and Emergency Care • Work with GWAS to implement service redesign to improve ambulance response times • Implement a recruitment drive for Community First Responders • Implement GP in urgent care model through the GP Led Health Centre • Work with WAHT to maximise the potential of the Assessment and Treatment Centre • Reduce waiting times in A&E and make progress against the 2 hour target

18. End of Life Care • Deliver the Marie Curie Delivering Choices Programme and implement plans agreed with the North Somerset End of Life Strategy Group • Introduce and implement Advanced Care Planning • Introduce and deliver the use of the Gold Standards Framework module for Care Homes

19. Improving Quality • Project working with Nursing Homes to reduce MRSA and targeted improvement events e.g. diabetic foot ulcer patients • Continued focus on reducing C-diff in hospitals • Supporting ‘Safety First’ initiative around avoidable deaths • CQUINs included in contracts with acute providers • Implement Patient Safety Report ‘Safety in Doses’

20. Supporting Strategies Action Plans also included to improve: • Patient satisfaction • Involvement and engagement • Information management and Technology • Workforce development • Estates and capital development • Organisational performance and development • Leadership capacity and capability

21. ChallengingFinancial Context • Funding position relative to neighbouring PCTs • Significant savings over last two years – further savings less easy to deliver • Need to be in the top 10% of the country for efficiency and productivity

22. Next Steps • Equality Impact Assessment (ongoing) • Consultation and Engagement (ongoing) • Continued risk assessment • Amend plan to take account of engagement and consultation • Draft plan to Board 25 February 2009 • Submitted to NHS South West for comment • Final plan published by 31 March 2009

23. Let us know whatyou think We are keen to know what you think of our plans. Please let us have your comments. E-mail: operationalplan@nsomerset-pct.nhs.uk Write to: North Somerset PCT, Waverley House, Old Church Road, Clevedon BS21 6NN Telephone on 01275 546678