Right Care, Right Time, Right Place Programme

Monitor & NHS England

Developing Health Services in

Calderdale and Kirklees
7th May, 2015

Matt Walsh
Carol McKenna

Objectives

To understand
Commissioners strategy and plans
The changes we are making
The changes we are planning to make
The high level timetable
The current Contract position
The Issues and Gaps we have identified

Engagement - findings and themes

Improved access to health services

More services in the community
All agencies working together, to deliver integrated health and
social care
Improved discharge planning and better resourced hospitals
Staff training to improve communication and transparency
Regular check-ups - for people with chronic conditions
Improved management of risk and safeguarding when people
are unwell
More education and information
Support for Self Managed Care
Investment in technology
Consideration around travel and transport
Improvements to mental health services
Greater community participation

Care Closer to Home Key Themes CCCG & GHCCG

One size does not fit all

The needs of the community by locality must be
considered
The key is prevention and empowering patients to
take responsibility for their own health
Improve access to services outside of normal
working hours
Ensure transfer of care commences at the right time
Need to see the models work in practice
Both CCGs are committed to ensuring everyone will
have a say in how the future services are planned,
commissioned, delivered and reviewed.

So what is our challenge?

Early intervention and diagnosis

Support self managed care
Closer to home wrap around services
Realigning mind-sets of individuals, their
carers and their health professionals to this
vision
Changing the way we commission and provide
services to drive this change

Commissioners Strategy
&
Plans
Carol McKenna
Matt Walsh

CCGs Strategy

Understand the Case for Change.

Reflected on our Engagement to Date
People need to experience Community first
Changes to the Hospitals will be required
We are working with the Provider to identify how
we mitigate risks they identified in the OBC
We are continuing to get ready for Consultation
When we are ready we will consider when
We will continue dialogue with Calderdale Scrutiny,
Kirklees Scrutiny and Joint Scrutiny Committees

Programme Phasing
Phase 1
Strengthen existing
community services in
line with the new
model of care

Phase 2
Enhance community
services which is likely
to require more
engagement

Phase 3
Hospital changes.
Will require formal
consultation.

The Changes we are making

NHS Calderdale CCG
Current Position Community
Services
Matt Walsh

Calderdale Care Closer to Home (CC2H) Programme

Phase One - What have we done

Agreed the model and services in Phase One with KPIs

Approved the Phase One specification and engagement assurance.

Agreed the Commissioning approach

Used Feedback from stakeholders in our model & case studies.

Delivered three stakeholder events.

Aligned CC2H with BCF and QIPP schemes

Actively engaged our current community service providers

Presented to Calderdale OSC and JOSC

Submitted a successful Vanguard bid

Established the Governance and work streams.

Calderdale Care Closer to Home Programme

What's Next

Single Point of Access design work underway

Upper Valley Programme underway
Finalise the scope of services in Phase Two
Agree the Engagement and Equality action plan for
Phase Two
Develop the Phase Two Specification (that includes
services in Phase 1)
Long term commissioning process and approach to be
developed

Calderdale Care Closer to Home Programme Plan

CC2H Timeline (Version 9.0)

Run SPA workshop

16

Share specification with providers by email

22

Refresh CHFT Community Contract Meetings

Share draft Dashboard with GB Dev Session

15

Meeting with providers on process (week commencing)

19

Share spec and process with OSC (public at this point)

27

Workshop for Upper Valley (to be confirmed)

Design SPA
Design Upper Valley Programme
Share final Dashboard with GB Formal

12

Final P1 spec and KPIs to Quality Committee

26

Draft P2 Spec to Quality Committee

Measure progress at contract meetings

26
5

Assess progress using Dashboard, prepare reports

15

Share findings with F&P Committee

30

Share findings with Quality Committee

30

Findings and recommendation to GB Formal

Start commissioning process (approach to market)

15

The Changes we are making

NHS Greater Huddersfield CCG
Current Position Community
Services
Carol McKenna

Kirklees Care Closer to Home

Greater Huddersfield and North Kirklees have agreed to use a
competitive dialogue procurement process
The tender was issued 20 October
Pre-qualification questionnaire (PQQ) stage concluded
Established and recruited a patient/carer panel, involved
patients, carers, children and young people in evaluation process
Two bidders invited to participate in competitive dialogue (ITPD)
Received and evaluated the responses from potential bidders
Notified bidders of the shortlist and issued the ITCD
Completed the dialogue sessions with bidders
Currently evaluating final submissions
New contract award in May; to take effect from October 2015

CC2H Timeline Kirklees

Programme

Workstream

Aug 2014

Sept 2014

Oct 2014

Nov 2014

Dec 2014

Jan 2015

Feb 2015

Programme
Board

Mar 2015

Apr 2015

May 2015

Jun 2015

July 2015

Aug 2015

CCG Programme Management

CCG Communications (Pro-active and reactive)

B2B Mtg
13/05

B2B Mtg
24/9

Provider Implementation
Contract in
place

Contracting / Estates /
Finance / HR

Commissioning /
Evaluation
Transformation / Business
Team
Intel

Procurement

Engagement (CCG/CSU/LA/GPs/Clusters)

Invitation to Participate
in Dialogue (ITPD)

Pre-Qualification

Market
Sounding
Develop PQQ Docs / Market
Analysis & Stimulation

Advert
Issued

Develop
Docs

Standstill
Contract Award

ITCD
Evaluation

ITPD
Evaluation

Update Demographics
Confirm
Scope/Lots/Outline
Spec/services CCG Sign
Articulate Vision & Off
Technical PQQ
Questions

Revise
Specs/
Model

CCG Sign
Off

Confirm Contract
Duration

Finalise Contract
Documentation

Develop Commercial
Approach & Questions

Confirm Approach to
PQQ Fin Assessment

CCG Sign
Off

Develop Contract
Documentation

Develop detailed
Estate Info

Create benchmark
information to assess VFM

Key:
CCG Lead

CCG Sign
Off
Workforce

Invitation to Continue
in Dialogue (ITCD)

Develop
Docs

PQQ
Evaluation

Confirm Scope
(estates)

Sept 2015

Develop detailed TUPE Info

CSU Lead with CCG involvement

Provider

Phase Two Community Services

To continue to enhance community
services and begin to move services out of
hospital that can be provided more
appropriately in communities, as per
ongoing engagement.

Any potential significant Service change to

be included in the engagement and
consultation in relation to Hospital

The changes we are

planning to make
Carol McKenna
Matt Walsh

Hospitals Have to Change

Workforce pressures.
Increasing Demand.
Increasing specialism.
Financial pressures.
Quality challenges.
Regulation & Standards.

The question is how?

Specialist sites we can do this ourselves

Planned Care
Unplanned care

Network solutions we can do this with other

hospitals
Acute providers operating at scale

Integration solutions we can become more than

a hospital
DGHs integrating with other community, social and
Primary Care

Scope - Hospital Future Model of Care

Acute, Emergency and Urgent Care

Paediatrics and Maternity
Planned Care (Elective, Day Case & Diagnostics)
Utilisation of Estate and Specialist Commissioned
Services

Hospital Services (1)

We have agreed our hospital standards

We have established the outputs and outcomes we expect
these standards to achieve.
We have established a Hospital Services Programme Board.
A joint CCG Assurance Group has looked at the Providers
OBC.
Findings considered by Hospital Services Programme Board.
Agreed to produce Commissioners Future Model of Care for
Hospital Services that reflects our proposed changes to
Community and our Hospital Standards.
Completed work on the Financial Case for Change pending
development of proposals for changes to Hospital Services

Hospital Services (2)

We have completed five clinicians workshops
20th Nov - CCGs clinicians to consider different
model of care
22nd Jan - CCGs clinicians developed
Commissioners thinking regarding the
future provision of Hospital services
24th Feb - CCGs and CHFTs clinicians to
understand collective thinking
14th Apr - CCGs clinicians Commissioners
position on outline model
16th Apr - CCGs and CHFTs clinicians to develop
collective thinking

Next steps

Define the Financial Envelope

Undertake a Feasibility study with CHFT (Inc. 24 x7
operation, GP OOH).
Data to understand the demand/volumes/patient flow
Relationship with other community based urgent care and
transport services including Ambulance transfers
Establish and publish roadmap for change
Continue to consider the perspective of patients and the
public alongside clinical considerations
Engage the clinical senate in relation to Hospital services
Continue our work on the Case for Change
Consolidate this work into a pre-consultation Business
Case

The High Level Timeline

Carol McKenna
Matt Walsh

Jul- Oct 14
Scoping

Phase 3- Hospital Changes

Agreed high level scope

of services
Develop Hospital
Standards for high level
services
Develop high level
outcomes and benefits
Baseline Finance

Nov Sept 15
Pre consultation
(Design)

Finalise the high level

outcomes and benefits
Develop metrics for
balanced scorecard
Develop Commissioners
Hospital Future Model of
Care
Refresh of Hospital
standards outcomes and
benefits
Consultation resource plan
complete
Options Development and
Appraisal
Equality assessment
Pre-consultation
engagement
Write the Pre-consultation
business case
Finalise proposal
Write consultation
documents and consultation
questions
Agree consultation plan and
appoint resources
Stakeholder engagement
and communications plan
Develop approach to market
NHS England sense check 2

Oct - Dec 15
Consultation
(Implementation)

Deliver public
consultation
Plan for post
consultation
Stakeholder
engagement and
communications

Jan 16
Post- Consultation
(Planning for
Delivery)
Consider and respond to
consultation feedback
Finalise proposal
including additional work
on finance, workforce
and implementation
planning
Equality assessment
Write decision making
business case
Stakeholder engagement
and communications
Finalise approach to
market

Procurement,
Contracting and
Delivery

Detailed implementation
plans
Service specifications
Capital business cases (if
required)
Service change
Stakeholder engagement
and communications

Timeline Hospital
Phase 3 (Draft V3.5)

Timeline Hospital
Phase 3 (Draft V3.5)

Hospital Services High Level Plan Pre-Consultation (Design)

Jan
Solution
Design

Feb

High Level
Outcomes
and Benefits
approved
Financial
Case for Change
approved

Mar

Apr

May

Jun

Jul

Aug

Sept

Oct

Nov

Transformation Road
Map
Clinical
design

Outline draft
Hospital Model
Quality & Safety
Case for Change

Ind
Fin
Revie
w

Informal
Clinical
Senate

PCBC approved

Finalise
PCBC

Consultation
Doc approved

Options
development Outline
& Appraisal Proposals
EQIA

Resources for consultation secured

Comms &
Engagement
Develop
Narrative
Questionnaire
finalised

Report of findings
Deliberation
Inc Stakeholder events

Launch Public
Consultation

Finalise
consultation
document

Formal Clinical Senate

Assurance
NHSE Sense Check Onecompleted

NHSE Sense Check Two

Gateway Review
10th June

Governing
Body Dates
Key

Pre- consultation
Engagement
Outline
Consultation
Document
Consultation
Plan

11th
Key Decision

Key Milestone

Key Deliverable

9th Sept

June

Greater Hudds
Gov Body

10th Sept
Calderdale
Gov Body

Demonstrating Readiness for Consultation

We expect to demonstrate readiness for

consultation in 2015
Once we have demonstrated that we are ready
for consultation we will determine when that
consultation should commence
Confidence that Community services are
working well
Performance framework developed by both
CCGs to measure the impact of the changes
being made in Community

Our Current Position Summary

We are progressing our changes to Community.

We need to baseline and set ambition for our quality
and performance outcomes (metrics).
We understand the financial pressure we are facing
We are developing our Quality and Safety Case for
Change.
We have considered six different models of care.
We have agreed the Commissioners position on
what the potential future model could look like.
We have agreed to work together with the
Providers clinicians to arrive at a collective view on
the potential future model.

The issues and gaps we

have identified
Carol McKenna
Matt Walsh

Issues and Gaps

Workforce
Establishing existing and required capacity and capability
Assumptions and criteria for workforce modelling on options
Expected workforce benefits
Finance
Availability of capital funding
Independent Financial Assurance
Business Case
Writing the Pre-Consultation Business Case