REPORT TO THE JOINT CALDERDALE AND KIRKLEES HEALTH OVERVIEW AND SCRUTINY PANEL

AUGUST 2015
Right Care, Right Time, Right Place Programme update
1.0

BACKGROUND
The Right Care, Right Time, Right Place programme is the Commissioners' response to the
Case for Change that was developed as part of the Strategic Services Review. From this Case
for Change and the feedback from our engagement, we know that significant changes are
required in order to ensure health and social care services are fit for the future. There are
three interlinked pieces of work: Calderdale Care Closer to Home Programme; Kirklees Care
Closer to Home Programme; and the Hospital Services Programme1. Collectively, these
programmes are developing proposals for what the future Community services in Calderdale
and Kirklees and the future Hospital Services in Calderdale and Greater Huddersfield could
look like. These proposals will be implemented in three separate phases over the next five
years:
Phase 1 - Strengthen 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.

2.0

INTRODUCTION
The aim of the Calderdale Care Closer to Home Programme is to define and commission the
future model of community services for Calderdale. In recognition: of what people have
told us through our engagement; the duplication and inconsistency in the current service
delivery; and the need for more integration with Social Care, the programme is closely
aligned with the Better Care Fund plans and focused on commissioning services that will
result in fewer people being admitted to hospital. The Programme covers care provided to
children, young people and adults.
The Kirklees Care Closer to Home (CC2H) is a flagship programme for both NHS North
Kirklees CCG and NHS Greater Huddersfield CCG. The Care Closer to Home vision is for the
development of integrated community-based healthcare services across Kirklees for all,
from children and young people through to and including the frail, vulnerable and older
people. It aims to make lasting changes to the Kirklees health and social care system to
ensure that services are fit for purpose and sustainable in the future.
The aim of the Hospital services Programme is to define and commission the future model
of Hospital services for Calderdale and Greater Huddersfield. Calderdale CCG and Greater
Huddersfield CCG are working together in relation to Phase 3. We are clear that
1

There is also an inter-relationship with the Meeting the Challenge programme (which covers North Kirklees
and Wakefield) that is looking at improving and modernising hospital services provided by the Mid Yorkshire
Hospitals NHS Trust (MYHT) and services in the community; Kirklees Care closer to Home is integral to the
success of the MYHTs clinical services strategy.

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REPORT TO THE JOINT CALDERDALE AND KIRKLEES HEALTH OVERVIEW AND SCRUTINY PANEL
AUGUST 2015
transformational change is needed in our hospital services to meet current and future
healthcare needs. We believe that we will gain public support for change when we can
demonstrate that we have put in place enhanced and integrated community services that
will meet local population needs.
At the meeting of the Joint Health Overview and Scrutiny Committee on the 29th June the
committee received an overview of our journey so far for new members of the panel and an
update on progress since September for all members of the panel. In addition, the report
provided an update on our approach to engagement and an overview of our key milestones
in relation to these three programmes and our approach to demonstrating readiness for
consultation. The Committee also received a presentation that described a number of risks
that the Hospital Services Programme Board is managing in relation to their high level
programme timeline. Since that meeting the Hospital Services Programme Board has
reviewed and updated timeline risks. The updated version is attached at appendix A.
The purpose of this report is to provide the Joint Health Overview and Scrutiny Panel with
further information on how we are progressing in the areas of work covered by the first
three risks that were presented to the panel on 29th June. These are:
Pre-consultation engagement,
Development of the potential outline model and Pre-Consultation Business Case;
Progress in relation to Care Closer to Home and;
Capacity and capability to deliver the programme work.
3.0

PRE- CONSULTATION ENGAGEMENT

Within the June report we updated that we had established and gained approval through
the CCGs Quality (and Safety) Committees for our overall approach to Pre-consultation
engagement. This engagement will cover any services in Phases Two and Three where we
have gaps in our engagement to date.
We have taken an approach that will:

enable us talk to the right people about the right things and focus our efforts on
gathering quality information.

be considerate of what people can or cant influence and that asks the questions
which will help the decision-making process.

inform people what we have already done and what we already know and;

doesnt repeat previous engagement conversations but uses pre-engagement as an

opportunity to further explore our thinking.
A narrative was developed to support our pre-engagement activity. The information was
provided to the facilitators of this engagement (engagement staff and engagement
champions or voluntary sector networks) to set the scene for the pre-engagement, provide
an overview of where we are at now and answer any questions.
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REPORT TO THE JOINT CALDERDALE AND KIRKLEES HEALTH OVERVIEW AND SCRUTINY PANEL
AUGUST 2015
We identified that we needed to ask more questions on hospital care, what services are best
delivered in a hospital setting and what services are better placed in a community. We
identified that we needed to do more engagement to help us understand:

Emergency and urgent care

Hospital services
Services as part of Care Closer to Home model for Calderdale and Greater
Huddersfield
Maternity and Paediatrics

In relation to the first three elements listed above, the narrative and questions were signed
off by Calderdale and Greater Huddersfield CCG on the 26 th June and the engagement
champions and Voluntary sector networks, who were delivering the engagement, were
inducted the following week. Pre-engagement activities were launched on the 2nd July and
will run until the 10th August. The narrative and questionnaire documents were shared with
the Joint Health Overview and Scrutiny Committee Chairs in July and are included with the
papers circulated for this meeting.
In relation to Maternity and Paediatrics, the approach and plan for Communications,
Engagement and Equality has been signed off by the Hospital Services Programme Board.
We have identified the key groups we would like to engage with; will be undertaking a
review of any existing data from patients and service users over the last year and we will
provide the opportunity for a targeted group of women, young people and their families to
have a say on maternity and paediatric services. We are aiming to commence engagement
on maternity and paediatric services in August, 2015.
As part of our pre-consultation engagement process we will also be holding deliberative
events to ensure that the information gathered has been carefully considered. There will
be three deliberative events. The first two events will essentially be the same event with
one delivered in Calderdale and one in Greater Huddersfield. The purpose of this event will
be to deliberate over the findings from all the engagement activity to date, and give due
consideration to the findings. This includes giving due regard to the equality and diversity
profile. The stakeholder list for this event includes patient representatives, voluntary and
community groups, third sector, councillors, MPs and service users. The event will also
provide a final opportunity to further inform any plans. The dates for the first events are as
follows:
Greater Huddersfield 19th August 1-4pm, Textile Centre
Calderdale 20th August 3-6pm, The Shay

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REPORT TO THE JOINT CALDERDALE AND KIRKLEES HEALTH OVERVIEW AND SCRUTINY PANEL
AUGUST 2015
A second joint event will be held on the 3rd September, 2-5pm at the Cedar Court Hotel,
Ainley Top. This event will build on the first event and provide further information on future
potential plans for hospital and community services.

4.0

POTENTIAL FUTURE MODEL FOR FUTURE HOSPITAL SERVICES AND PRE CONSULTATION
BUSINESS CASE
We know that we need to progress our improvements to Community Services before we
start to make changes to our Hospital Services. We are progressing the work in relation to
Phase One Strengthen Community Services and we have identified the potential services
to be included in Phase two Enhance Community Services. For Phase Three Hospital
Services, we have agreed our Hospital Standards and our Quality and Safety Case for
Change. We are in the process of agreeing our potential Future Model of Care and we are
progressing the identification of the supporting Activity, finance and estates implications.
In the June update to Joint Scrutiny we reported that we would establish two clinical
working Groups, one for Planned Care and one for Urgent Care to establish more detailed
proposals that would enable the high level workforce and finance implications of potential
models to be scoped. The Planned Care Clinical working group met on the 3rd and 17th June
and the Urgent Care Clinical working group met on the 4th June. At their meeting in June,
The Hospital Service Programme Board agreed that a clinical working group be set up in
relation to Maternity and Paediatric services. There was a Maternity and Paediatrics clinical
working group on the 9th July and a second clinical working group is scheduled for
Paediatrics on the 5th August.
We are continuing the work on the design of our potential outline model for Hospital
Services and the development of a collective view on what the future provision of hospital
services could look like. The potential outline model will form part of the draft preconsultation business case. CHFT are continuing to develop a Business Case to clarify the
capital requirements for all potential options. CCGs will use the high level capital numbers
and supporting financial detail as one of the elements of their options appraisal that will be
undertaken to inform the Pre-consultation Business Case.
In addition to the above we also need to complete our work on Commissioner requested
Services Designation Framework in order to understand the implications for the PreConsultation Business Case. We have commissioned support from North of England
Commissioning support in order to undertake this work.
Commissioners have agreed that they will hold a Governing Body in parallel on the 24 th
September, 2015 in order to consider and make a decision on the our Readiness for
Consultation. If the CCGs decide that they are ready to go to formal consultation they will
then make a decision on when this should be.

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REPORT TO THE JOINT CALDERDALE AND KIRKLEES HEALTH OVERVIEW AND SCRUTINY PANEL
AUGUST 2015
5.0

PROGRESS IN RELATION TO CARE CLOSER TO HOME.

In the June update to Joint Scrutiny we provided an update on The Calderdale Care Closer to
Home Programme and The Greater Huddersfield Care Closer to Home Programme.

5.1

Greater Huddersfield Care Closer to Home

The Greater Huddersfield Care Closer to Home Programme proposals have been developed
with North Kirklees CCG and Kirklees Council. Following a competitive procurement process,
the Governing Bodies made a decision on the award of contract at their meeting in May,
2015. On the 7th July the CCG formally announced the award of the contract to Locala CIC in
partnership with South West Yorkshire Partnership Foundation Trust (SWYPFT). A
mobilisation plan has been developed and confirmed with Locala and SWYPFT and
appropriate actions in the plan will commence to ensure the service is ready to start as soon
as possible. The new contract will commence on the 1st October, 2015 with a phased
implementation of initiative to deliver these services across Kirklees.
The mobilisation of the programme has now commenced and a refreshed governance
structure has been put in place to oversee delivery. The award of the contract will support
the development of better healthcare services within the community with an emphasis on
care being closer to peoples homes or within their homes. It will also ensure a focus on
services that help patients recovery and promote independence.
The lead provider will be responsible for ensuring that community care is much better coordinated across Kirklees. They will provide some of these services directly as well as using
other organisations, including the community and voluntary sector to provide care as
appropriate.

5.2

Calderdale Care Closer to Home

In the June update to Joint Scrutiny we reported that in August, 2015, Calderdale CCGs
Governing Body will be asked to agree the approach to the future commissioning of phase
one community services. The CCG is preparing to make two decisions at their Governing
Body meetings in August;
a)
As an organisation are we confident that the Care Closer to Home
Programme is beginning to deliver the vision set out in our 5 year Planparticularly; strengthening existing community services and beginning the
shift for unplanned hospital care to planned, integrated community and
primary care
b)
For Calderdale only- how should we approach the future commissioning of
community services in Calderdale and how will this approach deliver on our
Vanguard commitment to develop new care models?
We expect our Governing Bodies to make a decision in relation to our Readiness for
Consultation at the end of September.

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REPORT TO THE JOINT CALDERDALE AND KIRKLEES HEALTH OVERVIEW AND SCRUTINY PANEL
AUGUST 2015
6.0

CAPACITY AND CAPABILITY

It was reported at the meeting on the 29th June that we are aiming to complete our Design
and first draft of the Pre-Consultation Business Case by the end of August, 2015.
In relation to the capacity and capability to complete this work the CCGs have secured
additional expert support from North of England Commissioning Support (NECS) to support
the development of three critical products: The Pre-consultation Business Case; The
Consultation document and; The Commissioner Requested Services Designation Matrix.
In relation to the Communications, Engagement and Equality capacity and capability to
deliver a consultation, the CCGs are currently developing a resource plan and are beginning
to describe the outline of the consultation plan that will help to inform the capacity
required. It is expected that we will be available to share the Outline draft Consultation
Plan with the Joint Health and Overview and Scrutiny Committee by the end of September.

6.0

OVERALL TIMELINE AND NEXT STEPS (High Level Timeline Attached)

In August, 2015, Calderdale CCGs Governing Body will be asked to agree the approach
to the future commissioning of phase one community services

We are working to complete the Design of our Potential Future Model of Care and
draft our pre-consultation Business Case by the end of August, 2015.

We will ask our Governing Bodies to make a decision in relation to our Readiness for
Consultation at the end of September.

Jen Mulcahy, Programme Manager

5th August, 2015

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AUGUST 2015

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