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Foundation Report for the creation of a Blueprint for the future of Health and

Wellbeing in South Northamptonshire

1. Vision and Purpose What we want to achieve South Northamptonshire residents are enjoying the best possible health and wellbeing, living in safe, warm and comfortable homes, in better health and with support from the community. Purpose of this document To establish the foundation and pathway to creating a future multi agency blueprint for Health and Wellbeing Services in South Northamptonshire.

2. Organisational Scope Stakeholders South Northamptonshire Council (SNC) ; Nene Clinical Commissioning Group (CCG); Northamptonshire County Council (NCC); Northamptonshire Healthcare Foundation Trust (NHFT); South Northamptonshire Homes (SNH); Action for Children; South Northamptonshire Volunteer Bureau (SNVB); MIND; Age UK; Principal Medical Limited (PML); East Midlands Ambulance Service (EMAS); Northamptonshire Police; Northamptonshire Fire and Rescue; South Northamptonshire Leisure Trust (SNLT); Healthwatch; Northamptonshire First for Wellbeing; Sponne School

3. Strategic Outcomes: Informed by key evidence from the Joint Srategic Needs Assessment (JSNA), South Northamptonshire’s Health Profile, Health Inequalities data and other intelligence and joint working we have prioritised the delivery of the following outcomes to achieve our vision:

Work together to plan for the needs of a growing population with changing demographics

Prevent illness by raising awareness and promoting healthy lifestyles

Develop community services and infrastructure to help people maintain active and independent lifestyles

4. Context National In 2010, the Marmot Review, Fair Society; Healthy Lives was published which set out the evidence demonstrating relationships between health, distribution of health services and social and economic conditions. The government’s 2011 public health white paper welcomed the review and placed health inequalities at the centre of its public health aims. The transfer of public health from the NHS to local government and Public Health England (PHE) has seen a significant extension of local powers and duties; it is intended to present an opportunity to change the focus from treating sickness to actively promoting health and wellbeing.

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The costs of poor health on a range of service providers has led to an increase in reactive solutions in a range of general public health-related services, the rising demand for these services has consequently placed individuals at increased risk of falling off universal pathways and in need of intense support to get back onto them. In times of austerity and the need to secure reductions to the public purse, there is a clear necessity to consider measures that secure longer term savings and deliver efficiency in the short and medium terms, without reducing access to services and where possible improving them to mitigate against the “ticking time bomb” of demographic changes and public health risks. Local In April 2013 the Health and Social Care Act introduced new arrangements for Health and Social care, namely;

The abolition of Primary Care Trusts (PCTs) and Strategic Health Authorities

Transfer of NHS planning and delivery functions to NHS England and local Clinical Commissioning Groups (CCGs)

Upper tier councils becoming responsible for appointing a Director of Public Health, establishing a Health and Wellbeing Board and Local Healthwatch

Health and Wellbeing Boards becoming responsible for undertaking a Joint Strategic Needs Assessment (JSNA), publishing a local Health and Wellbeing Strategy and reviewing CCG commissioning plans to ensure they reflected local priorities.

A statutory duty on upper tier authorities to “take steps to improve the health of their local populations”.

Since then

Northamptonshire has in place a Health and Wellbeing Board

A Northamptonshire Health and Wellbeing Strategy has been developed

Healthier Northamptonshire has been set up to provide a collective 5 year Health and Social Care economy-wide strategic programme

Nene CCG is operational, covering six out of seven Northamptonshire Districts including South Northamptonshire

SNC has established member and officer representatives for the coordination of the wellbeing agenda

SNC has established a Health and Wellbeing Forum to facilitate dialogue between local partners including SNH, Children’s Centre’s, Police, CCG, SNVB, NHFT; Healthwatch, SNLT, NCC Public Health, MIND

Northamptonshire’s Joint Health and Wellbeing Strategy 2016-2020 This Strategy, aimed at “Supporting Northamptonshire to Flourish” is out to Public Consultation between January and March 2016. The Strategy has taken into consideration local organisational health and wellbeing strategies, health and wellbeing trends and national priorities. Four themes have emerged:

Giving every child the best start

Taking responsibility and making informed choices

Promoting independence and quality of life for older adults

Creating an environment for all people to flourish.

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Prevention, early help and intervention is fundamental to the strategy in order to reduce the burden on health and social services. The strategy also looks at the wider determinants of health such as housing, infrastructure and planning, public safety, crime, education and employment.

5. Healthcare Landscape

The landscape of healthcare in Northamptonshire is changing in response to the following: i) Healthier Northamptonshire Healthier Northamptonshire is a strategic alliance of local NHS organisations and the county council, working together on how best to reshape services for the future.

The overall aim of the programme is to deliver better health, better care and better value for the people of Northamptonshire. This work is being undertaken to respond positively to challenges relating to the quality of local services, the growing demand for services, and the finances to pay for them.

The key principles of Healthier Northamptonshire are:

A focus on keeping people out of hospital wherever possible by empowering them to stay healthy

and look after themselves, with more proactive joined-up care for those who need it

Close collaboration between different clinical teams and other professionals, to achieve the right

results for all concerned

Integrating health and social care

Collaborating to manage resources jointly across organisations, to achieve greater efficiency

Individual organisations working more efficiently to make their budgets go further. ii) Integrated Care Close to Home Agenda Effective and efficient community services are the foundation of healthcare in the NHS. They help people stay healthy and care for them through debilitating illness and at the end of their lives. They are a lifeline for vulnerable people, and at their best are innovative, flexible and personal. However, there are challenges: • variation in service quality and health outcomes

• activity and achievement goes unmeasured

• lack of usable data

• disparity in quality, productivity and costs

• outdated infrastructure

• access can be uncertain and confusing The integrated care close to home agenda is seeking to harness the energy and enthusiasm of existing service providers from across all sectors to deliver consistently high quality care.

iii) Establishment of GP federations GP practices in Oxfordshire and Northamptonshire are working together as part of the PML GP Federation. The Federation was formed so that GP practices can join together more easily to improve the delivery of health and care services for the people registered with them, and for the wider community. There are 40 GP practices in Oxfordshire and 16 GP practices in Northamptonshire within the Federation, covering a population of over 530,000.

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PML’s central office in Banbury provides administrative and management support, governance and strategic planning for the Federation as a whole. These are some of the services PML provides, either centrally or through the Federation groups:

Collaborative Care Counselling Dementia Assessment Hospital at Home Out of Hours

iv) Nene CCG Priorities for South Northamptonshire

Nene CCG has established a five year plan to support Better Healthy, Better Care and provide Better Value of money.

There are three key areas of work:

Responsive Urgent Care

Sustainable Health and Social Care Economy

Meeting the Financial Challenge. Areas for improvement include: Primary Care Services – GP Practice Development; Mental Health Services; Community Hubs Secondary Care Services – Transformational change; working across providers Urgent Care – Primary care streaming; Frail elderly crisis hub; urgent care centres Integrated Health and Social Care – modern models of integrated care; joint commissioning; use of Better Care Fund The ambitious plan also aims to:

Increase the quality of lives of people with one or more long term health conditions

Reduce the proportion of people reporting poor patient experience of inpatient care

Improve the experience of people visiting their GP and Out of Hours services

Reduce emergency admissions to hospital

Reduce the potential years of life lost per 100,000 population from causes considered to be amenable to healthcare

Improve access to psychological treatment

Increase dementia diagnosis

The CCG intends to work in partnership with a range of agencies in order to achieve its goals. In South Northants there will be a particular focus on the Integrated Care Closer to Home Agenda which incorporates an integrated community nursing model.

v) Northamptonshire “First For Wellbeing”

Northamptonshire “First for Wellbeing” is a Community Interest company which was launched in December 2015. The venture has been created by Northamptonshire County Council, Northamptonshire Healthcare NHS Foundation Trust and the University of Northampton. By working in partnership and with

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others its overall mission is to create a collaborative prevention service that that will enable people to feel healthier and better about themselves.

The types of services First for Wellbeing is likely to offer could include smoking cessation clinics, help with weight management, debt advice, befriending services and support for people to improve their physical activity levels or improve their literacy. First for Wellbeing aims to offer a ‘tell your story once’ approach which will provide residents across the county with an online or face to face single wellbeing assessment and easier access to integrated preventative services. It is expected that First for Wellbeing will be operational by summer 2016. There is a dedicated website www.firstforwellbeing.co.uk

i) Integration of Emergency Services

In September 2015, the Government announced a consultation into the future integration of the emergency services. Northamptonshire has led the way in integrating the police force and the fire and rescue services, making significant progress in its journey to bring the two organisations into a single governance structure A number of steps have already been taken to bring the two organisations together including: Locating senior management at one headquarters to promote closer working arrangements Establishing the county’s first co-located police and fire station at Thrapston A Joint Operations Team and Prevention and Community Protection department Introducing collaborative pilot schemes, which has seen the organisations responding to incidents

together through two new Rural Intervention Vehicles (RIVs) and Multi-Agency Incident Assessment Team (MIAT), which also includes the East Midlands Ambulance Service (EMAS)

6. What the future of Health and Wellbeing in South Northamptonshire might look like The diagram overleaf offers a model for health and wellbeing service delivery some of which may be appropriate to our District. The model demonstrates the breadth of services that could be included and shows the dependencies on infrastructure and environmental features.

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Source: Kings Fund Time and commitment is required to work up the detail but the type of services that could be made available in a similar South Northamptonshire model might include:

First aid services e.g. using community responders, ambulance and fire personnel

Group therapy and support for mental health, obesity and alcohol and substance misuse

Access to sexual health advice e.g. via local pharmacies

Support for young people and adolescents via a self-referral helpline

Support for people with dementia e.g. care beds

A community hub with diagnostic capability for screening, outreach clinics, simple x-ray and physiotherapy.

Greater engagement with the Voluntary and Community sector including libraries for information and signposting and social prescribing.

District care services with a menu of care to choose from and one point of contact.

7. Key Public Health Observations for South Northamptonshire Overarching public health indicators Figures show that the outcomes of most indicators for South Northamptonshire are significantly better than the England average. Life expectancy at birth for males and females is 82.3 and 84.7 years, compared to the England figure of 79.4 and 83.1 years and the gap in life expectancy at birth for males is 2.9 years’ Wider determinants of health South Northamptonshire performs better than or similarly to the national average for most areas covered in this domain. For example, it performs better than the national average for children in poverty, pupil absence, violent crime, noise pollution and households in temporary accommodation. The only area that South Northamptonshire performs worse than the national average is killed and seriously injured casualties on roads (7.6 vs. 39.7 per 100,000). This significantly high rate exists since 2009/11.

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Health Improvement Nearly half of the indicators for South Northamptonshire relating to healthy lifestyle and healthy choices display performance that is significantly better than or similar to the England average. These include under 18 conceptions, excess weight in 45 and 10-11 year olds, physically active adults, smoking prevalence (particularly amongst the routine and manual population), alcohol related admissions to hospital, breast cancer and cervical cancer and all indicators on injuries to falls. However, South Northamptonshire has a significantly higher proportion of adults who have excess weight than the national average (66.8% vs. 63.8%). Health Protection South Northamptonshire shows a significantly lower rate of TB than the national average (3.5 vs. 15.1 per 100,000). In addition Chlamydia detection in 15-24 year olds is significantly lower than England’s rate in both 2012 and 2013. Healthcare and Premature Mortality South Northamptonshire’s performance in the indicators that relate to people living with preventable ill health and dying prematurely is significantly better than or similar to the England average. Its infant mortality rate is significantly lower than the national average (1.5 vs. 4.1 per 1000). The mortality rate from causes considered preventable is better than the average for males and females. The male premature mortality rates (<75 years) for cardiovascular disease, liver disease, resiratory disease is better than the national average. However, there is no such difference in premature mortality rate for females when it is compared to the national average.

8. Key Challenges for South Northamptonshire

i) Population Growth The population in South Northamptonshire is increasing: it is predicted that the population will grow by over 8% by 2030

2015 2018 2020 2025 2030

87,675

88,722 1.2%

90,391 3.0%

93,147 5.9%

95,557 8.2%

Source: ONS subnational population predictions

PHOF Locality Priority Measure (Feb 2015)

England Average

South Northamptonshire

Rating

Killed and Seriously Injured Casualties on Roads 39.7 77.6

Proportion of adults who have excess weight 63.8 66.38

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ii) Demographics Demographics are also changing which is increasing the demand for healthcare; this is alongside a changing pattern of needs which reflect those of older patients with complex long term health problems such as diabetes, heart disease and dementia.

South Northamptonshire population (000’s) by age range 2015: source ONS

South Northamptonshire population (000’s) by age range 2030: source ONS

The number of elderly residents (80+) is predicted to steadily increase by 57% by 2030.

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iii) Access to Services

South Northamptonshire replicates the profile of rural areas with poorer access to services than average

Source: CSIP Locality Profile iv) Housing Growth in population is fuelling the demand for housing in the District. The key areas of expansion in South Northamptonshire are Towcester and Brackley along with a spread across the larger villages including Silverstone, Bugbrooke, Middleton Cheney, Roade and Old Stratford.

Projected housing completions by: 2018 2025 2030

Towcester 614 2,409 3,244

Brackley 810 1,752 1,934

Villages 1,281 2,127 2,429

Total 2,705 6,288 7,607

Source: SNC Actual Projected completions

If we were to assume the average household might include 2.3 people the population growth could be

higher than predicted.

2018 2025 2030

Towcester 1,412 5,540 7,461 Brackley 1,863 4,030 4,448 Villages 2,946 4,892 5,587 Total 6,221 14,462 17,496

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v) Financial Pressure

a) Health Sector The health sector is facing financial challenges and Northamptonshire’s status as a financially-challenged health economy has resulted in a forecasted gap of £279m in 5 years. Without changes to the way services are delivered there will be a steady increase in

Demand for urgent and emergency care

Increasing lengths of stay for vulnerable patients

Further financial pressure across health and social care organisations b) Local Government NCC is looking to make £77m savings during 2016/17 (on top of the £226m saved since 2010 against a backdrop of unprecedented soaring demand for services and ongoing cuts in government funding. The Council is developing a “Next Generation Model” for the future delivery of services which includes the establishment of a Wellbeing Community Interest Company (First for Wellbeing) and a Children’s Trust. Over the next five years SNC is estimating a potential funding gap of £2.3m, this is against the backdrop of savings that have already been made and the likelihood of further cuts in government funding. SNC, in partnership with Cherwell District Council is developing a Confederation Business model to deliver savings and capitalise on opportunities for income generation. c) Voluntary and Community Sector (VCS) Grants to the voluntary sector have steadily diminished as a result of continued austerity and cuts to public sector funding. Increasing dependence has been placed on project based and ‘one off funded’ activities. In response to funding challenges the voluntary sector has recently formed “Commsortia” a company limited by guarantee which has been set up to facilitate voluntary, community and social enterprise (VCSE) groups coming together to deliver larger and more complex services and contracts. Cuts and changes in NCCs Adult Service provision has also dealt a blow to projects formally delivered by the VCS and Housing Associations under the “Supporting People” and “Advice Services” programmes. These include extra care housing support, day care and generic advice and floating support services for vulnerable people. The potential for the VCS to deliver future health and wellbeing initiatives should not be overlooked, provided there is adequate funding to provide training to ensure the quality and consistency of service that is necessary. d) Housing Associations (Has) From April 2016 HAs will be forced to cut social housing rents by 1% each year for the next four years. The change equates to a 12% reduction in average rents by 2020/21 The reversal of the rental formula, which currently allows HAs to raise rents in line with the consumer prices index (CPI) plus 1% and forms a significant part of their investment profile, comes as part of £12bn of welfare reform savings the government wants to make by 2019-20. Universal Credit is being rolled out in South Northamptonshire from November 2015 replacing six of the current means-tested benefits and tax credits. Universal Credit is paid in a different way to current benefits because it is paid directly into a client’s account on a monthly rather than weekly basis. There is concern about the capability of vulnerable claimants to be able to manage their own funds and failure to pay rent

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may result in a greater number of evictions. A move to one monthly payment ‘per household’ could further exacerbate problems. vi) Workforce Gaps Across the globe, the demand for health and social care workers is growing, but the number of workers is not. Many acute trusts are already finding it difficult to recruit nurses, and the Royal College of Nursing predicts that the number of nurses could fall by 28 per cent by 2022. This fall will be driven by an ageing workforce, international movement of health care workers and fewer people training to be nurses.

In social care the mismatch between supply and demand could be 1 million workers by 2025, a 35% shortfall on predicted demand. In the informal workforce (unpaid care provided by friends and relatives) the gap could be even bigger. Between 2010 and 2030 the number of people requiring informal care is expected to grow by 1.1 million to 3 million, while the number of people living alone and isolated from family support is growing.

The situation with the medical workforce is more complicated. The Centre for Workforce Intelligence, the national workforce planning body in England, is forecasting an oversupply of hospital doctors and an undersupply of GPs. However, although there is expected to be a large oversupply of hospital doctors, there will be significant issues in particular specialties with emergency, geriatric and psychiatric medicine facing recruitment difficulties. Yet these are precisely the specialties where the need is greatest and growing most significantly, given changing demographics and the need for consistent 24/7 care.

Workforce redesign is needed not only because of a potentially dwindling workforce, but also because the nature of health care work is changing and the skills of the current workforce are not well matched to future needs.

9. South Northamptonshire’s Assets

Definition: For the purpose of this document an “asset” is considered to be a useful or important property or service that can be regarded as having value to the health and wellbeing of South Northamptonshire’s residents and which we might seek to protect. The following list represents those properties, organisations and services that have come to the attention of South Northamptonshire Health and Wellbeing Forum since its creation in 2012. It must be noted that this is not an exhaustive list as the total number of organisations and services which have a positive impact on Health and Wellbeing is too difficult and numerous to quantify. i) Health and Social Care GP Surgeries There are 8 GP practices in South Northamptonshire and 14 sites. These are:

Brackley Health Centre - Brackley Kings Sutton

Byfield Medical Centre -Woodford Halse, Byfield

Greens Norton and Weedon Surgery - Greens Norton, Weedon

Springfield Surgery

The Brook Health Centre - Silverstone, Towcester

The Parks Surgeries - Grange Park, Hanslope, Roade and Blisworth

Towcester Medical Centre -Paulerspury, Towcester

Washington House Surgery, Brackley

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GP practices in South Northamptonshire have a higher than average list size (13%) and lists are increasing steadily. There was a 6.7% increase in practice size between 2014/15 and a further 11.4% increase is expected during 2015/16. Hospitals SN residents access a range of hospitals:

Northampton General Hospital

Horton General Hospital, Banbury,

Oxford University Hospitals

Milton Keynes General Hospital. Community Clinics Nene CCG and GPs aim is to bring services ‘closer to home’ for patients where is it safe to do so. Three community clinics are already in the final stages of development:

Cardiology

Dermatology

Musculoskeletal Spinal (back and neck pain)

Community Nursing A review of community nursing is underway which aims to have a more integrated team of nurses working in GP surgeries and in patients own homes. Collaborative Care Team This new scheme aims to provide help and support to help people who have multiple or complex health, social problems or require support during difficult times. Patients are identified by GPs and nurses and referred onto a caseload. School Nurses (NHFT) Promote the physical, mental, social and emotional health of children, young people of school age and

their families. All children and young people have an allocated school nurse team led by a specialist school

nurse.

Breastfeeding Support Service (NHFT) Support and information for breastfeeding mothers experiencing difficulties either at home or drop in setting. Team is made up of senior health visitors and health professionals. Wellbeing Navigators (NHFT) Provided by NHFT and working alongside MIND to give support in the community to people experiencing difficulties with their emotional wellbeing, living conditions and physical health. Referrals are received from GP’s, primary care liaison and other professional services. Integrated sexual health services (NHFT) Contraception, screening and treatment for sexually transmitted infections. Services are available from teams in Kettering and Northampton with smaller sites (one based in Daventry) offering basic care.

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Smoking Cessation (NHFT) Stop smoking clinics run by NHS advisors and specialists trained in stop smoking medication and behavioural advice. Clinics are held across the county. Contact is made via GP or self-referral. Falls Service (NHFT) Offers specialist falls assessments and treatment for people over 65 who have fallen and are considered to be at further risk. Children and Young People Mental Health A single point of referral for Professionals was introduced in September 2015 which includes Emotional Wellbeing and Mental Health Services for Children and Young People, Community Paediatrics, Children’s Community Nursing, Children’s Physiotherapy, Child and Adolescent Bereavement Services and NHFT Specialist Children’s Services ii) Local Authority Assets

Children’s Centres Offer a range of services which are open to families including information and advice, activities, universal health services, early help and targeted support from professionals. The centres are at Brackley, Bugbrooke, Deanshanger, Middleton Cheney, Roade and Towcester. Leisure Centres Managed by South Northants Leisure Trust, there are three centres, one in Towcester and two in Brackley. There are swimming pools in both towns. Libraries There are libraries at Towcester, Brackley, Deanshanger, Roade and Middleton Cheney. Recreation and Play SNC offers a range of activities for children and adults including holiday play schemes, health walks, community Nordic walking courses, arts workshops, youth sessions. Food Safety SNCs Health Protection Team provides residents and businesses with advice about food safety. Duties include inspecting food businesses for compliance with food safety requirements, investigating complaints about food premises and food items whilst also providing advice on all matters related to food safety. Workplace Wellbeing Assessors Led by Environmental Health and the County Health and Safety Liaison group, two officers from each district are being trained as assessors with a view to implementing a Wellbeing accreditation scheme across the workforce in Northamptonshire. Housing SNCs Housing Team has responsibility for Housing Allocations, Housing Need and Homeless people. The team also manages Disabled Facilities grants and provides householders with basic energy efficiency advice and information.

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Money Advice SNC in partnership with SNH employ a money advice worker to assist residents with severe debt problems. iii) Voluntary and Community Sector Assets

Age UK Lifetime Centres - there are five centres, two in Towcester and Brackley and one in Deanshanger which offer a range of day care facilities Home Care - offers help and support with domestic tasks including housework, laundry, local shopping, changing beds and ironing. The scheme employs domestic care workers who are security checked. Hospital Aftercare - free service which provides practical and emotional support to older people who have been discharged from hospital, to re-adjust and return to independence. Hospice Care

South Northamptonshire patients are referred to Katherine House Hospice in Banbury and Cynthia Spencer

Hospice in Northampton.

Community First Responders (CFRs)

Coordinated by EMAS this volunteer service provides lifesaving care in local neighbourhoods until the arrival of an emergency ambulance. There are 9 schemes in Northants with 110 responders. MIND Provides information and support for people living with mental health problems. Weekly drop in sessions are held in Towcester and Brackley.

Northamptonshire Women’s Aid

Offer support to victims and perpetrators of domestic abuse and their families. Drop in, group work, advice, refuge and signposting. Citizens Advice Weekly advice drop-ins at Towcester and Brackley. There are additional telephone and web-based services. Volunteer Car Services There are two schemes operating in the District based in Towcester and Brackley. Volunteers transport patients to and from medical and or social care related appointments in and outside the district. SNLT Neighbourhood Life - Aimed at encouraging more people to become more active and more often. Range of activities to encourage people to adopt healthier lifestyles This Girl Can – Sport England initiative encouraging women to become more active. Activity on referral – GP referral scheme to a 12 week course of exercise or activity as part of a rehabilitation programme following physical or mental illness. Alive N’Kicking – Children’s lifestyle weight management service that helps overweight children and young people and their families to reach and maintain a healthier weight.

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SNVB Volunteer brokerage service - advice, support and guidance for VCS organisations. Happy at Home – befriending scheme for elderly residents. Charity Crafts- opportunity for people who are isolated to use their skills to help local charities. School of Life – activities to break down barriers between different generations to reduce isolation in communities. Garden buddies – practical help for elderly and disabled people to maintain and enjoy their gardens. Village networks – mobile rural information centre offering advice and support with money, welfare and benefits, job seeking and health and wellbeing. Other Community Assets There are a myriad of smaller charities, churches and community groups offering a range of support services together with numerous sports, arts clubs and societies e.g. University of the Third Age Brackley and Towcester. In addition there are public parks, playing fields and recreational spaces throughout South Northamptonshire as well as forest trails, public footpaths and other accessible open space. Both towns and the majority of villages have a functioning Hall or Community Centre. iv) Housing Associations

SNH Retirement schemes - retirement properties are spread widely throughout South Northamptonshire. There are extra care schemes in Towcester and Brackley offering on-site support. Lifeline Alarm and Visiting Service - subscription service available to anyone of any age, the service can be tailored to fit the needs of the client. Skills 4 U - free training programme delivered by SNH includes a range of activities aimed at all age groups including sport, cooking, wellbeing, budgeting, and confidence workshops. Supported accommodation Chartwell House in Brackley operated by Bromford provides long term supported accommodation for individuals with a learning disability who are aged 18 years or over. Private provision Additional assisted living services are privately provided by McCarthy and Stone in Brackley and by Richmond in Grange Park, in addition there are a number of residential care homes in the District.

10) How we will deliver our vision for health and wellbeing.

South Northamptonshire Health and Wellbeing Forum will need to work with key stakeholders to:

Develop different delivery models which make the best use of the resources available in the future:

Strengthen partnership working between Public Sector Agencies, CCGs, GP Federations, the Voluntary and Community Sector and other key local players

Plan and develop the infrastructure required to deliver healthcare for a growing and ageing population which embraces the ‘care closer to home’ agenda; and opportunities for innovation

Design services and pathways which utilise and develop skills and resources available in the community; including the use of diagnostics, data sharing and technology .