The North Central London Sustainability and Transformation ... · For North Central London to be a place with the best possible health and wellbeing, where no one gets left behind

The North Central London Sustainability and Transformation Plan

and

Camden Local Care Strategy

Caz Sayer

Chair, Camden CCG

About the Sustainability & Transformation Plan (STP)

STP triple aims:

1. Close gaps in Health & Wellbeing

2. Close gaps in Care and Quality

3. Close gaps in Finances

N C LNorth Central London Sustainability and

Transformation Plan

http://www.england.nhs.uk/futurenhs

Enfield CCG / Enfield Council

320k GP registered pop

48 GP practices

Barnet CCG / Barnet Council


62 GP practices

Camden CCG / Camden Council


35 GP practices

Haringey CCG / Haringey Council


45 GP practices

Islington CCG / Islington Council


34 GP practices

What is North Central London (NCL)?

UniversityCollegeHospital

BarnetGeneralHospital

ChaseFarmHospital

NorthMiddlesex

Hospital

RoyalFreeHospital

StAnn’sHospital

TheWhittingtonHospital

EdgwareCommunityHospital

FinchleyMemorialHospital

StMichael’s

PrimaryCare

Centre

LondonAmbulanceService

EastofEnglandAmbulanceService

Moorfields EyeHospital

GreatOrmondStreetHospital

CentralMiddlesex

Hospital

Highgate Hospital

StPancras Hospital

StanmoreHospital

Tavistock Clinic,PortmanClinic,

GloucesterHouseDayUnit


Transformation Plan

The NCL case for change

Health & Wellbeing Gap Care & Quality Gap Financial Gap

People in NCL are living longer but

in poor health.

Differing levels of health and social

care needs.

Different ethnic groups with

differing health needs.

Widespread deprivation and

inequalities.

Significant movement into and out

of NCL.

Lifestyle choices put local people at

risk of poor health and early death.

Poor indicators of health for

children.

High rates of mental illness among

both adults and children.

Not enough focus on prevention

Disease and illness could be detected

and managed earlier

Challenges in provision of primary care

in some areas.

Lack of integrated care and support for

those with a long term condition.

Many people are in hospital beds who

could be cared for closer to home.

Disease and illness could be detected

and managed much earlier.

Hospitals are finding it difficult to meet

increasingly demanding emergency

standards.

Challenges in mental health provision.

Current spend on

health and care

services in NCL is

approx. £2.5bn.

Health commissioners

and providers are

already approx. £120m

in deficit in 2015/ 16.

In the next 5 years, if

nothing changes this

will rise to

approximately £875m

deficit by 2020/ 21.


Transformation Plan

For North Central London to be a place with the best possible health and wellbeing,

where no one gets left behind

Vision

This means we will:

help people who are well to stay healthy

work with people to make healthier choices

use all our combined influence and powers to prevent poor health and wellbeing

help people to live as independently as possible within their own homes and communities

deliver better health and social care near to home wherever possible

reduce the costs of the health and social care system, so that it is affordable for the years to

come

ensure services remain safe and of good quality


Transformation Plan

• residents and patients will be at the heart of what we do and how we transform NCL

• health and social care providers will work together across organisational boundaries to

achieve better health and social care for all

• we will be radical in our approach and not be limited by the system that exists now

• we will work with local communities and organisations and their expertise

• we will be advised by clinicians and frontline staff who are close to residents and patients

• we will build on existing good practice in North Central London

Our core principles are… N C LNorth Central London Sustainability and

Transformation Plan

How we will do this

Service

Transformation

Improving

Productivity

Enablers

Focus on prevention and self care

Upgrading care provided closer to home

Joining up mental and physical health services and supporting people to live well

Improving care through integrated health and social care

Focus on improving patient safety, quality and outcomes in hospitals

Delivering efficiencies through better alignment of health and care services

Increasing productivity of current workforce

Sharing back office services across different organisations

Design of new workforce models to deliver transformed care

Review the estates across NCL to improve facilities for delivering care

Harness technology to provide new ways of managing and delivering care

Development of strong commissioning through partnership working


Transformation Plan

den Local Care Strategy to the North Central London STP

Health and care workforce

Health and care estates

DigitalNew delivery

modelsCommissioning arrangements

ProductivityBusiness as usual commissioner QIPP System wide productivity Business as usual provider CIP

PreventionHealth and care closer to home

Mental health

Urgent and emergency care

Consolidation of specialties

Cancer

ENABLERS

STP CARE CLOSER TO HOME - CAMDEN LOCAL CARE STATEGY

Optimising the elective pathway

Workforce EstatesTechnology &

SystemsQuality &

SafetyCommissioning

& ContractsALIGNED ENABLERS

LeadershipEngaging Residents

Health & wellbeing services: smoking, alcohol, nutrition

Information and advice

Health education and self management

Specialties in-reach in communities

Extended primary care access

Care planning & co-ordination

Co-ordinated access to emergency care

Clear step-up and step-down pathways

Proactive case finding and risk stratification

High quality specialist services

More speciality support to community services

Multi-disciplinary teams

Admissions prevention and reablement

FLOW

DISCHARGE

D

E

M

A

N

D

STP SERVICE TRANFORMATION INTERVENTIONS –ALIGNED TO CAMDEN LCS

Strategic Review of Local Care

45 pathways developed for NCL

Procedures of Limited Clinical Effectiveness (PoLCE)

A&E delivery plan including GP at the Front Door

LOCAL WORK ON TRANSFORMATION ALREADY UNDERWAY Integrated

Practice Units

Frailty Complete Care Management

N C L

North Central London Sustainability and Transformation Plan

Aligning the STP to the Camden Local Care Strategy


Why do we need a strategy?

• Need to bring together all key health and care organisations to agree a single model for the delivery

of health and care services in the future

• Have an agreed approach on how we will achieve a sustainable system that provides high quality

care

• To set out a shared programme of work to deliver the model using the agreed approach so that we

can jointly work on implementing our vision by 2021

The strategy will complement and contribute to the NCL sustainability and transformation plan (STP).

What is the Camden Local Care Strategy?

Aim: Health and care services will work together with local people to provide coordinated,

proactive, accessible, good quality care in order to improve the health and wellbeing of

people in Camden


National challenges

Health and wellbeing gap

Care and quality gap

Funding gap


The partnership board is made up of the following organisations:


Focus on outcomes:

• Reduce health inequalities

• Prevent early death

• Improve people’s access to care

• Improve people’s experience of care

• Enhance people’s quality of life

• Outcomes for mental health, children

and adults

• Outcomes for sub-groups of

population with similar needs

and service use

Whole system outcomes

Population outcomes

Population cohort outcomes


Where we want to be

•

•

•

•

•

•

•Enablers: Quality & Safety – Workforce - Estates - Technology & Systems –

Leadership - Commissioning & Contracts - Engaging Residents


Five key principles

Accessible:

Person-centred:

Coordinated:

Preventative:

Effective:


How will care be different for local people?

Self care

Voluntary

sector

Integrated primary

and community

services

Hospital

services

When I get ill, I know who to

contact and where to go to get

the right support

I understand the importance

of a healthy lifestyle and have

lots of information on how

to be healthy

I know where to find

information on local services

My GP told me about a local

group of people with similar

health issues who meet up

I am part of a network of local

people who share information,

help me understand services

and provide informal support

The people involved in my

care are part of one team.

They understand what works

for me, and they communicate

with each other

Things are much easier now

I don’t have to travel to the

hospital every week ─ I can

just pop into a nearby GP

practice

I can sort all my appointments

and prescriptions online

My doctor talks to me about

my overall health and the

things I need to do to

stay healthy

With my complex needs

I know I will get fast and

responsive care in hospital,

but I need it less often

these days

I thought I’d have to be

referred to hospital, but I was

given an appointment with

the specialist in a local

GP practice

When I need to see

a specialist, I don’t have

to wait too long

I feel like an expert in my

health condition and know how

to manage it so I don’t get ill

When I was ready to go home,

the hospital worked with the

nurses and carers to make

sure I had the support

I needed at home


Soundings from local partners, during the development of our Local Care Strategy have indicated that there may be three organisational development horizons for successful implementation

Our three horizons for successful implementation

Create new entity/entities for

further changes in

implementation• Develop and implement innovative

partnership models towards

accountable care with

a range of organisations

influencing health and social

outcomes of Camden’s residents

(commissioners, providers, third

sector, employers, etc.)

Finalise Local Care

strategy• Develop a strategy and

dedicated mobilisation

plan by an integrated

project team with buy-in

from all stakeholders

Integrate commissioning

in a comprehensive way

• Develop and implement

changes to joint

commissioning

arrangements to create a

much more integrated

health and social care

commissioning

What is the purpose?

• Deliver seamless

integrated local health

and care services

- to improve outcomes,

narrow health inequalities

and achieve sustainable

services

Horizon 1: Complete Horizon 2: Work in progress Horizon 3: Future

Documents

The North Central London Sustainability and Transformation ... · For North Central London to be a place with the best possible health and wellbeing, where no one gets left behind