Authors: Sarah Parker, Director of Transformation

Paper for: For Information/approval

note this paper will be published on our website After Transformation Board

Since the last Transformation Board on 6th September 2017 the following is a summary of key actions or events:

  1. Programme Management Team and key workstream updates:

    The New Care Models Evaluation Team from NHS England have continued to work with us to finalise logic models (defining our expected outcomes) and Andy Cross, Public Health, is developing an evaluation framework to ensure we are focussed on what outcomes we want to achieve and to evaluate our success. We have also used this approach to develop our Surrey Heartlands wide outcome model – a live version of which was finalised with comments received after presentation at the last Transformation Board.

    Highlight reports from each workstream are included in papers for today’s Transformation Board

    Dates are being set for the next review sessions with Transformation Board of all workstreams in November 2017 which will include clarity of expected outcomes; refresh of financial opportunities and identifying any barriers to programme delivery.

    Transformation Board members will be invited as Executive Sponsors to the workstream they are leading on but are also invited to all the reviews.

  2. Investment Framework: next steps – identifying our investment priorities

    A substantive agenda item on today’s Transformation Board is the implementation of our Surrey Heartlands Investment Framework. This will be to start the allocation of £9m (from a total of £15m) of Transformation Funding that NHSE have agreed to devolve to Surrey Heartlands from end Sept 2017.

    Surrey Heartlands Transformation Board will consider the long list of level 1, 2 and 3 outline business cases and ensure clarity of criteria for investment, next steps for formal approval/rejection and any further actions.

  3. Winter

    A key agenda item today is in regard to checking our plans for responses to the pressures that winter places on our health and care system and our ability to respond well and support faster system recovery from any impact. Included in this discussion will be prioritise

  4. Clinical Academy Update:

    • Appointment of Dr Mark Hamilton to the role of Executive Clinical Director
    • Scoping with clinical work streams of innovation support requirements by Academic Health Science Network post of Tech Navigator aligned to Surrey Heartlands
    • Briefing paper for Surrey Heartlands Expo to be held in Feb/March 2018 currently being prepared; for November Board. Expected to include showcasing of beneficial tech aligned to work streams, showcase for our machine learning and Artificial Intelligence (AI) expertise. We have secured facilitation from the Kings Fund as part of our ACS development package to support this
    • Scoping underway to identify solution for “bottom up” engagement to identify and spread innovations from work force.
    • Clinical Forum for 11th October 2017 scheduled with a focus on mental health, prevention and primary care engagement
    • Scoping work underway with the Institute of Healthcare Innovation to develop proposals for Surrey Heartlands to become a “Quality Improvement System”
  5. Systems Leadership Support

    • Transformation Board member attended a 3 days system leadership event run by Professor David Berg as part of our ongoing development supported by Health Education England and Yale University. Feedback from attendees was positive. Board members formed 5 ‘units’ to tackle 5 key areas ahead of a follow-up 2 sessions on 13th and 14th November 2017.
    • Two teams from of Surrey Heartlands (UEC and digital/MSK) started NHSI funded Transformational Change System Leadership events in September 2017.
    • One team formed to apply for the next Yale Strategic System Leadership programme (funded by the NHS Leadership Academy). The team is Russell Hills, Chair of Surrey Downs CCG, Justin Newman Devolution Director and Ruth Hutchinson, Deputy Director of Public Health. If accepted into the programme their specific focus will be on diversity and inclusion. As Board members will know we have specific areas of inequality and deprivation in Surrey that we would like to responded better too – in particular a high population of people with learning disabilities as well as one of the highest Gypsy Roma traveler populations nationally.
    • The Workforce workstream is overseeing the development of a whole system approach to investing in system leadership locally.
  6. Communications

    Since the Board last met the core team has overseen our public communications refresh including:

    • Surrey Heartlands website ( live from 22nd September 2017. We are still working to make this more dynamic and to be the first site of responses in any searched. We welcome feedback to
    • The launch of the Surrey Heartlands twitter account (@surreyheartland
    • A generic presentation on Surrey Heartlands for any engagement events is available on our partnership. If anyone wants them please ask
    • Incorporating this Programme Update onto the new website since it has sufficient information to update the public on our current priorities
    • The relaunch of the Surrey Heartlands staff and stakeholder newsletter as a wholly digital e-newsletter
    • Continuously reviewing how we are using digital media to better communicate our plans and achievements as well as promoting wider engagement. Priority is currently being given to developing increased use of video – for example short ‘talking head’ interviews on the website to explain key elements such as the clinical academy and devolution
    • Blogs from the SRO, and guest bloggers within our system, which will appear on the website and be promoted across our social media channels
    • All workstreams have their own pages on the website. Programme Managers have been made aware so that they can provide individual updates.
    • The team is also planning the next public stakeholder meeting, which is taking place on Wednesday 18th October, focused around the Cancer Workstream.
  7. Supporting our system – update on key roles

    We are delighted to confirm the following updates:

    • David McNulty has formally commenced as Independent Chair of our Surrey Heartlands Health and Care Partnership Transformation Board. Today is his first meeting in that capacity
    • Dr Mark Hamilton has been appointed to the role of Executive Clinical Director: Surrey Heartlands Health and Care Partnership commencing formally 1st November 2017. Mark is the Medical Director at CSH Surrey.
    • Dr Andy Sharpe has been appointed as our Surrey Heartlands Partnership Clinical Chief Information Officer to provide additional system-wide clinical

      leadership to our digital workstream. Andy is a GP in Epsom and also on the NHS Surrey Downs CCG Governing Body.

    • Barbara Bool has started as a joint appointment with RSCH providing administrative support to the core team, reporting into Karen Rodgers Executive Business Manager for Surrey Heartlands
    • We have been secured a 6 month graduate management trainee placement from Surrey County Council’s graduate scheme, Victoria Berry, who will start with us on Tuesday 10th October 2017
    • Diabetes Transformation Funding – we are seeking both a workstream Clinical Lead (2 sessions a week) and a band 7 (0.50wte) Clinical Education Lead for this workstream.
    • Steve Abbott has been appointed part time as our Surrey Heartlands Clinical Information officer with part backfill into his substantive CCG role
  8. Supporting our system – update on key events Since last Board

    • On 20th September 45 people from across our partnership, attended the cardiovascular co design event. Citizens, patients, cardiologist, specialist nurses, county council, commissioners, the third sector and other professionals worked together to discuss priority pathways that would improve the outcomes for citizens with cardiovascular disease. It was agreed hypertension, heart failure, chest pain and atrial fibrillation were all priority areas for the Surrey Heartlands Partnership. A programme board is being set up for November where project level outcomes using the logic model approach) will be developed linked into costed pathway models. This will form part of an options paper to be submitted to the Transformation Board (anticipated for Dec 2017).
  9. National Bids

    On 12th September 2017 we submitted 2 bids to NHS England to support our digital transformation work.

    On 25th September we were notified that Surrey Heartlands Urgent and Emergency Care Transformation Fund Investment Proposal was successful. This will bring circa £400k one off funding into our system. The bid is to enable us to implementation of a Surrey Heartlands wide interoperable real time Urgent and Emergency care data platform will encourage openness and transparency between partners, develop a culture of shared responsibility and expedite the formation and development of alliances.

  10. Regional/National Context

    On 22nd Sept we submitted detail to support progress against our Mental Health Delivery Plan to NHS England (regional team) for a stock take review undertaken by the local DCO assurance and Clinical Network team. The key

    purpose is around assurance of robust plans being in place and feedback will support and additional support or focus of required.

    On 26th Sept we attended the National STP Leaders day hosted by Simon Stevens and Jim Mackay sharing good practice and potential solutions to the complex issues we are facing. A key focus of discuss was on winter planning and improved resilience; capital/estates and workforce. The same day in conjunction NHS England and NHS Improvement hosted an STP Clinical leader’s event.

    NHS Digital and Surrey Heartlands met on 28th September for a constructive dialogue about how we can move faster in achieving our Digital workstream ambitions. Themes covered were:

    • Global Digital Exemplars – fast followers, and supporting provider partners to accelerate progress in key priority areas of their shared digital strategy
    • Urgent and Emergency Care – a look at the current portfolio of work: to enable NHS online, decision support (triage), access to a single source of truth (Summary Care Records and local Integrated Care Records)
    • Digital Hospital – lean flow management systems from industry improving flow, capacity and resilience.
    • Interoperability – integrated care records, integration platforms, target architecture; creating a learning system to support service delivery, service redesign and research
    • Cyber Security
    • Learning from elsewhere: Single care records; e-Referral system; national roll out of systems to support Child Protection
  11. Devolution (Integrated Commissioning) Update since last Board

We are in our shadow year progressing to full devolution from April 2018.

Work continues to refine the 2018/19 ‘asks’ to progress. Three workshops were held last month with NHS England colleagues with further discussion planned during October. The output from this work will be a report that will be presented to the NHS England Commissioning Committee for approval in December setting our clearly the functions and responsibilities that will be changing from 1st April 2018.

We are continuing our work to move to aligned system planning and transparency on intentions. With the appointment of a joint Accountable officer the 3 Surrey Heartlands CCGs are drafting a single set and aligning these to Public Health and Social Care. We will be outlining a plan to work with providers towards a future single plan

4th October 2017 will be our first Joint Committee which will be informal focussing on set up arrangements and shared commissioning intentions.