The following briefing provides an update on the Surrey Heartlands Programme:
Transformation Workstream update
Work has been ongoing over the last couple of weeks to refresh the Transformation Programme and the work streams within it, building upon the opportunities identified at the Efficiencies workshop that took place on 1st February.
The proposed refresh of workstreams and key priorities for 2018/19 will be discussed with CEOs this month and a paper taken to the March Transformation Board.
In the meantime a new Transformation Programme Delivery Board will be implemented, commencing in shadow form in March, going live in April. This will take the place of the existing Strategy Leads forum and will bring together all of the leads from across the system for each of the workstreams. The meeting will be co-chaired by Claire Fuller, SH SRO and Matthew Tait, CCG Joint AO and will focus on monitoring delivery of workstream outcomes, progressing pilot areas at scale and pace, review of risks and resolution of system barriers. The new Board will also have oversight of system wide efficiency savings to ensure there is alignment with workstreams.
Seven Citizen Ambassadors have now been recruited and will start working with Programme Managers this month to support key work streams. This is an exciting opportunity and we will be using their skills to ensure that the views of local people and communities contribute to the co-design of our transformation programme.
NHSE have agreed to provide Surrey Heartlands with some fixed term funding to support perinatal mental health activity. This will be developed further and we will be applying for further funding (wave 2 application) later in March.
A useful meeting was held with the Frimley Health STP’s Director of Transformation to share plans and discuss areas of opportunity to work closely together across the wider footprint. Frimley has already developed a system wide dashboard and will share that with us with the opportunity to work together on development of dashboards at programme / work stream level in future.
At Transformation Board in December 2017, it was agreed that there would be value in a strategic alignment conversation between commissioners and providers and Chief Executives and Finance Directors were invited to a session on 7 February.
However, given the delay in publication of the 18/19 Planning Guidance, draft organisational operating plans did not reflect the Planning Guidance and partners were not yet in a position to have this conversation. Instead, the session on 7 February was used to understand the implications of and any concerns in relation to the Planning Guidance for Surrey Heartlands and to agree next steps.
Following this session, a project plan has been developed and a further session for Chief Executives and Finance Directors is being arranged for early March. A further update will be provided to Transformation Board in March and the draft system operating plan narrative will be presented to the Transformation Board in April.
Clinical Academy Update:
The Surrey Heartlands Academy model and clinical leadership approach was presented at the first national meeting of STP Execs and Clinical Leads. There was significant interest in the approach nationally which is leading to enquiries and interest in work we are undertaking.
A significant amount of planning has gone into our Surrey Expo taking place on 13th March, again this is generating regional interest in our approach.
A paper on our strategic approach to working with industry has been revised and updated and will be presented to Transformation Board in March.
We have secured some funding to help us with our journey to improvement quality outcomes. Most notably these have been:
- from NHSE to support us in our focus on clinical leadership and developing of communities of practice – bringing together people who share a desire for improvement, or see a problem that they cannot solve alone to work together.
- from Health Education England to focus on embedding quality improvement approaches across our system, where historically these have been based around individual organizational approaches
Citizen-led Communications and Engagement
We are now partnering on a highly innovative research project, funded by the Wellcome Trust, to raise awareness and provide compelling materials for experience-based co-design methodologies by producing a short video based on the challenges for prisoners in accessing healthcare in prison.
Our last stakeholder reference group meeting was held in Guildford on 17th January and was well attended (around 60 people) – positive presentation given by Dr Roselle Herring on the development of our programme for diabetes prevention and management across Surrey Heartlands. Rich Stockley presented on our Citizen Ambassador recruitment and David McNulty gave a general overview of SH including progress on devolution. Dates have now been set for the rest of the year.
On 19th January we hosted an engagement workshop for our newly appointed Citizen Ambassadors (CAs), Programme Managers and Comms and Engagement leads including Healthwatch, with Annie Laverty, Director of Patient Experience for Northumbria Healthcare NHS FT. Annie and colleagues gave an inspiring presentation, with some inter-active sessions, and the event also served as a first introduction for our CAs.
NHS 70 – as a partnership, working with the Health & Wellbeing Board’s Communications Sub-group, we are starting to plan a series of events to celebrate NHS 70 including our Surrey Heartlands Choir Concert at G-Live on Thursday 5th July (the anniversary). Invites will be circulated very shortly, but please put the date in your diary now!
Plans are now in place for David Berg’s visit in March. Sessions will be held with Strategy Leads on 12th, finance leads on 14th, and Transformation Board members on 15th and 16th. Further details on the content and plans for each of the days will be sent out in due course.
Surrey Heartlands was successful in securing £50k from the Leadership Academy, as part of our ‘In Place Leadership’ bid process and as part of this we have commissioned two Associates to support us in this work, which will include researching and presenting a clear profile of the Surrey Heartlands workforce, to understand who is in our leadership and management communities at each level, which teams work together and the current level of integration work across the footprint. The work will also include development of OD capacity across Surrey Heartlands.
Supporting our system – update on key events
A Surrey Heartlands Efficiencies workshop was held on 1st February which brought together national leads for programmes such as RightCare, Getting it Right First Time (GIRFT) and the Model Hospital, looking at our local Surrey Heartlands data to identify opportunities for future efficiencies. This was a new approach offered to us by the national team as part of our devolution agreement.
There was an extremely good turnout from across the footprint (approx. 100 people) and following discussions in the morning on national context and reviewing the local data, the afternoon was spent reflecting on priorities for 2018/19. This feedback has informed the refresh of the programme for next year as detailed in section 1 above.
A recurring theme at the workshop was the need to focus on population health management to understand our gaps in health and wellbeing and to enable us to target change in the right areas. A system wide population health workshop is now planned for April with the support from NHSE.
Planning Guidance for 2018/19 was published on 2nd February and a meeting to review the details and understand the impact for Surrey Heartlands was held with CEOs and Directors of Finance on 7th February following agreement that there would be value in a strategic alignment of plans next year.
The detailed planning guidance can be found here: www.england.nhs.uk/wp-content/uploads/2018/02/planning-guidance-18-19.pdf
Keep points include:
- An additional £540m in funding to be provided by the DHSC (Department of Health and Social Care) for 2018/19, but funding will slow down in 2019/20
- No additional funding will be provided for winter pressures in 2018/19
- CCGs and trusts will be expected to achieve financial balance over the course of 2018/19
- STPs are expected to play a more prominent role in the planning and management of system-wide efforts to improve services and to meet financial targets
- ACSs (Accountable Care Systems) have been renamed ICSs (Integrated Care Systems) and the most advanced will receive additional freedoms and flexibilities
- It is anticipated that more ACSs/ICSs will be confirmed in 2018/19
- NHS England expects extended access to GP services in evenings and on weekends to be in place in all CCGs by October 2018
- CCGs will be expected to actively encourage every GP practice to be part of a local primary care network by the end of 2018/19. These will be geographically contiguous, and therefore all areas of a CCG (and all practices) will be covered
Devolution (Integrated Commissioning) Update since last Board
As we close in on the end of the ‘shadow year’, work continues to evolve the integrated commissioning governance arrangements – workshops have been held between the CCGs and at the County Council to discuss the commissioning powers planned to be moved to the Joint Committee. The Joint Committee also held a workshop facilitated by Chris Ham of the Kings Fund to discuss the development of Strategic Commissioning in Surrey Heartlands.
Immunisations, dental services and specialised services continue to be the focus of discussions with NHS England with regards to the increasing role Surrey Heartlands will play in decision making; a workshop held with local, regional and national leads on 12th February discussed how we could strengthen Surrey Heartlands voice in the commissioning of dental services; work is ongoing on the development of the case for change for immunisations; and final approvals are being sought to secure external support in relation to specialised services. The draft MoUs for the delegation of Health Education England and the Academic Health Science Network responsibilities are due to be presented to the Joint Committee at its next meeting in March.