Transformation Board Programme Update – June 2018

//Transformation Board Programme Update – June 2018

Transformation Board:       6th June 2018

Authors:                               Vanessa Harding Programme Director
                                                               
Paper for:                             For Information/approval

1. Executive Summary

  • NHSE and NHS Improvement have published a detailed set of proposals about how they are going to work closer together as system leaders.
  • 4 new systems selected to join the ICS Development Programme.
  • A first draft refresh of workstreams was presented to Delivery Board on 17th May. Further work is underway on development of outcomes and metrics and a dashboard is expected to be in place by July.
  • The Institute of Healthcare Improvement (IHI) will be visiting Surrey Heartlands 19th – 21st June to support development of a system-wide Quality Improvement approach.
  • Over 100 clinicians and system leaders attended the system wide population health management event in May.
  • NHS England PHM leads are visiting Surrey Heartlands on the 5th June to assess our capability to manage population health within our organisations and across the integrated system.
  • Every STP/ICS is due to submit their Estates Strategy Workbook to NHSE/I by 16th July. A workshop was held on 11th May with Clinical leaders to identify gaps and opportunities and confirm projects captured so far. 13 projects have been identified as Wave 4 Bids and a panel will meet on 25th June to prioritise the bids
  • Surrey Care Record public communications is going live on Tuesday 29th May, which will be the start of a 12 week Fair Processing Notice.
  • Surrey Heartlands Choir event takes place on 5th July.to mark the NHS 70th anniversary celebration.
  • JCC has approved in principle the allocation of Transformation Funding allocation of funding and has agreed that a Prioritisation Tool should be developed to inform the approval process for Business Cases.
  • It has been agreed that ICPs take responsibility for approval of Business Cases for funding against their ICP allocation, and use the Prioritisation Tool to inform their decision making. The Board are asked to approve the Prioritisation Tool.
  • Work continues between the CCGs and County Council to formalise the integrated commissioning governance arrangements and pooling of commissioning budgets through the development of a ‘section 75’ partnership agreement.

2. National News

NHSE/I Alignment

NHSE and NHS Improvement have published a detailed set of proposals about how they are going to work closer together as system leaders for the health service by establishing a new NHS Executive Group and an NHS Assembly.

The two organisations have outlined ways they will align the two bodies in an effort to streamline quality of care for the population and efficient usage of public money. The proposals include the creation of a new NHS Executive Group, headed by two new chief executives who will oversee all national and regional directors from the two arms of the NHS.

Amongst the financial changes, the bodies will introduce a single financial and operational planning process for the health system alongside the new CFO to ensure effective use of national resources at areas of need. Similarly, there will be a single performance management process and alignment of regulatory interventions, a single internal talent management process, and a single process for establishing and reviewing national strategic programmes.

A copy of the proposals can be found using the following link:
https://improvement.nhs.uk/documents/2823/Next_steps_on_aligning_the_work_of_NHS_England_and….pdf

ICS Leads Development Day
Claire Fuller attended an ICS Leads development day on 25th May. Key points to note are:

  • 4 new systems selected to join the ICS Development Programme (Gloucestershire STP, Suffolk and North East Essex STP, West, North and East Cumbria STP, and West Yorkshire and Harrogate STP)
  • Formation of NHS Assembly to oversee the NHS 10 year plan.
  • Agreement that Claire will support clinical leadership across all 14 ICS systems using similar approach to the Surrey heartlands Clinical Academy

3. Surrey Heartlands  – Delivery Board and Workstream Update

The Surrey Heartlands Delivery Board met on 17th May (the notes of which are included within Transformation Board papers).

Each workstream presented a first draft refresh of their programme, which included clarity on the overall workstream strategy and projects underpinning the programme, as well as a refresh and update of key deliverables, milestones and risks.

One of the key objectives of the refresh is articulation of the outcomes and the metrics by which we will measure success, and workstreams are at different stages of development in this area, which some already clear on their outcomes and metrics whilst others still require further work.

Follow up meetings are underway with workstream programme managers to assess progress against a PMO framework, particularly with regards to outcomes, and this is being supported by the CCG PMO, Performance and BI teams who have now agreed to take on support of the ICS workstreams to help align this with Business as Usual. The expectation is that a dashboard detailing all workstreams outcomes, metrics and performance will be in place by July.

Some of the key points of note from the workstreams this month are:

  • Confirmation received of successful perinatal bid totalling c£970k for 2018/19. Local Delivery Plan has received positive feedback from NHSE.
  • Surrey Heartlands has received confirmation of deliverables and confirmation of funding totalling £219,500 from NHSE to support implementation of the LMS Better Births transformation plans in 2018/19.
  • Thames Valley & Surrey Local Health & Care Record Exemplar (LHCRE) – NHSE have confirmed selection of 3 of the 10 proposals received to move to the next stage, with further information requested from the remaining bidders (including Surrey Heartlands) with a view to selecting a further 2 bids. The Digital team remain hopeful of selection.
  • Contracts signed with Diabetes UK around 2 year Community Champion programme and first scoping meeting held. Positive feedback received from NHSE on end of year Diabetes Programme assurance report
  • Funding successfully secured from NHSE for Primary Care at Scale – NAPC commissioned to work alongside us to deliver Primary Care Home models across the system.
  • Social Prescribing Citizen engagement project commissioned and underway, to be completed by September 2018
  • The first Advisory Board of the Surrey SQuIRE (Surveillance, Quality Improvement, Research and Education) project has met. National funding has been secured, and we are working closely with the RCGP Research & Surveillance Centre and NHS England to give a picture of the complexity of cases that we increasingly see in general practice.  

Clinical Academy Update

IHI Visit – The Surrey Heartlands Academy strategy includes developing a system-wide Quality Improvement approach. To support us with this, Health Education England via our Workforce Board has agreed funding to support the Institute for Health Improvement (IHI) to work with us. Each partner organisation has been kept updated and requested to confirm their lead contacts.  IHI will be on site in Surrey Heartlands 19th – 21st June.

Our journey to improve outcomes, reduce inequalities and address the wider determinants of the health of our population continues, and on the 10th May Surrey Heartlands Academy hosted a system-wide event looking at local, national and international examples of population health management (PHM).

Population health Management Event – over 100 clinicians and system leaders attended the event which focused on where we are already managing population health well, what we are doing over the next year to improve the infrastructure for effective PHM. Presenters from outside Heartlands also gave examples of how PHM approaches are changing the way systems are improving health, reducing variation and managing demand for services elsewhere in England and beyond.

As a follow up to this, NHS England PHM leads are visiting Surrey Heartlands on the 5th June to assess our capability to manage population health within our organisations and across the integrated system and influence how PHM is defined nationally when the matrix is rolled out across other ICSs later in the year. The sessions will also help NHSE and the Surrey Heartlands Academy informing next steps in the development of planning and infrastructure for our 3 Integrated Care Partnerships.

Estates Strategy Update (also see appendix A)

Every STP/ICS is due to submit their Estates Strategy Workbook to NHSE/I by 16th July. Surrey Heartlands is required to submit a final version to NHSE South Region on 29th June. A full update is attached in Appendix A. A summary of progress is as follows:

  • The Strategy Workbook outlines the current make-up of our estate along with our high level estates strategy and demonstrates how our current and proposed estate plans across the system contribute to and support Surrey Heartland’s priorities.
  • As well as capturing all the estate projects across the system, we are also required to state which projects we intend to fund using Wave 4 Capital.
  • A workshop was held on 11th May with Clinical leaders to identify gaps and opportunities within the workbook and confirm projects captured so far of which there were c36 different projects.
  • 13 projects have been identified as Wave 4 Bids (as detailed in the appendix) and Bid templates and guidance has been circulated to leads for completion by 21st June.
  • We are required to prioritise the Wave 4 schemes within the workbook and leads will be invited to present their schemes to a panel on Monday 25 June as part of the prioritisation process.
  • It has still not been decided whether the Epsom-led bid to move NEECH beds to Epsom General will sit in Surrey Heartland’s or South West London’s workbook and this will need to be resolved prior to submission.

4. Communication and Citizen-led Engagement

Key activities that have taken place in the last month include:

  • Giselle Rothwell and Rich Stockley led two facilitated discussions on 24th May at the NHS England Communications Leaders conference at Camden Lock in London on engaging communities, showcasing the citizen-led engagement work we are doing in Surrey Heartlands and leading two sessions with delegates.
  • Surrey Care Record public communications is going live on Tuesday 29th May, which will be the start of a 12 week Fair Processing Notice.  Dr Andy Sharpe gave pre-recorded radio interviews on 25th May with BBC Radio Surrey and Eagle Radio and our website has been updated with all the relevant information.  Leaflets are currently being printed and will be part of a large door drop in June.  An additional communication to GPs went out on 24th May to raise awareness of the public campaign.
  • We have been working with ITN Productions on production of a short (4 min) film on Surrey Heartlands, commissioned by NHS England as part of the NHS 70 celebrations which will be showcased at NHS Confederation in June. 
  • A reminder that the Surrey Heartlands Choir event to mark the NHS 70th anniversary celebration takes place on 5th July. The event will take place at the G Live Centre in Guildford in the evening.  Tickets for the event will be £5 and are available to purchase via this link – https://www.eventbrite.co.uk/e/surrey-heartlands-health-and-care-partnership-nhs70-choir-event-tickets-43606419976?utm_term=eventurl_text.  All the money raised will be going to the Fountain Centre. 

5. 2018-19 Transformation Funding and Prioritisation Tool

 A presentation was made to the Joint Commissioning Committee (JCC) at their informal workshop on 16th May to outline details of the Transformation Funding for 2018/19. The discussion included confirmation of the funding aligned to national ‘must dos’, proposals for the allocation of the remaining funding to be used for local initiatives, and a discussion on the process for prioritisation.

The JCC agreed:

  • That the proposed allocation of funding met with their approval whilst noting the national priorities are still subject to change (and therefore impact on the remaining funding for local initiatives).
  • That a Prioritisation Tool should be developed to inform the approval process for Business Cases.
  • That ICPs take responsibility for approval of Business Cases for funding against their ICP allocation, but that this should continue to be reported through Delivery Board (and Transformation Board as appropriate), and that ICPs use the Surrey Heartlands Prioritisation Tool to inform their decision making.

It was also agreed that that regular updates on approval of Business Cases, spend and outcomes of delivery are presented to the Committee. The Investment Framework will be updated and brought to Board for approval in July.

Prioritisation Tool

Appendix B sets out the agreed proposed allocation of Transformation Funding (subject to final confirmation of national priorities), the process for approval of Business Cases and the proposed Prioritisation Tool.

The tool below has been developed using examples from elsewhere and proposes the categories, criteria and weighting that should be applied when considering approval of Business Cases submitted for funding this year.

Bids against the £1.5m ‘other’ pot, have been requested by 13th July at which point a panel will assess the bids using the Prioritisation Tool. ICPs are also expected to use the tool when approving their bids.

The Transformation Board are asked to approve the Prioritisation Tool.

 6. Devolution (Integrated Commissioning)

  • Work continues between the CCGs and County Council to formalise the integrated commissioning governance arrangements and pooling of commissioning budgets through the development of a ‘section 75’ partnership agreement.
  • The Joint Committee met informally in May to discuss the development of the section 75 agreement and talked through the NHS transformation funding and the Committee’s role in overseeing its allocation.
  • A draft case for change document (describing the case for devolving a small number of NHS England functions to Surrey Heartlands in 2018/19) has been developed and discussed with NHS England’s Director of Finance alongside proposition for the system taking greater responsibility for system assurance.
  • The next meeting of Joint Committee will be the first meeting in public and will be chaired by Councillor Tim Oliver (Russell Hills will be vice chair).
  • Attain have been progressing with their work programme over the last month, holding one to one meetings with different key leads and presented to the Surrey Heartlands Chief Executives meeting on 23rd May. Geographic footprints have now been mapped out and clinical service lines provisionally identified.
  • The initial assurance work has now been completed and is being discussed on the 1st June with NHSE. The key principles are:
    • Reduce direct involvement of regulators
    • ICS to report directly to NHSE region
    • subsidiarity – to develop the role and responsibility of ICPs
    • light touch
    • shift the focus of performance monitoring to one based upon outcomes
  • The next step is to agree the proposed approach with all partners/regulators, and to fully develop the system assurance framework.
2018-06-04T13:37:32+00:00 June 4th, 2018|