North East NHS

Response to national imperatives

Chris Willis

Regional Director – Transition

7 September 2011

2

Purpose of presentation

To describe:

• An overview of our current position• How we are maintaining delivery and continuous

improvement• How we are supporting staff• How we are supporting the implementation of the health

reforms

Grip and momentum!

3

North east NHS is in a relatively good position

100% of hospitals

are FT

Track record of good

performance

Track record of

satisfaction

All organisations

in financialbalance

30 % management

cost reductiondelivered

Rapidly improving outcomes

Historical levels of poor

population health

PCTs workingas clusterssince 2006

4

But still facing significant challenges

Over relianceon hospitals

£859 mQIPP challenge

Poor health of the public

Needing to changeactivity patterns

5

Maintaining delivery and continuous improvement

• Realistic and stretching 2011/12 contracts agreed by 1 April• Community services transferred to providers• Strong performance management in place • Constantly seeking to ensure that essential capacity and

expertise are in place and that morale is maintained• Cluster ISOP meetings with PCTs, FTs, CCGs, LAs show

strong local alignment, balancing delivery and transition• Transformation fund to drive real change in FTs• A focus on the QIPP agenda …….

6

QIPP challenge - £859m

• Good progress in 2010/11 with management cost savings• Strong Integrated strategic and operational plans developed

with GP commissioners, Local Authorities and FTs • Investing more than other SHAs on health improvement• Majority of savings secured in contracts via tariff• Focus now on delivery of allocative savings • North East Transformation System is helpful to all of this

2008/9 2009/10 2010/11 2011/12 2012/13 2013/14 2014/153500

4500

5500

6500

4.33b 4.54b 4.85b 4.95b 5.06b 5.17b 5.28b

38m304m

498m 686m859m

Column1QIPP challenge

0

7

Putting patients and the public first

Promoting choice and competition

Relative market contestability and choice index (HHI)

Higher than averageAverageLower than average

8

Improving health and healthcare outcomes• Preventing premature death

• LTC - GPs good at managing their ‘at risk’ population• Recovery – Primary PCI and comprehensive stroke services in place• Experience – Top results in patient satisfaction surveys• Safe care – Safer Care North East

9

An agreed clinical vision to tackle poor outcomes

• Facilitated ASE events for clinicians

• Issues tackled included:• variations in delivery• long term conditions• alcohol• deaths in hospital

• Created a strong clinical consensus and innovative solutions to problems

• Now in the process of implementing

10

Commissioning for patients

• Effective collaboration by GP leaders• Contracting, performance management and data• Governance and scheme of delegation• Patient involvement and engagement• Coordinating decisions on individual cases

• Programme to identify and meet support needs

Jan 2011 Feb 2011 Jul 2011Apr 2011

= 9 36%

= 1157%

= 20100%

= 1572%

11

Transitional commissioning arrangements

PathfinderCommittee

PathfinderCommittee

PathfinderCommittee

PathfinderCommittee

Shared Support

Integrated Board(including a single cluster chair and executive)

12

Local democratic legitimacy

Excellent relationships with local authorities

• All local authorities are early implementer sites for H&WB• H&WB development being supported by a team led by a

local authority chief executive• Innovative health and social care system diagnostics• 3 Healthwatch pathfinders (Northumberland, Gateshead &

Hartlepool)

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Developing healthcare providers

• Transforming community services• Education and training – single provider skills network• NEAS to complete FT application• Strong public accountability – 180,000+ members• Big reconfigurations being progressed

TransformingNewcastle Hospitals

NorthumbriaEmergency

Care Hospital

Durham Seizing the

Future

North of TeesMomentum

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Supporting staff

• Staff satisfaction is still good • Strong regional social partnership forum• TCS – listened to staff• Management cost reduction exercise behind us; supported

voluntary redundancies, limited compulsory redundancies and fair process

• HR transition group to manage risks and ensure consistency• Suite of support packages for staff• Regular events with all SHA/PCT chief execs and directors• North East Leadership Academy (hosted by CD&D FT)

1515

Managing the transition

A two year programme, coordinating the implementation of new commissioning arrangement in the north east

1616

Goals…

...to establish a single transition plan for the north east covering the following functions:

• How we maintain and improve the quality of health outcomes

• Development of the workforce• Provider development• Public health services• Commissioning arrangements • Support for local authorities to establish health and

wellbeing boards

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Managing the transition

Transition programme directorChris Willis

Corporate and HR transitionworkstream

Development of health and

wellbeing boards workstream

Commissioning developmentworkstream

Public health services

workstream

Provider developmentworkstream

Outcomes and quality

workstream

Workforce developmentworkstream

Transition programme boardChair David Stout

Neil NicholsonKaren Straughair

Ian ParkerWendy Balmain

Richard BarkerYasmin Chaudhry

Peter KellyChris Willis

Aidan Mullan Stephen Childs

Stephen SingletonKen Bremner

Aidan MullanMartin Barkley

• Local authority representatives• PCT cluster chief executives• GP consortia leads

• Workstream leads• Staff side representation• HealthWatch

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Managing the transition together...

• A clear leadership role for local authorities and GP consortia

• A partnership of equals – recognising the interdependence of services

• Jointly using the learning from previous large scale change

• Listening to stakeholders and enabling proactive engagement

• Robust governance and programme management• Sharing risks to ensure stability• A commitment to full staff and staff side engagement in

change management

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In summary

• The north east NHS is in a good position, but with much more to do

• We are clear of our role in supporting the successful transition to the reformed NHS

• We are working closely with our partners to build a successful future for patients and the public and avoid unintended consequences

And• The aim is to ensure that when the SHA and PCTs come to

an end that the arrangements in place, together with the momentum, will ensure that the transition continues to a satisfactory conclusion