Creating Infrastructure for the 21st Century Strategic Service Development Planning 24th March 2006

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Creating Infrastructure for the 21st Century
Strategic Service Development Planning 24th
March 2006
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Alan MillerPrimary Care Contracting
AdvisorLondon South
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AGENDA
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Creating Infrastructure for the 21st Century
Strategic Service Development Planning 24th
March 2006
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Our Health Our Care Our SayService delivery in
primary care infrastructure issues

• Dr Tony Snell
• Medical Director
• Birmingham Black Country SHA

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Key issues

• The NHS seen to have primary focus on treatment
  not prevention
• Consequently only be used at times of ill health
• Unresponsive when self care advice is sought
• Too busy for people to trouble with smaller
  things in life
• People indicated they wanted help navigate own
  health choices
• People need to take more responsibility for own
  health
• Becoming nation accepting of many health risks
  sexual and physical health deteriorating
• Unless citizens better manage health risks future
  health costs will be significant
• Primary prevention proven as most cost effective
  way to manage health
• Health inequalities gaps are increasing
• Services and self care support need targeting at
  most in need
• Most at risk from their lifestyle and environment
  can be hard to reach intelligent information
  will help to identify and target them (social
  marketing)
• Advice, self care and support needs to be
  delivered in ways that mean something to people
• Commissioners have found it hard to develop
  primary and secondary prevention services despite
  huge increases in funds

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The Demographic Challenge

• Lifestyles are adding to risks
• rise in obesity associated problems
• rise in binge drinking
• rise in STIs, substance misuse, LTCs
• Baby boomers are getting older
• elderly more LTCs use more services
• more older people living alone, away from family
  and friends

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Most patient contact occurs in the community

• 86 of patient contact occurs in the community
• 890,000 Consultations with GP/practice nurse
• 315,000 Non GP Community contacts
• 18,000 NHS Direct calls
• 4,000 Walk in centre events
• 26,000 NHS sight tests
• 482,000 social care contact hours
• 1.7m adults receiving social care

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primary care still offers limited convenience to
users
Access has been improved
but opportunities remain for improvement
NHS Direct 6.6m calls 9.3m web visit
Walk-in centres 2m visits
More minor surgery in Primary Care
Pharmacies
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The system fails to adequately integrate services
from other sectors
Fragmentation marked at boundary between health
social care. Adversely affects people with
complex needs LTCs.
Community health care
Social care
Other support services
Nursing care
Residential care
Benefits advice
Personal care
Rehabilitation
Respite care
Leisure
Equipment
Housing adaptations (major)
Housing adaptations (minor)
Intermediate care
Chiropody
Physiotherapy
Domiciliary care
Access to work
Acute care
free at point of use
means-tested service
Person needing a bath in community could receive
a health bath (free of charge) or a social
bath (means-tested). Inefficient and confusing
for users and providers
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The White Paper Our Health Our Care Our Say
increasing patient choice and improving services
by increasing the plurality of providers
The case for action
The vision

• Poor access to services in some places,
  particularly deprived areas
• Variable quality and scope of service offering
  postcode lottery
• The system is not fully focussed on outcomes and
  cost-effectiveness
• Poor management and integration of services for
  intensive users of NHS

• Free choice of GP
• Competition for users to drive quality and
  replace targets
• Direct intervention to fix shortages in poor
  areas
• More convenient access to GP services
• Greater integration of health and social care
• Managed care for intensive users

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OUR HEALTH OUR CARE OUR SAY WHITE PAPER

• Partnership working across health and social care
• Work with local Practices- move care out of
  hospital
• developing new Expanding Practice Allowance -
  incentivise further development of practices in
  under-doctored areas.
• further guidance on development / support for
  PBC.
• timetable for delivery of more OP appts in
  primary care, initially targeting key specialties
  e.g. dermatology, ENT, trauma and orthopaedics,
  urology, gynaecology and general surgery.
• extending patient transport to enable this to be
  used for outpatient appointments in primary care
• performance management to measure degree of shift
  from secondary to primary care providers

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Infrastructure to support these changes

• Firm commitment to resolve pension issues for
  staff transferring to new providers
• National procurement support for those PCTs
  dealing with recruitment of alternative providers
  
• Further work on delivering a balanced score card
  approach with review of PBR
• Work on unbundling tariff to support development
  of different care packages across health, social
  care and voluntary and community sector providers
• Turnaround teams for reconfiguration of services
  and the implementation of ISIP (Integrated
  Service Improvement Programme)

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New services and developments for existing
services

• NHS Life Check to assess peoples lifestyle risks
  target interventions advice
• Expansion of EPP with trebling of investment
  development of community interest companies to
  deliver local models.
• Information prescription for people with LTCs.
• Development of Expert Carers Programme for
  carers of people with LTCs.
• Support of carers through improved emergency
  respite and national helpline
• Strategy to improve access to emergency care
  particularly in community
• improvements in End of Life Care
• rapid access to sexual health services
• new screening programme for bowel cancer
• more choice for women in maternity care
• better follow up for ex offenders with MH
  lifestyle problems
• improved access to CAMHS
• Direct access to some services delivered by AHPs

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Health commissioners should actively manage
integrate care

• Proactive management 5 most at-risk intense
  users of NHS
• Proportionate care management to increase
  welfare, satisfaction and improve
  cost-effectiveness by reducing acute episodes
• Broad single assessment of needs leading to a
  care plan
• Improved choice over, access to and quality of
  palliative care
• Promotion of an overall HMO approach
• Development of specialist providers e.g. chronic
  disease specific

Management of care
Integration of care

• Integration of health and social care
  commissioning - Range of options
• Merge social care commissioning into NHS
• Joint commissioning between local government and
  NHS
• A greater role for local government in
  integrating health and social care needs
  and wider integration to include housing,
  transport, security etc
• A role for a care integrator or patient
  advocate
• A more principled and rational approach to
  charging for services

• Improved choice of provider
• Individual budgets for community aspects of
  health care, offering user empowerment and
  holistic care provision
• Better choices at the end of life so that
  people are more likely to die in their preferred
  setting

Choice about care
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Integrated case management needs further
development and diversification to ensure
cost-effectiveness and impact

• US HMOs reduced hospital admissions and costs of
  high intensity.
• Differences in context which complicate direct
  comparisons e.g.
• Per capita costs may be similar (and outcomes
  better in the US) but it is unknown if
  differences in incentives and structure may
  account for this
• The use of the nursing home model in the US
  different
• Emerging UK evidence of managed care is mixed
  (see box)

• Key elements of case management
• Clear target population and events to be avoided
• Identify individual patients at risk
• Key worker to monitor, plan and implement care
• Manage information to identify patients support
  care

• Some evidence on managed care
• Initial evidence indicates that
• Hospital admissions may only reduce by 1
• The older people may have had fewer hospital
  admissions without managed care interventions
• Limited evidence of cost-effectiveness
• But pilots have also demonstrated
• Improved quality of life for patients
• Contact with patients previously unknown to
  services (increasing demand but also delivery)
• A weakness of pilots is risk profiling

Sources National Primary Care Research
Development Centre Picker Institute
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Commissioners should respond to case management
by using cost-effective interventions such as
assistive technology
Assistive technology e.g. remote care
BP monitor, fall detector, panic pendant,
medicine dispenser
Group appointments
Building on expert patient model
Telephone-based care
Providing more channels through which care is
delivered e.g. older person phoned daily rather
than visited weekly
Internet-based care
Email-based care
Nurse clinics
Using diverse workforce with specialist training
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Settings for development delivery self care
support

• As number providers increase, commissioners will
  offer different self care support services e.g.
  health champions, to their population above basic
  range of services
• People will be able to choose services
  appropriate for their risk and personal needs in
  keeping with their care plan (LTC) or personal
  health guide (Choosing Health)

Plans will represent service offersmade by
alternativeproviders

• New comms platforms
• Youth services
• Social marketing
• Civic society

• SureStart
• Childrens Trusts
• Social services
• GP practices
• Civic society

• Workplace
• Benefits agency
• Civic society

• National curriculum
• Healthy Schools
• School nurses
• Childrens Trusts
• SureStart
• Civic society

• Workplace
• Social services
• General practice
• Care providers
• Civic society

Patients couldchange provider as their condition
and needs change
Young people
Middle years
Older people
Family
Commissioners willgive people access to a
network ofproviders and services
Children
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Structural changes required

• Commissioners need strong, cost effective service
  providers
• Current health well-being services clearly
  identified through a commissioning review and
  revenue, infrastructural and staff costs
  identified
• PCTs be encouraged (or mandated) to provide these
  services under umbrella of either local
  government, PCT or joint governance arrangements
• Choosing Health funding increases be linked to
  local health outcomes e.g. LPSA stretch targets,
  linking any future investments to the growth of
  local social enterprise and capital
• Develop current services e.g. health trainers,
  school nurses, health promotion staff, smoking,
  alcohol , sexual health services, HVs, out
  reach and community development workers
• Create discrete service providers that will also
  act as catalyst to develop future community
  provision and ensure prevention is part of
  hospital-based care
• Complemented by services providers developed by
  pharmacists, optometrists, dentists, mental
  health or acute services and other high street
  and community providers

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Service provision who can meet the need?

• MOT
• GP practices ( via essential, additional or
  enhanced services)
• Community pharmacies via essential services)
• Health Direct website
• Other public sector providers e.g. benefits
  agencies, housing, Health Trainers
• Accredited against national standards (Skills for
  Health)
• Under LAAss could also be provided by e.g.
• schools under Healthy Schools
• local authorities
• workplace, incentivised via tax breaks or via
  Investors in People status, independent sector
  e.g. Boots, Lloyds
• Key service delivery (sexual mental health,
  obesity, exercise, diet, smoking cessation,
  alcohol drugs services)
• Traditional providers
• GP practice, pharmacy, community hospitals,
  secondary care, LA
• New providers
• Schools
• Workplace e.g. occupational health professionals
  running mental well-being services etc
• Other public sector providers e.g. secondary care
• New providers NFP, independent sector

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Procurement Process

• Securing essential services
• Can choose PCTMS, or commission-
• For greenfield sites, two stage process
• competition between GMS and PMS practices (which
  would have preferred provider status)
• open competition.
• For brownfield sites, could go straight to tender
  
• para 7.20 Investing in General Practice

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Commissioning Strategy

• Whole systems approach
• Commissioning strategy must cover full range
  services
• Key area is boundary between primary and
  secondary care enhanced services
• Focus on commissioning services not contractual
  form
• Contractual form may depend on organisational
  structure of contractor
• Whatever the service and whoever the provider,
  there is a contractual form that fits!

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Barriers to implementation

• Lack of integrated commissioning
• Understanding the role of PCTs
• Relationship between PCTs and PBCs
• Resolving conflicts of interest
• Who commissions primary care?
• Procurement expertise
• Contracting expertise
• Development of the market

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How to deliver
Workforce

• Exploit skill mix opportunities
• Competence based practice
• New models training accreditation

• Integrated pathways clinical networks
• Team working
• Build in patient feedback

Flexible and adaptable workforce
Sustainable solutions
Patient focused processes
System Configuration
Service Design
Improving quality and access

• Exploit new technologies
• Expand community infrastructure

• Whole systems solutions

Capacity infrastructure
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Our Health Our Care Our SayService delivery in
primary care infrastructure issues

• Dr Tony Snell
• Medical Director
• Birmingham Black Country SHA

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Creating Infrastructure for the 21st Century
Strategic Service Development Planning 24th
March 2006
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Creating Infrastructure for the 21st Century
Strategic Service Development Planning
REFRESHMENTS
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Creating Infrastructure for the 21st Century
Strategic Service Development Planning 24th
March 2006
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• SSDP Requirements and Innovation
• Vision and Principles for PCTs
• Alternative Funding Routes

Andy Pratt SHA Estates Strategic Estates
Advisor
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The Purpose of SSDPStrategic Service Development
Plan

• Will be a whole system document that reflects
  service and capital investment across the whole
  health community.
• Should reflect plans and aspirations with an
  emphasis on Primary Care.
• Will demonstrate engagement with L/A and the
  voluntary sector.
• Acts as a joint planning document for premises
  development.

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• Can act as a basis for procurement either 3PD
  PFI, LIFT etc.
• Will describe procurement priorities and
  proposals for phased investment with target
  dates. This will reflect future capital/revenue
  consequences.

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Who will have access to the SSDP?

• All health and social care stakeholder
  organisations, independent contractors (G.P.s,
  Dentists, Chemists, Opticians, etc.) as well as
  potential private sector providers, Strategic
  Health Authorities, PCTs, and L.As.
• Local community and professional representative
  groups including trade unions.
• Potential private partners who may also wish to
  use the document as a risk analysis tool in
  relation to PFI developments.

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What should an SSDP contain?

• Reflect implementation of national and local
  priorities and integrate service aspirations
  reflected in capacity and local delivery plans.
• Baseline estates information to reflect where
  are we now?.
• Proposed General Practice, PCT, SHA and LA
  investment including proposed joint funding.
• Costed premises proposals that reflect national
  building and design requirements.

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• It should be integrally linked to local estates
  strategies, workforce plans and IMT
  implementation plan.
• Detail about priorities in respect of premises
  investments (reflecting premises investments with
  other PCTs and partner organisations) also
  planned sale or disposal of redundant premises
  when relocating to new facilities.
• A summary of short, medium and longer term
  premises investment including the purchase of
  land and use of nGMS flexibility's.

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Specific relevance to Primary Care.

• Needs to reflect current and future service
  aspirations of NHS and independent contractors
  providing primary care and related
  community-based services.
• Needs to take account of the physical condition
  of the primary care estate in private ownership.

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• Will take account of NHS retained estate (e.g.
  health centres, health clinics, bases for
  community staff, community hospitals and
  treatment centres etc.)
• Reflect local policies to use Flexibility's
  that enable incentives to encourage contractor
  professions to move into new and modernised
  premises.

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Opportunities for Stakeholder involvement and
innovation.

• Enable frontline staff to influence design and
  planning solutions.
• Reflect priorities in meeting health needs,
  tackling social exclusion and contributing
  towards urban regeneration.
• Inclusive of all local health services - all
  contractor professions and service providers in a
  neighbourhood should be invited to participate in
  a local project and be fully involved in
  consultation/discussion with patients.

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• Enable a wider range of non-NHS community based
  service providers to be accommodated in a single
  civic building (e.g. welfare rights, employment
  training, local crèche, fitness suite, library,
  etc.).
• Consider opportunities with the commercial sector
  (e.g. a premises developed in conjunction with a
  retail outlet.).

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Service change and impact assessment.

• Describe planned service change (e.g. transfer of
  services from Acute to Primary Care should be
  highlighted.).
• Proposed joint investment i.e. integrated working
  and joint provision (e.g. intermediate care with
  social services, emergency care between primary
  care and acute sector), as well as NSF changes.

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• Anticipated change resulting from the impact of
  service redesign and local modernisation reviews
  (e.g. Keeping the Services Local.).
• Where significant service change or location is
  proposed, the SSDP may also act as a public
  consultation document.

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Approval Process and Wider Use.

• An SSDP should be approved by all relevant
  agencies/organisations at Board level including
  the SHA.
• An SSDP should be a live document to be amended
  and updated regularly in conjunction with
  relevant stakeholders and those required to
  approve development and capital investment.

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• In the case of batched schemes (even where phased
  developments are agreed or procurement relates to
  more than one PCT) SSDPs will inform the
  OJEC/tendering process.

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Funding Routes Primary Care Schemes.E.U.
Regulations January 2006

• Threshold Limits Supplies - 93,738
• Services - 93,738
• R D -
  144,371 Works - 3,611,319
• All totals exclusive of VAT
• (source www.ogc.gov.uk)

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• These are mandatory limits.
• This will widen the procurement into the full EU.
• If the above contacts for the supplies, services
  and works must be advertised in the Official
  Journal of the European Union (OJEU).
• This includes a timetable for the process.
• These details can be found on the DH website.

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ALTERNATIVE FUNDING ROUTES FOR PRIMARY CARE
DEVELOPMENTS

• Strategic Capital L/A s106 Agreements
• PCT Capital L/A Grant Funding
• P21 EU Funding
• 3PD ODPM
• PFI Other Potential
  Funders
• Lottery Funding
• Private Capital

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• Strategic Capital.
• This could be a direct grant from the DH or SHA
  for improvements to service the PC estate.
• PCT Capital.
• From PCT capital allocations again to improve
  services and the PCT estate.
• P21 - Procure 21.
• Can be used in both of the above, speeds up the
  procurement route from the 12 selected partners.

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• 3pd - 3rd Party Development.
• This is where a 3rd party developer enters into
  a deal with a GP or PCTs to build a new surgery
  and then lease it back to the GPs and the PCT.
• PFI - Private Finance Initiatives.
• This is usually for a larger development and
  would involve the EU procurement route in a
  structured framework approach.

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• Lottery Funding.
• This could be a joint venture with the L/A or
  other stakeholders who have access to lottery
  funding to provide capital.
• Private Capital.
• Where an individual sum for a new health
  facility is provided by a private benefactor.

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• L/A s106 Agreements.
• This is where the L/A and the Health Community
  enters into agreements with developers for health
  and social gain. This could result in land for
  development or a tariff being paid (new planning
  guidance).
• LA Grant Funding.
• Usually for a joint venture with the L/A, SBR 6,
  Regeneration Funding and Sport England to name a
  few. The LA are the key to this funding.

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• EU Funding.
• Again this could be a joint venture with the LA
  or other stakeholders who have access to EU
  funding.
• ODPM.
• This is John Prescotts office where funding for
  different projects could be available such as the
  Thames Gateway.

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• Sum Other Funding Routes.
• RDA - Regional Development Agency.
• Kings Fund.
• English Partnerships/English Heritage/
  Conservation Groups.

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Discussion and Questions
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Creating Infrastructure for the 21st Century
Strategic Service Development Planning 24th
March 2006
54
Our health, our care, our say
A new direction for community services
Introduction by the Prime Minister

• greater emphasis on prevention intervention
• meet public preference for as much treatment at
  or near home
• local government and NHS to work effectively in
  tandem
• need for partnership working across Government.

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Our health, our care, our say
Foreword by Health Secretary

• unprecedented investment in the NHS
• focussed first on hospitals and stabilising
  social care
• primary, community social care settings will
  now be the
• focus and lead to..
• ..significant changes to how patients access
  services and the
• way they are provided

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Our health, our care, our say
Executive Summary - four main points

• better prevention and earlier intervention

• more choice and a louder voice

• tackle inequalities and improve access to more
  local services

• more support for people with long-term needs.

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Our health, our care, our say
Executive Summary - achieved by

• practice-based commissioning (PbC)

• shifting resources onto prevention

• more care outside hospital, including in the
  home

• better joining-up of services locally

• encourage innovation

• allow different providers to compete.

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Our health, our care, our say
Ambition for community-based care

• more services outside hospital

• which will have impacts on the primary care
  estate
• need to undertake a primary care premises audit
  to support
• SSDP\ and assess existing capacity likely
  future need

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Our health, our care, our say
Better access to general practice

• open but full lists

• NHS Employers to discuss incentives with GPC

• consider Expanded Practice Allowance to support
  more
• services and better access for patients.

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Our health, our care, our say
Access to health services for offenders

• currently, the Prison Service is responsible for
  provision
• of health social care

• whilst some do now, from April 2006 all PCTs
  will have
• responsibility

• need to have modern primary care facilities.

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Our health, our care, our say
Support for people with longer term needs

• assistive technology to support and monitor home
  living

• build on Expert Patients Programme etc
  initiatives

• significant increase by 2012.

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Our health, our care, our say
Care closer to home

• PbC and patient choice pivotal for change to
  happen

• health and care delivered through
  new/re-designed service
• pathways

• E, N T, trauma and orthopaedics, dermatology,
  urology,
• gynaecology and general surgery will lead
  shift of hospital
• services.

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Our health, our care, our say
Better transport to access care closer to home

• PCTs and LAs to influence transport of the
  future..

• ..to reflect the needs of people accessing
  services moved
• from hospital to community settings

• and extend the patient transport costs
  reimbursement scheme
• for lower incomes

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Our health, our care, our say
Ensure reforms put people in control

• Choice, individual budgets, PbC, PbR

• forums representing patients and users eg., new
  Patient
• Public Investment resource centre

• merged Healthcare Commission and Commission for
  Social
• Care Inspection to be brought forward

• Patient Advice Liaison Service (PALS) to
  expand

• new, improved services in the Independent
  Complaints
• Advocacy Service.

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Our health, our care, our say
Support for service re-design

• comprehensive guidance on national commissioning
• of specialist service

• comprehensive guidance for joint commissioning
  of health
• social care

• need for strategic estate reconfiguration.

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Our health, our care, our say
Support develop Third Sector
and Social Enterprise

• 70 of social care provided by private sector

• however, considerable barriers to third sector
  provision of
• health services

• Third Sector Commissioning Task Force with
  representatives
• from health and social care, ODPM, HO, DfES
  and DH.

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Our health, our care, our say
Making sure change happens

• high quality information to help people choose
  access

• .. to guaranteed high quality services.

• .........through minimum standards set by merged
  General
• Social Care Council and Healthcare Commission.

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Our health, our care, our say
Conclusions

• White Paper sets challenging agenda for change

• services that do not need hospital setting to
  transfer

• past ambition based on rhetoric

• now have a written public service agreement.

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Our health, our care, our say
Conclusions (contd)

• whole health social care system to change
  through
• Patient-led NHS, PbC, PbR amended Tariff,
  services
• closer to home etc

• historic lack of focus to reconfigure acute
  sector estate,
• shift services and modernise primary,
  community social
• care estate
• key objective of seminars like today is to
  reinforce the need
• to analyse existing service pathways as part
  of SSDPs to.

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Our health, our care, our say
Conclusions (contd)

• strategically plan a health social care
  estate that best
• supports re-design of co-located services in
  closer-to-
• home facilities for which..

• .the new Strategic Health Asset Planning
  Evaluation
• (SHAPE) toolkit will greatly aid that process
  and
• ...support investment in the primary social
  care estate.

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Creating Infrastructure for the 21st Century
Strategic Service Development Planning LUNCH
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Creating Infrastructure for the 21st Century
Strategic Service Development Planning

• Achieving the Vision
• Linking SSDPs to LDPs Commissioning Plans
• Barbara Richardson
• Director
• Richardson Executive Solutions Ltd

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Credentials

• Client Partnerships for Health
• Two national pilots for creating collaborative
  and useful Strategic Service Development Plans
• Plymouth
• Barking Dagenham and Havering PCTs
• Active regular reviews of progress
• What went well
• What could have gone better
• Associated thoughts

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Keys to success

• Building partnerships through leadership
• Designing the right process
• Creating the environment for innovation
• The powerhouse existing strategic partnerships
• Linking with the LDP, the ISIP and the LSP

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A. Building partnerships through
leadershipPermission to lead

• Principal responsibility at director level
• Needs to be recognised as an objective in the
  performance assessment framework
• Visible outcomes
• Local authority as well as health
• Partnership takes time and application

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A. Building partnerships through leadershipFull
participation

• Patients
• Patient representative groups
• Clinicians complete cross-section
• GP practices
• PCTs
• Local authorities
• Acute trust

• Mental health
• Learning disability
• Voluntary organisations
• Ambulance services
• Private health and social care providers
• Strategic health authority
• Delivery mechanisms

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A. Building partnerships through
leadershipCollaborative gain

• Interdependence of aims
• Shared aims
• Organisational aims
• Time to explore what may (and may not) be
  achieved for each contributing group or
  organisation

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B. Designing the right processResponsibility and
authority

• PCT board? SPB? LSP? Strategic regeneration
  partnership?
• Project director
• Time
• Support from LSP members
• Project manager and project coordinators
• Project admin

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B. Designing the right processThe process

• Patient views
• Clinician views
• Base information regeneration, innovation,
  public health, major initiatives (eg new
  hospital), medical advances, IT opportunities
• Workshops
• Writing the SSDP
• Linking with the LDP and LSP

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B. Designing the right processPatient views

• National survey
• Local surveys health and local authority
• GP practice surveys
• CHI reports
• PALs view
• PPI view
• Canvassing current patients directly whats
  making a difference? What isnt?

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B. Designing the right process2. Clinicians
views

• Training days
• Direct approach to clinical teams
• In either case,
• Whats making a difference to the outcome of
  care?
• What isnt?
• Extend to local authority carers

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B. Designing the right process3. Base
information (1)

• National and local initiatives
• Local demographics
• Public health
• Joint commissioning strategies / plans
• Hospital development plans
• Local review documents, recovery or service
  development plans
• GP practice development plans
• Modernisation plans already in place
• Private health and social care provision locally

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B. Designing the right process3. Base
information (2)

• Regeneration important vehicle
• Innovation private sector and NHS
• Medical advances crystal ball gazing
• IT possibilities EPR by next Thursday!
• ALL presentations of the base information should
  have underlying question how do we think and
  do things differently?

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C. Creating the environment for
innovationCreative workshop

• The New World Workshop ten years away
• Purpose and outcomes
• Who to invite
• Designing the workshop the design team
• Communication
• Spreading the word

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C. Creating the environment for
innovationCreative workshop - invitees

• No more than 50 people in total, excluding
  facilitators
• Representative of all the participating
  organisations
• Representative of all the sectors of care
  (children, adults, older people, mental health,
  learning disability)
• Representative of all the types of care (urgent,
  unplanned, planned, long term)
• Representative of the patient/client base
• Representative of the private health and social
  care sector
• Representative of the delivery mechanisms
  workforce, estates facilities, IT, finance

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D. The powerhouse existing strategic
partnerships Service development workshops

• Review existing strategic partnerships
• Do they cover health and social care?
• Do they cover children, young adults, older
  people, mental health, learning disability?
• Do they consider urgent care, planned care and
  long term care?
• Do they have the support necessary to produce
• Workforce plan
• Facilities plan
• IT plan
• Finance plan
• Private healthcare provision plan?

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E. Linking with the LDP, the ISIP and the LSPThe
links

• With an adequate SSDP, the LDP can take financial
  decisions fully informed by detailed service
  needs
• With an adequate ten-year SSDP (rolled forward
  annually or biannually), the 3 5 year ISIP
  heads off in the right direction
• The holy grail fully synchronised planning and
  budget rounds

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E. Linking with the LDP, the ISIP and the LSPThe
programme

• So - its all in the programming!
• LDP Jan to Mar 07
• SSDP approved Nov/Dec 06 dont underestimate
  how long this takes
• SSDP drafted and costed Oct/Nov 06
• Care group SSDPs drafted by strategic partnership
  groups June Sept 06
• New World Workshop June 06
• NWW planning April June 06
• Invitations sent out for the NWW and service
  development workshops early April 06

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Achieving the Vision Linking SSDPs to LDPs
Commissioning Plans Conclusion

• Use the 80/20 rule over five years and prioritise
  for this year
• Go easy on yourselves this is a truly massive
  undertaking BUT
• You CAN do it!!

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Achieving the Vision Linking SSDPs to LDPs
Commissioning Plans

• Barbara.richardson_at_resl.me.uk

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Creating Infrastructure for the 21st Century
Strategic Service Development Planning 24th
March 2006
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Creating Infrastructure for the 21st Century
Strategic Service Development Planning Action
Planning Workshop
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The Plurality Agenda

• What practical steps would you take to ensure
  your SSDP provides plurality of provision?
• Would the service specification change if you
  expected a private provider?
• Would LIFT impact on plurality?
• If so, in what way?

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Partnership

• What local authority targets / objectives could
  be achieved through the health-led Strategic
  Service Development Plan?
• What success criteria for partnership would you
  include in Director for Strategic Partnerships
  performance assessment framework?
• How would you square the circle of LIFTco
  exclusivity for a development on a local
  authority-owned school site?

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Creating Infrastructure for the 21st Century
Strategic Service Development Planning Thank
you for attending