Programme Director June 2015 Change to structure of CLGs: now - - PowerPoint PPT Presentation

Caroline Taylor Programme Director June 2015

• Change to structure of CLGs: now working groups

looking at specific interventions / ideas; drawing in new specialists

• Implementation of work that does not require

consultation – e.g. Local Care Networks

• Options appraisal work starting – moving towards

possible consultation if needed

• Continuing financial modelling and testing of CLG key

interventions

• Publication of consolidated strategy June 2015
• Engagement with partners – providers, mental health
• Change to programme team: new Director/ structure

• Are the foundation of the Whole System Model, offering person

centred services to local populations

• Local Care Networks: going in to mobilisation phase, with

structure and details developed locally but working to an agreed set of criteria

• Each CCG is progressing with its own plans to progress the

target model through the 24 LCNs now established across SE London in line with the agreed characteristics of Community Based Care. Examples of ‘big hitter’ or high impact initiatives being or already implemented by individual CCGs have been collected and are being shared with their SE London colleagues to help expedite progress and achieve equitable and high quality services and outcomes across the whole population.

Delivery of community based care will be achieved through the platform of Local Care Networks (LCNs) in line with seven confirmed Characteristics of Care and an agreed Target Model:

• 1. More accessible primary and community care
• 2. Timely and prompt assessment
• 3. Enhanced health promotion and disease prevention
• 4. Proactive and empowering care
• 5. Seamless co-ordinated care
• 6. Multidisciplinary holistic care
• 7. Continuity of care professional

Characteristics of Community Based Care

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Serving geographically coherent populations between 50,000 – 150,000

The Community Based Care Target Model

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• Leadership team
• All general practices working at

scale (federated with single IT system and leadership)

• All community pharmacy
• Voluntary and community sector
• Community nursing for adults and

children

• Social care
• Community Mental Health Teams
• Community therapy
• Community based diagnostics
• Patient and carer engagement

groups

‘The Core’ (as a minimum all LCNs should encompass)

• Strong and confident communities
• Accessible HOT clinics and acute
• ncology (urgent and emergency and

cancer care)

• Specialist opinion (not face to face)

and clear specialist service pathways

• Pathways to MDTs
• Integrated 111, LAS and OOH system

(interface with UCCs co-located with ED model)

• Housing, education and other council

services

• Community based midwifery teams
• Private and voluntary sector e.g. care

homes and domiciliary care

• Cancer services
• Children’s integrated community team

and short stay units

• Rapid response services
• Carers
• And there will be others..

Working with…

• Asset mapping supporting enhanced

self management/care e.g. social prescribing

• Prevention – Obesity, Alcohol and

Smoking

• Improved Core general practice

access plus 8-8, 365

• Enhanced call and recall – improves

screening and early identification and management of LTCs

• Reduction in gap between recorded

and expected prevalence in LTC

• Supporting vulnerable people in the

community including those in care homes and domiciliary care

• Reduction in variation (level up)

primary care management of LTCs

• Reablement – Admissions avoidance

and effective discharge

• MDT configuration – main LTC groups

(incl. MH) and Frail elderly

• End of Life Care

Big hitters

Bexley Bromley Greenwich Lewisham Lambeth Southwark

Integrated Pathways of care Integrated Single System Leadership and Management

Primary and community care (defined in its broadest sense) will be provided at scale by 24 local care networks supporting whole populations across south east London. This will be a universal service covering the whole population ‘cradle to grave’. A local care network will involve primary, community and social care colleagues working together and drawing on others from across the health, social care and the voluntary sector to provide proactive patient centered

• care. Services will be delivered in ways that respond to the varied needs and characteristics of our communities.

Primary care working within LCN’s

GP Units & Community services GP Networks

Enablers supporting the transformation The Local Care Networks are the super enabler for integration of services IM&T, Commissioning Framework, Workforce, Estates

The transformation we are undertaking

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Local Care Networks are the foundation of the whole system model providing person centred services to populations. Community Based Care will be delivered through the platform of Local Care Networks.

Core elements of the current LCN proposition:

Transformational - The integration of care across the full range of provision focused upon local populations and the outcomes they achieve – Asking everyone to change - Multi-agency LCN leadership teams with autonomy to act together for that population according to the outcomes they have been collectively commissioned for. Population focused - Geographically coherent, serving natural communities, planned against a deep understanding of that population’s need, focused on prevention and inequalities Integrated – Networks will include ALL general practices in the locality, working ‘at scale’, providing the basis for integration between wider primary, social, community and mental health services (utilising the registered lists of that locality’s practices) Placed based – Effective LCNs will focus on individual patients and the populations they make up; they will utilise community assets, harness the capacity of the non-registered workforce and include community groups and local people General practice - working together at scale and with greater resilience to reduce variation and improve quality, with an enhanced ability to work with others to provide a wider range of community based services Scale – LCNs provide the ‘building blocks’ for integrated delivery with the ability to be considered separately or together at the ‘right’ scale to make best use of specialist expertise

Enablers supporting the transformation The Local Care Networks are the super enabler for integration of services IM&T, Commissioning Framework, Workforce, Estates

• 8. The Local Care Network Proposition (1/2)

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Key Activities

August September July June October November December

Impact analysis Develop evaluation criteria Option development and appraisal Supporting Strategies Consolidated strategy CLG implementation plans Ongoing engagement Business case development Business case Assurance

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Spring/ Summer 2015:

• Further work on the whole system model and the models of care
• Modelling expected impacts for providers and commissioners
• Further development of the supporting strategies
• Testing refreshed CCG Operating Plans against the strategy to ensure that there is consistency

between the short and longer term plans

• Engaging with Health and Wellbeing Boards and other key meetings for review and input
• Further wide engagement through pop ups and other events. These will be borough based and use

the Issues Paper and specifically developed materials such as case studies which are being tested with Engagement leads and PPAG.

Summer 2015 – mid 2016

• Development of options and criteria to assess options for implementation
• Modelling to support option appraisal
• Business case development
• Consultation, if required
• Continuing implementation of elements not requiring consultation, such as the development of the

local care networks, community based care and improved clinical pathways

Caroline Taylor Programme Director June 2015

Main focus of engagement between May – July is around the Issues Paper

• Engagement materials developed for CCGs to use

locally – at ‘pop ups’ and other events

• Individual CCG engagement plans developed –

associated gap analysis under constant review

• Six deliberative events to be held, focussing on the

questions within the Issues Paper

• Equality - Going out to tender to deliver an equalities

analysis summer 2015

• Further work to develop mechanisms for engagement
• n the options evaluation criteria

• Working closely in partnership with CCG communications and

engagement leads and the programme’s Patient and Public Advisory Group to develop plans and materials.

• Please see flipchart paper for programme timeline and associated

communications and engagement milestones

• CCG Engagement plans – Phase 2 Issues Paper engagement as Appendix

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• Currently there is inconsistency in targeting staff and GP members
• Gaps in information giving and engagement groups representing:
• Mental Health Groups (in outer London boroughs)
• Substance misuse (plans in development – not confirmed)
• Gypsy/ traveller communities (plans in development – not confirmed)
• LGBT and transgender groups (plans in development – not confirmed)