BARNSLEY METROPOLITAN BOROUGH COUNCIL Report … · Strategic Service Development Plan (SSDP) approving the document does not constitute a commitment to any of those schemes. A further

Revised ReportCab.30.7.2008/i 1.3

BARNSLEY METROPOLITAN BOROUGH COUNCIL

This matter is a Key Decision within the Council's definition and has beenincluded in the relevant Forward Plan

Report Reference No.

REPORT OF THE INTERIMEXECUTIVE DIRECTOR OF ADULTSOCIAL SERVICES!INTERIM DIRECTOR OF STRATEGY(PCT

LIFT PROJECT - STRATEGIC SERVICE DEVELOPMENT PLAN

Purpose of Report

1.1 To consider the content of the latest Strategic Service DevelopmentPlan (SSDP) and obtain approval to the plan in order to continuepartnership working and participation in the Barnsley StrategicPartnering Board (SPB) with Barnsley Primary Care Trust (PCT) andBarnsley Community Solutions (BCS) to deliver new projects throughthe LIFT initiative.

2. Recommendations

2.1 That the revised Strategic Service Development Plan isapproved.

3. Introduction/Background

3.1 Cabinet on 26th April 2006 approved an updated Strategic ServiceDevelopment Plan (SSDP) for the LIFT joint venture. This followedapproval to the first plan in 2002 and met the requirement that thisshould be reviewed on a regular basis in order to demonstrate anintegrated approach to service planning for the needs of the localcommunity.

3.2 The Barnsley Strategic Partnering Board (SPB) on 2nd June 2008formally agreed to adopt Version 6 of the latest Strategic ServiceDevelopment Plan and this is now attached for endorsement byBarnsley Metropolitan Borough Council. When considering the planregard should be had to the fact that the Strategic Partnering Board(SPB) is the forum where agreement on the local community's needsand requirements for local services and facilities to be provided bythe Barnsley LIFT are agreed and that the LIFTco (BarnsleyCommunity Solutions (BCS)) have the exclusive right to provide newor improved facilities and/or services commissioned by the Boardprovided that the proposals meet the requirements set out in theSSDP, are affordable to the budget holders affected anddemonstrate good value for money.

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3.3 The aim of the revised Strategic Service Development Plan is tooutline a vision of how the Strategic Partnering Board (SPB) will workwith providers of Health and Social Care and Barnsley CommunitySolutions to deliver a programme of new and improved primaryhealthcare and social care facilities in Barnsley. The revised planseeks to:

• Reflect and respond to changing population needs and servicegaps.

• Implement the key locality and community regeneration strategiesof Local Strategic Partnerships.

• Outline the key service strategies for primary Health Care andSocial Care.

• Outline the priorities for investment in services and estate requiredto support the key service strategies.

4. Proposal and Justification

4.1 The intention of a Strategic Service Development Plan (SSDP) is toset out a rolling ten year vision of expected need for services andillustrate the way in which potential providers could respond to thatdemand.

4.2 In response to the initial plan Barnsley Community Solutions (BCS)has completed three Primary Care Centres at Worsbrough,Thurnscoe and Goldthorpe in 2004 as the first tranche of LIFT andsince the updated plan was approved centres at Cudworth andGrimethorpe have been developed as the second tranche of LIFT.These centres attempt to reflect the vision of greater integration ofprimary care services enabling people to access Health and SocialCare services in their local communities in premises, which offer thenecessary capacity and standard required.

4.3 The latest plan incorporates the third Tranche of LIFT and whilst thishas still be agreed and signed off it currently comprises the followingschemes likely to start to open from mid 2010-

Hoyland (& Renaissance Hoyland).

The facility comprises a three GP Practice, Community HealthServices, Community Information Service, Community Library,Children and Family Services, Assessment and Care Management,Community Learning Kitchen and Pharmacy.

The Renaissance development includes the provision of a new Co-Op supermarket, flexible retail space, business incubation units anddemolition of the town hall and formation of a new town/marketsquare.

The Renaissance element of the development requires grant fundingto ensure financial viability. Barnsley Community Solutions (BCS) arecurrently working with Barnsley Development Agency (BDA) andYorkshire Forward (YF) regarding this (which supports this project inprinciple). Should the Renaissance element fail, the agreed fallbackposition is to construct the LIFT facility on the G&T's bar and FactoryShop site.

Darton

This scheme will provide a facility mainly for the Council incorporatingCommunity Information Services, Adult Social Services, a Children'sCentre, Community space and Community Health Services.Discussions are ongoing with a local Dentist regarding the provisionof dentistry from this centre.

Barnsley MBC has indicated that their preferred site is now theexisting Darton Council Offices site. A revised design is currentlybeing produced for this site.

Athersley/New Lodge

A three GP Practice, Community Health Centre and Pharmacy on theA61 site, opposite the existing retail centre in Athersley is planned.

Currently only GP and PCT services are to be offered from thisfacility. Further work is required to ascertain whether retail and/oradditional Community space (that the Council would like to seeprovided) could be incorporated in this scheme, perhaps initiallyfinished to 'shell' specification.

In line with this Berneslai Homes have approached BCS regardingthe provision of additional Community facilities (bungalows,enhanced public ream and/or sports facilities) on the public openspace to the rear of the proposed facility.

Great Houghton (NB. Scheme brought forward since latest planproduced).

A two GP Practice located on the site of the existing Health Centre isproposed.

4.4 As part of the overall process the creation of Joint Service Centres atCudworth, Hoyland and Darton either have (Cudworth) or areexpected (Hoyland and Darton) to attract significant PFI Credits of upto £11.4 million making the schemes more financially beneficial to theCouncil.

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4.5 The latest plan also identifies the following potential schemes forfuture tranches of LIFT -

Monk Bretton - Two General Practices

Town Centre - Potential development for General Practices and! orCouncil Services

Penistone - PCT Clinic and large Practice (NB. Previous plans forBMBC now overtaken by subsequent development of PenistoneTown Hall)

Brierley - 1 General Practice

Mapplewell - Health Centre with 1 General Practice and PCTServices.

Thurgoland - 1 Branch Surgery

(NB. Other developments have changed the previous plans forWombwell to a lower priority).

4.6 However, the advent of Practice Based Commissioning (PBC), therecent changes in primary care contracts and the development ofSelf Directed Support and Individual Budgets within Social Caremeans the environment is now changing.

4.7 As a consequence there may be a need for innovative proposals inthe future that deliver greater Value for Money (VFM).

5. Consideration of Alterative Approaches

5.1 Cabinet have the option to approve the revised Strategic ServiceDevelopment Plan (SSDP), propose amendments or reject it.

5.2 The revised Strategic Service Development Plan (SSDP) has beenadopted by the SPB and its further approval by the Cabinet is thepreferred option.

6. Local Area Implications

6.1 The Strategic Service Development Plan (SSDP) provides a strategicdevelopment programme and consultation with local stakeholders willbe key to fully developing specific proposals within the plan. Thenature of LIFT Centres as hubs for Health and Social Careimprovements will have significant positive impact on localcommunities.

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7. Compatibility with European Convention on Human Rights

7.1 There are no adverse impacts upon Convention rights arising fromthis report or from LIFT itself. However, it is expected that thescheme will have a beneficial impact, in a broader sense than limitedto the specific rights under the Convention, by contributing to animprovement in the quality of life of citizens served by developments.

8. Promoting Equality and Diversity and Social Inclusion

8.1 Social Inclusion will be promoted by the provision of improved localfacilities providing Community Health and Social Care. Furthermore,there is the prospect for facilities developed to be used for communitypurposes as an adjunct to their main use and Barnsley CommunitySolutions has a specific remit to contribute to CommunityDevelopment through its activities; provided the rate of return earnedby the Company exceeds certain thresholds, there is provision in theShareholders' Agreement for payment of sums into a CommunityFund.

9. Reduction of Crime and Disorder

9.1 In investigating the options set out in this report, the Council's dutiesunder Section 17 of the Crime and Disorder Act have beenconsidered.

10. Conservation of Biodiversity

10.1 This report does not have any implications for biodiversity.

11. Risk Management Issues including Health and Safety

11.1 The LIFT Project has a Risk Register, and additionally, from afinancial aspect there are also risks that will be managed on aproject-by-project basis.

12. Financial Implications

12.1 The Council does not become liable for any financial costs unless itspecifically signs up to particular developments, i.e. by completing aStage 1 New Project Proposal. Although some potential futureschemes are highlighted in the Development Programme of theStrategic Service Development Plan (SSDP) approving the documentdoes not constitute a commitment to any of those schemes. Afurther report to Cabinet would be needed for each development forwhich Council commitment was sought. There are therefore nofinancial implications for the Council as a result of approving thisStrategic Service Development Plan (SSDP).

13.. Consultations

13.1 Consultations on the content of the Strategic Service DevelopmentPlan (SSDP) have been carried out with:

a) The Chief Executiveb) The Executive Director, Finance and Propertyc) Interim Executive Director of Adult Social Services/Interim

Director of Strategy (PCI)d) Service Providerse) Barnsley Primary Care Trustf) Barnsley Community Solutions (the LIFT Company)g) Local Partnerships

14. Glossary

14.1 SSDP - Strategic Service Development PlanSPB - Barnsley Strategic Partnering BoardPCI - Barnsley Primary Care TrustBCS - Barnsley Community Solutions

15. List of Appendices

15.1 Appendix 1 - Revised Strategic Service Development Plan (SSDP)

16. Background Papers

16.1 Correspondence regarding the matter is held on the file in Property &Procurement*

* Contains exempt information - not available for inspection.

Officer Contact: Tel. No: Date:Peter Beckwith 01226 775601 18.7.08

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ANNEX A

LIFT PROJECT - STRATEGIC SERVICE DEVELOPMENT PLAN

(a) Financial Implications

The Executive Director, Finance and Property has been consulted onthe financial implications.

(b) Employee Implications

There are no employee implications arising directly from this report.

(c) Legal Implications

The recommendations of this report do not propose a significantchange to Council practices.

(d) Policy Implications

The recommendations of this report do not propose a major change toCouncil policies.

(e) Local Members

None.

(f) Health and Safety Considerations

None arising from this report.

(g) Property Implications

There are no property implications arising directly from this report.

(h) Implications for Other Services

These are contained in the revised Strategic Service DevelopmentPlan.

(i) Implications for Service Users

Working groups have been established since the outset of LIFT tocontinue to work to develop future programmes.

(j) Communications Implications

Presentations have previously taken place at Area Forum meetings; itis intended to continue this.

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APPENDIX I

BARNSLEY PCT/ BARNSLEY MBC

BARNSLEY STRATEGIC PARTNERING BOARD

STRATEGIC SERVICE DEVELOPMENT PLAN (SSDP)

UPDATE MAY 2008


CONTENTS

1 INTRODUCTION AND BACKGROUND

1.1 Overview

1.2 Aims of SSDP

2 THE BARNSLEY COMMUNITY PLAN

3 CONNECTION TO LIFT

4 CONTEXT FOR CHANGE

4.1 Vision and Principles

4.2 The Primary Care Model to Achieve the Vision

5 VISION AND PRINCIPLES FOR SERVICE PROVISION

5.1 Primary Care development

5.2 Service Strategies within the Partnership in Action

Framework____

5.3 Priorities for Development in Localities/BPCT provision

5.4 BMBC Developments

6 PROCESS

7 CONCLUSION

Appendix 1 - Significant improvements to date within Primary Careinfrastructure

_____

____Appendix 2 - Process

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INTRODUCTION AND BACKGROUND

While this revision of the SSDP replaces the previous version dated February2006 it should be noted that it does not replace all elements of the previousversion. For example, the vision of a fit for purpose modern estate based on ahub and spoke model remains a valid model that prospective providers may wishto emulate.

The intention of a Strategic Service Development Plan (SSDP) is to set out arolling ten year vision of expected need for services and illustrate the way inwhich potential providers could respond to that demand.

This should include elements that address:• New methods of service delivery based on consultation with users of the

service and providers• Anticipated changes to workforce• The role that buildings and facilities can play in service delivery• Information Technology• Anticipated advances in medical technology• The interaction between the desire to improve services and the constraints

in terms of financial regimes

In effect the outcome of producing an SSDP is that potential providers canpresent proposals that address future solutions to the challenges outlined in thePCT's Local Delivery Plans (LDP5), and the Council's Community Plan. Thisshould take into account the many challenges posed by local Health NeedsAssessments! the need to reduce health inequality and the demands on socialcare. Potential providers therefore will be clearly expected to illustrate both thecosts and potential benefits of service solutions.

Clearly however, the document concentrates on health and social careperspectives but within the well developed local partnership structures it alsoseeks to draw together the overall needs of the population, seeking synergywhere health and social needs align.

1.1 Overview

This SSDP will therefore outline the strategic commissioning intent of BarnsleyPCT1 and that of the Council! PCT2 through the Joint Agency Arrangement (JAG)and reflect the links between the commissioning intent within the Local DeliveryPlan3! Community Plan4.

Barnsley Primary Care Trust Commissioning IntentJAG Commissioning IntentBamsley Primary Care Trust Local Delivery Plan

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An SSDP is also expected to take account of the capital consequence of wholesystem thinking, building on the commissioning intent and the resultantrequirements from the following perspectives;

• NPfIT• Every Adult Matters (EAM)• Changing Workforce• Estate Strategy• Capacity Plan• Workiorce Plan• Joint Strategic Needs Assessment

The SSDP enables potential providers to develop outline business cases andinform commissioners of the likely capital consequences of the commissioningintent.

1.2 Aims of SSDP

The purpose of the SSDP is the production of a capital investment plan from awhole system perspective reflecting the plans and aspirations of potentialproviders through commitment of resources within the LDP/ Council processesand achieving genuine demonstrable engagement with Health, Local Authority,Social Services, and voluntary sector.

Progress to date has produces significant improvements to the physicalinfrastructure. However, any further developments need to clearly demonstratethat the SSDP constantly focuses on development of innovative solutions toenable new models of care services to be delivered in response to overallcommissioning intent.

2 THE BARNSLEY COMMUNITY PLAN

One Barnsley, the Borough's Local Strategic Partnership is a clear demonstrationof the commitment to engagement of all parties in the development of planswithin the Borough.

3 CONNECTION TO LIFT

The LIFT process, as required, is led by the Strategic Partnership Board (SPB),with voting members drawn from the BCS, the PCT, and the BMBC. The work ofthe SPB and the development of the SSDP is key to enabling the document to beused as a vehicle for strategic planning and enable Barnsley Community

Barnsley Community Plan

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BARNSLEY PCT/ BARNSLEY MBCSolutions (BCS) to propose innovative and cost effective estate solutions to theanticipated service and demand needs of the area.

While the contribution of BCS to date has been fundamental to the delivery ofimprovements in the physical infrastructure we have now reached a stage whereit is less likely that further major developments are required in the near future. Itis clear therefore that there are expectations of BCS that they independently seekassociated business beyond the scope of the SSDP. The process associatedwith this is of course a matter for the BCS business planning processes.

In this context it is important to consider wider connotations arising, fromcomplementary strategic statements, for example, the Community Plan. Thiswould highlight the need for innovative proposals that deliver the advantages ofthe commercial sector while reducing the traditional level of costs associated withhealth and social service provision. Any future buildings therefore would addressissues such as contribution to community regeneration, producing added value,and extended utilisation periods (retaining a balanced consideration of costrelative to benefits).

4 CONTEXT FOR CHANGE

The provision of quality primary care services remains central to the delivery ofreform within the NHS. The outcome of previous SSDP's has led to aconsiderable improvement in the health and social care estate (see Appendix 1).

The time has therefore arrived to reassess future requirements for furthersubstantial developments. The PCT will seek to establish the level of need withinPrimary Care and align any requirements identified to those arising from estatestrategies within the Local Authority and PCT provider arm.

An initial view of primary and social care development requirements seems tosuggest that there is minimal residual estate issues to address outside of currentplans.

This does not however mean that the improvements should stop - furtherconsideration of the strategic intent will inevitably lead to potential providersseeking to provide solutions either through LIFT, PFI or entirely independentmodels - the consequences of which need to be recognised within futureiterations of the LDP and Community Plan.

The previous SSDP was written within the context of an environment where thePCT/ Council deliberately adopted a role that supported primary and social carein developing its systems and infrastructure. However, with the advent ofPractice Based Commissioning (PBC), the recent changes in primary carecontracts and the development of Self-Directed Support and Individual Budgetswithin Social Care the PCT and Council are now moving toward a stance with

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BARNSLEY PCT/ BARNSLEY MBCdecreased emphasis on a supportive and developmental role. This is in line withthe application of outcome based commissioning principles and the increasingemphasis on the market management role of the commissioning organisations.

4.1 Vision and Principles

Reiterating the above the PCI and Council are seeking to deliver the visionthrough service redesign and significant secondary to primary shift. Clear driversfor this are Practice Based Commissioning (PBC) and the consequences of truechoice through Individual Budgets driving non institutionally based care provision.

This reinforces that the SSDP will be, at one level, a reiteration of theCommissioning Intent and that LIFT and other significant recent developments goa long way toward delivering potential solutions to enable secondary to primaryshift.

4.2 The Primary Care Model to Achieve the Vision

The expected future configuration of both health and social care services isexpanded upon within the Primary Care Strategy5 and further in Every Adult Matters(EAM)6.

This is replicated in the commissioning stance being adopted with secondary carecontractors and the commissioning plans being developed with Practice BasedCommissioners.

5 ACHIEVING THE VISION

The LDP addresses inequality in health and the Community Plan identifies therequirements of the wider community.

5.1 Primary Care Developments

The anticipated end product of the suite of documents and policies driving secondaryto primary shift is that Barnsley PCT will be able to provide locally accessible, patientcentred services, particularly via PBC.

Improvements within Primary Care premises may proceed through a variety ofroutes ranging from minor improvement grants through to replacement premises thatcould be delivered through BCS or third party development schemes.

5.2 Service Strategies within the Partnership in Action Framework

Barnsley Primary Care Trust Primary Care StrategyEvery Adult Matters

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This strategic response will be within the context of joint service delivery and thevehicle for delivery will be embodied within the service prospectus of respectiveclient groups.

5.3 Priorities for Development in Localities/BPCT provision

Similar considerations will form the response from PCT provider services in the formof the PCI estate strategy document.

5.4 BMBC developments

Similar considerations will form the response from local authority provider services inthe form of the local authority estate strategy document.

6 CURRENT PLANS & PROCESS

6.1 Current Pans

As referred to in section 4, Appendix 1 attached details significant improvements todate within the primary care infrastructure and lists proposed, future and previousdevelopments.

6.2 Process

The process whereby proposals against the Commissioning Intent would beconsidered is described at Appendix 2.

7 CONCLUSION

Unlike previous versions of the SSDP it is not envisaged that this document includesa list of specific estate development priorities for the Strategic Partnering Board'SPB) to consider but on the wider planning process and it will be the response(s) tothis document that will be prioritized within the LDP and Community Plan.

This will of course require a process of reviewing 'bids' for future funding alongside asystem for proactively seeking responses where this is indicated. Any proposals todevelop estate will be assessed against their potential to deliver the stated strategicobjectives of the partners.

This version of the SSDP needs to be seen within the context of a rapidly changinghealth and social care economy responding to a number of key policy drivers. It isunclear how policy, and agendas, around Choice, Every Adult Matters, and PracticeBased Commissioning will impact on premises solutions to service delivery.Similarly it is not within the remit of this document to fully address issues such asfuture lease holding and asset ownership in advance of potential structural changeswithin the PCT/ Council,

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APPENDIX 1

SIGNIFICANT IMPROVEMENTS TO DATE WITHIN PRIMARY CAREINFRASTRUCTURE

Priorities for Development in Localities were articulated in the previous SSDP(source document; SSDP2 final draft Feb 2006);

The following locations comprised the outcome of the health and social careprioritisation process:

NEW PROPOSALS

RANCHE 3 LIFT DEVELOPMENTS - CURRENT PLANI:

• Hoyland (Locality 1) - 3 Practices and POT! Council staff providing services to anarea of deprivation. Premises considered as extremely limited for purpose.Expressed need from all parties for new development.

• Athersley/ New Lodge (Locality 4) - Premises in an area of deprivation andunsuitable for modern health and social care services. 2 branch surgeries and POTstaff. Dr Balac and Partner for several years have wanted to pursue a Third PartyDevelopment in Athersley, with no immediate prospect of progress.

• Darton (Locality 2) - Premises in an area of deprivation and unsuitable for modernhealth and social care services Health Centre with 1 General Practice and POTservices

CommentHoyland and (closely followed by) Athersley were clear priorities suggested by theoutcome of the prioritisation process.

[POTENTIAL TRANCHES OF LIFT DEVELOPMENTSI:

• Great Houghton (Locality 5) - Premises in area of deprivation and unsuitable formodern health and social care services. 1 General Practice and limited POTservices. A more radical solution may be to examine potential for dedicated patienttransport service to nearby new Thu rnscoe Centre.

• Monk Bretton (Locality 4) The premises at Monk Bretton Health Centre is inreasonable condition. However, the space allocated by the existing landlord to thetwo General Practices who wish to move to new premises are extremely limited andunfit for purpose. Therefore, special consideration may need to be given to thispotential development.

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BARNSLEY PCT/ BARNSLEY MBC• Town Centre (Locality 3) - a potentially complex scenario, with the relative priorityfor a premises development varying in relation to the General Practices and! orCouncil services who express a wish to be located in a new development.

• Penistone (Locality 1) - PCI clinic and large Practice (Dr Brown and Partners).Practice premises are Ok and have had recent upgrades. PCT clinic is limited andwould be difficult to undertake cost effective upgrades.

• Brierley (Locality 4) - 1 General Practice. Premises are limited with little scope forfurther expansion / upgrading. Potential solution in future would be to centralizeservice provision from Grimethorpe.

• Mapplewell (Locality 2) - Health Centre with 1 General Practice and PCT services

• Thurgoiand (Locality 1) - 1 branch surgery.

Comment

Monk Bretton, Great Houghton and Town Centre formed a middle cluster, with theremaining areas lower on the priority scoring.

PREVIOUS DEVELOPMENTS

Below is a review of estate improvements, and existing commitments, in this area todate;

tIRANCHE A LIFT DEVELOPMENTS OPENED IN 2OO4/O5:

• Goldthorpe Centre - 'hub' complete for Council! PCT plus 'minihub' for PCT

. Worsbrough Centre - 'hub' complete for Council! PCT

Thurnscoe-' 'minihub' complete for PCI

tTRANCHE 2 LIFT DEVELOPMENTS IN PROGRESS:

• Cudworth Centre- 'hub' and 'minihub' for Council! PCI

• Grimethorpe Centre - 'hub' and 'minihub' for Council! PCI

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PROCESS

SSDP - informed byStrategicCommissioningIntents

Proposal to PCT/Council forconsideration

Agreed in principle

APPENDIX 2

Informs Potentialproviders business caseplanning and proposalformulation

Rejected

Specification (seeking evidence ofinnovation, wider partnership, etc)

Provider response

Revenueconsequences in LDP/Cnmmiinitv Plnn

Aligned tocapitalprogrammes

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