Bracknell and Ascot, Slough and Windsor Ascot and ... · Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 To include: Delivery of the four hour standards Ambulance response times Implementation of the A and

Bracknell and Ascot, Slough and Windsor Ascot and Maidenhead

CCGs

Operating Plan 2017/18 – 2018/19

Version Control

Version Date Changes Author/ By

1.0 16/09/16 Creation of structure Viki Wadd

1.1 28/09/16 Review of structure following publication of the Planning Guidance

Viki Wadd

1.2 29/09/16 Addition of risk section and insertion of logic model to describe programmes following AO session following Right Care evaluation documentation

Viki Wadd

Operating Plan Structure 2017/18 – 2018/19

Lead Director

Lead Manager

Contents Page FSB VW

1. Exec Summary

FSB VW

2. Introduction and overview

Our vision

Ambition under the IAF

Op plan to support delivery of the 5YFV, drive improvements in healthcare, restore financial balance, deliver core access and quality standards

Underpinned by the Right Care approach

Working together as 3 CCGS

2 year contracts, tariff, CQUINs and Quality Premium

New models of care – timelines, implications for contracts

New Vision of Care principles

New roles in primary care and specialised commissioning

Key must dos

FSB VW

3. The CCGs working as part of a system

STP o Op planning and contractual process to support delivery of

the STP o Control total o STP as route map o Infographic of how the OP Plan supports delivery of the

STP o Partnership behaviours the new norm o Do what is right for patients, communities and the

taxpayer o System change – investment in preventative, primary and

community care

Plan on a Page

System resilience

System leadership

Move to integration

FSB FSB FSB FSB FSB

VW VW RW VW MP

4. Challenges ahead

Financial context

Working differently as part of a system

Increasingly frail population

Social care/ UA financial challenges

NF FSB FSB FSB NF

DF VW VW VW DF

5. Key outcome measures

Achievement of constitutional standards

Programme outcomes

Increase in patient (and staff? Satisfaction)

NF FSB SB

CS Prog Leads tbc

6. What will be different in two years time?

FSB VW

7. Our strategic priorities

FSB VW

8. How we developed our vision and priorities

Feedback on patient experience

Right Care

Five year forward view

Alignment to STP

Clinical engagement

Patient public engagement

SB FSB FSB FSB FSB SB

Tbc VW VW VW Prog Leads TBC

9. Our Operating Plan in the context of the STP and Five Year Forward View

Infographic

FSB Comms/ VW

10. Our Transformation Programmes

12.1 Primary care To be structured under following headings, following NHS Right Care Logic Model (see attached guidance for completing)

Inputs Activities Outputs Outcomes

Milestones/ Deliverables

2017/18 2018/19

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

To include:

Cover all areas of Annex 6 of Planning Guidance

Sustainability of general practice, 10 impact changes and practice transformational support

Plans to ensure local investments meets of exceeds minimum required levels

Tackling worforce and worksload issues

Extend and improve access in line with requirements

Support general practice at scale

Enable primary care to plat its part in the forthcoming framework for improving health in care homes

Please refer to requirement for trajectories in Annex E of Planning Guidance (p20 onwards)

FSB AT

12.2 Urgent and emergency care To be structured under following headings, following NHS Right Care Logic Model (see attached guidance for completing)

Inputs Activities Outputs Outcomes

Milestones/ Deliverables

2017/18 2018/19

FSB RW

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

To include:

Delivery of the four hour standards

Ambulance response times

Implementation of the A and E Improvement Plan

Meet the four priority standards for 7-day hospital services for urgent network specialist services

Implement the Urgent and Emergency Care Review

Reduction in the proportion of 999 calls that result in avoidable transportation to A and E

Forthcoming waiting time standard for urgent care for those in a mental health crisis

Compliance of NICE guidelines on hospital discharge

Mandatory data sharing agreements for urgent and emergency care providers

Please refer to requirement for trajectories in Annex E of Planning Guidance (p20 onwards)

12.3 Integrated care To be structured under following headings, following NHS Right Care Logic Model (see attached guidance for completing)

Inputs Activities Outputs Outcomes

Milestones/ Deliverables

2017/18 2018/19

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

To include:

Personal health budgets

Improvement plans to halve the number of children waiting 18 weeks for wheelchairs

Continued pooling of budgets and integrated spending plans for BCFs

Speedier assessments for patients and CHC

Mainstreaming the delivery model for NHS Continuing Care and Continuing Care for children

Please refer to requirement for trajectories in Annex E of Planning Guidance (p20 onwards)

FSB FSB FSB

MP LC LC

12.4 Mental Health, Learning Disability and/ or Autism To be structured under following headings, following NHS Right Care Logic Model (see attached guidance for completing)

Inputs Activities Outputs Outcomes

Milestones/ Deliverables

2017/18 2018/19

FSB NB

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

To include

Cover all areas of Annex 8 of Planning guidance

Additional psychological therapies

Evidence based mental health services for children and young people

Expanding capacity for psychosis treatment

Increase access to individual placement support for those with a severe mental illness

Community eating disorder teams

Reduce suicide rates

Delivery of mental health access and quality standards – community crisis resolution teams, home treatment teams and mental health liaison in acute hospitals

Delivery of the mental health investment standard

Dementia diagnosis rates

Post-diagnostic care and support

Eliminate out of areas placements for non-specialist acute care for mental health

Deliver Transforming Care partnership Plans

Reduce inpatient bed capacity for learning disability

Improve access to healthcare for people with a learning disability and access to annual health checks

Improve aceess to health services, education and training of staff and making necessary reasonable adjustments for people with a learning disability/ autism

Please refer to requirement for trajectories in Annex E of Planning Guidance (p20 onwards)

12.5 Childrens and Maternity To be structured under following headings, following NHS Right Care Logic Model (see attached guidance for completing)

Inputs Activities Outputs Outcomes

Milestones/ Deliverables

2017/18 2018/19

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

To include:

Implementation of Better Births Please refer to requirement for trajectories in Annex E of Planning Guidance (p20 onwards)

FSB NB

12.6 Planned Care To be structured under following headings, following NHS Right Care Logic Model (see attached guidance for completing)

FSB SS

Inputs Activities Outputs Outcomes

Milestones/ Deliverables

2017/18 2018/19

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

To include:

RTT

Patient choice of first outpatient appointment

100% use of e-referrals

Outpatient re-design and unnecessary follow ups

To cover all aspects of Annex 7 of Planning Guidance (Cancer)

Implement the cancer taskforce report

62 day cancer standard and other cancer standards, including diagnostic capacity

Improving one year survival rates from cancer

Improvement in the proportion of cancers diagnosed at stage 1 and 2

Reducing the proportion of cancers diagnosed following an emergency admission

Follow up pathways for breast cancer and roll out for other cancer types

All elemnets of the cancer recovery package are commissioned

Plans to tackle obesity and diabetes via National Diabetes Prevention Programme

Potential for investment into care and support for those who already have diabetes

Transmission of clinic letters to GPs ( 10 days from April 2017 and 7 days from April 2018)

Mandates use of ERS from April 2017

Changes to outpatient tariff Please refer to requirement for trajectories in Annex E of Planning Guidance (p20 onwards)

12.7 Specialised Care To be structured under following headings, following NHS Right Care Logic Model (see attached guidance for completing)

Inputs Activities Outputs Outcomes

Milestones/ Deliverables

2017/18 2018/19

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

To include:

Impact of reviews in 2017/18

New specialised services framework

FSB RW

Specialised co- commissioning incentive scheme Please refer to requirement for trajectories in Annex E of Planning Guidance (p20 onwards)

12.8 Medicines optimisation To be structured under following headings, following NHS Right Care Logic Model (see attached guidance for completing)

Inputs Activities Outputs Outcomes

Milestones/ Deliverables

2017/18 2018/19

Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

To include:

Multi-year medicines optimisation approach

Reforms to medical device chain, high cost drugs reimbursement Please refer to requirement for trajectories in Annex E of Planning Guidance (p20 onwards)

SB CK

11. Planning/ FYFV requirements To be added after 20/9/16

FSB VW

12. Commissioning for Quality

Strategy

Patient experience

Concerns

Risks

Safeguarding

CQUINS

Quality Premium

SB JG

13. Financial overview

Allocations

Forecast position

QIPP

STP financial context

NF DF

14. Enabling programme/ strategies –

Digital o New data security standards (April 17) o New interoperability requirements for clinical IT systems

(January 2019)

Workforce

Estate

Mark Sellman TBC TBC

15. Innovation and Learning

NHS Innovation Accelerator

Innovation and Technology Tariff

FSB VW

16. Implementing the Plan

Governance o How we will monitor delivery of the plan

Contracting o How contracts will be used to support delivery, including

the independent sector

OD o How we will set ourselves up to deliver the plan

NF NF FSB

AV AW VW

17. Risks and mitigations FSB VW

18. Glossary FSB VW

Appendix 1 – 2016/17 Performance

NF CS

Appendix 2 – 2016/17 QIPP Delivery

NF DF

Appendix 3 – 2017/18 – 18/19 – QIPP Plan by Programme

NF DF

Guidance on developing Logic Model (Taken from NHS Right Care Evaluation Plans)

1.1 Developing the logic model A logic model is a graphic display or map of the relationship between a programme’s resources, activities and intended results, which also identifies the programme’s underlying theory and assumptions. In many ways the material for generating logic models is an intrinsic part of NHS planning practice. What makes a logic model useful is to be able to communicate internally and to an assurance function, that there is a consistent theory of change. There are four elements required for the logic model, to specify the inputs, activities, outputs and outcomes/impact.

2 The logic model 2.1 Developing the logic model

A logic model is a graphic display or map of the relationship between a programme’s resources, activities and intended results, which also identifies the programme’s underlying theory and assumptions. In many ways the material for generating logic models is an intrinsic part of NHS planning practice. What makes a logic model useful is to be able to communicate internally and to an assurance function, that there is a consistent theory of change. There are four elements required for the logic model, to specify the inputs, activities, outputs and outcomes/impact.

Input Activity Output Outcome

What is being invested e.g. money, skills,

people

What activities are being undertaken?

What is produced as a result of

those activities?

Short and

medium term results

For more information

The Magenta Book: Guidance for evaluation https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/22 0542/magenta_book_combined.pdf

Logic Model briefing from Midlands and Lancashire CSU http://midlandsandlancashirecsu.nhs.uk/news-insight/case- studies/publications/publications/52-logic-model-guide/file

It’s not necessary to create your logic model all in one sitting. It will almost certainly be useful to talk to other programme stakeholders and get their input along the way. 2.2 Suggested approach for developing your logic model

Below we have outlined an approach that starts with the outcomes and works backwards.

I. Describe the concept of what you are doing In the narrative part of the logic model template, CCGs will describe the concept of the work that they are undertaking for the programme of care. Key questions to consider include:

What are the objectives of the intervention?

Why is work being undertaken in this programme of care?

What is the aspiration that the CCG is hoping to achieve?

II. Identify the outcomes you expect to achieve CCGs are asked to describe outcomes in at least two dimensions, financial expenditure and health gain. CCGs are welcome to describe other outcome dimensions as well. Add a box in the outcome section for each outcome that is defined. Key questions to consider:

In terms of financial and health gain outcomes, what is the intervention

looking to achieve in the short to mid-term?

Do these outcomes align with other health system work contained in the Sustainability and Transformation Plan?

III. Identify the activities that are part of the intervention Describe the activities that will directly result as a result of the intervention, i.e. a new Home Oxygen Service is developed or remote monitoring of Chronic Obstructive Pulmonary Disease (COPD) symptoms to allow better allocation of District nursing resources. Create a box on the logic model for each of these activities.

IV. Identify the outputs you expect to achieve There will be emerging measurable outputs as a result of the activities. These may include counting the number of patients that use a new service or reduction in service use as a result of the action. Create a box on the logic model that represents the output of each activity that is being undertaken. These outputs will be further developed in the measurement framework.

V. Identify the inputs

This step involves being specific as possible about the elements you need in order to undertake your activities. Add text to the input box. Think about for example:

What are the resources invested?

What staff are required?

Who are the stakeholders?

East Berkshire CCGs Operating Plan Development 2017/19 – outline timetable

What When Exec Lead Lead Manager

Outline timetable drafted and circulated to SMT

31 August Fiona Viki

Design principles agreed including

Clear delineation of core (3 CCGs) and local (individual CCGs)

Section numbering

Version control

5 year context; 2 year plan

Focus on quantified outcomes

2 September Fiona Viki

Framework for plan(s) agreed

Sections and structure defined

Owners assigned; drafting starts

9 September Fiona Viki

Digest of horizon scanning and benchmarking (CSU)

16 September Fiona Viki

Baseline established for the financial plan incorporating latest forecast outturn

20 September Nigel Debbie

Planning Guidance issued 22/23 September NHS England

Planning/ QIPP development workshop

20 September Fiona Viki

Guidance highlights circulated 23 September Fiona Viki

Collation of Member and patient inputs

From all sources

Listed and described

23 September Sarah Viki/Ally

First draft content as bullet points

28 September Fiona Viki

Discussion of bullet point draft at SMT

29 September Fiona Viki

Paper to GBs on Commissioning intentions, Planning guidance (pending publication date) including process for Operating plan development.

4, 5 and 12 October

Fiona Viki

Headlines from planning guidance and process to Member practice meetings

5, 13, 20 Oct Fiona Viki

Initial QIPP list produced 10th October Fiona Debbie, Strategy & Ops team + Annette

QIPP Business cases 17/18 considered and approved

20 October/17

November Business Planning and Development Committee

Fiona/Nigel Viki/Annette

First submission by section owners of full text

21 October Fiona Viki/Section Owners

Agreed financial templates agreed with Ops Team

28 October Nigel Debbie/Programme Leads

Editorial review and iteration of full text

4 November Fiona Viki

Finance section draft complete 9 November Nigel Debbie

Presentation to Healthwatch on headlines

8, 16 November Sarah/Fiona Viki/ Comms Team

Draft to Joint Governing Body 16 November Fiona Viki

Plan on a page produced 20 November Sarah Ally

First cut plan submission to NHSE

24 November Fiona Viki

Initial feedback and KLOE ratings

[9 December] Fiona Viki

Final draft Presentation to member meetings

24 November, 7 December

Execs Viki

Update to Governing Bodies

Approval to make final updates and submit

6, 7 and 14 December

Fiona Viki

Final review of document 21 December Fiona Ally

Final submission 23 December Fiona Viki