East Anglia area team Staff development session Sheila Bremner East Anglia Area Director Adrian Marr Director of Finance.

East Anglia area teamStaff development session

Sheila Bremner

East Anglia Area Director

Adrian Marr

Director of Finance

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Purpose of the session

• To provide an update on latest national policy and to consider what this means for our roles

• To provide an update on local development of the NHSCB East Anglia office

• To provide an opportunity to reflect on the past and look forward to the future

• To wish you a HAPPY CHRISTMAS!

What’s new

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• From Secretary of State for Health to NHSCB

• Outlines expectations of NHSCB for the next two years

• Underpinned by NHS Constitution • Outcomes approach based around the

five domains of the NHS Outcomes Framework

• Based on NHSCB supporting local autonomy of Clinical Commissioning Groups, Health and Wellbeing Board and local providers.

How will we deliver

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Patient-centred, customer focused

The planning guidance addresses two key challenges:

Guaranteeing no community is left behind or disadvantaged – focusing on reducing health inequalities and advancing equality in its drive to improve outcomes for patients; and

Treating patients respectfully as customers and putting their interests first – transforming the service offer of the NHS to take control and make more informed choices.

Everyone Counts: 4 inter-related sections

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Context 5 offers from Board 3 lenses to view planning &

delivery

Improving outcomes & quality NHS Outcomes Framework NHS Constitution Financial Control QIPP

Tools & levers NHS Standard Contract Quality Premium CQUIN Financial / business rules

Planning timetable Who needs to do what by

when Supporting Area Director

assurance of plans

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Five offers from the Board

NHS services, seven days a week

More transparency, more choice

Listening to patients and increasing their participation

Better data, informed commissioning, driving improved outcomes

Higher standards, safer care

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The three lenses

There are three inter-related lenses through which planning can be viewed:

Local area based planning;

Clinical commissioning group organisational planning; and

Direct commissioning by the NHS Commissioning Board

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A patient centred approach

Area:

CCGs and the Board (through Area Teams) as key partners on the Health & Wellbeing Board

Board is well placed to provide information and support to determine local priorities based on local need

But we won’t performance manage the outcomes of these discussions nationally – we will be a strong player (with CCGs)

Viewed through three lenses:

The CCG:

As well as local priorities, each CCG asked to deliver its statutory responsibilities around quality improvement (ie delivery of the NHS Outcomes Framework and NHS Constitution) within financial allocations

Assured by the Area Team

Clinically led and locally responsive

Direct Commissioning:

How the Board ensures the best return for patients from its £26 billion of commissioning

Primary and dental care, optical services

Specialised services

Some public health services

Offender health

Veterans’ health

Key role for the Board’s Area Teams to secure the best outcomes for patients through each of the lenses

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Planning to meet responsibilities

Each clinical commissioning group will need to satisfy itself that it is maintaining its statutory duties to improve quality of services by:

reducing inequalities;

obtaining appropriate professional advice;

ensuring public involvement;

meeting financial duties; and

taking account of the local Joint Health and Wellbeing Strategy.

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Improving outcomes, reducing inequalities: our responsibilities

To support clinical commissioning groups and our own commissioning to improve outcomes.

We have identified a number of outcome and delivery measures that commissioners can use.

This approach is informed by the mandate that asks us to oversee improvements against:

NHS Outcomes Framework;

maintaining the right and pledges under the NHS constitution within allocated resources; and

with a view to meeting the QIPP challenge.

• Improving outcomes unites us as commissioners:

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NHS Outcomes Framework

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Patients rights: the NHS Constitution

We expect the rights and pledges from the NHS Constitution 2013/14 (subject to current consultation) including the thresholds the NHS Commissioning Board will take when assessing organisational delivery.

The delivery of NHS Constitution rights and pledges on waiting times will be taken into account in determining Quality Premium payments for clinical commissioning groups.

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Planning to improve outcomes

• Eliminating long waiting times – zero tolerance on 52+ week waits

• Urgent & emergency care – better turnaround times for ambulances

• Reducing cancellations – penalties in contract

• Mental health – completion of improving access to psychological therapies (IAPT) rollout

QIPP

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Clinical commissioning groups must take ownership of local plans.

Cost improvements in providers must have explicit clinical agreement from the Trust’s Medical and Nursing Directors.

Area Directors must be active in overseeing clinical commissioning group agreement to cost improvements.

We must use all the tools available to us: National Quality Dashboard, NHS Safety Thermometer, staff and patient views – and act quickly where there is doubt.

Quality and patients’ safety must not be compromised as we seek out efficiencies.

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Tools and levers to support commissioning

To secure better outcomes for patients we will provide a number of financial and related levers that commissioners can use in their overarching strategies:

the NHS Standard Contract;

Quality Premium;

Commissioning for quality and innovation (CQUIN); and

Financial and business rules.

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Planning and assurance

We will support clinical commissioning groups to ensure that every plan is as strong as it can be.

The approach aims to:

strike a balance between local determination and priorities; and

to ensure that statutory requirements around improving quality and financial duties are being met.

No specific targets are being set for improvement of those indicators contained in the NHS Outcomes Framework, other than a defined level of reduction in Clostridium difficile infections.

Next Steps

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First cut of clinical commissioning group plans in January Iterative discussion between clinical commissioning groups

and Area Teams Area Directors are the Board – to lead the planning process

locally and provide definitive advice to clinical commissioning groups

Final plans by end of March 2013 CCGs to publish Prospectus for local population by end of May

2013 Annual assurance cycle

QUESTIONS?

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Local update

What’s new – all leadership appointments in place

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• Sheila Bremner – Local Area Director

• Margaret Berry – Director of Nursing

• Tracy Dowling – Director of Operations and Delivery

• Sallie Mills Lewis – Director of Commissioning

• Adrian Marr – Director of Finance

• Susan Stewart – Medical Director

• Sarah Jane Relf – Interim Director of Transition and Development

Recruitment update

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• Structures finalised – 144 posts in total

• First stages of restricted recruitment completed by 21 December

• 80+ offers made

• Appointments letters to be issued as soon as possible

• Moving to open recruitment after Christmas for any unfilled posts – preference will still be given to those at risk within the system

• Support programmes for staff that have not secured positions at this stage

Key appointments – some highlights

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Medical • Assistant Director of Revalidation – Sarah Rann and Mark Sanderson• Network and Senate Director – Ruth Ashmore

Nursing• Assistant Director Quality & Safety – Birte Harlev-Lam• Assistant Director Patient Experience – Mavis Spencer

Finance• Head of Finance – Ann Hogarth• Assistant Head of Finance Corporate – Mike Pym• Assistant Head of Finance CCG Assurance – Rachel Pilsworth• Head of Finance (Specialised) – Justine Stalker Booth

Key appointments – some highlights

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Operations and Delivery• Head of Assurance and Delivery – David Matthews

Commissioning• Head of Primary Care – Andrea Patman• Head of Public Health – Tracy Cogan• Head of Offender Health – Rob Jayne• Head of Specialised Commissioning – Carole Theobald

Estates and IT update

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• Main base at CPC1 at Fulbourn

• Satellite hot desk “outposts” – ten desks in the following locations:

• Suffolk – Rushbrook House• Norfolk – Lakeside• Essex – Collingwood Road, Witham

• Development session in January to design the “guidelines” for use of the outposts.

• IT “vision” for the NHSCB is for all staff to have up to date IT hardware that enables you work from home and to set up base in any NHSCB premises.

CCG authorisation update

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• All site visits completed – nationally and locally• Great Yarmouth and Waveney CCG authorised with no conditions

Moving forward

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• Recruitment processes to continue after Christmas

• New Year planning session for Directors and Assistant Directors to map the transition of functions and staff to the NHSCB

• Finalising the office infrastructure

• Team “away days” for each new function

• Induction sessions for staff

QUESTIONS?

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CELEBRATING THE PAST AND MOVING FORWARD TO THE FUTURE

What are you most proud of in your current role?

What would you like to take forward to the new world?

What would you like to leave behind?

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[email protected]

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HAPPY CHRISTMAS