Liverpool has the lowest life expectancy in England

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What is the challenge?

• Liverpool has the lowest life expectancy in
  England
• Over 25 of people suffer from a long term
  illness
• High levels of alcohol misuse
• High incidence of deaths from cancer heart
  disease

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The Strategic Plan

• An ambitious plan focused on delivery - we will
  make a difference
• A plan for NHS Liverpool partners
• Getting the people of Liverpool on board
• Joining up all drivers - NHS targets, frameworks,
  policies and guidance
• Tailored to the needs of Liverpool people at
  neighbourhood level

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Emphasis in the Strategic Plan

• Importance of Partnerships
• Improving Health
• Improving Services
• Continuous Improvement
• Developing the Workforce
• Research and Development
• Making Decisions

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Ambitions of the Plan

• Making a Difference
• Better Understanding of Self Care
• Gold Standard Primary Care
• Gold Standard Hospitals
• End of Life Services
• Personalised Care
• End Waiting
• Joined Up Services

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Making a Difference

• Cutting Deaths from Cardiovascular Disease
• Cutting Deaths from Accidents
• Cutting Deaths from Cancer
• Improving Health and Well Being of Children
• Knowing about Self Care
• Knowing about Health Services
• Availability of NHS Dentistry
• Reduce admissions due to alcohol misuse

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Cross Cutting Themes

• Smoking/Exercise/Diet/Alcohol
• Effectiveness of Primary Care Intervention
• Impact of Secondary/Tertiary Interventions
• Self Care
• Moving to Wanless Fully Engaged scenario
• Supporting people at home in the community
• Reducing unnecessary admissions
• Enabling timely discharge

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Connections

• Comprehensive Spending Review
• Public service Agreements
• Local Area Agreements
• National Indicators
• Vital Signs
• NHS Operating Framework
• PCT Operational Plan

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A New Health Service for LiverpoolThe Outside
of Hospital Strategy
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Outside of Hospital Programme

• Over the next 4 to 7 years, there will be an
  increasing range and volume of healthcare
  services provided outside of hospitals in more
  local community settings.
• Sustainable primary care infrastructure
• Shifting care out of hospitals where appropriate
• New generation of community facilities
• But what about the patients?

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The Start of the Debate

• Future Healthcare Programme
• Model of Care
• Primary Care Vision
• Achieving World Class Health
• Our Health, Our Care, Our Say
• The Big Health Debate

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Big Health Debate Priorities

• Access
• Access to tests (bloods, x-ray, minor surgery) in
  community settings rather than in hospital
• A GP appointment at a convenient time, including
  at week ends
• Making GP appointment systems simpler
• Services in locations that are accessible by
  public transport
• Better quality premises that are open longer
  hours
• Better information on alternatives to going to
  Accident Emergency
•  
• Bringing services together
• Placing certain health and care services together
  in the same location
• A range of services tailored to the needs of
  local communities
• Personal care based on the needs of the
  individual
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• Staying healthy
• Tackling and reducing health inequalities by some
  targeting to areas of greater ill health
• Supporting children to get and stay healthy
• Helping people to stay healthy with a specific
  priority to tackle issues caused by alcohol

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Big Health Debate Trade-Offs
Sometimes see a different GP from their own in
order to get a more convenient appointment Consid
er, with sufficient information, whether they
could get the treatment they require somewhere
other than Accident Emergency Accept some GP
practices moving together into better, larger
premises so that a larger range of services can
be provided Travel a little further to their
nearest GP practice Attend hospital less
for tests they could access locally
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Exploring the Issues

• Access in Liverpool
• Making the Best Use of Facilities
• Testing Public Preferences
• Quantifying Trade-Offs
• Considering Needs and Opportunities

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Comparison with Current Position
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Accessibility
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Flexible Capacity Modelling

• Schedules of Accommodation
• Level 1 2
• Generic Spaces
• Flexible Utilisation
• Linked to Activity
• Consultations
• Various Interventions
• Diagnostics
• Linked to Capital Costs
• CAPEX
• Annual Lease Plus
• Other Running Costs

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Efficiency
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Condition Survey

• Physical Condition
• Functional Suitability
• Space Utilisation
• Statutory Requirements

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Sample Distribution

• Sample 602
• Frequent Users
• City wide

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Relative Importance
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Current
Current Comparison of Clusters with
current facilities
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Needs
Needs Comparison of clusters with Health Need
indicators
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PBC
PBC Comparison of Clusters with Practice Based
Commissioning
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Levels of Care
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Hubs and Spokes
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PCT Intentions

• Three new NHS Treatment Centres
• 20-25 Neighbourhood Health Centres
• Nearest Practice within 15 minutes
• Initial investment in 200 extra staff
• Up to 100 million capital investment
• Develop detailed plans with Partners
• Implemented in 4 to 7 years