The future provider landscape

1
_at_nhsc_conference confed2015

• The future provider landscape

• Chair Stephen Dalton, Chief Executive, Mental
  Health Network
• Katrina Percy, Chief Executive Southern Health
  NHS Foundation Trust
• Bev Humphrey, Chief Executive, Greater Manchester
  West NHS Foundation Trust
• Professro Ian Stewart, The City Mayor of Salford
• Sir David Dalton, Chief Executive, Salford Royal
  NHS Foundation Trust

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_at_nhsc_conference confed2015

• The future provider landscape

• Katrina Percy, Chief Executive Southern Health
  NHS Foundation Trust

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The future provider landscape Our perspective as
a mental health and community provider
Katrina Percy, Chief Executive
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Introduction toSouthern Health

• Southern Health NHS FT formed on 1 April 2011
  through merger of a community services and mental
  health provider
• 350m budget, 8000 staff
• Delivering community services, mental health,
  learning disability some social care services

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Our future
Developing our specialist Mental Health and
Learning Disability Services and ensuring their
sustainability
Developing a Multi-Speciality Community Provider
(MCP) integrating primary care community
services
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Developing an MCP
Your Health, In Your Hands, With Our Help.
Commissioner Reform
Provider Reform
Our new care model
Coming together to deliver the new model of care
that has been co-designed with local people, is
seamless across health and social care services
and is cost effective
Pooling the combined resources for the local
population and commissioning services using long
term outcome and capitation based contracts
A new care model with better access to care,
extended primary care team proactively managing
need, and specialist advice and support in the
community.
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MCP Care Model
Wider primary care at scale
Improved access to care
An extended primary care team
De-layering specialist support
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An extended primarycare team


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Delivering the model

• East Hampshire
• 10 practices / 70k patients
• Semi-rural new town

• Gosport
• 11 practices / 80k patients
• Urban deprived

• New Forest
• 7 practices / 70k patients
• Rural older demographic

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Specialist MentalHealth Services

• Delivering recovery orientated services
• Redesigning care pathways
• Reducing reliance on inpatient care
• Integrated health and social care model with
  local authorities

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Specialised and forensicservices

• Adult low andmedium secure services
• Adolescent mediumsecure services
• Tier 4 CAMHS
• Services that require capital investment and
  scale to be sustainable

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Delivering the new models and implications for
organisations such as ours
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Building leadershipcapability
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Organisational form?
With primary care, these services will form MCP(s)
These services increasingly need to operate at
scale (whilst maintaining local focus)
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Determining organisationalform

• An organisational form is required for the MCP to
  succeed, and for our specialist mental health and
  learning disability services
• Our work is to determine the best solutions that
  enable success
• Our Board clear that the Trusts long term future
  is in the new organisational forms
• Working to overcome the hurdles with regulators

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Conclusions

• Focus on the new model of care this is what
  will improve care and enable financial
  sustainability
• Building leadership capacity and capability is
  key
• Our provider organisational forms will also
  change
• Working with partners and regulators to ensure a
  smooth transition

17
_at_nhsc_conference confed2015

• The future provider landscape

• Sir David Dalton, Chief Executive, Salford Royal
  NHS Foundation Trust

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• 12 15
• LAs CCGs Providers

1948
2016
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Coherent Public Services
Serving the needs of people, - not Regulators or
central funding bodies
Although each township is proud of its heritage
we share a common view and have more that binds
us than separates us.
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or
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Coherent Improvement Programme
Early Deliverables
Other Deliverables
Enablers
7 day services Specialist Cancer Services
Diabetes - Prevent - Identify - intervene Dementia Better Service National Institute
Support unemployed with mental health needs
Single Shared Hospital Services CYP Mental health wellbeing Eating disorders
Reduce GP variation in quality
Integrate Pharmacy Dentistry 1 Care Offer
Relationship with Industry Popn Based Trials
Adopt Spread Vanguard Learning
GM Workforce Passport GM Contracts for GPs (GMS PMS)
Datawell Intelligence Analytics
Academic Health Science System
Estates Optimisation Ed Training Skills Job Design
Improving Outcomes Access
Improving Health Care
Improving Wealth Employment
Improving Models Of Care
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Collaborative assets Integrated health and
Social Care Academic clinical excellence
Exemplary business development and environment
infrastructure
F U S O N
FASTER
Industry
Improved health economic growth
FUS I ON
Solutions
Unmet needs
Academia

BETTER
Collaborative resources Clinical trial
infrastructure facilities Integrated Ehealth
infrastructure Business development NHS adoption
and procurement Health economics Entrepreneur
development Large, stable ethnically diverse
population NICE strategic relationship
IMPACT
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Salford Vanguard

• BENEFITS
• Full range of services within a single management
  arrangement more effective, efficient and
  coordinated care
• Collaborative environment without the need for
  new organisational forms
• Aligns interests of commissioners and providers,
  removing organisational and professional silos
  that contribute to fragmented and sub-optimal
  care
• Collective ownership of opportunities and
  responsibilities any gain or pain is linked
  to performance overall
• Supports a focus on outcomes and incentivises
  better management of population demand

• CCG, City Council, SRFT, GMW, Salix
• Health, social care wellbeing for 65
  population
• Some services subcontracted
• Phased introduction 2014/15 onwards

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GM Improvement Dividend

• 16 differential in weekend mortality rates
• Saving 500 lives over 3 years by meeting trauma
  and emergency surgery standards
• Liberating 1500 hospital beds (with closer to
  home facilities or in home support)
• 20 reduction in urgent care admissions
• 25 reduction in care home admissions
• Supporting 000s of people back to work

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Regulation

• NHS Constitution/Core National Standards
• ALB Regionalised Offices?
• GM Local Standards
• GM Improvement Programme metrics
• Employment Contracts (Primary Care)

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Governance (a personal view)

• 3 levels of decision making
• - local
• - sector
• - regional
• Must not travel at the speed of the slowest
• Decisions must stick limit power of
  veto/appeal

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What might a GM Health Care Organisation look
like in five years time?
Federated Back Office With GM Providers
?
Management Contract, or Organisational Chain
Service Line Contract for with Specialist
Providers
Single Shared Service with 2 Providers
serving 1m population
Integrated Care Models for Long term conditions,
Dementia Mental Health and Urgent Care
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_at_nhsc_conference confed2015

• The future provider landscape

• Ian Stewart, The City Mayor of Salford

29
_at_nhsc_conference confed2015

• Bev Humphrey, Chief Executive, Greater Manchester
  West NHS Foundation Trust