Our strategic five year health and care plan 2019 20

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OUR STRATEGIC FIVE YEAR HEALTH AND CARE PLAN 2019/20 ? 2023/24

Coventry and Warwickshire Health and Care Partnership VERSION ? 26TH SEPTEMBER 2019

CONTENTS

Executive Summary

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1 Introduction

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2 Our Vision

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3 Our Population Needs

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3.1

Our Approach

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3.2

What we know about our population needs

11

3.3

Our approach to engagement for our Five Year Strategic Plan

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4 Our System Priorities and Workstreams

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5 Responding to the NHS Long Term Plan

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5.1

Out of hospital care

21

5.2

Personalised care

22

5.3

Digitally enabled primary and outpatient care

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5.4

Increasing focus on Population health

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5.5

Prevention and Inequalities

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5.6

Further progress on care quality and outcomes

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5.7

NHS staff will get the backing they need

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6 Building a sustainable partnership

29

6.1

Our Partnership governance arrangement

29

6.2

Our Health and Care Partnership Board

29

6.3

The Partnership Executive Group (PEG)

29

6.4

Our journey to becoming an ICS

30

6.5

Our system enabling workstreams

30

6.6

Place

34

6.7

The role of the Strategic Commissioner

34

6.8

Our Provider Alliance

35

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6.9

Partnership Working

36

6.10

Our future approach to engagement

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6.11

Our approach to quality

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7 Finance, Activity and Workforce Assumptions

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7.1

Finance

38

7.2

Activity

40

7.3

Workforce

40

7.4

Key risks to delivery and mitigating actions

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8 Conclusion

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EXECUTIVE SUMMARY

Since 2016 when our previous `Better Health, Better care, Better Value' plan was published, much has happened across Coventry and Warwickshire. We have invested in health and care services, strengthened our partnerships and relationships, and continued to make improvements in care for the one million people we serve.

Our vision is that `We will do everything in our power to enable people across Coventry and Warwickshire to pursue happy, healthy lives and put people at the heart of everything we do.'

We believe that each of our residents deserves to: ? Lead a healthy independent and fulfilled life ? Be part of a strong community ? Experience effective and sustainable health and care services when they need them.

To achieve this vision and deliver the NHS Long Term Plan (LTP) commitments, additional money will be coming into our system over the next five years. We will use this and our existing resources to respond appropriately to rising demand for health and care services from our growing and ageing population.

Prevention will be at the centre of everything we do. We will invest to promote health and wellbeing. Through a strategic and targeted approach to earlier intervention, we will make it easier for people to lead healthy lives and stay well for longer. The early years are particularly important, and we will work with partners to give every child the best possible start in life.

Our approach to Population Health focuses on all of the factors that affect health and their impact on health outcomes. This includes education, affordable and appropriate housing, stable employment, leisure opportunities and a healthy environment. We will build on the work of our Health and Wellbeing Boards and the Year of Wellbeing 2019 to ensure that these determinants are tackled and that associated inequalities are reduced.

The further development of Primary Care Networks (PCNs) and our Integrated Community/Neighbourhood Teams are at the heart of our plans. Building on our `Out of Hospital' programme, these teams will focus on preventing ill health, supporting people to stay well, and providing them with high quality care and treatment in their own homes when and where they need it. We will also improve the responsiveness of crisis response services and work to achieve closer integration with social care.

Demand for Urgent and Emergency Care continues to rise and improving access to appropriate care and early interventions will be critical to meeting and managing demand. Our vision is to simplify our UEC offer and deliver a fully integrated networked response so that the most appropriate care can be given as quickly as possible. We will support patients, their families and carers to do as much as they can for themselves and improve primary care access and pre-hospital urgent care. We will also reduce unnecessary, harmful stays in hospital through increasing same day emergency care and improving timely discharge.

We will deliver a step change in Mental Health services by focusing much more on prevention, early intervention and supporting more people to actively participate in their own self-care, wellbeing and recovery. We will ensure timely access to high quality appropriate specialist services when needed, delivered wherever possible in the communities where people live. Improving mental health services for children and young people is a particular priority.

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Mental health services will be delivered as locally as possible through our neighbourhood teams, with a commitment to reduce and ultimately remove the need for patients to be treated outside of our area (Out of Area Placements). We will build on our recent improvements to services and support for people with learning disabilities and autism and increase the number of patients cared for locally in their communities.

We will identify more people at risk of Cancer earlier and undertake more community-based screening. We will treat cancer patients more quickly in order to improve survival rates and increase the overall experience our patients receive throughout their diagnosis and assessment, their treatment and then living beyond a cancer diagnosis and treatment.

Following extensive engagement with local people, we have commenced a programme to consider how we respond to the changing needs of women, babies, children and young people. Initially, this work will enable staff working in Maternity and Children's Services to consider how their services can be most effectively be delivered to improve health outcomes, quality, and patient experience in the context of the existing health inequalities, workforce, estate and financial constraints.

The final phase of our redesign of Stroke services will take place over the next 12 months, with implementation of a new agreed model, once public consultation is concluded, evaluated and considered. We are also committed to ensuring other major health conditions such as CVD, diabetes and respiratory disease deliver the LTP commitments.

In order to improve efficiency and value for money, we will implement a number of system-wide Service Improvement Schemes, which will look to redesign diagnostic and outpatient services, streamline and modernise radiology and pathology services, improve the productivity of surgical services to reduce waiting times, deliver more care inside the NHS and optimise medicines management. These measures will contribute to us achieving financial sustainability.

We will exploit the opportunities offered by technology (including the introduction of an Integrated Care Record) to support people in managing their own health and care needs in the community. We see our system estate as a key enabler to successful delivery of locally delivered, integrated care and we will work with local authorities to maximise the value of the estate.

To deliver our plan, we have reviewed our system governance arrangements and introduced a new Partnership Board - a mechanism for collaborative action and common decision-making for those issues which are best addressed on a wider scale. The Board is strongly aligned to and heavily influenced by the Health and Wellbeing Boards Concordat and our emerging Strategic Framework. Our Local Authorities are heavily involved in these arrangements.

Within each of our four Places (Coventry, Rugby, Warwickshire North and South Warwickshire), local partnership arrangements are being established that ensure all stakeholders including Local Authorities, voluntary and community groups, NHS commissioners, acute and mental health providers, GPs and other primary care providers and patients and the public have an input into how we progress as a health and care system.

We appreciate the importance of whole system clinical leadership and engagement in delivering our vision. Our Clinical Forum provides clinical advice and expertise to all our workstreams, with clinicians leading our programmes. It ensures the voice and ideas of clinicians, from a range of professions and organisations, lead the development of new clinical models.

Our three CCGs and our Local Authority colleagues are working closely together to consider how they become a leaner and more strategic `commissioning function'. Our Provider Alliance is working

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to share expertise, knowledge and skills and draw on the strength of partners to redesign delivery and develop new models of care. We recognise the role of Healthwatch, the Voluntary Sector, charities and others in supporting us engage with our communities and citizens to better understand their needs and seek their views. We also acknowledge the critical role of carers and any redesign we consider will be underpinned by a commitment to give people more control over their own health and an ability to co-produce and then fully engage to develop our future plans. Fundamental to delivering our vision is our workforce. A high priority is to attract, develop and retain a workforce that will be supported and trained to work differently in the future. This requires a profoundly different approach to addressing our challenges and exploiting new ways to utilize the skills staff offer, enabling all to reach their full potential. This plan outlines our collective ambitions as well as our remaining challenges and how we will overcome them. It also reinforces our commitment and contribution to delivering the NHS Long Term Plan and to ensuring that the additional funding we receive will be invested in the things that matter most, from providing safe and high quality treatment and care to reducing pressure on our staff, investing in new technologies and to adopting a population health approach in order to improve the outcomes for our patients and communities.

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