Dorset Health and Wellbeing Board Date of Meeting 09 November 2016 Subject of Report Sustainability and Transformation Plan Refresh Update Report Author Partner Organisation Tim Goodson, Chief Officer, NHS Dorset CCG Responsible Commissioning body The System Leadership Team Delivery partner/s Executive Summary All partners of the Health and Wellbeing Board and the System Leadership Team. Bournemouth Borough Council Poole Borough Council Dorset County Council Dorset HealthCare NHS Foundation Trust Royal Bournemouth and Christchurch Hospital Foundation Trust Poole Hospital Foundation Trust Dorset County Hospital Foundation Trust NHS Dorset Clinical Commissioning Group The purpose of the report is to update the Systems Leadership Team and HWB on the refresh of the Sustainability and Transformation Plan (STP) due to be submitted to NHS England on 21 October 2016. 1. Introduction 1.1 The Our Dorset Sustainability and Transformation Plan (STP) was submitted in line with national guidance on 30 June 2016, this was followed by a review meeting with NHS England on 15 July 2016, which was very supportive. We have also received positive feedback from the Royal College of GP s who felt that the Dorset STP was an exemplar.
1.2 Formal feedback was received on the 19th August and identified four main areas for us to focus on in refreshing the STP, which are as follows: Build further on the good progress being made in moving forward with the many elements of the STP. In addition to the clinical and financial opportunities already identified, the October submission should go beyond the current headline savings and set out potential additional opportunities; Review the opportunities for primary care at scale which would help to strengthen the rest of the plan; NHS England will support us in moving forward to consult on the proposed service changes in acute services and community services. They will share good practice on effective consultations to help ensure that the consultation documents are of a high standard, setting out a compelling case for change with clear clinical support and tangible benefits for patients; Include stronger plans for mental health drawing on the recent publication of the Forward View for Mental Health that are supported by appropriate investment including national funding set out for this purpose. 2. Report This report sets out the key amendments made to the STP in line with the feedback received from NHS England. 2.1 The STP Planning Group met on the 31 August 2016 to review the feedback received from NHS England and to agree the amendments required and approach to the refreshing the STP. 2.2 Following this meeting Programme Leads were approached and the STP and the supporting Appendix documents have been updated (see Appendix 1) with the key changes were as follows: Sustainability and Transformation Plan Revised original community hubs introduction section to focus on community services/ networks page 1; Transforming General Practice has been updated in line with the draft Primary Care Commissioning Strategy- pages 2-3; Transforming mental health services has been updated to reflect the additional progress made since the initial submission- pages 3-6; Acute reconfiguration progress to date and next steps has been updated to reflect completion of stage 2 assurance- page 6;
Sustainable approach to funding has been updated to include RightCare and Lord Carter- pages 6-7. Sustainability and Transformation Plan Appendix Minor amendments have been made to digitally enabled Dorset to simplify messages- pages 7-8; Communications and engagement has been updated to reflect all activity undertaken to date. The draft timeline for consultation has not been included within the appendix document- page 8. 2.3 In addition to refreshing the STP narrative documents, we are required to resubmit the finance template which will be co-ordinated and approved by the Finance Reference Group (FRG). We have also been informed that we are now required to submit an estates template (although we are yet to receive this formally from NHS England). This will be led by Rob Payne (Dorset CCG) and Janet Kearney (NHS Property Services) in conjunction with the Dorset Local Estates Forum and will be signed off through the Finance Reference Group. 2.4 STP Project Group Members requested that the approval process for the refreshed STP should sit with each organisation via their Boards, who would be asked to delegate final approval for submission to the System Leadership Team (as previous submission). Next Steps STP 2.5 The STP is due to be submitted to NHS England along with the estates template and finance template on 21 October 2016, to enable us to meet this deadline the next steps and key dates are as follows: 21 October 2016- submission to NHS England. Operational Planning 2017/18 and 2018/19. 2.6 In addition to this we are required to develop organisation level operating plans for 2017/18 and 2018/19. We are expecting detailed two year planning guidance to be published on 20 September 2016, which will include the approach to Sustainability and Transformation Fund (STF) and process for agreeing capital bids. The high level milestones for the two year operational plans are: 24 November 2016- submission of first draft of two year operational plans; 23 December 2016- final submission of two year operational plans.
All plans are expected to align across the system and to link back to the STP, to enable us to do this we have arranged a meeting with the operational planners from health to take this forward. Impact Assessment: Please refer to the protocol for writing reports. Equalities Impact Assessment (EqIA): Equality impacts have been considered in developing the underpinning workstreams set out in the plan. Central to the plan is an understanding of our health and wellbeing gap and how this can be addressed ensuring that everyone in Dorset has the standard of care they need regardless of who they are and where they live. Locality Impact: Our workstreams within the STP recognise that one size does not fit all, and models will need to be flexible depending on local need. Budget: A key element of the STP is to describe the potential finance and efficiency gap if we continue as we are, both for the local NHS and for our local authorities. The plan also outlines plans to address this gap, and will provide a framework for how we continue to work together as a system to address this issue. Risk Assessment: Not DCC Report Current Risk: LOW Residual Risk: LOW Health and Wellbeing Implications: A key element of the STP is to describe the Health and Wellbeing Gap and our plans to address this. The STP clearly highlights the important role of the Health and Wellbeing Boards in leading on this work. In developing the STP we have worked closely with colleagues drafting the refreshed Joint Health and Wellbeing Strategies. Other Implications: Evidence Base and Strategic Alignment Use of Evidence: Our understanding of local challenges draws on substantial analysis of Dorset s health services conducted in the winter of 2014/15 as part of the Clinical Services Review, work underpinning the Better Together (Better Care Fund) work, and ongoing scrutiny of a wide range of clinical quality and safety data, clinical audit measures, patient and carer experience feedback and finances.
Evidence base within Joint Strategic Needs Assessment: Our understanding has built on work through the JSNA, and contributes to the JSNA. Community engagement / expressed needs: The plan has been developed and the refreshed through the system wide STP Project Group and shared widely with providers and local authorities. Stakeholder engagement in the STP is via the underlying work streams that make up the plan, such as that undertaken for the CSR and ICS programmes. Our workstreams on Integrated Community Services and one acute network have been developed through extensive engagement with partner organisations, patients and the public and will be subject to further consultation later this year. We will engage further with local people on our prevention at scale programme as part of the consultation on our Joint Health and Wellbeing strategies. Alignment with the Joint Health and Wellbeing Strategy: The prevention at scale programme within the STP aligns closely to the Joint Health and Wellbeing Strategies of Dorset HWB and Bournemouth and Poole HWB. Recommendation That the Board review and comment on the submitted STP plan. Reason for Recommendation To drive forward local sustainable transformation that will mean we provide services that better meet the needs of local people and deliver better outcomes. Appendices Appendix 1 Our Dorset Refreshed STP Background Papers Reports to Dorset HWB: Dorset HBW Agendas and Reports Officer Contact Name: Tim Goodson, Chief Officer NHS Dorset CCG Tel: 01305 368915 E mail: tim.goodson@dorsetccg.nhs.uk