Procuring Surrey Community Health Services for 2017 and Beyond

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1 Procuring Surrey Community Health Services for 2017 and Beyond Information and Networking Event Friday 25 th September 2015 Kemp Room, HG Wells Centre, Church Street East, Woking, Surrey GU21 6HJ

2 AGENDA Welcome Purpose and Format The Context, Scope and Vision Proposed Procurement Model and Timeline Discussion and Feedback Next Steps Julia Ross Chief Executive Officer, NWS CCG Rachael Graham, Head of Non Acute Contracts NWS CCG Ruth Hutchinson, Deputy Director of Public Health Jack Wagstaff, Head of Frailty, NWS CCG Rachael Graham, Head of Non Acute Contracts, NWS CCG Attendees Steve Emerton Director of Commissioning, NWS CCG Close and Networking

3 Welcome

4 Purpose and Format To share our vision for whole system change and the future commissioning of community services To identify and engage with potential providers of community services Consider potential procurement models for securing services To stimulate the market to think differently regarding community services provision To utilise providers feedback to shape and refine our high level plans To understand any concerns/queries market providers may have

5 Context

6 The Commissioners NHS East Surrey CCG (18 GP Practices serving a population of approx. 170,000 people) NHS Guildford and Waverley CCG (25 GP Practices serving approx. 207,000 people) NHS North East Hants and Farnham CCG (24 GP Practices serving a population of approx. 220,000 people) NHS North West Surrey CCG ( 42 GP Practices serving a population of approx. 360,000 people) NHS Surrey Downs CCG (33 GP Practices serving a population of approx. 300,000 people) NHS Surrey Heath CCG (10 GP Practices serving a population of approx. 90,000 people) Surrey County Council

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8 Sources of information on health needs CCG Health Profiles 2015 Joint Strategic Needs Assessment Pharmaceuticals Needs Assessment Surreyi

9 Demographics and changes

10 Deprivation

11 Children s health and wellbeing

12 Disease prevalence: an overview

13 The Scope and Vision

14 The Services in Scope It is anticipated that the following portfolio of community services will be tendered The scope of some of these services will be Surrey-wide; including potentially outside of the boundaries of the Surrey CCGs. Some service specifications will also have local variations. Commissioners are expecting to secure services in the order of 85 million per annum. Community hospitals Rapid Response Discharge Facilitation and Admission Avoidance Community nursing incl. Phlebotomy Community continence service Intermediate care services Community podiatry Speech and language therapy Community specialist nursing including but not limited to neuro rehab, cardiac, respiratory, diabetic, epilepsy, lymphoedema Wheelchairs School nursing for 5 to 19 year olds Children's community nursing service Community paediatric occupational therapy Paediatric physiotherapy Paediatric audiology Paediatric diabetes nursing service Paediatric epilepsy nursing (PENS) Paediatric speech and language therapy Special school nursing Youth counselling service Health visiting for 0 to 5 year olds Developmental paediatrician service Health assessment service Immunisations and Vaccinations NHS funded children's continuing care

15 Context National Context NHS 5 Year Forward View Integration Agenda Better Care Funding Patient centred services Efficiency / Economies Pooled Budgets Local Context Opportunities for joint commissioning under BCF Opportunity for system integration Opportunity to increase access to community services Opportunity to commission for outcomes Opportunity to minimise duplication Opportunity to address commissioning gaps Opportunity to eliminate boundary issues

16 The Vision The Health and Social Care System in Surrey wants to commission a new Community Health Service provider(s) to deliver high quality patient care in the right place at the right time. We want to embed a more proactive approach to care by putting General Practice at the centre, identifying and supporting vulnerable people in the community, preventing acute illness where possible and implementing timely, proactive care pathways. The key focus for this procurement is to ensure that the resources at all stages of care delivery offer quality interventions which are timely and measurable and address patient needs in a holistic and individualised way.

17 Our System Wide Vision NOW Large acute based provision Patient centred Community Hubs Aspiration Under developed Voluntary sector Social care system is separate Complex and disjointed community services contract Commissioning for outcomes Transformational system wide change Optimising provision of services in the community Collaborative Commissioning across the system

18 Community Hubs WHAT A range of health and care professionals working together to meet all of the health and care needs of the population Single HOW Doctors (family health and medical), Nurses, Social Care, AHPs and Pharmacists Working from health and care facilities integral to the Hub Actively liaising with professionals where onward referral for specialist support is needed. Linking into support services e.g. voluntary and third sector, community groups etc.

19 Key Principles (1) General Practice Leadership: Providers will be required to demonstrate that General Practice is at the heart of their proposals to deliver out of hospital care. Community Nurses: ideally nurses will be aligned to Primary Care Localities to facilitate continuity of care. MDT Coordination: pulling together professionals from within and across organisations to provide one seamless pathway of care to the most vulnerable patients and developing care plans for on-going interventions. Rapid Response MDT team: to rapidly assess and treat adults and elderly patients at home who are at risk of hospital admission and set up the appropriate support to manage them in the community.

20 Key Principles (2) The new Community Health Service needs to work closely with social care to ensure that these services are integrated with future healthcare pathways, capitalising and enhancing the integrated ways of working that are being embedded within existing services. Co-ordinated prevention, planning and commissioning with social care, voluntary sector organisations and other partners, promoting healthy ageing and providing support at an earlier stage in a proactive manner.

21 Proposed Procurement Model and Timeline

22 Milestone Deadline PQQ issued Jan 2016 PQQ evaluation Mar 2016 ITT issued Apr 2016 Closing date for Tender Submission Jun 2016 Notification of Award of Contract Aug 2016 Mobilisation and transition arrangements Sep 2016 onwards Commencement of Services April 2017

23 Proposed Procurement Models The contract let will be the standard national NHS contract The term of the contract will be at least five years Principles Partnership - with a wide range of organisations including general practices, voluntary and private sector providers and statutory organisations Integration - seamless pathways between primary, secondary and community services Whole System working - This must be across health and social care Outcomes Based Service Delivery - A performance management framework referencing KPIs and benefits taken from across the integrated health and social care spectrum Collaboration - the provider(s) must have in place suitable arrangements with the supply chain of other providers/partners (where necessary) and agreements to work collaboratively with other organisations

24 (Existing) Service Specifications Potential Groupings ADULTS Community Nursing, Community Matrons, Community Hospitals, Specialist Nursing Services e.g. PD, MS, Diabetes, CHD, Complex Wound Care - TVN, Diagnostic and Treatment Centres, Rehab and Reablement, Physiotherapy, Speech and Language Therapy, Occupational Therapy, Palliative Care, Podiatry, Phlebotomy, Neuro Rehab, Stroke - Early Supported Discharge, Telecare/health, X-Ray, Walk In Centres, Rapid Response, - Discharge Facilitation and Admission Avoidance, CHILDRENS Community Paediatric OT, Paediatric Physiotherapy, Paediatric Audiology (+/- Hearing Aid Fitting), Paediatric Diabetes Nursing Service, Paediatric Epilepsy Nurse, Paediatric Speech & Language Therapy, Special School Nursing, Youth Counselling Service, 0-5 Health Visiting, Developmental Paediatrician Service, Health Assessment Service OOA LAC Reviews, 5-19 School Nursing, Children's Community Nursing Service

25 (Existing) Service Specification Potential Groupings PAN SURREY SERVICES Wheelchairs Continence Treatment and Product Delivery NHS Children s Continuing Healthcare Nursing Immunisations and Vaccinations (NHS E) First Steps (Surrey CC)

26 LOTs of Options Multiple procurement models available: Secure a single provider to deliver locally orientated services across Surrey Allow providers to bid for services based on CCG boundaries, potentially securing multiple providers across Surrey Allow providers to bid for services based on CCG boundaries (as above) whilst recognising that some services are best delivered by a single provider at a County level

27 DISCUSSION & FEEDBACK What do you think of the service groupings? Are there other services that should be delivered at Pan Surrey level? Are services missing when you consider the vision/aspirations? How can we secure economies of scale and prevent fragmentation whilst also enabling localisation? How can we drive our vision of service integration, end-to-end pathway provision and general practice at the centre of out of hospital care, through this procurement? Is there anything that you wouldn t want to see?

28 Next Steps