Enclosure 8

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STRATEGIC SERVICE DEVELOPMENT PLAN

2008/2009

To be reviewed July 2009

1. INTRODUCTION

The Strategic Service Development Plan (SSDP) sets out the framework for development of primary and community care services in Stoke on Trent. It outlines the PCT response to the White Paper Our Health, Our Care, Our Say and the 2007 Lord Darzi Next Stage Review of the NHS. It also sets out the development of the community component of the Fit for the Future (FftF) strategy and the service model being developed within Stoke-on-Trent. The PCT Board have agreed that the SSDP will be reviewed annually. This is the update of the 2007/8 SSDP which was approved by the Trust Board in July 2007. The intentions and commitments made in the July 2007 SSDP have not changed, however during the past year, a number of new national and local policies and initiatives, such as the Overarching Vision for the local health economy, the PCT Assurance Framework which underpins Fit for The Future and the national Lord Darzi recommendations for service development, have emerged which will impact on the way ahead for services as described in the 2007 SSDP. Where this is the case, these have been highlighted in the plan. The PCT is in a good position to respond to these initiatives as the SSDP and Fit for the Future developments are in line with and in advance of emerging national direction.The PCT formally consulted on the SSDP between January and April 2007 the results of which were considered by the Board in May 2007. The final SSDP, published in July 2007, reflected the outcomes of the consultation. The main themes and concerns raised can be viewed in the consultation evaluation report on the PCT website at www.stokepct.nhs.ukConsiderable work has been carried out in the last year on the recommendations from the consultation and in particular on the ongoing public engagement in the development process. A clear process has been agreed with the Stoke Health Overview and Scrutiny Committee for the development of individual schemes who have supported a process of local active engagement on each scheme rather than a formal consultation for each scheme. Detailed public engagement is therefore being carried out, an example of which is for the planned development in Cobridge.The PCT is a partner within a LIFT (Local Improvement Finance Trust) company which covers Northern Staffordshire. The LIFT is the PCTs major vehicle for the development of new primary and community care centres. Within LIFT, the PCT is a part of a legal Strategic Partnering Agreement consisting of the following organisations:

Stoke On Trent PCT

North Staffordshire PCT

North Staffordshire Combined Healthcare NHS Trust

Newcastle Borough Council

Stoke on Trent City Council

Staffordshire County Council

What does the SSDP mean for patients?

The PCTs overall aim is that access to services is improved and that patients and users are seen in the most appropriate place.

The new centres and services will be developed so that:

they improve geographical access;

they increase the range of locally based specialities;

they can be accessed in a more flexible and timely manner.For example, patients with diabetes may currently have to visit the consultant, GP, practice nurse, podiatrist and dietician at different times and in different locations. Many of the new centres will enable the establishment of one stop services so that the person can see all the professionals involved with their care at one visit. The service could also link to the Expert Patient Programme and the local Diabetes UK group. This model could be developed for other long-term conditions such as coronary heart disease and respiratory disease

A referral from the GP in future would mean that a patient is seen at one of the centres either by a consultant or by a GP with a special interest in that condition. Or the outpatient visit following an admission to hospital could well take place more locally. Other outpatient follow-up, such as physiotherapy, could also be provided at the centres.

When planning and commissioning new services in the centres the PCT will also review whether there is a need for these to be provided in the evenings or at weekends to improve access.2. THE CITY OF STOKE-ON-TRENT

2.1The city and its key aims

The city of Stoke-on-Trent is located in the north of the West Midlands region and is a unitary Local Authority. Stoke-on-Trent City Council is responsible for a range of local services, including social services. In October 1st 2006, Stoke on Trent Primary Care Trust was created which shares the same geographical boundaries as the City Council. The PCT is responsible for commissioning all health services for its 247,000 population.

Stoke-on-Trent has been identified as a pathfinder city (one of only 9 cities in the country) for housing market renewal. This involves a programme of significant housing redevelopment over the next decade in specific areas across the city. These areas of major intervention are the focal point of detailed planning to improve the housing stock and the services for the community. The process of regeneration is being led by an organisation called RENEW which works closely with the City Council. Stoke-on-Trent City Council launched a community strategy in 2004 which outlines the main areas of improvement needed for the city and aims to make Stoke-on-Trent: a Healthier City

a Safer City

a Wealthier City

a Greener City

a Learning City

a City With a Strong Sense of Community Through the Local Strategic Partnership, the PCT is committed to working with its partners to help deliver this shared vision and in particular to ensure that Stoke-on-Trent does become a healthier city.

2.2 The health of the population Each year, the Director of Public Health for the PCT produces an annual report on the health of people living in Stoke-on-Trent. It outlines the progress being made in improving the major health outcomes experienced by the residents of the city.

In general the health of people in Stoke-on-Trent is improving but that improvement is not sufficiently fast enough to close the gap between Stoke-on-Trent and the rest of the country. In fact, the gap appears to be getting bigger.

Improvements in life expectancy and reductions in infant mortality are key areas which will make the most difference to overall health in Stoke on Trent.

There is a well established link between deprivation and ill health. In 2006, the City Council published its neighbourhood renewal strategy. It described the neighbourhoods within the city ranking them against various deprivation indicators with health as a specific indicator. It then brought all the factors together to show the overall outcome. Appendix 1 indicates the position of the various areas within the city in the Local Index of Deprivation for 2006. This shows that the neighbourhoods with the poorest scores on health deprivation and disability are:

Burslem

Abbey Hulton

Cobridge/Forest Park

Bentilee

Shelton North and Etruria

Northwood

Blurton and Newstead

Middleport and Longport

Smallthorne

Longton

Meir North

Hanley East and Joiners Square

Meir South

Bradeley

Berryhill and Eaton Park2.3 Integrating planning

In order to improve the integration of local planning and service provision the PCT, the City Council, Staffordshire Police and other bodies have agreed that services will increasingly be organised in five neighbourhoods across the city. These areas are:

North

Tunstall, Chell, Packmoor, Norton, Bradeley, Burslem North.West Burslem South including Longport, Middleport, Hanley (City Centre), Etruria, Shelton, Cobridge, Sneyd Green.EastBentilee, Abbey Hulton, Bucknall, Baddeley Green, Milton, Smallthorne.South East Longton, Meir, Weston Coyney, Blythe Bridge.South West Fenton, Blurton, Hartshill, Trentham, StokeIt should be acknowledged that there will be services that must still be organised on a wider basis either due to low numbers of users or because there is a scarcity of specialist workforce skills. Establishment of the neighbourhood hubs, as described in Section 5 will create a network of services across the city improving access to these services and patients will be able to choose the centre which will be the most appropriate for delivery of their care.

Within this framework organisations will be able develop services which respond to the needs of the local population. For the PCT this has led to the general alignment of the Practice Based Commissioning clusters with the neighbourhoods.

Working in partnership with the local authority and others is fundamental to improving the health and well being of the people in Stoke-on-Trent and the PCT will take every opportunity to develop premises in conjunction with partners.

3. MODERNISING SERVICES IN STOKE-ON-TRENT3.1 National Strategic context

In January 2006, the government White Paper called Our Health, Our Care, Our Say outlined how health services are expected to develop over the next decade. The document identifies 5 key areas for change:

more personalised care

services closer to peoples homes

better co-ordination with local councils

increased patient choice

a focus on prevention rather than cure

Put simply, the White Paper expects local PCTs to show how they will move as many services as possible and appropriate from the hospital (acute) setting into the community where they can be provided close to where people live. Due to changes in clinical skills and technology, services can