Integrated Commissioning for Integrated Services

Rob WebsterCE NHS Calderdale

Improving health, Improving Lives“We exist to improve the health and lives of the people of Calderdale

We will do this by increasing life expectancy, reducing health inequalities and ensuring the quality of services”

Enablers: Needs AssessmentCalderdale

Elland

Todmorden

Brighouse

Halifax

Sowerby

North Halifax

Standardised Mortality Rates

0

20

40

60

80

100

120

93-95

94-96

95-97

96-98

97-99

98-00

99-01

00-02

01 to

0302

to 04

03 to

0504

to 06

05 to

0706

to 08

07 to

09

DSR

per

10,

000

Least Deprived

Most Deprived

Projected f igures

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%Skir

coat

North

owra

m and S

helf

Illing

worth

Todm

orde

nSt. J

ohn's

Town

Elland

Ovend

enMixe

nden

Tobacco – Smoking by Ward

Alcohol Related Admissions

What our public want

• Access and waiting times.• Better co-ordination of services.• Staff and staff attitude• Equality and diversity• Value for money• Involving people• Quality

We set a vision in 2008• Life expectancy in Calderdale is amongst the

best in England, with a reduced gap between our worst area (Ovenden) and our best area (Northowram).

• We are amongst the lowest rates of smoking and obesity in England.

• We have amongst the highest rates of physical activity, and sensible drinking in England.

• We are amongst the lowest rate of infant mortality, low birth weigh and teenage conceptions in England.

• Our children have some of the best oral health in England.

Our Values

• Involve people, respect diversity, listen and learn.

• Act with honesty• Be fair• Achieve continuous

improvement through innovation

• Be committed to partnerships

Transforming Community Services

Partnerships

Single Commissioning Strategy for TCS

All health services that are provided or could be provided outside a hospital setting

All Local Authority adult social care services

Some Children and Young People’s services

Leisure to follow

Transforming community services

High Quality

InnovationSustainable

Promote health &

well being Integrated Services

Productivity

Provider Response• How partnership will help providers deliver the QIPP

challenge• How it will help us deliver the single commissioning

approach with Local Authority• Innovation and working differently• Focus on health promotion, prevention, self care and self

management• Cost efficiencies across organisations – actual and

potential.

Keeping it Real

Aim:• Real partnership with

our Provider Arm

• An opportunity to transform services for Calderdale’s families

• An opportunity to meetthe quality and productivity challenge.

Prejudice:• This is a takeover

• Transactional change

• Cherry picking/ stripping out/ “divvying up”

Leading As Peers

Our Strategic Outcomes

Single Commissioning

• Single approach with local authority• We want invest the £330m of NHS

expenditure alongside £500m of Local Authority expenditure to get the biggest benefit.

• Single commissioning executive and a set of joint commissioning intentions.

• There is a single set of programmes which recognises our shared commitment to Calderdale’s citizens.

Our programmes.

Urgent CarePlanned Care

Long Term Conditions

Cancer

End Of Life

Children and Maternity

Mental Health

Learning Disabilities Substance Misuse

Sexual Health Support at HomeContinuing Care and

Alternative AccommodationUniversal Services

Summary

Todmorden

Two Dimensions of Integration for Commissioning

1. THE PLACE

Tackling the Determinants of Health

Demand Management and Diagnosis

2. THE RIGHT NHS “FOOTPRINT”

PCT/MBC

Acute/MH Provider Footprint

Sub-Regional

Y&H

Health Improvement

and Prevention

Long Term Conditions and

Vulnerable People

Acute Healthcare

Interventions: planned and

urgent

Take Home Points• We have focused on families not

organisations• TCS has driven partnership and integration of

commissioning• TCS is driving new partnerships between

providers• TCS is a catalyst for whole system change to

benefit families• Collaborative Leadership makes this happen• We are in a better place to deliver our Vision