Welcome to the Swindon Strategic Partnership Conference

18th March 2011

Tom Charnock

Chair of Swindon Strategic Partnership Overview & Monitoring

Group

Pat Geenty

Assistant Chief ConstableWiltshire Police

Lyn Hill-Tout

Chief ExecutiveGreat Western HospitalNHS Foundation Trust

Some Facts About The Trust

• 3,300 staff• Serving 340,000 people across Swindon, Wiltshire, parts of

Oxfordshire, Gloucestershire and West Berkshire• 9,200 members (Over 5,000 are members of the public)• Annual income of £200 million • Authorised by Monitor (the Foundation Trust Regulator) as an

FT in December 2008• Licensed by the Care Quality Commission (April 2010) • Provide services at Great Western Hospital, Brunel Treatment

Centre, Fairford Hospital, Savernake Hospital and various GP practices in Wiltshire

GWH Income 2010/11 = £200.2m

Context

• Less care in hospital, more care provided in the community• Choice – where and how care is provided by GPs, hospital, any

willing provider (private or voluntary sector)• Greater regulation by the Care Quality Commission• Safety, quality and growing patient satisfaction (and

expectations)• Although the NHS is receiving the same level of funding,

nationally savings of £20bn are required• These savings need to deal with increasing health needs• White Paper published – radical reforms• Concerns about changes and effect on NHS

How The NHS Operates … Currently

Parliament

Department of Health

Strategic Health Authorities

Primary CarePrimary Care Trusts (PCTs)General Practitioners (GPs)DentistsOpticiansPharmacistsWalk in Centres

Secondary & Tertiary CareAcute HospitalsAmbulance TrustsMental Health TrustsCare Trusts

Foundation Trusts

Monitor(Regulator of Foundation

Trusts)

Contract

How The NHS Will Operate

Parliament

NHS Commissioning Board

? Regional Commissioning Boards

Foundation Trusts

Any Willing Provider

Monitor(Regulator of Foundation

Trusts)

GP Consortia

Contract

Regulated for Quality

by Care Quality

CommissionContract

What could the national £20bn savings mean for GWH

1. FINANCE 11/12 12/13 13/14

£m £m £m

Cost pressure to be funded internally 4.0 3.75 3.5

Tariff reduction 3.2 3.0 2.8

Total GWH savings requirement 7.2 6.75 6.3

Proposed income reductions

Swindon PCT 7.33 7.84 8.25

Wiltshire PCT 0.825 0.825 0.825

8.155 8.665 9.075

How Will This Be ManagedNHS Swindon NHS Wiltshire

Reduce emergency admissions (improve urgent care)

Shifting settings of care and optimising urgent care

Improve management of long term conditions (end of life care, virtual wards, assisted technology)

Long term conditions

Elective care (stop procedures of limited clinical benefit, telephone advice to GPs)

Elective care pathways

Primary and community care (review all primary care contracts)

Improving primary and community care

Medicines management (reduce prescribing costs)

Improve prescribing

Mental health (reduce out of area placements) Mental health

Learning disabilities (reduce out of area placements)

Learning disabilities

Non clinical productivities (organisation structure, estate disinvestment)

Non clinical productivities

GWH Approach1. Partnership Working

– With Swindon Borough Council, NHS Swindon and Wiltshire to reduce duplication/improve quality/add value

– Wiltshire Community Health Services will merge with GWH on 1st June– Work with other providers – e.g. Independent Sector Treatment Centre, Prospect Hospice

2. Service Change– Provide more local care– Less care and treatments in hospital – reducing cost to Primary Care Trust– Reduce length of stay in hospital = less beds– Work with commissioning intentions, e.g. no longer provide treatments of low clinical benefit– Treat patients locally– Innovate – use of technology to improve care and reduce cost

3. Staff– Engage staff so they understand the issues, help reduce waste and improve productivity and be

proud/promote the care we provide– Review who and how care is provided– Agency staff – only use in exceptional circumstances– Integrate GWH and Wiltshire Community Health Services staff

Gavin Jones

Chief ExecutiveSwindon Borough Council

The fundamental issueThe fundamental issue

time

demand demand

resources

Stem demand,More effective use of resourcesBuild new capacity

Drives a fundamental rethink of what we are here to do, how we should do it and how we are organised

Why we have to change further and fasterWhy we have to change further and faster

Rapidly diminishing revenue

Some public services can prolongdependency

The volume and complexity ofdemand is increasing

Major national policy changes including a drive for localism

Public Health role for LA’s

Working alongside communities to better understand and prioritise needs, create capacity and broker local solutions

(Securing services) Strategy &

Commissioning Ensuring Service

Delivery is effective

Local People &

Communities

Shaping and defining outcomes for local people, and building the framework for delivery

CE

Cabinet

Local People & Communities

Mixed market of community, voluntary, private and public providers

From…

What does this mean …. Direction of travel?What does this mean …. Direction of travel?

Local Engagement

Functional S

ervices

Functional S

ervices

Functional S

ervices

Functional S

ervices

To…

Commercial

Public Social

People &PlaceInfrastructure

Business

- Transport- Land Use- Digital infrastructure- Support Services

- Education &Skills- Housing- Community infrastructure- Engaged and active communities

Grow : Technology Environmental Start-ups and SME’s Retail & LeisureRetain: Manufacturing Insurance Distribution

OutcomesXx new jobsYy Growth sector increase££ new private investment?? Social Value

One Swindon :Resilient EconomicGrowth

© Participle Ltd. // www.participle.net

Throughout 2010

© Participle Ltd. // www.participle.net

Judgement

Agencies’ agendas

Be the parent/power & control

Enforcement

Professionalism and alienating language

Service design not relevant to people’s lives

Rescuing not empowerment

Lack of trust, honesty, transparency

Hopelessness, believe that change is not possible

Defensiveness & fear

Oppression

End up with parent/child relationship

Isolation

Exhausted with fighting system

No safe space to ask for help

Lack of trust, honesty, transparency

Hopelessness, believe that change is not possible

AGENCIES FAMILIES

Insight 4: Barriers

Facilitators: Matt Gott & Ruth Kennedy

Commitments:

One Swindon in Practice

•Twigs – Alan Holland •Broadgreen Mental Health Project – Sheena Dean

•Football in the Community – Tim Hall•Neurological Alliance – David Wray

•Promoting Positive Outcomes for 13-19 year olds – Kate Steel

•Groundworks – Kerry Wray & Mike Pringle

Coffee

Please be back at 11:25 to start the next session

Nick Stanhope, Managing Director,

‘We Are What We Do’

One Swindon

Facilitators: Matt Gott & Ruth Kennedy

One Swindon PrinciplesLocal and Lasting : We will encourage local people to get involved in decisions affecting their lives, to make the most of the opportunities available to them, and to help themselves, so they in turn can contribute to the place they live.

Stronger together :

Organisations in Swindon like the Council, Police, NHS Swindon, Voluntary and Community sector are working together more effectively than ever before – but have to get even better and we need to work more with businesses, communities and people in Swindon.

Prioritisation & Leadership :

There are leaders in all areas of our communities and we must enable them to flourish. Leadership will be about being open minded, flexible, showing humility and knowing when to let go as well as when to get involved.

Trust & Bravery: We will all need to trust each other and create a common purpose and shared endeavour. We need to share our ambitions, respect our differences and build on the things that bind us together.

One Swindon in Practice

•Bulb Planting Project – Paul Russell•‘Northview’ – Keith Smith & Maureen Penny

•Stay Safe – Peter Robinson

Lunch

Please be back at 1:45 to start the afternoon session

If needed a Quiet room has been set aside on the first floor for prayer and quiet contemplation

Welcome to the Swindon Strategic Partnership Conference

18th March 2011

Nick Stanhope, Managing Director,

‘We Are What We Do’

LeadershipFacilitators: Matt Gott & Ruth Kennedy

Local leadership:

How will it need to be different?How will we bring people with us?What will it look/feel like?How will decisions get made?How will we decide what’s important?What’s the role of elected members?

Plenary Session & Next Steps

Ruth Kennedy

Conference Close

Cllr Roderick BluhLeader of the Council