North SomersetNorth Somerset

Operational Plan 2009/10Operational Plan 2009/10

Health Overview and Scrutiny PanelFebruary 2009

North SomersetNorth Somerset

• Context including JSNA, national targets, operating framework

• Programmes of work and implementation plans for Improvements in the quality of care for patients

• Progress on ambitions in our Strategic Framework • Plans for the use of system reforms such as patient

choice, PBC, contestability, WCC• Supporting strategies such as workforce and OD, IM&T,

estates development• Financial framework and our investment plans• Risk assessment and management plans

What does it include?What does it include?

North SomersetNorth SomersetThe Operational Plan The Operational Plan in Contextin Context

Operational Plans (LDP)

1 year plan, detailed actions

Operational Plans (LDP)

1 year plan, detailed actions

Strategic Framework3-5 year plan, long term ambitions, big strategic

issues

Strategic Framework3-5 year plan, long term ambitions, big strategic

issues

Operational Plans (LDP)

1 year plan, detailed actions

Operational Plans (LDP)

1 year plan, detailed actions

Operational Plan (LDP)1 year plan

Operational Plan (LDP)1 year plan Commissioning

StrategyHow we commission

Commissioning Strategy

How we commission

Medium term financial plan3-5 year plan

Medium term financial plan3-5 year plan

Organisational development plan3-5 year plan

Organisational development plan3-5 year plan

Practice based commissioning plansPlans to meet health

needs of local communities

Practice based commissioning plansPlans to meet health

needs of local communities

Practice based commissioning plansPlans to meet health

needs of local communities

Practice based commissioning plansPlans to meet health

needs of local communities

Practice based commissioning plansPlans to meet health

needs of local communities

Practice based commissioning plansPlans to meet health

needs of local communities

Strategic Objectives2008-2011,

organisational goals for PCT

Strategic Objectives2008-2011,

organisational goals for PCT

North SomersetNorth SomersetStatutory Requirement e.g. NICE, Health & Safety

Highest

Lowest

Priority National Target

Improving Efficiency and Cash Releasing Saving (Resource Utilisation Management Schemes)

Reduces demand for acute services and is cost saving or cost neutral

Local Priority

Local Ambition

National Service Framework Gap or other National Target

PrioritisationPrioritisation

North SomersetNorth SomersetNational Operating Framework National Operating Framework 2009/102009/10

High quality care for allHigh quality care for allremains as guiding principle for the Operating Framework and underpinning every stage of development and reform are:

•safety of patients and staff•effectiveness of care•experience of patients

North SomersetNorth SomersetNational Operating Framework National Operating Framework 2009/102009/10

Opens with confident assessment that:

““we have never been in a better we have never been in a better place to deliver these place to deliver these

ambitions”ambitions”

Focus continues to shift from better health care to better health

North SomersetNorth SomersetNational Operating Framework National Operating Framework 2009/10 Priorities2009/10 Priorities

•improving cleanliness and reducing HCAIs•18 weeks Referral to Treatment (RTT) target•improving health and reducing health inequalities•improving patient experience and satisfaction•preparing to respond in a state of emergency such as

pandemic flu outbreak

National priorities essentially the same as 2008/09:

North SomersetNorth SomersetNational Operating Framework National Operating Framework 2009/10 Setting standards2009/10 Setting standards

Continued focus on ‘Vital Signs’ framework:

• Tier one:Tier one: “must do” indicators, apply to all Primary Care Trusts

• Tier two:Tier two: national priorities for local delivery

• Tier three:Tier three: Primary Care Trusts can use with Partners and local communities

North SomersetNorth SomersetOur Primary GoalsOur Primary Goals

• Reduce health inequalities in all areas of our work by targeting effort in the areas with greatest deprivation

• Address the inter-related issues of care for older people, long term conditions and increasing independent living at home

• Work across boundaries to improve joint working……in order to find new and radical solutions to systemic problems

• Get it right first time – deliver safe, effective care, by ensuring that systems and processes are efficient and reflect best practice

North SomersetNorth SomersetOur Strategic ObjectivesOur Strategic Objectives

• To improve quality and earn autonomy by meeting necessary targets

• To meet our challenges through innovative service redesign – to meet identified needs.

• To reduce health inequalities and promote health and wellbeing based on an understanding of health needs

• To be a competent commissioner and ensure the development of a fit for purpose provider service

• To be a good partner to work with – building public, stakeholder and staff confidence

North SomersetNorth Somerset

• Work to reduce childhood obesity• Targeted cardiovascular screening• Increase help for people who want to stop smoking• Additional health trainers• Promoting physical activity• Brief interventions for alcohol in A&E services• Intensive support for vulnerable families in

deprived areas

Healthy Living and Healthy Living and Health ImprovementHealth Improvement

North SomersetNorth SomersetLong Term ConditionsLong Term Conditions

• Single point of access to community services• Develop and progress North Somerset Self-Care Policy• Implementation of the North Somerset Carers Strategy• Implementation of a new Rehabilitation Care Pathway• Meeting target for diabetic retinopathy screening• Development of best practice care pathways for a range of

neurological conditions• Implementation of the national stroke strategy• Continue the development of Dignity in Care Challenge

North SomersetNorth SomersetCancer ServicesCancer Services

• Continue the implementation of Improving Outcomes Guidance specifically:– Expansion of bowel screening– Expansion of breast screening– Further reduction of wait times– Implementation of an intermediate level skin

care service– Improved access to diagnostics

North SomersetNorth SomersetMental HealthMental Health

• Further develop the primary mental health services by taking forward improvements in access to psychological therapies

• Implement the Joint Commissioning Strategy for people with dementia

• Developing psychiatric liaison services both in adult and older people services

• Review acute care pathways with providers to create a focus on recovery

• Develop training on understanding eating disorders and a range of educational leaflets for primary care

North SomersetNorth SomersetLearning DisabilitiesLearning Disabilities

• Develop and implement plans in response to ‘Valuing People Now’

• Deliver recommendations contained within ‘Healthcare for All’• Continue pilot of health checks with GP practices• Improve Speech and Language therapy services• Support the joint action plan to respond to the needs of

people with Autism and Aspergers• Continue to improve access to services by ensuring

information is produced in an accessible format

North SomersetNorth SomersetPlanned CarePlanned Care

• Reduce waiting times to 13 weeks from referral to treatment across all specialties

• Extend opening hours in all GP practices• Deliver a year on year increase in patients accessing

dentistry• Implement the new GP practice in Worle• Implement the new GP Led Health Centre and satellite

unit in central Weston• Open the new Marina Healthcare Centre in May 2009

North SomersetNorth SomersetUrgent and Urgent and Emergency CareEmergency Care

• Work with GWAS to implement service redesign to improve ambulance response times

• Implement a recruitment drive for Community First Responders

• Implement GP in urgent care model through the GP Led Health Centre

• Work with WAHT to maximise the potential of the Assessment and Treatment Centre

• Reduce waiting times in A&E and make progress against the 2 hour target

North SomersetNorth SomersetEnd of Life CareEnd of Life Care

• Deliver the Marie Curie Delivering Choices Programme and implement plans agreed with the North Somerset End of Life Strategy Group

• Introduce and implement Advanced Care Planning• Introduce and deliver the use of the Gold Standards

Framework module for Care Homes

North SomersetNorth SomersetImproving QualityImproving Quality

• Project working with Nursing Homes to reduce MRSA and targeted improvement events e.g. diabetic foot ulcer patients

• Continued focus on reducing C-diff in hospitals• Supporting ‘Safety First’ initiative around avoidable

deaths• CQUINs included in contracts with acute providers• Implement Patient Safety Report ‘Safety in Doses’

North SomersetNorth SomersetSupporting StrategiesSupporting Strategies

Action Plans also included to improve:• Patient satisfaction• Involvement and engagement• Information management and Technology• Workforce development• Estates and capital development• Organisational performance and development• Leadership capacity and capability

North SomersetNorth SomersetChallengingChallengingFinancial ContextFinancial Context

• Funding position relative to neighbouring PCTs

• Significant savings over last two years – further savings less easy to deliver

• Need to be in the top 10% of the country for efficiency and productivity

North SomersetNorth SomersetNext StepsNext Steps• Equality Impact Assessment (ongoing)• Consultation and Engagement (ongoing)• Continued risk assessment• Amend plan to take account of engagement and

consultation• Draft plan to Board 25 February 2009• Submitted to NHS South West for comment• Final plan published by 31 March 2009

North SomersetNorth SomersetLet us know whatLet us know whatyou thinkyou think

We are keen to know what you think of our plans. Please let us have your comments.

E-mail: operationalplan@nsomerset-pct.nhs.uk

Write to: North Somerset PCT, Waverley House, Old Church Road, Clevedon BS21 6NN

Telephone on 01275 546678