Community Healthcare Organisations

1. August 2014
19th November, 2014

2. Why a review?
Organise our services to make them the best that they can be

3. 3
Our Approach to the Review
 Learning from change since 2005
 Consultation
- Phase 1 - 17 ISAs … 600+ people
- Phase 2 – more than 40 groups
 Research & Learning – Integrated Care
Linking this learning to inform our
recommendations around
 Composition of Community Healthcare Organisations
 Governance & Management Structure
 Delivering the model of service envisaged in “Future Health”
over time

4. 4
What did the consultation tell us?

5. 5
What is integrated care ?
 Easier to navigate - making it simpler for people who
need services
 Better co-ordinated care, with continuity of care across
community and hospitals
 People moving easily through the different healthcare
services to meet their needs
 People receiving good quality services & outcomes
We must reorganise our structures and the way we work
to deliver this integrated approach

6. 6
What we learnt about integrated
care?
3

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What has the report recommended to
deliver this integrated model of care?

8. 8
The nine Community Healthcare Organisations
12

9. 9
Why these nine Community Healthcare Organisations?
Most appropriate option to deliver integrated model of
care. These nine Community Health Care Organisations
 meet a broad range of the defined criteria;
 meet the key requirement of linking Primary Care Networks
and acute hospitals;
 provide a strong basis for linkage with local authority
boundaries, county councils and the proposed Regional
Assemblies;
 strikes the right balance between an organisation of
sufficiently large scale to support organisation and business
capability, while at the same time sufficiently small scale to
provide the local community connection and response
required to deliver integrated care;
 accounts for cross-border links and connections;
 can be delivered from within existing resources.

10. Primary Care Networks
 90 Networks, approx. 50,000 population – one
for every large town / district
 Average of 10 networks in each CHO
 Network Manager working with GP Lead &
Network Team
 Responsible for service delivery & integration
with specialist services & access to acute
hospitals
 Strong relationships with local communities
 Standardised clinical governance & supervision
 Team Leader – protected time
 Key Workers – complex needs

11. Primary Care Networks- Illustrative
Population
Mid West
379,327
8 Primary
Care
Networks
Population
Range
31,300 –
73,547
Proposed
norm –
50,000
All care
groups co-terminus
–
National
oversight
process to
ensure
consistency

12. Changing how we work together
 Standardised models and pathways of care – Social
Care, Mental Health and Health & Wellbeing
 Integrated clinical programmes across community &
acute hospitals
 Rapid access to secondary care in acute hospitals &
specialised services in the community
Community Healthcare Organisations and Hospital Groups
 Working actively together – effective integration
 Continuity of care for people through all services

13. Management & Governance Structure to make this happen

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What does this mean for our clients ?
 Easier to
 Access services
 Move through services from community healthcare to acute hospitals and
returning to the community
 Receive “the right services, at the right time, in the right place,
by the right team”
 Improving services through:
 More local decision making around local needs
 Clinical staff and GPs on management teams - professional staff closer to
patient decision-making
 Network teams “championing” the needs and requirements of those living
locally
 Meeting high quality, safety and value for money standards
 Providing services locally in which people have confidence
 Consistency for all, based on nationally prescribed frameworks

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What does this mean for staff ?
Opportunities for staff
 Staff with greater say and involved in decision making at a local level
 New leadership roles, and involvement of GPs and clinicians in senior
management teams
 Networks will provide staff with opportunities to work with colleagues
from other disciplines in a new dynamic and integrated manner
 Investment in education & training with appropriate mentoring, and
development of leadership and management skills
 Strong leadership will be required - must be supported and developed
at all levels in the organisation
To ensure these changes happen staff will be
 Included in the decision-making process
 Enabled and supported throughout the process
 Provided with training in the knowledge and skills required to make
integration a success

16. Next steps
Communication & Engagement
Phase 1
 Comprehensive process of communication will be undertaken
 4 “regional type” briefings DG & leadership team: 5th – 12th November
 CHO based briefings, voluntary sector & wide range of stakeholder
groups – Project Lead & National Directors
Phase 2
 Informing the implementation process
 Engagement with staff associations & representative bodies
 Service users & advocacy groups
Implementation
• Comprehensive governance process – national steering group to
provide oversight
• High level implementation agenda being developed
• First step towards implementation – appointment of Chief Officers
We want everyone involved

17. 17
Vision

18. 18
Thank you for your attention
Questions & Answers