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Norfolk and Waveney Sustainable Transformation Partnership Executive Briefing - February 2019

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Community Action Norfolk are sharing this from the Norfolk and Waveney STP (Sustainable Transformation Partnership) Executive, please contact them directly with any queries.

Norfolk and Waveney STP Executive briefing note (February 2019)

Here’s an update summarising the key issues discussed by the Norfolk and Waveney STP Executive at their meeting on 15 February 2019.

Developing our Primary Care Networks

  • The NHS Long Term Plan sets out a new service model for primary and community health and care services based on Primary Care Networks (PCNs), which must be in place throughout England and operating from July 2019. This is reinforced by the new five-year GP contract and funding to develop PCNs.
  • The STP Executive discussed the requirements for setting-up PCNs, the timetable and our progress. This is important because our 20 PCNs covering Norfolk and Waveney will form the fundamental building blocks of our Integrated Care System.
  • Each PCN will have a new role of clinical director, which is expected to be a GP. 
  • There is clear guidance for community provider organisations to reconfigure services around PCNs. We are developing plans for what this will look like Norfolk and Waveney.
  • CCGs are expected to support PCN development both financially and support in kind. The STP Executive agreed that we should develop a consistent offer across CCGs.
  • Our mental health strategy commits to the co-location of services with PCNs and our social care colleagues are committed to reconfiguring services to integrate with our PCNs. The Executive agreed we should look at how children’s services fit with our PCNs.
  • The Executive also agreed we need a clearer plan for population health management and the use of data to target our resources at all levels of our system, including our PCNs.
  • Next steps: By 15 May, each PCN must have applied to the CCG to register itself with the full agreement of constituent practices, its nominated payee for PCN funding, its initial network agreement and its clinical director. The Executive felt that JSCC could play a role in this process and the strategic commissioning of primary care. On 1 July PCNs go live and funding investment begins.
  • Overall the Executive feel this is an area we’re doing well on and that the Long Term Plan fits well with the work our Primary and Community Care Workstream has been doing. By the autumn, we will publish a primary care strategy as part of our wider system five year plan.

This diagram shows our 20 primary care networks – we’ll have four in each ‘place’ (CCG area):

Map of Norfolk GP areas

Our financial position

  • Following on from January’s meeting, the Executive further discussed our system’s financial position. Having done more detailed work together, our system control total for 2019/20 looks like it will be a combined deficit of £87 million. If we agree this and go on to meet our control totals we will be awarded £71 million of non-recurrent funding, meaning our deficit for 2019/20 would be £16 million.
  • Our draft plans indicate that we will need to make savings of £113 million in the next financial year, which will be challenging.
  • To make sure that we have a shared understanding of the financial position of our system, we are going to start producing a monthly system finance report which we will ask CCG governing bodies and provider boards to discuss at their meetings in public. We are aiming for the first report to be discussed in March.
  • We are also going to start producing a monthly system performance report. The report is likely to include a dashboard and a deep dive into one area. We need to have a collective understanding of how our system is performing – this is now expected of us by NHS England and NHS Improvement.  

Modernising care

  • The Executive discussed a Strategic Outline Case (SOC) for replacing the electronic patient record systems used by our three acute hospital trusts. The SOC identified that we could achieve much better value for money by the three acute trusts procuring and implementing a single, shared electronic patient record solution.
  • By doing this there’s an opportunity to improve clinical outcomes and patient safety, as well as improve productivity and efficiency by enabling the operation of streamlined processes and work flows.
  • It was felt that it would be better for our community providers not to procure the same system as the acute trusts, but to make sure they have an electronic patient record system that works for them. We do need to make sure the systems used by our acute trusts, community services, primary care and social care are interoperable.
  • The STP Executive supported the collaborative approach. The next step is to produce a more detailed Outline Business Case.
  • The STP Executive also discussed the resources needed to pick-up our pace on the modernisation of health and care. They agreed to create an STP Digital Team and fund four new posts initially to give us extra capacity to work on projects like the creation of a single electronic patient record for our acute hospitals.

Implementing our diabetes strategy

  • Diabetes care is a priority for our partnership because we know that outcomes for people with diabetes locally are not good enough. The Executive discussed the progress with the implementation of our Diabetes Strategy.
  • Overall, progress is being made and we have a much clearer plan in place than a year ago, for example around the implementation of the National Diabetes Prevention Programme. However we know that improving outcomes will take time.
  • There is more work for us to do to quantify the clinical and financial benefits of the work being done to implement our strategy.
  • It is important that all of our organisations understand their role in implementing our strategy, preventing people from getting diabetes and improving care for with the condition.
  • There is a significant role for non-NHS organisations in helping to deliver the improvements needed. We need to make sure we are making the most of the wider resources and funding available to achieve the objectives in our diabetes strategy.