Health & Social Care Reforms and the 5yr Forward View: reconfiguration, integration and the new care models in the East of England

                        

Health and social care in England is going through a period of significant change. A range of national programmes are changing the way services are delivered, to align every-day practice with the vision set out in the five year forward view (5YFV)

While there is national direction and oversight of these programmes, how they work in practice will be determined locally. Key stakeholders including those from the Third sector; the voluntary community and social enterprise sectors, need to engage in and influence these programmes as they develop.

The 5YFV covers a number of themes, such as the importance of public health and ill-health prevention, empowering patients and communities, strengthening primary care and making further efficiencies within the health service.


National programmes

New care models - ‘vanguard’ sites

Success regimes

Integration Pioneers

Integrated personal commissioning (IPC)

The prime minister’s GP access fund (formerly known as the prime minister’s challenge fund)

Diabetes Demonstrator sites

Devolution


What's happening in East of England?

The new care models 'vanguard' sites

The theme receiving most attention is the new models of care. Seen as one of the first steps for delivering the shared vision for the future of the NHS in the five year forward view (5YFV) the new care models programme supports the improvement and integration of NHS Services.

The divide between primary care, community care and care in hospitals is seen increasingly as a barrier to coordinated services. While developing strategic plans across local areas is not new, new care models are being actively promoted across England to develop blueprints that can be adopted across the rest of the health and social care system. The models aim to break down the artificial divides between different parts of the health service, as well as between the NHS and social care.

(please click on the headings for more information about each vanguard) 

East and North Hertfordshire Clinical Commissioning Group

This is one of six enhanced health in care homes vanguard sites across England It is a partnership between:

  • Hertfordshire County Council;
  • East and North Hertfordshire Clinical Commissioning Group;
  • Hertfordshire Care Providers Association.

The Vanguard will focus on enhancing the skills and confidence of care home staff through a package of education and training.The programme will create dedicated multi-disciplinary teams for Care Homes which will include GPs, community psychiatric nurses, district nurses and geriatricians.

 

Cambridgeshire and Peterborough Clinical Commissioning Group

This is one of eight urgent and emergency care vanguard sites across England. It is a partnership between:

  • Cambridgeshire and Peterborough Clinical Commissioning Group;
  • East of England Urgent and Emergency Care Network.

As a UEC Vanguard the CCG aims to accelerate improvements and develop a best practice model for urgent care services which helps address variations in access to services and health inequalities in the region.

See also Cambridgeshire and Peterborough UEC Vanguard  FAQ’s pdf for more information.

To read more about the Vanguard programme visit our Introduction to the New Care Models – Vanguard Sites


The success regime

In June 2015, NHS England identified three challenged local health and care economies, including Essex, where the conditions necessary to change do not exist. The success regime is designed to address the systemic issues in these areas.

(please click on the headings for more information about the success regime in Essex) 

Essex
The Success Regime in Essex is focusing on central and southern areas, rather than the whole county. This includes:

  • Basildon and Thurrock University Hospitals NHS Foundation Trust;
  • Southend University Hospital NHS Foundation Trust;
  • Mid Essex Hospitals Services Trust;
  • Basildon and Brentwood CCG;
  • Castle Point and Rochford CCG;
  • Mid Essex CCG;
  • Southend CCG;
  • Thurrock CCG.

Read more about the  Success in the document Success Regime: a whole systems intervention approach 

and from Healthwatch Essex Report: Update on Success Regime, South and Central Essex Vanguard status, and the Health and Wellbeing Board Integration Board


The Prime Minister’s Challenge Fund (GP access fund)

In 2014, the prime minister announced a new challenge fund to help improve access to general practice and stimulate innovative ways of providing primary care services. Across two waves, 57 pilots, covering over 2,500 practices, were chosen to test these new methods.

(please click on the headings below for more information about the Prime Minister's Challenge Fund in the East) 

Phase 1 Pilots

The Care UK Superpractice
Two practices in North Colchester and Clapham Junction are offering 12,000 patients the facility to access services by phone 24/7, using a single point of contact.

Transformational Innovations for Primary Care in West Hertfordshire – Watford Care Alliance

In West Hertfordshire, 115,000 patients across 15 practices can access GP appointments up to 8pm, seven days a week, giving an additional 12,000 GP appointments a year.

Phase 2 Pilots

Community Primary Care HUB Clinics
15 practices within the area of Basildon and Brentwood CCG are working together to deliver access seven days a week 8am-8pm through multiple community-based primary care HUB clinics.

West Essex 7 Day Primary Care Innovation and Integration Project
This pilot works across 38 GP practices and aims to improve primary care access for the population of West Essex CCG with a special focus on those patients at risk of A&E attendances and unplanned admissions.

Primary Care Transformation Programme - Peterborough
The 29 practices in this scheme have organised themselves into three hubs, serving populations of up to 100,000 patients, supported by the planned formation of a new “umbrella” organisation for primary care in the locality.

Working Together to Transform Primary Care in Ipswich
This pilot will offer patients from 40 practices with 390,000 registered patients, improved access to appointments in the evenings and weekends from 6.30pm-9pm Monday to Friday, and 9am-9pm Saturday, Sunday and Bank Holidays.

Find out more about the prime minister’s GP access fund

See also the Prime Minister’s Challenge Fund: Improving Access to General Practice First Evaluation Report: October 2015


Integrated Care Pioneers

In 2013, national partners asked local areas (NHS and local government together) to express an interest in becoming pioneers to act as exemplars, demonstrating the use of ambitious and innovative approaches to efficiently deliver integrated care. Following an independent selection process, 14 pioneer sites across England were announced in November 2013. The selection process was then repeated in the autumn of 2014, and a further 11 pioneer sites joined the programme in January 2015.

(please click on the headings below for more information about the Integrated Care Pioneers in the East) 

Southend
Partners include:

  • South Essex Partnership University NHS Foundation Trust;
  • Southend University Hospital NHS Foundation Trust;
  • Southend CCG;
  • Other local organisations.

West Norfolk
Partners include:

  • Norfolk and Suffolk NHS Foundation Trust;
  • Norfolk Community Health and Care NHS Trust;
  • The Queen Elizabeth Hospital, King’s Lynn, NHS Foundation Trust;
  • West Norfolk CCG;
  • Other local organisations.

Find out more about integrated care pioneers and also LGA Local Integrated Care and Support Pioneers

 

See also Integrated Care Pioneers: one year one  and Integrated care pioneers – two years on


Integrated Personal Commissioning (IPC) Demonstrator Sites

In 2014, nine demonstrator sites were selected for the IPC programme to allow individuals, commissioners and the voluntary sector to blend comprehensive health and social care funding, allowing the patient to direct how it is used.

IPC is a new approach to joining up health, social care and other services at the level of the individual. It enables people, carers and families to blend and control the resources available to them across the system in order to ‘commission’ their own care through personalised care planning and personal budgets. In tandem, IPC also supports people to develop their knowledge, skills and confidence to self-manage through partnerships with the voluntary and community sector (VCSE), community capacity building and peer support.

(please click on the heading below for more information about the Integrated Personal Commissioning in Luton) 

Luton
Luton has recently become an Integrated Personal Commissioning demonstrator site. Luton CCG and Luton Borough Council are working together through the IPC model to offer people with dementia more choices about their care.

Read more about integrated personal commissioning and also from the Local Government Association National Children & Adult Services Conference

Voluntary Voices has been selected as a partner to the Integrated Personalised Commissioning programme and is establishing a workstream on co-production with the Integration Pioneers. 

The Regional Voices website comprises useful information about IPC and what it can mean for the voluntary sector.


Diabetes Demonstrator sites

In December 2014, NHS England announced in the Five Year Forward View into Action planning guidance that it would establish a national Type 2 Diabetes Prevention Programme in partnership with Public Health England (PHE) and Diabetes UK. Seven demonstrator sites have been testing innovative approaches to programme delivery for the last year and this learning has shaped the final programme to get the best results for patients 

The programme launch coincides with PHE’s new national campaign, One You, which encourages people in midlife to take control of their health and make better lifestyle choices – helping them to prevent ill health and help them live well for longer.

First wave

In a phased approach 27 areas will open their doors to patients in the next few months and throughout 2016 including:

 

  • East and North Hertfordshire
  • Norfolk and Norwich
  • Essex
  • Cambridge and Peterborough

 Read more about the Diabetes Demonstrator sites on the NHS England website


Devolution of health and social care

There are no formal devolution deals taking place at the moment in the East of England.

Read the Kings Fund briefing: Devolution: what it means for health and social care in England


Wellbeing East is the name of Regional Voices Health and Social Network in the East of England. 

*From the 1st October 2015 Regional Voices' Health & Social Care Networks in the East and East Midlands (formerly managed by OEM) are being managed by selfhelp UK

Please email wellbeing@selfhelp.org.uk  if you would like to join our Wellbeing East network or if you have any news, events or resources you would like to share with network members.

or you can contact Jayne Quantrill contact, Health and Wellbeing Coordinator Wellbeing East directly at  jayne.quantrill@selfhelp.org.uk  mobile telephone number: 07508490731 


 

  Regional Voices champions the work of voluntary and community organisations to improve health, well-being and care, across 
England
. Regional Voices is a partnership of nine regional networks. Together, we directly connect to over 25,000 voluntary and community organisations. Our coverage is broad, deep and well-established. Our vision is for a society where voluntary and community organisations are connected with decision-makers at all levels, able to influence policy and improve community health, care and well-being through better services.