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STRATEGIC DIRECTION

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The document outlines Lincolnshire County Council's strategic direction and financial challenges over the next few years. It summarizes: 1) The council faces a funding gap of £148 million by 2015 due to grant reductions and budget pressures, with an additional £90 million challenge expected by 2018-2019. 2) Commissioning strategies are outlined to improve services for children, adults, and communities in light of reduced funding. 3) The vision is for more integrated and proactive health and care services delivered through community teams and urgent care centers, freeing hospitals for specialist care. 4) Emerging proposals are described to restructure services around proactive urgent care, planned care, and women's and children's services

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STRATEGIC DIRECTION Teresa Roche

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Finances and the future challenge • 2014/15 is last year of current CSR, this period = Grant reductions / budget pressures = £148m gap (£129m savings and £19m reserves) to March 2015 • Spending Review 2015/16 = 14% reduction in Government support with an expected downward trajectory in funding through to at least 2018/19 • Uncertainty around levels of funding and potential use of Better Care Fund • An additional £90m challenge by 2018/19

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Commissioning Strategies • Children are Safe and Healthy • Learn and Achieve • Readiness for Adult Life • Readiness for School • Adult Specialities • Carers • Adult Frailty, Long Term Conditions and Physical Disability • Safeguarding Adults • Enablers and support to the Council’s outcomes • How we do our business • Protecting the Public

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Commissioning Strategies • Sustaining and growing business and the economy • Protecting and sustaining the environment • Sustaining and developing prosperity through infrastructure • Community Resilience and Assets • Wellbeing • Enablers and support to key relationships

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Our Vision Quality, safety and sustainability for health and care services Improved joint working of health and care professionals - an integrated service for patients Providing the right care at the right time closer to patients’ homes 7 day a week services for local people through community 'neighbourhood' teams, supported by urgent care centres across the county Hospitals ‘freed up’ to provide specialist or genuine emergency trauma and time critical services

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Emerging proposals for a new model of health and care Proactive Urgent Care (Reactive) Elective (Planned Care) Women & Children 6 A suite of proactive responses to care needs delivered through neighbourhood teams, comprising health and social care working with the local community and voluntary sector workers. Development of a network of urgent care provision (aligned to Keogh Review). Possible consolidation to address quality & recruitment issues and meet reduced future demand from proactive interventions including improved Single Point of Contact. Possible single management / commissioning structure. Improving the way referrals work and end-to-end integration of services (standardising and sharing best practice). Possible consolidation of elective care services to meet national standards & respond to reductions in activity from proactive interventions. Improve delivery of care needs outlined in the CYPP Development of “mild to moderate” pathways delivered closer to home. Possible consolidation to address quality & recruitment issues Possible single management / commissioning structure.

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STRATEGIC DIRECTION

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STRATEGIC DIRECTION

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STRATEGIC DIRECTION

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THE PEOPLE’S PARTNERSHIP LINKS INTO THE HEALTH AND WELLBEING BOARD

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Where are we now? • Working in partnership with Involving Lincs • Expressions of Interests have been put forward by Involving Lincs full members for the overarching role of ‘Accountable Body’ • We will work in partnership to create the EOIs for the role of ‘Strand Lead’ – Carers – Children and Young People – Learning Disability – Mental Health – Older People – Physical Disability and Sensory Impairment • November 2014 – Accountable Body awarded • January – May 2015 – Development work • April 2015 – March 2016 – People’s Partnership Early Implementation, Pilot year

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STRATEGIC DIRECTION

  • 2. Finances and the future challenge • 2014/15 is last year of current CSR, this period = Grant reductions / budget pressures = £148m gap (£129m savings and £19m reserves) to March 2015 • Spending Review 2015/16 = 14% reduction in Government support with an expected downward trajectory in funding through to at least 2018/19 • Uncertainty around levels of funding and potential use of Better Care Fund • An additional £90m challenge by 2018/19
  • 3. Commissioning Strategies • Children are Safe and Healthy • Learn and Achieve • Readiness for Adult Life • Readiness for School • Adult Specialities • Carers • Adult Frailty, Long Term Conditions and Physical Disability • Safeguarding Adults • Enablers and support to the Council’s outcomes • How we do our business • Protecting the Public
  • 4. Commissioning Strategies • Sustaining and growing business and the economy • Protecting and sustaining the environment • Sustaining and developing prosperity through infrastructure • Community Resilience and Assets • Wellbeing • Enablers and support to key relationships
  • 5. Our Vision Quality, safety and sustainability for health and care services Improved joint working of health and care professionals - an integrated service for patients Providing the right care at the right time closer to patients’ homes 7 day a week services for local people through community 'neighbourhood' teams, supported by urgent care centres across the county Hospitals ‘freed up’ to provide specialist or genuine emergency trauma and time critical services
  • 6. Emerging proposals for a new model of health and care Proactive Urgent Care (Reactive) Elective (Planned Care) Women & Children 6 A suite of proactive responses to care needs delivered through neighbourhood teams, comprising health and social care working with the local community and voluntary sector workers. Development of a network of urgent care provision (aligned to Keogh Review). Possible consolidation to address quality & recruitment issues and meet reduced future demand from proactive interventions including improved Single Point of Contact. Possible single management / commissioning structure. Improving the way referrals work and end-to-end integration of services (standardising and sharing best practice). Possible consolidation of elective care services to meet national standards & respond to reductions in activity from proactive interventions. Improve delivery of care needs outlined in the CYPP Development of “mild to moderate” pathways delivered closer to home. Possible consolidation to address quality & recruitment issues Possible single management / commissioning structure.
  • 10. THE PEOPLE’S PARTNERSHIP LINKS INTO THE HEALTH AND WELLBEING BOARD
  • 11. Where are we now? • Working in partnership with Involving Lincs • Expressions of Interests have been put forward by Involving Lincs full members for the overarching role of ‘Accountable Body’ • We will work in partnership to create the EOIs for the role of ‘Strand Lead’ – Carers – Children and Young People – Learning Disability – Mental Health – Older People – Physical Disability and Sensory Impairment • November 2014 – Accountable Body awarded • January – May 2015 – Development work • April 2015 – March 2016 – People’s Partnership Early Implementation, Pilot year

Editor's Notes

  1. Our Vision hasn’t changed! As a programme we are still looking to achieve this.
  2. Some models are starting to emerge and we are starting to look at what other areas aside from the neighbourhood teams – Do we want to talk about the other areas to progress here?
  3. The People’s Partnership will allow the Council services to gain access to the community through one point of access. The principle of the Peoples Partnership is to provide a platform for service users to:-  Inform Commissioners of needs , gaps and issues  Support one another with good practice / self-help tips  Celebrate success The Peoples partnerships will be networks that will engage with communities of ‘vulnerable ‘people. Each network will have an organisational lead. The organisations leading the networks (strand leads) will have a place on the Peoples Partnership Board. Organisations leading Peoples Partnership Networks will be expected to be or become members of Involving Lincs. Structure The Peoples Partnership pilot will be funded through LCC/Public Health. The lead partner will be Involving Lincs. Involving Lincs will source a lead body through an Expression of Interest process. The Involving Lincs steering group will form part of the People's Partnership Board, along with the network leads and Involving Lincs lead coordinating body.
  4. The People’s Partnership has the potential to influence what the Authority does during every single stage of the Commissioning Cycle. We can strengthen engagement and co-production within the development of services, increase the numbers and influence of people within consultation processes, us the views of people to inform us during contract monitoring and service improvement and use the vast knowledge of the community when looking at intelligance gathering throughout the JSNA processes.
  5. We are working at improving the involvement of the People’s Partnership within the Health and Wellbeing Board, through links with Healthwatch (as a member) and Involving Lincs who have strong links with the HWB members. This increases information provided to the HWB about issues that the community is facing, increases the intelligence ‘pool’ from which the HWB use within the JSNA processes and strengthens the ability of the HWB to gather engagement feedback and distribution of information in each direction
  6. November 2014 - contract awarded to core IL member Jan - May 2014 development work:  Expression of Interests sent out through Involving Lincs and Community Engagement Team contacts  Strand Lead posts awarded to relevant bodies  set up People’s Partnership working group  training and network day planned with New Economics Foundation for January 2015  marketing etc  Development of web pages  Review of Data base  Successful links forged between People’s Partnership and the Health and Wellbeing Board April 2015 – March 2016  People’s Partnership Early Implementation  Report on learning throughout the period including lessons learned  Further partnership working and development of potential future strands  Potential funding streams explored External evaluation to identify if the scheme is worth extending in its current format or whether it should change in any way – in order to help it’s longevity. Evaluation to identify future core funding, alternative and additional external and internal funding, growth and lessons learned (internally and externally) We will use the pilot year to look at internal and external funding, greater links and opportunities with partners (internally and externally) and look at lessons learned throughout the year in order to cement the People’s Partnership within the Council’s Commissioning Cycle