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Lincolnshire Sustainability and Transformation Plan Lincolnshire Sustainability and Transformation Plan

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Lincolnshire Sustainability and Transformation Plan Lincolnshire Sustainability and Transformation Plan Lincolnshire Sustainability and Transformation Plan Lincolnshire Sustainability and Transformation Plan Contents Foreword ........................................................................................................... 3 Women and Children ......................................................................................... 69 Lincolnshire Sustainability and Transformation Plan on a Page ............................ 6 Operational Efficiencies ...................................................................................... 72 Executive Summary ............................................................................................ 7 Operational Efficiencies - Implementation Plan ................................................... 73 Our vision .......................................................................................................... 14 Capacity Optimisation ........................................................................................ 74 Patient Stories .................................................................................................... 15 Capacity Optimisation - Implementation Plan ..................................................... 74 Lincolnshire’s Hoshin Planning Matrix ................................................................. 20 Workforce ......................................................................................................... 75 Lincolnshire Context ........................................................................................... 22 Workforce - Implementation Plan ....................................................................... 75 Developing our Plan ........................................................................................... 24 Commissioning Priorities / Right Care ................................................................. 76 You Said, We Did ............................................................................................... 29 Commissioning Priorities / Right Care - Implementation Plan .............................. 77 CCG Improvement and Assessment Framework (current position) ...................... 31 Impact of our work streams ............................................................................... 78 Meeting Our Health and wellbeing challenge ..................................................... 33 Closing the Finance and Efficiency GAP – impact by year ................................... 79 Meeting our Care and Quality Challenge ........................................................... 34 Specialist Commissioning ................................................................................... 80 The Quality challenges for Lincolnshire ............................................................... 36 Enablers ............................................................................................................. 85 Our Quality Ambitions ....................................................................................... 38 Technology ........................................................................................................ 88 Closing the financial gap .................................................................................... 40 Workforce and Organisational Development ...................................................... 90 Working as a system to manage growth in demand ........................................... 41 Workforce modelling to support service transformation ..................................... 98 Transformation Schemes overview ..................................................................... 43 Transport ........................................................................................................... 102 Detail for the Transformation Schemes .............................................................. 47 Implementation ................................................................................................. 104 Clinical Service Redesign .................................................................................... 47 System Governance ........................................................................................... 104 Prevention ......................................................................................................... 47 Programme leadership and support structure ..................................................... 106 Primary Care ...................................................................................................... 51 Current PMO ..................................................................................................... 107 Proactive Care .................................................................................................... 55 High Level (single) critical path for mobilisation ................................................... 108 Urgent Care ....................................................................................................... 57 Critical Milestones in the next 12 month ............................................................ 114 Planned Care ..................................................................................................... 61 Risk and Controls ............................................................................................... 118 Mental Health Learning Disabilities and Autism .................................................. 65 Appendices ........................................................................................................ 121 2 Lincolnshire Sustainability and Transformation Plan These changes are as follows: 1. Changed awareness and understanding of the challenges. All organisations in Lincolnshire now realise that irrespective of statutory boundaries we are all inter-dependent and everyone has a part to play. All of these organisations now have a greater understanding of the priorities and the financial positions of other organisations thanks to the adoption of an open book process. 2. A changed approach to leadership – the leaders of the Lincolnshire system accept that there is a collective responsibility for addressing the issues and that in Foreword the light of the scale of the challenge; each senior leader will be needed to lead Lincolnshire has worked together more closely than ever in the past 3 years to across the system. There is an acceptance from leaders that the well-being of develop the Lincolnshire Health and Care Programme; our Blueprint for future health the system and the people of Lincolnshire is the primary responsibility as leaders and care services in Lincolnshire and our new model of care. The development of with organisational priorities secondary. the Sustainability and Transformation Plan over the last year has built on this strong foundation and is a major milestone in a very complex and extensive programme of 3. Changed behaviours in the past year - leaders and Lincolnshire organisations work. The implementation of this Sustainability and Transformation Plan will bring have worked hard to put behind them the historical adversarial and transactional about the most radical change which most people will see in their working lives, but relationships which have characterised the past to develop common agendas, these changes do reflect the best evidence of what will give us the best outcomes for common assessment of problems but also to hold each other to account in a the people of Lincolnshire. As important as the evidence, there is also collective will positive and respectful way. to make it happen and a growing confidence, in our ability to deliver real change in challenging circumstances. 4. Changed understanding of the solutions – whilst historically we have been very focussed on issues around hospitals, there is an acceptance across the system In 2013 the work of Lincolnshire Health and Care programme confronted the system that the key issue is the move to community services, the prevention agenda, with the fact that if we did not act soon not only would the quality continue to proactive care and the development and scale of self-care for many of the deteriorate in our services but we would face a growing overall system deficit in people who currently use services. There is an acceptance that only by resolving excess of £200m. By 2015/16 the deficit had risen from around £15m to around these issues will we create the space to address the challenges our hospitals face. £73m but little action in reality had been taken confirming the need for radical change. For those whose task it is to scrutinise and critically evaluate this plan, the question must be “so what will be different this time and what has fundamentally changed in order for good ideas to be translated into action?” 3 Lincolnshire Sustainability and Transformation Plan This STP has been developed by cross- scenario”; it does in no way constitute to ensure that our services are safe organisational working; much of its the preferred option nor the final and sustainable for the future. A poor content has already been the subject of option as full public consultation will be service that is very close to home is engagement with the public and with required. The choices we will be required not an alternative option to a high stakeholders through the LHAC process to make will be complex and will quality service that is a bit further but is but some of it is new. Whilst people may inevitably involve change. It is vital that accessible. see the headlines of
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