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Integrated Medium Term Plan 2016-2019

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Integrated Medium Term Plan 2016-2019 Integrated Medium Term Plan 2016-2019 Page 1 of 303 MESSAGE FROM CHAIR AND CHIEF EXECUTIVE Powys Teaching Health Board’s key purpose is to promote the health and well-being of the population and to provide and secure excellent healthcare services. This Plan sets out the key needs of the population and how we will anticipate and respond to these. Last year as a health board we set out our Plan (2015-18) to meet the population’s health and healthcare needs and following scrutiny by Welsh Government Ministers the plan was approved, demonstrating confidence that the needs of the Powys population had been taken into account and that the health board had the capability of delivering. This was a significant achievement for Powys Teaching Health Board, providing a platform for continuous improvement. Whilst the progress made will be detailed in other documents such as the forthcoming Annual Report of Powys Teaching Health Board, in summary, 2015/16 has been a very positive year. Good progress has been made in implementing the key actions we set out to achieve and the difference to patients and citizens is evident. General improvements in health indicators, improved access to local services, excellence in many service areas as judged by patients, greater engagement of staff in our collective work, increased integration with Powys County Council and a balanced budget all demonstrate the way in which we collectively have worked with partners and the public to keep improving. We would wish to take this opportunity to thank all involved for their commitment and hard work in making such a positive improvement. Looking forward, this three year plan continues the work we set out last year as well as focusing specifically on some key priority areas that have become increasingly important. Having a prudent approach to health and care means that citizens, patients and professionals share responsibility for health and healthcare services; we wish to embrace this approach in all that we do. Furthermore, the need for responsible uptake and provision of health and care services is essential – seeking to use only services that are known to have a positive impact. We know that the NHS and care system continue to have challenges in relation to workforce availability. We will therefore need to make the most of all our skills to promote a flexible and innovative approach to care provision. Finally, we must do no harm. Healthcare in a complex business and from time to time things do go wrong. We are committed to improving safety and reducing the risk of harm, always striving for excellence. There are some key areas of the Plan to draw out as our leading priorities including: The development of a long term HEALTH AND CARE STRATEGY- Developing a long term view of health and care for the county is essential. It will aid the access of capital funds to renew buildings and bring technological and infrastructure solutions in support of new service models. ENHANCING PRIMARY AND COMMUNITY CARE - Providing high quality and efficient care in or close to home makes sense on all fronts, especially in our rural county. Supporting GP teams, pharmacists, optometrists/opticians and dentists is key, as is developing a wide range of services in health and social care settings and our community hospitals. INTEGRATED WORKING – Accelerating our work with Powys County Council to integrate services where clear benefit can be achieved. This also includes finding new and better ways to work jointly with people who use our services, with other health organisations in and outside of Wales who provide services to the people of Page 2 of 303 Powys, and essentially with our key partner Powys County Council. Powys, with its often complex arrangements and multiple borders, can demonstrate leadership and expertise on integrated working to others. Excellent Commissioning – There are services we will continue to need to ‘buy’ from others for the people of Powys. We want these to be high in quality and effectiveness, innovative in approach and sensitive to the needs of the individuals who use them. We know that health and care services will need to change and embracing that change will put us in a strong position to achieve the goals for health and wellbeing. Working together for a stronger Powys is at the heart of our values as an organisation. We look forward to continuing to build positive partnerships, networks and alliances with staff, partners and citizens to improve health and wellbeing and to deliver better services for all. Page 3 of 303 TABLE OF CONTENTS LOCAL INTELLIGENCE AND INFORMATION ............................................................................................................................ 10 1.1 HEALTH BOARD PROFILE ........................................................................................................................................................... 11 1.2 PROGRESS AND DELIVERY IN 2015/16 ...................................................................................................................................... 20 1.3 LOCAL HEALTH NEEDS ............................................................................................................................................................... 28 1.3.1 WORKING WITH PARTNERS TO UNDERSTAND HEALTH NEEDS ...................................................................................... 28 1.3.2 POWYS POPULATION DEMOGRAPHICS ........................................................................................................................... 28 1.3.3 WIDER DETERMINANTS OF HEALTH ................................................................................................................................ 30 1.3.4 HEALTH INEQUALITIES .................................................................................................................................................... 35 1.3.5 LIFESTYLE ......................................................................................................................................................................... 44 1.3.6 HEALTH STATUS .............................................................................................................................................................. 45 1.3.7 MENTAL HEALTH POPULATION NEEDS ASSESSMENT ..................................................................................................... 47 1.3.8 HEALTH SERVICE UTILISATION ........................................................................................................................................ 52 1.3.9 FOCUSING ON OUTCOMES .............................................................................................................................................. 54 1.3.10 USING DATA AND HEALTH INTELLIGENCE TO BEST EFFECT IN POWYS ...................................................................... 56 1.4 DEMAND AND CAPACITY MODELLING ...................................................................................................................................... 57 1.5 NATIONAL AND LOCAL POLICY DRIVERS ................................................................................................................................... 59 1.6 INVOLVING THE PEOPLE OF POWYS .......................................................................................................................................... 62 1.6.1 ONE POWYS PLAN AND LOCAL POVERTY ........................................................................................................................ 62 1.6.2 THIRD SECTOR ................................................................................................................................................................. 63 1.6.3 PUBLIC ENGAGEMENT..................................................................................................................................................... 65 1.6.4 CHAT TO CHANGE............................................................................................................................................................ 65 1.6.6 APPROVED STRATEGIES................................................................................................................................................... 66 INTERPRETING THE INTELLIGENCE ......................................................................................................................................... 67 2.1 RESPONDING TO NEED ............................................................................................................................................................. 68 2.1.1 UNDERSTANDING THE INFORMATION AND INTELLIGENCE ............................................................................................ 68 2.2 VISION, AIMS AND OBJECTIVES ................................................................................................................................................. 71 2.2.1 THE VISION ...................................................................................................................................................................... 71 2.2.2 AIMS AND STRATEGIC OBJECTIVES ................................................................................................................................. 71 2.2.3 VALUES AND BEHAVIOURS .............................................................................................................................................. 72 2.3 ORGANISING PRINCIPLES
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