CCG Operational Plan 2019/20 Staffordshire and Stoke-On-Trent Version: V.1 Final 1 | P a g e Contents 1. Introduction ..............................................................................................................................................4 2. Context .....................................................................................................................................................4 3. Our priorities and deliverables .................................................................................................................6 4. Urgent and Emergency care (UEC) and Enhanced Primary and Community Care (EPCC) .......................8 Integrated Care Teams and Hubs .....................................................................................................................8 Integrated Urgent Care .....................................................................................................................................9 Ambulance services ....................................................................................................................................... 10 Model of same day emergency care (SDEC) .................................................................................................. 11 Care Homes ................................................................................................................................................... 11 Delayed transfers of care (DToC) .................................................................................................................. 12 Long term conditions (LTCs) .......................................................................................................................... 12 Respiratory .................................................................................................................................................... 13 Diabetes ......................................................................................................................................................... 14 Frailty ............................................................................................................................................................. 15 5. Quality, safety assurance and improvement ......................................................................................... 16 6. Primary care........................................................................................................................................... 17 Primary care networks (PCN) ........................................................................................................................ 17 Quality in primary care .................................................................................................................................. 18 Primary care digital work stream .................................................................................................................. 19 7. Planned care and cancer ....................................................................................................................... 19 Outpatient follow up reduction ..................................................................................................................... 20 System Speciality Reviews ............................................................................................................................. 21 Musculoskeletal (MSK) .................................................................................................................................. 21 Gastroenterology ........................................................................................................................................... 22 CCG Pathway reviews .................................................................................................................................... 23 Ophthalmology .............................................................................................................................................. 23 Dermatology .................................................................................................................................................. 23 Cardiovascular Disease (CVD) ........................................................................................................................ 24 Cancer ............................................................................................................................................................ 24 8. Mental health and learning disabilities ................................................................................................. 29 Out of area ..................................................................................................................................................... 29 High volume and intensity users ................................................................................................................... 30 CAMHS (Child and Adolescent Mental Health Services) ............................................................................... 32 Special Educational Needs and disabilities (SEND) ........................................................................................ 33 Learning disabilities and autism .................................................................................................................... 34 2 | P a g e Learning from deaths report (LeDeR) ............................................................................................................ 35 9. Maternity and neonatal ......................................................................................................................... 36 10. End of Life .............................................................................................................................................. 37 11. Personalised care ................................................................................................................................... 38 Continuing healthcare (CHC) ......................................................................................................................... 38 Personal health budgets ................................................................................................................................ 38 12. Estates ................................................................................................................................................... 39 13. Specialised Commissioning .................................................................................................................... 39 14. Workforce .............................................................................................................................................. 39 15. Data and technology .............................................................................................................................. 40 16. Finance................................................................................................................................................... 41 17. Public involvement ................................................................................................................................ 43 18. Summary ................................................................................................................................................ 44 Appendix 1 – North Staffordshire and Stoke-on-Trent CCG locality focus ........................................................ 45 Appendix 2 – Cannock Chase CCG, Stafford and Surrounds CCG and South East Staffordshire and Seisdon Peninsula CCG locality focus .............................................................................................................................. 48 Appendix 3 – East Staffordshire CCG locality focus ........................................................................................... 51 Appendix 4 - Supporting primary care .............................................................................................................. 52 Appendix 5 – Further detail on 2019/20 deliverables ....................................................................................... 55 Appendix 6 – Regional Assurance Statements .................................................................................................. 60 3 | P a g e 1. Introduction NHS England published planning guidance for 19/20 operational planning along with a ten year plan that places emphasis on significant transformation of healthcare systems, building on the requirements of the five year forward view. The long term plan is clear on the importance of integrated working and the development of Integrated Care Systems. Along with equivalent provision mechanisms it essentially suggests a shift for local areas from focusing redesign initiatives on predominantly curative and episodic care interventions, to looking at prevention focused pathway and whole system transformation in line with a population health management and outcomes approach to care delivery. This plan outlines our ambition for healthcare delivery in Staffordshire and Stoke-on-Trent and sets out our priorities building on commissioning intentions and local priorities set out in September 2018, whilst fulfilling the expectations placed upon us through the national planning cycle. It reflects across the 6 CCGs where things should be done once but also reflects some locality based