SaHF DMBC Volume 1 Edition 1.1.pdf - Shaping a healthier future

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Shaping a healthier future has set out a clear stakeholder engagement strategy that is crucial to the successful delivery of our proposals. We understand that patients, staff and the wider public care deeply about what happens to their local NHS services and it is critical that they are part of the journey we undertake. Stakeholder engagement work started at the beginning of the Shaping a healthier future programme and built on similar work carried out with Clinical Working Groups and other stakeholders in previous years. The programme carried out a systematic and wide-ranging programme of engagement based on an agreed set of principles and an understanding of who our stakeholders are and how they should be engaged. It is now advising the JCPCT on decisions to be made following consultation. Figure 3.3: Summary of stakeholder engagement strategy 3.5.2 Stakeholder engagement principles A set of stakeholder engagement principles to underpin our activity was developed. We committed to: Plan and undertake appropriate engagement with relevant stakeholders at each stage of the programme Deliver sufficient levels of awareness and understanding about proposed service changes across NW London among key identified stakeholder groups Provide regular opportunities for stakeholders to engage with us before, during and post formal consultation to facilitate engagement and consultation through high quality, credible communications channels and messages Baseline and monitor support among key stakeholder groups, before, during and after consultation Meet statutory requirements to engage stakeholders 3. Introduction to Shaping a healthier future and purpose of document 20
Ensure consistency of communications between commissioners and providers, as part of managing internal communications Ensure consistent clinical engagement through regular dialogue between programme Medical Directors and provider/borough clinicians Be proactive in identifying existing stakeholder events and meetings to tap into to increase programme awareness and relationship with stakeholders Work collaboratively with the media to ensure access to accurate information for the public. 3.5.3 Identification of stakeholders The programme conducted a robust process that identified a wide range of stakeholders who should be involved in the development of proposals to change the way NHS services are delivered. To identify all the stakeholders, we considered how we could capture the full range of opinions in the development process and how we could incorporate different experiences and learning from similar programmes. As part of the identification and prioritisation process, the programme developed: Stakeholder groupings through an intensive stakeholder workshop A stakeholder analysis showing key groups of stakeholders A stakeholder prioritisation grid in which stakeholder groups were assessed with respect to specific concerns about the programme and prioritised to ensure those concerns are being discussed, understood and met A stakeholder diary in which all external meetings with stakeholders were logged and communication tracked regularly A meetings calendar in which all relevant stakeholder meetings were logged to ensure engagement with key stakeholders groups such that meetings were well attended and prepared for. Figure 3.4 provides a summary of the different stakeholder groups that were identified and the table in Figure 3.5 shows the purpose of engagement with each of the six groups. 3. Introduction to Shaping a healthier future and purpose of document 21
Page 1 and 2: North West London Shaping a healthi
Page 3 and 4: Table of contents Volume 1 Foreword
Page 5 and 6: Foreword Dr Mark Spencer The Clinic
Page 7 and 8: 6. Consultation, feedback and how w
Page 9 and 10: 13. Equalities implications This ch
Page 11 and 12: 1. Executive Summary Introduction t
Page 13 and 14: The overall programme timeline is b
Page 15 and 16: The process was used before consult
Page 17 and 18: • Delivery of multi-disciplinary
Page 19 and 20: Stage 1 - Case for Change Our work
Page 21 and 22: For Quality of care, clinicians hav
Page 23 and 24: 1 2 3 4 5 A 6 B 7 C 8 Quality of Ca
Page 25 and 26: Assuring the proposals Throughout t
Page 27 and 28: Programme implementation arrangemen
Page 29 and 30: 5. To agree that Hammersmith Hospit
Page 31 and 32: DMBC Chapter 2 - Introduction to th
Page 33 and 34: 2. Introduction to the NHS in NW Lo
Page 35 and 36: Figure 2.3: Clinical Commissioning
Page 37 and 38: West Middlesex University Hospital
Page 39 and 40: major hospital, elective centre and
Page 41 and 42: DMBC Chapter 3 - Introduction to th
Page 43 and 44: 3. Introduction to the Shaping a he
Page 45 and 46: 3.3 Programme governance The Joint
Page 47 and 48: The JCPCT is advised by a Programme
Page 49: Consultation - during this phase, t
Page 53 and 54: Stakeholder Group Political Individ
Page 55 and 56: o o o o o Rationale for options dev
Page 57 and 58: The implications of the options in
Page 59 and 60: DMBC Chapter 4 -The Case for Change
Page 61 and 62: 4. The Case for Change This chapter
Page 63 and 64: Stroke Services: The provision of s
Page 65 and 66: We need to do more to support patie
Page 67 and 68: In NW London, however, the NHS is s
Page 69 and 70: Figure 4.6: Emergency general surgi
Page 71 and 72: attack or stroke to designated cent
Page 73 and 74: Figure 4.9: Evaluation of primary c
Page 75 and 76: Inequalities would continue and pro
Page 77 and 78: DMBC Chapter 5 - Process for identi
Page 79 and 80: 5. Process for identifying a recomm
Page 81 and 82: Figure 5.1: Basis of decision of wh
Page 83 and 84: We confirmed this decision, and the
Page 85 and 86: 5.5 A detailed description of the s
Page 87 and 88: Correct care setting to deliver hig
Page 89 and 90: Figure 5.11: Ratings used in evalua
Page 91 and 92: DMBC Chapter 6 - Consultation, feed
Page 93 and 94: 6. Consultation, feedback and how w
Page 95 and 96: 6.2.1 Key findings from the consult
Page 97 and 98: times (particularly for patients tr
Page 99 and 100: Westminster City Council, Adult Ser
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Analysed and considered consultatio
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6.3 Our responses to feedback This
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Feedback received Stakeholders who
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6.3.3 Theme 3: Clinical vision and
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6.3.5 Theme 5: Proposals for local
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DMBC Chapter 7 - Clinical vision, s
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7a. Clinical, vision, standards and
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Local clinicians agreed that in ord
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▪ Expectant mothers should have t
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# Standard care services (111). As
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Figure 7.8: Development of the acut
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# Standard Adapted from source depa
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Figure 7.11: Shaping a healthier fu
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No. Standard Adapted from source Su
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No. Standard Adapted from source se
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# Standard All emergency department
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# Standard All non-urgent - within
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Figure 7.18: Shaping a healthier fu
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# Standard Adapted from source shou
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# Standard Adapted from source Comm
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The final standards are more demand
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Figure 7.26: Proposed services to b
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Each CCG is taking steps to help pr
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in major hospitals) and equipment t
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tangible differences for patients
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Referral A&E Illustrative patient j
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Illustrative patient journey matern
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Illustrative patient journey in mat
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Illustrative patient journey planne
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GP-led care Illustrative patient jo
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7.8.1 Scope of the CIG’s work The
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Theme Clinical outcomes Staff attit
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Further stakeholder engagement is n
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Figure 7.31 E&UC CIG Responses to N
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NCAT recommendation CIG response Se
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Conditions suitable for UCC Clinica
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Exclusion criterion Mental health A
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Diagnostics 7.14.3 Streaming, regis
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Biochemistry Microbiology Radiology
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The Provider must deliver appropria
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Figure 7.41: E&UC CIG recommended k
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will be able to establish a service
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The UCC provider will be responsibl
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Key differences Governance As with
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should be provided with appropriate
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Process map 1: Assessing UCC patien
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Process map 3: UCC to ED transfer p
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make an appointment with their own
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7.19 ED workforce A programme-wide
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The purpose of this section is to s
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Figure 7.45 Consultation results on
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Figure 7.46: Specific Responses the
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NCAT recommendation Original Progra
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7.25.1 London Health Programmes cli
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Future capacity in centralised serv
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3. There would be an additional "st
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in NWL will have a choice of delive
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Support for the proposal is higher
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Figure 7.49: Specific feedback the
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Sub-Theme Organisation Support Conc
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Sub-Theme Organisation Support Conc
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7.36.1 National Clinical Advisory T
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NCAT recommendation Further engagem
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edistributed nationwide. We envisag
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6. The Maternity CIG have considere
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DMBC Chapter 8A-E - Out of hospital
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Out of hospital improvements This c
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8.2. Settings of out of hospital ca
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practical solution for the site, wh
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Brent Health Partnerships Overview
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Consultation theme Standards for ca
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Consultation theme Integration Inve
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8.5.3. Workforce Following feedback
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Delivering this workforce shift wil
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Measure type Domain Potential measu
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8b. Primary care development 8.6. S
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consultation they could have receiv
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8.10. Next steps We are developing
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Figure 8.11: Hub/health centre requ
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some cases, these will be offered o
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Process for development of local ho
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The result is an emerging picture o
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Across NW London, these sites will
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need redeveloping or rebuilding to
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8d. Urgent care centres When indivi
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Figure 8.22: NW London urgent care
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Conditions suitable for UCC Clinica
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Key differences Governance As with
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processes of the CCG and as such th
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around the table accelerates the un
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Improved empowerment - specifically
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Figure 8.28: Realising our integrat
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Figure 8.29: Summary of CCG commiss
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DMBC Chapter 9 - Decision making an
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9a. Decision making analysis stages
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Correct care setting to deliver hig
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“The Brent Health Partnerships Ov
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Royal College of Midwives “The RC
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clinicians wanted to take this into
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9.6.3 Feedback received about the s
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Confirm the service models reflect
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Figure 9.9: The seven hurdle criter
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surgeons in NW London, but we would
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We confirmed this decision with the
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Appropriate staffing is integral to
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The proposals are supported by Depa
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NW London to deliver high quality c
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1. Support predicting where activit
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Figure 9.15: Example travel time ma
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The analysis shown in Figure 9.18,
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Figure 9.18: Impact on private car
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33% support 10% opposed 57% of peop
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Figure 9.21: Watershed map for blue
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etained as a major hospital, becaus
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9.7.29 The implications of this fee
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Figure 9.25: Potential activity flo
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Figure 9.27: Changes in travel time
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Figure 9.29: Changes in travel time
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Figure 9.31: Possible choices betwe
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Either Charing Cross or Chelsea & W
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Figure 9.33: Option A, excluding ca
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Figure 9.36: Option C responses, in
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Richmond Upon Thames LINk Royal Bor
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Southall Black Sisters “The closu
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Figure 9.38: Ranking of evaluation
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Figure 9.42: Evaluation criteria as
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anked third according to the mean s
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9.9.5 The analysis of the five eval
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Figure 9.45: Quality Dashboard data
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Response to feedback about the eval
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Figure 9.48: Quality of care - Acut
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experience. In order to use this as
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Figure 9.50: Time to major hospital
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Rationalising provision across the
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Figure 9.51: Blue light travel time
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Figure 9.52 shows the reduction in
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3 Value for money 9.9.26 The purpos
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Staff recommendation as a place to
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This analysis was agreed prior to c
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Figure 9.56: Ease of delivering eac
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Response to feedback about implemen
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Changes to the designation of the M
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5 Research and Education: Disruptio
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Figure 9.60: Evaluation of disrupti
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9.9.48 The outcome of the disruptio
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Greg Hands, MP for Chelsea & Fulham
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comprises more than 22 million cita
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Quality/Impact score Figure 9.65 Re
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9. Decision making analysis - stage
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There were six distinct parts of th
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Figure 9.69: 5 year gross savings,
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Figure 9.73: Commissioners intend t
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Figure 9.75: Beds bridge: 2012/13 t
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The key modelling assumptions appli
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Figure 9.79: DMBC NHS net capital e
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Figure 9.81: Approach to estimating
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Figure 9.84: Summary of net surplus
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Figure 9.86: Evaluation of total su
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9.13.9 Impact of the changes: Updat
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Figure 9.89: Effect of the expanded
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Sensitivity tests g) Tariff efficie
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Figure 9.93 summarises the impact o
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Figure 9.94: Change in expanded NPV
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The sensitivity analysis supports t
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DMBC Chapter 10 - The recommendatio
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10. The proposed future configurati
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The changes to the scoring before a
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10.3. Why this is the recommendatio
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In the rest of this section, the se
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