Surrey Heartlands Diagnostic Services Endoscopy Market Engagement 30

Surrey Heartlands Diagnostic Services Endoscopy Market Engagement 30 th July 2020 9. 15 am - 12. 00 noon WELCOME

Jack Wagstaff Managing Director North West Surrey Integrated Care Partnership on behalf of Surrey Heartlands ICS Welcome and Introductions

Aims for Today 1. To outline and discuss the challenges faced by SH with regards to diagnostic capacity – specifically Endoscopy 2. To gain a better understanding from the provider market about potential solutions and best practice examples that will inform the development of a series of options and next steps

Programme 09: 15 Welcome and Introductions Jack Wagstaff, MD, North West Surrey Integrated Care Partnership for Surrey Heartlands ICS 09: 20 Endoscopy Provision in Surrey Jack Wagstaff 09: 40 The Ambition for Surrey Jack Wagstaff 10: 00 Questions from the floor Facilitated by Rachael Graham, Deputy Director of Contracts, Surrey Heartlands CCG on behalf of Surrey Heartlands ICS 10: 10 Introducing the Break Out Sessions Rachael Graham 10: 30 Break Out sessions Participants to dial into allocated MS Teams session 11. 00 Feedback and discussion following Break Out sessions Facilitated by Rachael Graham 11. 30 Next Steps / Timeframes Jack Wagstaff 11. 45 Close Jack Wagstaff • • • Group 1: Fully Managed Service Group 2: Staffed Mobile Theatres Group 3: Static Premises Group 4: Insourcing Group 5: Community Pathway Model

Surrey Heartlands ICS Panel Simon Angelides Endoscopy Development Programme Director, Surrey Heartlands ICS Rachael Graham Deputy Director of Contracts, Surrey Heartlands CCG Stephen Hepworth Director of Planning and Contracting, Ashford & St Peter’s Hospitals NHS Foundation Trust Nikki Hislop Head of Access, Royal Surrey Hospital Trust Jack Wagstaff MD, North West Surrey Integrated Care Partnership for Surrey Heartlands ICS Neil Wagstaff Director Acute Network Review, Surrey Heartlands ICS

Welcome & Introduction to Surrey Heartlands Together we are known as an ‘Integrated Care System’ – partnerships where health organisations, the local authorities and others take a collective responsibility for improving the health of the local population, managing resources (including money) and making sure services are high quality. We were one of the first 14 of these new systems in the country (there are now 17, with the expectation that all health and care areas will work this way by 2021).

Our Geography Trust Site Ashford and St Peter’s Trust St Peters Hospital Royal Surrey Hospital Trust Royal Surrey County Hospital Surrey and Sussex Healthcare Trust Epsom and St Heliers East Surrey Hospital Crawley Hospital Epsom Hospital Surrey Heartlands NHS Endoscopy Providers

Endoscopy Provision in Surrey Heartlands Current Providers and Locations for Delivery Activity Information: pre COVID-19 Post COVID-19 Future projections

All Diagnostics (Referrals)

All Diagnostics (Waiting Lists)

All Diagnostics (by Modality)

The Challenge for Surrey Heartlands Prior to COVID-19 two factors at a strategic level have influenced the capacity requirement for Endoscopy services in Surrey Heartlands: • An aging population with more complex needs 1; • Greater emphasis on surveillance; and • Challenging workforce environment COVID-19 has placed additional pressure on the services provided across Surrey Heartlands both in terms of the delivery, but also in terms the current and future demand environment. Presently Primary Care in Surrey Heartlands is referring approximately 65% of the Pre COVID -19 volumes of patients for Endoscopies. Surrey Heartlands is currently quantifying the latent demand modelling how and when activity will return to Pre COVID-19 levels – regardless the expectation from clinicians is that there will be a significant backlog across all types of modality and caseload but specifically routine and surveillance. Surrey Heartlands Providers have undertaken a range of measures to support delivery including changing working patterns and engagement with the independent sector, however further capacity is needed, both in response to the COVID-19 backlog and the longer term demand on the service. Surrey Heartlands is considering how to address this challenge as a system, but in so doing needs to consider solutions both ‘at scale’ and ‘at place’. There is currently no view within Surrey Heartlands on this approach and this engagement with the market will inform the development of these options going forwards. 1 The number of people diagnosed with cancer has been rising in recent years, with a 29% increase in the number cancer diagnoses expected between 2016 -2028.

What do we want to achieve in Surrey? Within Surrey Heartlands our goals can be seen across two phases • Short Term – Our goal is to ensure we have sufficient capacity to recover and restore the provision of Endoscopy Services as quickly as possible • Medium / Longer Term – Our goal is support the provision of Endoscopy services and a wider range of diagnostics provisions, in due course, that mitigates the increased levels of demand complexity as noted in the challenges above, both in terms of the changing patient demographics and national landscape These market engagement events will help inform and develop our plans in both the short term context and well as the medium / longer term context across Surrey Heartlands.

BREAK OUT SESSIONS Introduced by Rachael Graham, Deputy Director of Contracts, Surrey Heartlands CCG on behalf of Surrey Heartlands ICS

BREAK

Facilitator : Rachael Graham, Deputy Director of Contracts, Surrey Heartlands CCG on behalf of Surrey Heartlands ICS Feedback and Group Discussion

Questions for discussion in Break Out Sessions 1. What challenges can you foresee in developing services to manage such a backlog whilst also seeking to optimise service quality, access and timeliness across such a broad geographic reach? 2. Can you describe any best practice, models of care and service delivery that would support the challenges we have described today? • Are there any additional considerations/issues that commissioners should be aware of? • What can we learn from others that we can implement immediately, in the immediate, mid and longer term? 3. On the basis of the detail presented today do you believe that your organisation/service offering could support Restoration and Recovery in the immediate/near term? 4. What parts of the patient journey can be provided from initial engagement to final diagnosis? 5. Do you have experience of rapidly mobilising services in support of backlog management/service recovery? • How quickly can services be mobilised and at what scale does speed become compromised? • Do you have any scalable options and if so what are the limiting factors to such an approach? 6. Can you describe your Clinical Quality Assurance Process? 7. What are the interdependencies upon which service delivery will be reliant e. g. referral support services, treatment capacity in primary/community and/or acute services etc. ?

Surrey Heartlands ICS Q&A Panel Simon Angelides Endoscopy Development Programme Director, Surrey Heartlands ICS Rachael Graham Deputy Director of Contracts, Surrey Heartlands CCG Stephen Hepworth Director of Planning and Contracting, Ashford & St Peter’s Hospitals NHS Foundation Trust Nikki Hislop Head of Access, Royal Surrey Hospital Trust Jack Wagstaff MD, North West Surrey Integrated Care Partnership for Surrey Heartlands ICS Neil Wagstaff Director Acute Network Review, Surrey Heartlands ICS

Next Steps / Timeframes • Review and summarise feedback from this event • Publish the event feedback on the SH CCG website • MDT group of SH representatives to meet to review feedback and learning and prepare options appraisal recommending next steps • Keep market informed of future procurement activity – in due course

Jack Wagstaff Managing Director North West Surrey Integrated Care Partnership on behalf of Surrey Heartlands ICS Close