West Sussex Practice Managers Association Conference Adam Doyle

NHS Long Term Plan Brighton and Hove CCG | Coastal West Sussex CCG Hastings

The NHS Long Term Plan • Published in January 2019. • Outlines how the

What is an Integrated Care System (ICS)? • ICSs aim to build on the

Integrated Care Partnerships (ICPs) and Primary Care Networks (PCNs) The NHS Long-Term Plan also

What are Integrated Care Partnerships (ICPs)? • Alliances of NHS providers that work together

What are Primary Care Networks (PCNs)? • Groups of GP practices that come together

Current response to LTP – what we know so far What the LTP implementation

What does this mean for CCGs? “ CCGs will become leaner, more strategic organisations

Background, context and history • • Clinical Commissioning Groups (CCGs) were created following the

The options • • • Option one – a federation/continue with current arrangements; seven

Assessing the options Key criteria agreed with GBs: • Supports delivery of the NHS

Current thoughts Having reviewed all criteria, the current thoughts are as follows: To propose

What does this mean for practices? • CCGs are changing • PCNs are envisaged

Slides: 14

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West Sussex Practice Managers Association Conference Adam Doyle Chief Executive Officer Senior Responsible Officer – Sussex and East Surrey STP 6 June 2019 Brighton and Hove CCG | Coastal West Sussex CCG Hastings and Rother CCG | | Crawley CCG | East Surrey CCG High Weald Lewes Havens CCG | | Eastbourne, Hailsham and Seaford CCG Horsham and Mid Sussex CCG

The NHS Long Term Plan • Published in January 2019. • Outlines how the NHS will change in the future. • Sets the target of having Integrated Care Systems (ICSs) covering the whole country by April 2021. • This will involve a fundamental shift in how CCGs will work and how future commissioning will be done. Brighton and Hove CCG | Coastal West Sussex CCG Hastings and Rother CCG | | Crawley CCG | East Surrey CCG High Weald Lewes Havens CCG | | Eastbourne, Hailsham and Seaford CCG Horsham and Mid Sussex CCG

What is an Integrated Care System (ICS)? • ICSs aim to build on the collaborative and integrated working that has already been established through Sustainability and Transformation Partnerships (STP). • Will involve NHS organisations (providers and commissioners), in partnership with local councils. • Will hold a collective responsibility for managing resources, delivering NHS standards and improving the health of the populations they serve. • Will provide more streamlined commissioning arrangements across whole systems and more joined-up commissioning between CCGs and local authorities. Brighton and Hove CCG | Coastal West Sussex CCG Hastings and Rother CCG | | Crawley CCG | East Surrey CCG High Weald Lewes Havens CCG | | Eastbourne, Hailsham and Seaford CCG Horsham and Mid Sussex CCG

Integrated Care Partnerships (ICPs) and Primary Care Networks (PCNs) The NHS Long-Term Plan also sets out the future formation of: • Integrated Care Partnerships (ICPs) • Primary Care Networks (PCNs) Both represent a transformation of how health and care services will be provided and will also involve some commissioning requirements at a more local level. Brighton and Hove CCG | Coastal West Sussex CCG Hastings and Rother CCG | | Crawley CCG | East Surrey CCG High Weald Lewes Havens CCG | | Eastbourne, Hailsham and Seaford CCG Horsham and Mid Sussex CCG

What are Integrated Care Partnerships (ICPs)? • Alliances of NHS providers that work together alongside local authorities and the third sector to provide care for populations of around 250, 000 to 500, 000 people. • Within our STP area, the ICPs are likely to be formed around four areas that are currently covered by what was previously called Coastal Care (West Sussex); the Alliance South; the Alliance North and East Sussex Better Together. Brighton and Hove CCG | Coastal West Sussex CCG Hastings and Rother CCG | | Crawley CCG | East Surrey CCG High Weald Lewes Havens CCG | | Eastbourne, Hailsham and Seaford CCG Horsham and Mid Sussex CCG

What are Primary Care Networks (PCNs)? • Groups of GP practices that come together locally to collectively develop and deliver services in partnership with other primary care providers (such as ophthalmology, pharmacy, dentistry), community services, social care voluntary sector and other providers of health and care services. • PCNs will enable a focus on the local population to address inequalities & with greater provision of preventative, proactive, personalised, coordinated and more integrated health and social care. • By working together in networks, GP practices and other care providers can deliver better care for their patients and better lives for their staff. • Thank you for the work done so far in establishing Primary Care Networks in West Sussex. Brighton and Hove CCG | Coastal West Sussex CCG Hastings and Rother CCG | | Crawley CCG | East Surrey CCG High Weald Lewes Havens CCG | | Eastbourne, Hailsham and Seaford CCG Horsham and Mid Sussex CCG

Current response to LTP – what we know so far What the LTP implementation framework will include: • What systems have to produce • System narrative plan - how systems will deliver the transformation activities required to deliver the LTP commitments • System delivery plan - integrated finance, activity and workforce plans • How it should be produced • Clinically led, locally owned, financially balanced, based on realistic workforce assumptions, deliver the entirety of the LTP and phase activity over 5 years • When things need to be delivered • Sept 2019 - initial submission • End of Oct 2019 – plans agreed with regional teams • Jan - Mar 2020 – light touch operational plans drafted and submitted Brighton and Hove CCG | Coastal West Sussex CCG Hastings and Rother CCG | | Crawley CCG | East Surrey CCG High Weald Lewes Havens CCG | | Eastbourne, Hailsham and Seaford CCG Horsham and Mid Sussex CCG

What does this mean for CCGs? “ CCGs will become leaner, more strategic organisations that support providers to partner with local government and other community organisations on population health, service redesign and Long Term Plan implementation. ” - The NHS Long-Term Plan Brighton and Hove CCG | Coastal West Sussex CCG Hastings and Rother CCG | | Crawley CCG | East Surrey CCG High Weald Lewes Havens CCG | | Eastbourne, Hailsham and Seaford CCG Horsham and Mid Sussex CCG

Background, context and history • • Clinical Commissioning Groups (CCGs) were created following the Health and Social Care Act in 2012, and replaced Primary Care Trusts on 1 April 2013. In 2016, all Sussex CCGs were arranged with the Sussex and East Surrey Sustainability and Transformation Partnership (STP). As such the Sussex CCGs have been working closely with East Surrey CCG. Since late 2016, the Sussex and East Surrey CCGs have been considering the future of health commissioning in Sussex and East Surrey. CCG have increasingly been working together over this time. LTP published: o All STPs to become an ICS o 1 ICS to equal 1 CCG o PCN in place o ICPs to be developed East Surrey CCG looking towards Surrey 7 Sussex CCGs need to establish their future shape Brighton and Hove CCG | Coastal West Sussex CCG Hastings and Rother CCG | | Crawley CCG | East Surrey CCG High Weald Lewes Havens CCG | | Eastbourne, Hailsham and Seaford CCG Horsham and Mid Sussex CCG

The options • • • Option one – a federation/continue with current arrangements; seven separate CCGs, continue a shared management team, governance and decision making. Option two – a single CCG for all Sussex CCGs, creating one statutory organisation Option three – a merger in a coterminous footprint with local authorities which creates three statutory CCGs in Sussex: o Brighton and Hove CCG o East Sussex CCG o West Sussex CCG o East Surrey CCG moves to Surrey Heartlands ICS Brighton and Hove CCG | Coastal West Sussex CCG Hastings and Rother CCG | | Crawley CCG | East Surrey CCG High Weald Lewes Havens CCG | | Eastbourne, Hailsham and Seaford CCG Horsham and Mid Sussex CCG

Assessing the options Key criteria agreed with GBs: • Supports delivery of the NHS Long Term Plan • Engagement • Co-terminosity with local authorities • Clinically-led • Optimising use of administrative resources • Arrangements with other CCGs • Strategic purpose • Prior progress • Future-proofed • Financial management and value for money Brighton and Hove CCG | Coastal West Sussex CCG Hastings and Rother CCG | | Crawley CCG | East Surrey CCG High Weald Lewes Havens CCG | | Eastbourne, Hailsham and Seaford CCG Horsham and Mid Sussex CCG

Current thoughts Having reviewed all criteria, the current thoughts are as follows: To propose to memberships a merger in a coterminous footprint with local authorities which creates three statutory CCGs in Sussex: o Brighton and Hove CCG o East Sussex CCG o West Sussex CCG o East Surrey CCG moves to Surrey Heartlands ICS The is also consideration to having joint committees and committees in common between CCGs This is relevant to all areas outside of the Sussex footprint Brighton and Hove CCG | Coastal West Sussex CCG Hastings and Rother CCG | | Crawley CCG | East Surrey CCG High Weald Lewes Havens CCG | | Eastbourne, Hailsham and Seaford CCG Horsham and Mid Sussex CCG

What does this mean for practices? • CCGs are changing • PCNs are envisaged to be a key enabler for delivery and potentially commissioning • The provider / commissioning relationship is changing and as such, CCGs are changing • We can design how to take this agenda forward together Brighton and Hove CCG | Coastal West Sussex CCG Hastings and Rother CCG | | Crawley CCG | East Surrey CCG High Weald Lewes Havens CCG | | Eastbourne, Hailsham and Seaford CCG Horsham and Mid Sussex CCG