Transforming Community Services (TCS)


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  • Transforming Community Services (TCS) is a change programme for the delivery of primary health care services to help meet the aspirations of the NHS Next Stage Review and new requirements in commissioning health care designed to promote high quality standards of care. The TCS programme aims to provide more integrated sustainable services to improve quality and patient experience, as well as increasing productivity and cost-effectiveness. LLR is adopting a collaborative approach to ensure the best solutions for local communities and staff. The current proposals are for most services to be integrated with existing NHS acute or mental health sector providers and a small number to be put out to tender. Services are due to be transferred out of PCTs by 1 April 2011.
  • Phase 1 – summary of what’s been achieved to date – to include stakeholder engagement Phase 2 – where we are now Phase 3 – what are the plans further down the line?
  • Project plan shared with Strategic Health Authority Transition Board, Steering Group, sub-groups (Commissioning & Finance, IM&T, Facilities, Communications & Engagement) and a core project team have all been established. Benefits criteria based on national tests plus local tests developed through a workshop On-going work to agree preferred providers – 3 categories, service that already have a process to select preferred providers, services with no assessed competition issues and services that require more preliminary work A service brochure is being developed for providers who express an interest in service Service specifications are being worked up and the initial financial analysis is nearing completion
  • Transforming Community Services (TCS)

    1. 1. Transforming Community Services (TCS) Ket Chudasama Associate Director – Programme Delivery NHS Leicester City & NHS Leicestershire County and Rutland
    2. 2. What do we mean by Community Services? <ul><li>Services that take place in in the community, such as in clinics, community hospitals, health centres, in people’s homes, in nursing homes or residential homes </li></ul><ul><li>Outpatients, day surgery and x-ray services at our community hospitals. Some dental, foot care, health promotion and sexual health services </li></ul><ul><li>A wide range of nursing and therapy services for adults and children and for patients with long term conditions like heart disease </li></ul><ul><li>Urgent care provided outside of GP/Dentist usual opening hours, and “walk in” services </li></ul>
    3. 3. What is TCS? <ul><li>A change for community services in Leicester, Leicestershire and Rutland and nationally </li></ul><ul><li>PCTs who currently have staff providing community care are not able employ these staff or keep these services within their organisations from 2011 onwards </li></ul><ul><li>TCS aims to transfer these services safely to other organisations, and in doing so ensure some additional benefits are achieved </li></ul><ul><ul><li>integrated community services </li></ul></ul><ul><ul><li>improved quality and patient experience </li></ul></ul><ul><ul><li>increased productivity and cost effectiveness </li></ul></ul>
    4. 4. The 3 phases of the work <ul><li>Phase 1 completed - initial direction of travel proposed March 2010 </li></ul><ul><li>Phase 2 completed. Confirm proposed destinations </li></ul><ul><li>Phase 3 – set up new contractual and service arrangements for 2011, carry out due diligence – completed on 1 April 2011 </li></ul>
    5. 5. Destinations for service lines <ul><li>University Hospitals of Leicester NHS Trust (UHL) – April 1 2011 (£2.7m) </li></ul><ul><li>(dietetics, diabetes specialist nurses and other specialist LTC nursing) </li></ul><ul><li>Derbyshire County CHS – April 1 2011 (£24.8m) </li></ul><ul><li>(for one year: elective services community hospitals: </li></ul><ul><li>outpatients, daycases, radiography, </li></ul><ul><li>Leicestershire Partnership Trust (LPT) - April 1 2011 (£115.3m) </li></ul><ul><li>(Children’s services, health promotion and prevention, adult community nursing and therapy services, intermediate care and community hospital beds) </li></ul><ul><li>Central Nottinghamshire Clinical Services (CNCS) – 1 April 2011 (£9.9m) (Out of hours services) </li></ul><ul><li>Open Tender (£23.7m) 1 April into interim arrangements – all procurements complete by end of year </li></ul><ul><li>Urgent care, Walk in centre (temporarily to Derbyshire CHS); community equipment (completed); ASSIST GP practice for asylum seekers (temporarily to LPT), community dental services (temporarily to LPT); dental out of hours (temporarily to CNCS) </li></ul>
    6. 6. Current Position <ul><li>Preparing for safe service transfers </li></ul><ul><li>* Contract negotiation – services, staff, estates </li></ul><ul><li>* Due diligence (financial, clinical governance, childrens’ and vulnerable adults assurance) </li></ul><ul><li>* Managing a small number of procurements </li></ul>
    7. 7. Safe service transfer <ul><li>UHL, LPT and Derbyshire CHS services due to transfer 1 April </li></ul><ul><li>Derbyshire County CHS </li></ul><ul><li>* Hosting arrangement for 12 months </li></ul><ul><li>* Services will continue to be provided locally in LLR </li></ul><ul><li>* GPs keen to influence as emerging commissioners </li></ul>
    8. 8. Contract negotiation <ul><li>Integration and transfer of clinical and corporate services </li></ul><ul><li>Financial implications </li></ul><ul><ul><li>Not all services are profitable </li></ul></ul><ul><ul><li>Staff </li></ul></ul><ul><ul><li>Estates </li></ul></ul>
    9. 9. Procurement <ul><li>The Out of Hours service specification has been developed by Leicester, Leicestershire and Rutland (LLR) </li></ul><ul><li>Local Medical Committee and GPs worked together to agree a local model of provision </li></ul><ul><li>Staff working in these services will be TUPEd across to CNCS, providing the out of hours calls to GPs, cover to community hospital beds and the relevant prisons during the out of hours period. </li></ul>
    10. 10. Procurement <ul><li>GPs leading redesign of the Urgent Care Centre based at LRI and the walk-in-centre in Loughborough </li></ul><ul><li>Procurement currently suspended </li></ul><ul><li>GPs to temporarily run the minor injury units in community hospitals in Melton, Market Harborough and Rutland until there is greater clarity about how GP consortia wish to commission minor injury care </li></ul><ul><li>The Minor Injury Unit at Feilding Palmer Hospital remains unchanged </li></ul>
    11. 11. Procurement <ul><ul><li>Community Equipment - 1 st April 2011 </li></ul></ul><ul><ul><li>Community Dental Services – July 2011 </li></ul></ul><ul><ul><li>ASSIST Asylum Seeker Practice – July 2011 </li></ul></ul><ul><ul><li>Interim arrangements from 1 April as appropriate </li></ul></ul>
    12. 12. Procurement <ul><ul><li>Community Equipment - 1 st April 2011 </li></ul></ul><ul><ul><li>Community Dental Services – July 2011 </li></ul></ul><ul><ul><li>ASSIST Asylum Seeker Practice – July 2011 </li></ul></ul><ul><ul><li>Interim arrangements from 1 April as appropriate </li></ul></ul>
    13. 13. After the transfer <ul><ul><li>Monitoring via - contract management meetings - provider implementation boards including representatives from PCTs and the GP consortia </li></ul></ul>
    14. 14. Voluntary Sector Engagement <ul><li>Audience views and questions please </li></ul>