Transformation Board: 1st November 2017

Authors: Sarah Parker, Director of Transformation Paper for: For Information/approval note this paper will be shared with organisations for internal communications and used to finalise newsletter for external publication

Since the last Transformation Board on 4th October 2017 the following is a summary of key actions or events:
1. Key workstream updates:

Highlight reports from each workstream are included in papers for today’s Transformation Board. We have also established risk registers for all workstreams except workforce and cancer which will be completed in November.

A Surrey Heartlands Evaluation Framework has been developed through the Clinical Academy, led by Public Health and is presented at today’s Board for agreement. We have already commenced identifying workstream outcomes through the use of logic models as part our suite of evaluation tools.

Workstreams Review sessions have been set up in November 2017 with learning and next steps to be shared at the December transformation Board.

A summary of key messages from workstreams:

2. Investment Framework: next steps – identifying our investment priorities
The first wave of devolved funding was released on 30th September 2017 following approval of our Surrey Heartlands Investment Framework.
Transformation Board on 4th October 2017 agreed a process to support the implementation of this Framework for 2017/18 given we were already in month 7. This included reinforcing our system commitment to winter preparedness; so that we prepare well for and recover quicker from surges in demand or

workforce issues – improving our system resilience. The Board agreed allocation of indicative envelopes to our prioritised areas for 2017/18 and recognised the key role that Workstream Programme Boards need to have in supporting implementation of Investment Framework through leading on coordination and prioritisation of bids.
During October two workshops were held to support teams in developing business cases for transformation funding. The workshops were facilitated by David Bacon from the Best Possible Value programme, upon which the Surrey Heartlands Investment Framework is based. These workshops are being re-run on 13th and 14th November, please contact Victoria Berry ( if you are interested in attending. You will get the most from the workshop if you bring a specific proposal to work up and attend with the key members of the team developing the business case.
A follow-up item on progress since last Board is tabled for today’s Transformation Board
3. Winter

A follow-up agenda item today is in regard to checking our plans for responses to the pressures that winter places on our health and care system and our ability to respond well and support faster system recovery from any impact. Since the last Board we have agreed to set up a single Surrey Heartlands Winter resilience group. The intention is not to replicate the local A&E Boards or the Surrey Local Health Resilience Partnership but to provide a CEO/Director of Social Care escalation forum to: – look at how we respond across systems as well as within providing a point of assurance, escalation and CEO intervention if needed – agree Common standards and payments for clinicians – use the same active capacity management system – ensure we can respond and report as a system – have a shared communication plan

4. Clinical Academy Update:

 A briefing paper for a Surrey Heartlands Expo to be held in Feb/March 2018 has been prepared for November Transformation Board.  Our Surrey Heartlands Evaluation Strategy has been finalised as is presented at today’s Transformation Board for endorsement.  Scoping work is underway to develop proposals for Surrey Heartlands to become a “Quality Improvement System

5. Systems Leadership Support

 The Workforce workstream is overseeing the development of a whole system approach to investing in system leadership locally. In October Suzanne Rankin, Executive Sponsor of our Workforce workstream, approved a bid to the NHS Leadership Academy to access the ‘In Place Leadership Innovation Fund’ for our Surrey Heartlands Health and Care Partnership. NHS Leadership Academy’s aim is to support local systems to develop local, innovative, inclusive and compassionate leadership programme that support achievement of the ambitions of the Five Year Forward View. The bid was developed by the OD leads from our partner organisations. We should hear if we are successful in mid Nov.  Our team that applied for the Yale Strategic System Leadership programme (funded by the NHS Leadership Academy) was notified that they were successful. This will commence 13th November 2017.

6. Communications
Since the last Transformation Board the communications and engagement team have led on directly or supported:
 Public engagement appearances at several Annual General Meetings (e.g. all three Surrey Heartlands CCGs, Royal Surrey County Hospital, Surrey Coalition of Disabled People)  Presentation on Surrey Heartlands Health and Care Partnership to Surrey Young Carers’ Forum 18 October. Young Carers will now send a rep to our Surrey Heartlands Stakeholder Reference Group events.  Surrey Heartlands Stakeholder Reference Group meeting was held on 18th October 2017 chaired by David McNulty, the meeting was well attended with the two key central presentations: the Wider Determinants of Health/unwarranted variation and Cancer.  Ongoing Surrey Heartlands website redevelopment to make the site more dynamic and to become the top option in online search results for Surrey Heartlands. The current website can be accessed by searching Surrey Heartlands and the old website links have now been removed by Partners  We are actively seeking stakeholder feedback on a new format website. We welcome any further comments. The development site can accessed at Please send any feedback to We are hoping for the ability to go live by 14th November 2017.  The new Surrey Heartlands twitter account @surreyheartland is performing well. The 28 day analytics summary at 25 October 2017 showed:

 Tweets  Tweet impressions
 Profile visits
 Mentions  Followers
 20 (up 81.8%)
 17K (Up 301.3%)
 348 (Up 25.2%)
 27 (Up 35.0%)
 90 (Up 49)


The most significant figure is ‘Tweet impressions’. Impressions are related to interaction or engagement after the tweet has been delivered. Tweet count is the total number of tweets sent by the account (not including retweets), whereas the impressions are the tweets sent that actually generate interaction or replies from others on Twitter. This is the communications value.  Shooting short video interviews with Claire Fuller, Matthew Tait and David McNulty 1st Nov 2017. Early use will be in clips for the website and Twitter, focusing in particular on the Surrey Heartlands Academy and Devolution.  Working with Digital workstream project group developing Integrated Digital Care Record (IDCR) launch comms.  Working with Digital workstream project group developing a digital maturity assessment test bed with Oxford Academic Health Science Network and NHS England. Eventual evaluation will help inform NHS England about how best to run future assessments across the country as they become mandatory for health and care transformation systems. As a test bed we also have the opportunity of achieving exemplar status.  Mental Health-related survey to run on Citizens’ Panel (3,000 strong) on 31 October  Arranging high level presentations to NW Surrey and Surrey Downs CCG Practice Managers’ Forums in addition to the one delivered by Sarah Parker at Guildford & Waverley CCG Practice Managers forum  Regular blogs from the SRO, and guest bloggers within our system, will now appear on the website with promotion in our social media channels

7. Citizen Insight and Engagement

The citizen engagement and insight team have collated and reported back to the CVD workstream team the findings from the Cardiovascular co-design event that they supported on the 20th of September 2017 to support planning.

The team has also been working closely with Healthwatch Surrey to develop a resource that can provide a much richer understanding of community priorities and perceptions through citizen representatives. These community ambassadors will be supported by Healthwatch so as to provide a level of independence from the STP. They will help to provide Surrey Heartlands with an insight source that can provide a much needed bottom-up, user-focused element to our social research and co-design work. It is planned for all six of these ambassadors to be in place by mid-January. A paper on this is presented at Transformation Board for noting. Further information can be obtained by contacting Rich Stockley our strategy lead

8. Supporting our system – update on key roles

We are delighted to confirm the following updates:

 Vanessa Harding, currently Associate Director: Transformation Projects at Ashford and St Peters Hospital has been appointed as the Surrey Heartlands Deputy Director of Transformation. Vanessa will commence in a phased transition from November 2017.  CSH Surrey has agreed to second Samantha Stevens to Surrey Heartlands. Sam will start on 27th November as Executive Business Manager with a lead for supporting David McNulty, Justin Newman and the Joint Committee.  Victoria Berry a graduate management trainee from Surrey County Council’s graduate scheme started with us on Tuesday 10th October 2017 and is particularly supporting us on preparing for the workstream reviews, implementing the investment framework.  A Programme Manager recruited to lead audit of existing digital infrastructure and to identify gaps and key priorities.

9. Supporting our system – update on key events

10. National Bids

Cancer – a bid was submitted by the Kent Surrey and Sussex Cancer Alliance to the NHS England for Achieving World-Class Cancer Outcomes: Transformation Funding focussing on developing and evaluating the benefits of a community model of care for cancer patients. We have been notified that this bid was not successful.

System leadership – we are applying for local system leadership funding for local ‘in place’ funding to support delivery of our ambitions (see section below)

11. Regional/National Context

On 5th Oct Larissa Han attended a King’s Fund session on behalf of Surrey Heartlands where they hosted a discussion with the CEO of the Canterbury District Health Board in New Zealand. The Canterbury health system is recognised as a high performing health system, and has transformed health care delivery in the region over the past decade. Learning reinforced our Surrey Heartlands focus the importance of honest, relationship building and that contracting arrangements will develop but must not hold us back. They achieved as they were clinically led, community engaged, management supported.

On 10th Oct we hosted a local visit from Sir Malcolm Grant, Chair of NHS England. Sir Malcolm was interested in our progress and how he could help. Surrey and Borders Partnership NHS Foundation Trust supported with a visit to observe the Technology Integrated Health Management research into using


technology to transform support for people with dementia and their carers. We heard constructive and powerful feedback from two families invited in the study.

On 12th October, Claire Fuller and David McNulty attended a national ACS development day chaired by Michael McDonnell, National Director for Health System Transformation, NHS England. 5 areas of action emerged: ACS evolution; Regulatory models; Control totals and pricing: Capital; Resourcing. A follow-up day will take place on 13th December 2017

On 24th October we hosted a joint visit from NHS England and NHS Improvement with a focus on taking a ‘stocktake’ of Surrey Heartlands’ journey to date and how the regional and national teams can provide further support, particularly regarding the national ACS. The meeting was chaired by Anne Eden, Executive Regional Director for NHS I/E in the South East. Anne was joined by colleagues including Ben Dyson Executive Director of Strategy NHS Improvement, Felicity Cox, Director of Commissioning Operations at NHS England (South East), Paul Bennett Director of Improvement and Delivery for Kent, Surrey and Sussex and Karen Breen New Care Models Programme Operational Lead. The sharing of where we are at, led to a conversation about opportunities and resources from NHSE and NHSI in supporting Surrey Heartlands ambitions.

12. Devolution (Integrated Commissioning) Update since last Board

We are in our shadow year progressing to full devolution from April 2018.

Work continues with NHS England to refine the 2018/19 ‘asks’. Initially these are focussing on the delegation of responsibilities regarding some aspects primary care, some specialised services and some ‘section 7a’ public health functions. This work will continue over the next few months as we work with national partners on the ‘detail’ of the asks.

Our new integrated commissioning Joint Committee met for the first time on the 4th October. In addition to electing Dr David Eyre-Brook as its chair, and Councillor Helyn Clack as vice chair, the meeting covered items related to the alignment and join up of planning and commissioning intentions, an update on the devolution work, and approving the investment framework for the NHS transformation funding.

We have had positive dialogue with the Department of Health (DH) which has led to a number of key connections being made including to progress discussions regarding one public estate. The Council has received a formal letter of support from the DH for the devolution work from Phillip Dunne MP.