Clinical Strategy

Introduction

We know that Surrey is already one of the healthiest places to live in England, with services that perform well.  Yet there are still avoidable differences in experience and health outcomes – known as health inequalities – depending on where you live.

We also know that clinical care alone only makes around a 20% contribution to health and wellbeing, with a further 30% from individual health behaviours; the rest is influenced by factors such as education, housing, employment and the environment.

Our ICS strategy has been designed to address these issues, focusing on prevention, reducing health inequalities and delivering care in different and more innovative ways which we are already delivering through our five-year Joint Forward Plan. 

This clinical strategy responds specifically to our clinical ambitions, with more preventative healthcare and support for people outside our acute hospitals, alongside a strong focus on collaboration to help improve the quality of services and reduce variation in care and treatment.

We recognise that we are working in an increasingly challenging context, both financially and within a system that is struggling with too much demand.  Our population is growing and becoming more elderly, generating an increased need to manage age-related diseases. At the same time, we need to take advantage of the advances in technology that present unprecedented opportunities for managing, diagnosing and treating disease.

Our strategy is based on input from residents, patients, carers, staff, colleagues and wider partners through a series of conversations, workshops and focus groups, and from Surrey’s Joint Strategic Needs Assessment.

Overall, we want to design healthcare around our residents – in places (towns and villages) that make sense to them – joining up services and making sure they are easy to navigate and straightforward to access, with a shift in resource to more preventative measures that will also help reduce overall demand.

About Surrey Heartlands

Surrey Heartlands is a partnership of organisations that have come together to plan and deliver joined up health and care services, and to improve the lives of people who live in Surrey.

Surrey Heartlands represents 92% of the Surrey population, with a combined health budget of over £2bn and an adult social care budget of over £400m.

Because of the size of the area we cover, we have also organised ourselves into four Place-based Partnerships (known as ‘Places’) to work across more local geographies:

• East Surrey Alliance
• Guildford & Waverley Health and Care Alliance
• North West Surrey Alliance
• Surrey Downs Health and Care Partnership

Our ambitions

At the heart of this strategy are three strategic ambitions:

1. Preventing ill-health

Providing a stronger emphasis on preventing illness, addressing inequalities and keeping our residents healthy.

• Shifting more resource to prevention and to populations and neighbourhoods most in need.
• A stronger focus on children and young people.
• Doing more to prevent physical and mental ill-health and promote physical  and emotional well-being.
• Supporting people to reach their potential by addressing the wider determinants of health, working alongside people and communities.

2. Healthier at home

Reducing the need for hospital care by making sure people can access the primary and community services they need.

• Creating neighbourhood teams (with hospital, primary, community, mental health and social care colleagues) to look after our most vulnerable residents.
• Making it easier for people to access the care they need when they need it, and, wherever possible, close to where they live.
• Maintaining the current level of general practice appointments, with almost 50% delivered on the day and 85% within two weeks.
• Targeting support for those most at risk to help keep them out of hospital.
• More diagnostic, outpatient and minor procedures outside larger hospitals and closer to where people live.
• Having a joined up urgent and emergency care pathway.

3. Collaboration at scale

Designing and delivering services collaboratively to improve quality, reduce variation and improve efficiency.

• Creating collaborative partnerships with partners including the local authority, voluntary, community and social enterprise colleagues.
• Working collaboratively with patients, carers and the wider public.
• Taking a system-wide approach to managing demand and capacity, removing variation and duplication where it makes sense to do so.
• Enhancing centres of excellence including:
  • District general hospitals that meet the needs of local populations.
  • Our elective surgical centre at Ashford Hospital.
  • The specialist cancer centre at Royal Surrey hospital in Guildford.

Collaborative partnerships

Provider collaboratives are starting to take responsibility for planning and delivering services across key pathways:

• Surrey Hospital Care (our Trust Provider Collaborative) – comprising our acute hospital trusts (Ashford & St Peter’s, Royal Surrey, Surrey & Sussex) and our mental health provider (Surrey & Borders Partnership).
• Surrey Community Care – bringing together community providers including general practice, pharmacy, optometry, dental, mental health and wider community services. 

We are also part of the Surrey/Sussex Cancer Alliance, a number of specialist mental health collaboratives, the Primary Care Collaborative and the Surrey Academic Health & Care Partnership.

What needs to be in place to deliver these ambitions

In delivering these ambitions, there are several other areas we need to focus on.

Workforce

Making sure our workforce has the right skills to care for and treat our patients.

Leadership

Developing our multi-professional leaders, with a standardised approach to quality improvement.

Patient records

Shared patient care records so staff have the right information to make effective decisions.

Data

We make best use of our data to understand and solve the issues we face.

Collaboration

A strong focus on co-production with staff, stakeholders and local people.

Innovation

Promoting innovation so what we do is effective and at the cutting edge of healthcare delivery.

Conclusion

This strategy has been a true collaboration between our workforce, clinical and professional leaders, stakeholders and local residents, supported by an ambitious delivery plan that sets out how we will implement our ambitions, so we continue to provide high quality, sustainable healthcare for local people.

Thank you to all staff, partners and local residents who have helped to shape this strategy.

More information can be found at: www.surreyheartlands.org