Request for Proposal to undertake a Case for Change for Major Service Review

NHS Surrey Heartlands ICB spends £2.3bn funding the healthcare services commissioned for its 1.1 million population. Looking at our current health and care landscape, although services overall perform well, the significant financial and resource challenges we face mean it is becoming increasingly difficult to sustain high quality services that respond to what local people need in a timely way.

Of significant concern to us is:

• Rising demand: across the system there are long waiting lists for physical and mental health services for adults and children
• Inequalities: in healthy life expectancy and health outcomes
• Changing population: which is growing and becoming more elderly, with many people managing one or more complex health conditions
• Workforce challenge: low community workforce capacity, high medical staff costs, difficulties in recruitment, low morale and greater burn-out, as well as cost-of-living pressures
• Financial challenge: overall funding remains tight, a position likely to continue amidst rising costs which means we urgently need to find a way to become a sustainable and efficient health and care system
• Digital advancements: including how we and our residents make the most of the investments already made and take advantage of new technologies in their care

Given the scale of the challenge, coupled with our ambition, we need to take a fresh look at how we work and provide care across our system to support the three strategic shifts:

• Hospital to community
• Treatment to prevention
• Analogue to digital

Now is the time to be bold and transform what, where and how we provide care. This will require universal system and clinical change, through collaborative working with our communities, partners, and workforce in a fundamentally different way.

We are seeking a delivery partner to work as part of our internal programme team; bringing additional resource and expertise to support development of the programme and the case for change.

The case for change must be data driven and reflect what local people are telling us, align to our key strategies and meet the requirements of existing or emergent national directives. This work will not exist in a vacuum and must not negatively impact on any of the decisions we have already made but rather it must build on everything we have already achieved, complementing the good work currently underway and drawing on the expertise we already have within our system. Building on the learnings from recent reviews conducted previously in our system will be important and findings will require incorporation into the rationale for the Case for Change and future proposed sustainable framework approach.

The scope of the Surrey Heartlands Major Service Review Case For Change deliverables will include:

1. A population health management approach to understanding physical, mental health and social care needs; covering the Surrey Heartlands population as a whole, recognising that patient flows are not always consistent with ICS boundaries. We want to understand where services are accessed and delivered, rather than where and by whom.
2. Data analysis of activity, outcomes and patient flows across primary, community, elective, urgent and emergency care, including private sector flows. Consideration should be given to the interface with social care and other agencies.
3. A modelling tool and analysis to underpin our system-wide case for change that enables review of the optimal scenarios and associated initial requirements to inform future decisions about new models of care
4. A Financial Model
5. A literature review that analyses the potential benefits of best practice models of care, both nationally and internationally, within the context of our local system insights.
6. Risks and potential consequences of inaction.

A delivery partner must be able to evidence capability to deliver specified technical and communications/engagement components of the requirement detailed within the specification.