Transcript Slide 1

Transforming Community
Services
WHAT IS TRANSFORMING
COMMUNITY SERVICES ?
Transforming Community
Services
TCS Programme – What is it?
 A national programme
 Define what community services to look like in the future
 PCTs to move to a “Commissioner only” organisation
 Provider arm could move to a different organisational form
 Need to assess the current and potential provider market
 Need to develop a strategic response
Transforming Community
Services
Commissioning Cycle
Transforming Community
Services
Process
Formal SLA in place
Need to prioritise
which areas we
analyse first
PCT Commissioning
arm would look to
retaining premises
Transforming Community
Services
Review Services under 7 Pathways
 Health and wellbeing/health inequalities
 Children and families
 Long term conditions
 Mental health
 Rehabilitation (including neurological rehab)
 Acute care in the community
 End of life care
Transforming Community
Services
PCT’s 5 year TCS Strategy (Oct)
 Informed by service reviews & market analysis
 Develop procurement strategy and procurement plan
 Agree how we want to develop the estate
 Share with providers
 Work with providers to develop organisational form (Oct
2009+)
Transforming Community
Services
Transformational change
–taking a personalised approach?
 Take the perspective of the service user
 Needs and drivers
 Identify the main service elements the user may have to access
 Not about individual professions or buildings
 Integrated, broad approach across agencies, across boundaries
 A chance to re-design services?
Transforming Community
Services
Possible direction for future services
 Flexible pathways with various entry points
 Integrated social and health care pathways
 Personalised care
 Personalised budget – various providers at points in the
pathways
 Defined quality outcome measures
Transforming Community
Services
NHS Central Lancashire
Sue Mason
Associate Director
Collaborative Commissioning
Transforming
Community
The Corporate
“Day”
Services
Our vision for commissioning
services
 Focused on prevention, case and disease management
 Seamless and holistic care, particularly for those with chronic,
multiple conditions.
 Timely and targeted services in home or community environments
to meet individual’s needs and lifestyles
 Strengthen community and primary care to provide real alternatives
to acute care.
Transforming Community
Services
Achieving our vision
 Proactive management of the flow of elective patients into
acute settings
 New and better information
 Development of informed and empowered patients
and proactive, multidisciplinary teams
Transforming Community
Services
Prioritising the three pathways
Reviews of need and existing services in three areas –



Long term conditions
Rehabilitation
End of Life care pathways.
These reviews support the work already being undertaken through local
Clinical Pathway Groups and the development of service line management.
Transforming Community
Services
Long Term Conditions: diabetes,
respiratory disease, CVD, rheumatology
 Future disease patterns will be dominated by long term
conditions, rather than acute episodes of need.
 Focus resources and attention on high need and high
cost patients to achieve the greatest impact.
 Commissioning personalised programmes of services
End of Life
Transforming Community
Services
Baseline review of end of life care services completed May 2008
 Health needs assessment
 Review of care services provision and cost
 Examine the quality of care
 A gap analysis
Results from the baseline review highlighted that:
 Incidence of death declining as people live longer - 82% of deaths in 65+ yrs
 In 2006, 56% of people died in hospital, 19% in their home
 Approx. 95% of palliative services are utilised by people with cancer
 Inequities in service provision exist
Transforming Community
Services
End of Life
May 2008 review identified the following commissioning priorities,
which will form the basis of our future plans for end of life care
Build workforce capacity
Provide flexibility in the provision of services with attention to out
of hours services
Increase support to enable death at home
Monitoring of outcomes
Transforming Community
Services
Rehabilitation services
 Positive developments
conditions services
in
rehabilitation
and
neurological
 33.1% projected increase for late onset dementia by 2020.
 Need comprehensive re-design and re-alignment of older people
services.
 Market analysis and provider segmentation of Rehabilitation &
Neurological Conditions community services determined health
need against service status.
Transforming Community
Services
NHS Central Lancashire
contact details
Sue Mason
Associate Director, Collaborative Commissioning
[email protected]
(Commissioning Strategy and Community Contract)
Matt Gaunt
Project Leader – Transforming Community Services
[email protected]
Transforming Community
Services
NHS East Lancashire
Michael O’Connor
Procurement Manager
Transforming Community
Services
Improvement Framework
SUPPORTING FEATURES:
Commissioning Strategic Plan
Transforming Community Services
Prioritisation Matrix
Matrix project team
Work package methodology
Process mapping
Value stream analysis
Benchmarking
Draft service specification
Service review steering group
Contestability framework
Final service specification
Procurement strategy
Implementation plans
SERVICE
PRIORITISATION
REVIEW
STAGE 1
DEEP DIVE
SERVICE
REVIEW
STAGE 2
THE
CONTESTABILITY
GATEWAY
STAGE 3
IMPROVEMENT
STRATEGY
DECISION
STAGE 4
'PARK'
Disinvest
Improvement Plan
(Co-operative)
Service re-design
(Competitive or co-operative)
New service
(Competitive or co-operative)
Transforming Community
Services
3 Key Priority Pathways
 Long Term Conditions:
Diabetes & Vascular Risk Assessment Underway.
Hospital avoidance/Development of Integrated case Management for High
Intensity Service Users i.e. COPD and End of Life
 Health & Well Being:
Assess improved models of provision to enable improved performance &
effectiveness i.e. Smoking Cessation, Vaccination & Immunisation &
Obesity provision
 Mental Health:
CAMHS (16-18) underway
Development of integrated Dementia provision linked to case management.
Work continues on remaining pathways
Transforming Community
Services
Engaging the market
The PCT will look to develop the market and the range of potential
providers including the third sector:
 Where services need to be substantially improved; where there are
major gaps in capacity or services or where new approaches are
required
 By holding “Engage the market” events
 By posting tender opportunities on the PCT website and Supply2Health
and professional media where applicable
 What do PCTs need to do improve engagement – please tell us.
Transforming Community
Services
Response to Informal Expressions of Interest
ELPCT recognises it may be approached by providers outside the normal
tender process wishing to provide services to the PCT population:

For services where ELPCT has AWP arrangement

For new services

For services where other providers are in contract with the PCT
Transforming Community
Services
NHS East Lancashire
contact details
www.eastlancspct.nhs.uk/
TCS
- Colette Crowther – Associate Director for Strategic
Commissioning
email – [email protected]
Procurement
- Michael O’Connor – Procurement Manager
email – [email protected]
Transforming Community
Services
NHS North Lancashire
John Butterworth
Transforming Community
Services
3 Key Priority Pathways
 Long term Conditions
– Chronic Obstructive Pulmonary Disease (COPD)
 Mental Health - Depression
 End of Life
Transforming Community
Services
Admissions Avoidance of long term conditions
Funding the shift
Potential commissioning shifts by locality - Based on data for 2007/08
Fylde & Wyre
Lancaster & Morecambe
Total
Group
Spells
Tariff
Spells
Tariff
Spells
Tariff
Cardiac
956
£1,270,243
729
£920,842
1,685
£2,191,085
Respiratory
358
£664,224
279
£456,551
637
£1,120,775
Skin
240
£395,968
250
£362,267
490
£758,235
Urology
163
£396,975
145
£368,108
308
£765,083
Musculoskeletal
71
£96,467
24
£51,063
95
£147,530
Diabetes
38
£59,371
39
£63,066
77
£122,437
Hepato-Biliary
37
£73,043
58
£90,837
95
£163,880
Stroke/TIA
33
£50,114
21
£31,856
54
£81,970
1,897
£3,006,405
1,544
£2,344,590
3,441
£5,350,995
Total
Source: Teamwork. (2008). Patient Activity Analysis for North Lancashire PCT: Report update based on 2007/08 Patient Activity.
Transforming Community
Services
Remaining Pathways
 Health and wellbeing/health inequalities
 Rehabilitation
 Acute care in the community
 Children and families
 Sexual health
Transforming Community
Services
NHS North Lancashire
contact details
Jon Hayes
Contracting Officer
North Lancashire Teaching PCT
Trust Headquarters
Moor Lane Mills, Moor Lane
Lancaster, LA1 1QD
Tel - 01524 519446
Transforming Community
Services
NHS Blackpool
Priority care pathways:
 Children and families
 Health and wellbeing (esp. smoking, alcohol &
drugs)
 End of life care
 Long term conditions
Transforming Community
Services
NHS Blackpool
Potential new providers should:
• Register their interest or address queries to
[email protected]
• View our website www.blackpool.nhs.uk
NHS Blackburn with Darwen
Rob Bellingham - Director of
Governance and Engagement
Transforming Community
Services
Blackburn with Darwen Care Trust +

PCT working with Blackburn with Darwen Borough Council to
create a Care Trust Plus

Commissioning Health Services, Adult / Children's Social Care
Transforming Community
Services
‘Big Ticket’ areas 1
The PCT has prioritised the following areas:

Long Term Conditions

Acute Care Closer to Home
Transforming Community
Services
‘Big Ticket’ areas 2
The PCT has also prioritised:

Children and Families
–
–
–
–
Maternity and Early Years
School Age Children
Young People
Complex & Acute Health Care Needs
NHS Blackburn with Darwen
contact details
Rob Bellingham - Director of Governance and Engagement
[email protected]
Vanessa Hollings – Associate Director of Planning and Performance
[email protected]
NHS Blackburn with Darwen
Guide Business Centre
School Lane
Blackburn
Lancashire
BB2 4DW
01254 282000