Transcript NHS WCC slide master

Intelligence to Support
World Class Commissioning
East Midlands Overview
Philip DaSilva
Director Commissioning & Service Improvement
NHS East Midlands
9th December 2008
Outline
The Context
NHS Next Stage Review
World Class
Commissioning
Patient Power
System
Management
Delivering for patients, public and the taxpayer
Why change?
Health Profile of England 2007
Infant mortality
England, EU countries and selected averages, latest data (2004*), ranked
Rate per 1,000 Live births
Romania
Bulgaria
Latvia
EU-12new average
Lithuania
Poland
6.8
6.8
Slovakia
6.6
Hungary
Estonia
6.4
5.9
Malta
5.6
Belgium*
5.3
EU average
England
5.0
4.9
Ireland
4.6
Italy*
Denmark*
4.6
4.5
Austria
4.4
Netherlands
EU-15 average
4.3
Germany
4.1
4.1
Greece
4.0
Spain
Portugal
3.9
3.9
France
3.8
Czech Republic
Slovenia
3.7
Luxembourg
3.5
3.3
Finland
3.2
Sweden
Cyprus
3.0
* Denmark, Italy – 2001; Belgium - 1997
16.8
11.7
9.4
9.0
7.9
EU weighted averages
EU-15 (member countries before 2004)
EU-12 new (member countries from 2004)
England
The programme
Vision and competencies
Assurance framework
Support and development
tools
Vision
Better health and well being for all
 People stay healthier for longer – “adding life to years.”
 People live longer and health inequalities are dramatically
reduced – ”…and years to life”
Better care for all
 Services are of the best clinical quality and evidence based
 People exercise choice and control over the services that they
access so they become more personalised.
Better value for all
 Informed investment decisions
 PCTs work across organisational boundaries to maximise
effective care.
Competencies
1. Locally lead the NHS
7. Stimulate the market
2. Work with community partners
8. Promote improvement and innovation
3. Engage with public and patients
9. Secure procurement skills
4. Collaborate with clinicians
10. Manage the local health system
5. Manage knowledge and assess needs
11. Make sound financial investments
6. Prioritise investment
Review
current
service
provision
Assess
needs
Decide
priorities
Strategic planning
Managing
performance
(quality,
performance,
outcomes)
Specify outcomes &
procure services
Managing demand
and performance
Design
service
Shape
structure
of supply
Clinical
decision
making
Manage
demand
and ensure
appropriate
access to
care
A commissioner assurance system
Assessment against
three domains:
Health outcomes and
quality
NHS
Input
Competencies
Measures quality in health care
and ability to deliver key health
outcomes and services
NHS
Input
Governance
Measures whether the organisation
possess the competencies associated
with world class commissioning
Review of board controls and
processes , strategy, and long
term financial controls
Incentives and interventions driven by ratings
•PCTs that have improved greatly or reached world class should be
recognised. They would also be expected to share their knowledge and
experience
•PCTs that remain below baseline, or have had static performance,
should receive intervention to ensure they improve
Current
Previous
Upper quartile
HEALTH OUTCOMES
COMPETENCIES
GOVERNANCE
World class
0
Strategic priority
National
Healthy life expectancy
National
average
Below
baseline
10 Rate of
change %*
0.1
1.
Local leader of
NHS
2.
Collaborates with
partners
3.
Patient and public
engagement
Health inequalities
–
CVD mortality rate
2.5
Cancer mortality
-1.8
4.
Clinical leadership
Stroke mortality
0.9
5.
Assess needs
–
6.
Prioritisation
7.
Stimulates
provision
8.
Innovation
9.
Procurement
and contracting
Teenage pregnancy
Smoking prevalence
Local
•Those
improving
faster than
the national
average
should be
rewarded
•Those that
have lost
growth
relative to
the national
average
should be
addressed
Childhood obesity
3.2
–
All-age all-cause
mortality
1.1
Suicide mortality
-0.2
Amber
PCTs failing to
meet
governance
standards will be
expected to
• Receive
interventions
and support
• Meet the
standard within
a short time
period
Strategy
Green
Finance
Amber
Board controls
and processes
Amber
10. Performance
management
* relative to national average rate of change
Adding years to life and life to years
Strategic plan
Long term financial plan
Organisational development
plan
The toolkit contains guidance to support
PCTs to write their plans
Finance
Guidance and
Template
Next steps for the NHS
 First cut strategic plans – autumn 08
 Second cut strategic plans – winter 08
 Clinicians highly involved
 Formal assessment of PCTs published – 09/10
What does World Class
Commissioning mean for NHS East
Midlands?
Our Promises
 A better experience for patients
 High quality, safe services
 Health Improvement and reduced inequalities
 Value for Money
 Good access for services
 More influence for patients and the public
The SHA will work with PCTs to define:
 What they need to focus on
 What good looks like
 What further development they need
to become good
 Where they get this development
from
 How they can provide the assurance
that they are good
 How best to present the assurance
D
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Developing and assuring PCT progress to become World Class
Commissioners means that the Development and Assurance work of
the SHA are inextricably interlinked
PCT
Development
PCT
Assurance
PCT Assurance Process 08/09
3 insights:
Alignment of Plans - Strategy, Finance and OD
 That there have been differential approaches taken by PCTs
Embedding Improvement (Ensuring systematisation)
 Some good examples of innovation and good commissioning practice –
However, PCTs will need to be able to ensure approaches are
systematised and not just isolated examples
PCT Development - Market Management and Procurement Skills
 These two themes are areas where all PCTs acknowledge that these are
areas for potential improvement
Thank you