alistair blair and birju bartoli presentation · 2016. 3. 2. · alistair blair and birju bartoli...
TRANSCRIPT
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Northumberland VanguardCreating an integrated ‘primary and
acute care system’ – moving towards and ACO
January 2016
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Background
• Mix of large rural and urban areas covering 2,000sqm
• Challenges of providing local services to rural areas– Population of 320, 000
– 44 GP practices
– NHCFT main acute provider (11 sites), NUHT 3o
services, NTW
– NE area has 8 FTs
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Background
• Good working relationships between Nland CCG , NHCFT, Nland county council – built over number of years
• 2002: Adult social care and community services under new management - Nland care Trust
• 2013 Nland CCG established• 2011:‘transforming community services’ transfer to NHCFT• 2011: Formal partnership agreement between NHCFT and
Nland CC – NHCFT receive delegated authority to manage adult social care
• Prime provider for end of life care established and subsequent joint venture partnership with Marie Curie.
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Commissioning Integration
• 2013: CCG and Council co location
• 2013: CCG and adult social care s75: £35m
• 2015: total s75 agreement: £60m
• 2015: Development of PACS vanguard working and movement towards an ACO
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At a glance…
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PACS programme
• Stage 1: the opening of the Northumbria Specialist Emergency Care Hospital in June 2015.
• Development of primary care hubs, complex care team, workforce
• Stage 2: ‘primary care at scale’ supporting both in hours and extended hours periods including weekends, as well as reducing the duplication in provision
• Stage 3: complex care “enhanced care model” –movement of care outside of hospitals
• Stages 4 and 5: create the ACO in Northumberland first in shadow form (stage 4) and then as an organisational reality (stage 5)
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Accountable Care Organisation
• The ACO is a consequence of the PACS• Depends on taking our integration further and turning a
hospital dependent system on its head• Removal of perverse incentives from the system• Maintain statutory functions of CCG – at min cost• Move to a capitated budget• Local GPs and Council included in the ACO model and its
development• Option already exists for GPs to remain independent or
salaried – no pressure !• Involvement of other providers – eg 3o FT, NTW • Re-set the system
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Accountable Care organisation• Cultural shift started – vanguard status has supported this• Split CCG duties broadly into tactical and strategic
commissioning• ‘Strategic commissioning agreed to be ‘housed’ with council• Transfer strategic role early 16/17 with amends to
constitution• Need to keep minimal CCG infrastructure to ensure statutory
duties • Use of joint posts where possible – precedence already set
between NHCFT and council• Working with legal team to now finalise ACO construct by
April 16 –Due diligence and shadow running where possible from April 16
• Submission to relevant Boards /regulators through 16/17• Go Live April 17
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Accountable Care Health Outcomes
• Long term and ambitious.
• Organisational health
• Improve healthy life expectancy
• Excellent patient care and experience.
• Ensure excellent clinical service delivery at the
most vulnerable times of people’s lives
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Engaging patients, the public and staff
• Engagement and involvement with patients, the public and staff
• Northumberland vanguard co-design forum
• Building the future system together
• Widespread communications and engagement from February 2016
• Website live www.northumberland.nhs.uk
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Engaging patients, the public and staff
• Engagement with patients, the public and GPs
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THANK YOU
Any questions?