the perfect storm – are we eqipp’d to survive it? peter rowe, national qipp lead – medicines...

The Perfect Storm – are we eQIPP’d to survive it?

Peter Rowe, National QIPP Lead – Medicines Use and Procurement

Rowe Creative Limited ©

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The Perfect Storm

Austerity

White Paper

Management Cost Savings

Department of Health

“These changes are so big you can see them from space”

David Nicholson.

3Department of Health

Managing the Transition

4Department of Health

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1. PCTs still trying to address management cost reduction on their own?2. QIPP delivery falters3. Legitimacy post WP – ‘abolition’ has an immediate effect4. Leadership changes – ‘domino effect’5. Referrals on the increase6. Secondary care activity levels on increase

1. ‘Take your time’ message to GPs from DH

2. Competition for leadership/mandate creates delays in getting going

3. Negotiations between DH and GP professional bodies

4. Pilots?Department of Health

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1. ‘Holding PCT’ sub-regional structure2. Stronger LA role in managing transition and secondary care

negotiations3. Industrial strength QIPP and management cost reduction4. Through holding PCT structure, shared responsibility for business

continuity during transition5. Clear role and mandate for PCT in transition

1. Even ‘bottom-up’ emergence of GPCC can be coordinated

2. PCT ‘Facilitator’ role helps encourage new GP leadership to come forward and to build network of GPCCs

3. Targeted GP development programme tailored to what they are telling us they need

4. Coordinated commissioning support offers best chance to compete with private sector

Department of Health

Provider Transition

o All NHS Trusts to be Foundation Trusts (FTs) by 2014

o Special Health Authority to be established to hold non FTs to account until then

o All sectors to prepare for any ‘willing provider’

o Tariff can be undercut

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NHS ‘Post’ White Paper Commissioning

Independent Commissioning Board

Commissioning Consortia

Health & Wellbeing Boards

Patients (Personalisation)

Provision

Any Willing Provider Monitor Care Quality

Commission

Department of Health

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Who will have the commissioning cash?

Independent Commissioning Board – 20-30%

Commissioning Consortia – 62-75%

Health & Wellbeing Boards – 5-8%

Patients - ?????

Department of Health

Commissioning Consortia

Primary Care and Commissioning from same place

Most patients with long-term conditions will have care provided and most hospital care commissioned from the same place

Medicines are one of the key enablers for system reform

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QIPP

Minimal growth for the next 3 – 5 years

Increasing Demand - Demographic- Technological- Consumer Driven/Political?

Gap £15 - £20 Billion over 3 – 5 years

Department of Health

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Options??

Waiting Times Reduced Quality Stop Prevention Salami Slice R & D Education and Training

Department of Health

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NO!

Not acceptable and will not deliver!

Department of Health

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QIPP(S)

Quality Innovation Productivity Prevention ….Safety

Department of Health

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QIPP at Every Level

Organisation (1) Local System (2) Sub Regional – eg Greater Manchester (3) Regional(4) National (5)

Department of Health

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The Real Action is at Level 1

That’s where our people are and where the medicines are

prescribed and used

Department of Health

Heads, Beds and Meds!!

Heads – Staff

Beds – Infrastructure

Meds - Medicines

17Department of Health

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Medicines and Procurement

Quality and Value

Repositioning Medicines

Supply Chain

Department of Health

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Quality and Value

National Prescribing Centre (NPC) Good Prescribing Guide

‘Top Tips’ for Providers Better Care, Better Value (BCBV)

Indicator

Department of Health

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Repositioning Medicines

Support Better Outcomes Support Service Re-design Support Greater Productivity Support/Require Workforce Re-

design

Department of Health

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Supply Chain

Self Care Community Pharmacy Contract Hospital Procurement Cancer Drug fund Home Care Value Based Pricing Working with Pharmaceutical Industry

Department of Health

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Medicines and Workforce

`Blockbusters’ Application of best practice Improving access to medicines through new ways

of working

Support:

Better outcomes/quality Pathway Re-design Workforce Re-design Greater productivity

Department of Health

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QIPP(S)

Quality Innovation Productivity Prevention ….Safety

Department of Health

Thank you!

Any questions ?

24Department of Health