commissioning for a new era. the challenges we face…
TRANSCRIPT
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Commissioning for a New Era
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The challenges we face…
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Economic Factors Lowest average wage levels Inadequate housing and overcrowding Low educational attainment 6th most deprived local authority in England High levels of:
o Unemploymento Benefit claimants o Deprivationo Crimeo Domestic abuse o Transience
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Impact on Health
Worst life expectancy rates for men in England
Third worst for women
Significantly higher number of Children Looked After in comparison with similar areas
Highest rates of liver and lung disease in England
High prevalence of cancer, heart disease and stroke
Add to that high rates of mental illness, suicide, teenage pregnancy and drug abuse
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Futu re p ressu res on the hea lth se rv ice
A ge ing S oc ie ty
R ise o f long -te rm cond itions
Increas ing expecta tions
Increas ing costs o f p rov id ing care
L im ited p roductiv ity ga ins
C on stra ined pub lic resources
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Funding Gap£b
ns
Pro jected resource vs. Pro jected spending requ irem ents
140.0
135.0
130.0
125.0
120.0
115.0
110.0
105.0
100.0
95.0
90.0 FY 13 /14 FY 14/15 FY 15/16 FY 16/17 FY 17/18 FY 18 /19 FY 19/20 FY 20 /21
Tota l P ro jected C osts P ro jected R esource
Source: NHS England
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7
Any questions?Commissioning more of the
same …..?
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What the data is telling us
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Out of Hospital Strategy
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New Models of Care
C oordinated and integrated health and socia l care for patients w ith at least tw o
com plex conditions, e.g. fra il e lderly
C oordinated and integrated health and socia l care for
patients w ith one com plex condition, e.g. d iabetes
C are for patients w ith m inor health issues, if any
Extensivist
Enhanced prim ary care
Episodic care
Multiple complex conditions
Single com plex
conditions
M inor health issues
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NeighbourhoodsClinical Engagement- Mapping practices and resources
Mosaic Groups of populationPractice location and size
Existing services
Libraries, churches etc.
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CENTRAL EAST (25K)
SOUTH CENTRAL (22K)
SOUTH (38K)
CENTRAL WEST (26K)
NORTH (30K)
FAR NORTH (20K)Blackpool Neighbourhoods
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Infrastructure
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Proactive New Models for Primary Care
• Extensivist Service focused on High Risk frail elderly Patient cohorts
• Re-orienting capacity in General Practice to implement Extended Primary Care Model
• Ambition is to materially improve the Quality and Clinical outcome for this patient group
• Driving up the quality of patient satisfaction
• Reduced usage of Secondary Care- 23-45% reduction in admissions- 20-30% reduction in unscheduled attendances for targeted population
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Partnership with Third SectorFulfilling Lives
• £10 million over 7 years• Complex mental health, substance misuse, homeless or criminal justice• Partner - Addaction
Better Start• £45 million over 10 years• 0-3 year olds• Partner - NSPCC
How good is your memory• Memory tests for 50-90 year olds