Health/Business Planning in Primary Care

Costing of services – Payment by Results

Alan Miller

NHS Primary Care Contracting Adviser

Imperatives for the NHS

Priorities

I: Improving the health of the population

II: Supporting people with long-term conditions

III: Access to services

IV: Patient/User Experience

More diverse providers, with More diverse providers, with more freedom to innovate more freedom to innovate

and improve services and improve services

(supply-side reforms)(supply-side reforms)

More choice and a much More choice and a much stronger voice for patientsstronger voice for patients

(demand-side reforms)(demand-side reforms)

Money following the patients, Money following the patients, rewarding the best and most rewarding the best and most

efficient providers, giving efficient providers, giving others the incentive to others the incentive to

improve improve

(transactional reforms)(transactional reforms)

A framework of system A framework of system management, regulation and management, regulation and

decision making which decision making which guarantees safety and guarantees safety and

quality, fairness, equity and quality, fairness, equity and value for moneyvalue for money

(system management (system management reforms)reforms)

Better careBetter careBetter patient Better patient experienceexperience

Better value for moneyBetter value for money

Planning and NHS Reforms

Major inequalities in health and wellbeing across the country

Variation in care across the country

NHS lags behind other countries on treatment outcomes

Care could be more convenient and easier to access for many

Care needs to keep pace with the expectations of citizens

Disease patterns evolve & the population is ageing

New technology and treatments

Clinical Case for Change

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_081096

The NHS Plan introduced the Government’s intention to link the allocation of funds to service providers to the activity they undertake.

Latest Guidance – Dec 2007

PbR Tariff Structure

National Priority - PbC

18 Week Wait

Local Priorities

http://www.newhampct.nhs.uk/aphr/slides.asp?slideshow=%25

Local Priorities

Local Priorities

Local Priorities

The report highlights the challenges in Newham and the opportunities that lie ahead.

There are significant health challenges - Newham is the eleventh most deprived borough in the country with the worst female life expectancy in London and high infant mortality.

The biggest killer in Newham is cardiovascular disease which kills over 500 people per year.

Local Priorities Public Health

Pre-qualification QuestionnaireBidders are required to complete this PQQ.Contents

SECTION DESCRIPTION PAGE

A.1 Details of the Bidder 3

A.2 Governance questions 6

A.3 Financial questions 9

B Clinical Services Supplier(s) questions 11

C.1 IM&T Services questions 17

D Bidder’s Declaration 19

Appendix A Summary of Regulation 14 20

Appendix B PQQ Response Checklist 21

Appendix C Glossary of terms 22

Tender Process

1 Service Description

1.1 Bidders are required to describe the service model that will provide an out-of-hours District Nursing service incorporating the requirements described in the service specification. This will include describing how the service will be convenient for the patients and how the service will be guaranteed to be available 365 nights of the year.

2 Workforce Considerations

2.1 Staff TrainingBidders must provide details of how they will ensure that all staff involved in treating NHS customers are trained appropriately before the service commences and remain appropriately trained and competent to carry out the roles required of them for the duration of the contract.

3 Information Management and Technology

3.1 SystemsBidders must provide IM&T systems and infrastructure as necessary to support this contract, in particular the clinical and contract management processes. Please describe the proposed IM&T system to be used.

4 Infrastructure

4.1 AccommodationBidders are required to provide details of the accommodation intended to be used for the provision of services should an NHS facility not be provided:Location(s)Description of accommodation

5 Contract Management

5.1 Capability and CapacityBidders must provide details of fulfilling similar contracts

6 Financial

Bidding

National Association of Primary Care

http://www.napc.co.uk/

Improvement Foundation

http://www.improvementfoundation.org

NHS Alliance

http://wwww.nhsalliance.org

Support Organisations