new models of care, vanguard sites and beyond...new models of care, vanguard sites and beyond jane...
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New Models of Care,
Vanguard sites and beyond
Jane Milligan
Chief Officer, NHS Tower Hamlets
8 February 2016
• In March 2015, the first 29 vanguard sites were chosen. There were three
vanguard types – integrated primary and acute care systems; enhanced health
in care homes; and, multispecialty community provider vanguards.
• In July 2015, 8 urgent and emergency vanguards were announced.
• In September 2015 a further 13 vanguards were announced – known as acute
care collaborations, they aim to link local hospitals together to improve their
clinical and financial viability.
Tower Hamlets Integrated Provider Partnership (THIPP)
THIPP was formed in December 2013
as part of the provider development
workstream of the WELC (Waltham
Forest, East London and City)
Integrated Care Programme and
incorporates the following partners:
• Tower Hamlets GP Care Group CIC
• Barts Health NHS Trust
• East London NHS Foundation Trust
• London Borough of Tower Hamlets
Built upon the network model
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Tower Hamlets before networks
• 8 LAPs
• 36 practices
• Total population of ~245,000
• Practice list sizes of 3,000 to 11,000
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Pop: 29,892
Pop: 18,027
Pop: 29,801
Pop: 35,720
Pop: 28,995
Pop: 33,186
Pop: 27,839
Pop: 31,975
8 Networks1 were formed in the borough during 2009
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Why networks?
• Focus on population health across a geography
• Collaborative relationships with wide range of partners (e.g. Borough, schools, charities)
• Sufficient scale for specialisation of staff, ability to access rare skills and ensure access, resources (e.g. equipment)
• Integration with estates plan
Outcome based contracts linked
to improving population health
Key components of
the programme
• Using risk stratification to
proactively identify 20% of
population most at risk of a hospital
admission and commission
some/all of services below for this
group
• Commissioners moving to focus on
outcomes for population health,
new models of care (the integration
function/provider alliances) and
reforming financial incentives
(capitation and payment on
outcomes)
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Diabetes Care Package Dashboard 2015-16
Multidisciplinary teams
QIPP 2015/16: Emergency Admissions (Integrated Care population)
QIPP 2015/16: Outpatients (Integrated Care population)
QIPP 2015/16: A&E (Integrated Care population)
Outcomes and incentives
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Specialist commissioning
• Planning guidance outlines need for sustainability and transformation plans (STPs) - specialist commissioning is integral to this and a step change in relationship between CCGs and NHSE signalled
• NHSE London commissions 3.6bn from 48 providers across acute and mental health
• 12 providers account for >80% of the spend
• Jonathan Fielding has been appointed as the new National Director for Specialist Commissioning reporting directly to Simon Stevens with John Stewart as Strategy and Policy Director.
• Current workstreams are Neuro rehabilitation, Tier 4 CAMHS and HIV
• Limited active QIPP in the past so opportunity for pathway redesign in some areas
• Shadow periods being proposed
Thank you
Questions?