the future of the nhs in north central london islington voluntary sector health network 18 january...
TRANSCRIPT
The future of the NHSin North Central London
Islington Voluntary Sector Health Network
18 January 2011
Jacqueline FirthEngagement Manager, NHS Islington
All change
• Please understand that the NHS is undergoing a significant period of change. Two issues:
1. NHS White Paper, including GP commissioning
2. Efficiency savings• Don’t have all the answers now• Our transition plans are as flexible and adaptive as
possible so that we can deal with uncertainty • We await the new Health Bill• Information in today’s update could change
July 2010 – White Paper Liberating the NHS: Equity & Excellence
• Patients to be placed at the heart of everything the NHS does
• The NHS to focus on improving what really matters to patients: the quality and outcome of their healthcare
• Clinicians to be empowered to innovate with the freedom to focus on improving healthcare services
GP Consortia
• Shift decision-making as close as possible to the patient• build on the pivotal and trusted role already held by Primary Care
professionals• GPs best placed to co-ordinate commissioning and pathways of care
• Clinically-led redesign of pathways and services• more effective working relationship between primary and secondary care
clinicians• bringing together responsibility for clinical decisions and the financial impact
of those decisions
• GPs to work with local partners to commission the majority of healthcare services• will not commission general practice, but will increasingly drive up the quality
• Practice level budgets to be allocated directly to consortia
To make future commissioning plans a success …
• GP consortia need to inherit a system which is performing well and in financial balance which means:
– getting a grip on the current financial position– delivering savings on commissioning spend and savings on
management costs
Management cost savings
• NHS London and its 31 PCTs must deliver management cost savings of £180 million by April 2013• savings to be reinvested in frontline services to ensure London’s patients
receive better, more efficient and more effective care and also to support set up of GP consortia
• This means delivering management cost savings of 54%• while maintaining the quality and safety of local services• and supporting our people in planning their personal futures
• In North Central London, we cannot sustain five separate organisations and deliver those management cost savings • Equates to some £28 million by the end of 2010/11
The transition plan
• A single transition team for North Central London to be operational from 1 April 2011
– do at a borough level what needs to be done locally
– do at North Central London (sector) level what can be done centrally, once
• We are pooling our talent, resources and expertise to tackle our biggest problems
• Maintaining the relationship with GP community is crucial over the next two years
• Retaining local knowledge is also so important for the future• We need to be as flexible and adaptive as possible so that we can
deal with uncertainty
Principles for the new structure
• The purpose is to deliver the NHS North Central London Board objectives and lead transition programme up to 2013
• Many functions can best be done centrally – some must be responsive to local needs
• There will need to be a strong and credible borough presence – the face of the NHS in each borough
• Value and build on existing local knowledge, skills and relationships• GPs and local authorities will be part of the leadership shaping the
future• We will all need to work differently• Services for patients will continue to be delivered locally
Proposed single management team structure and functions
Borough DirectorBorough Director
Borough DirectorBorough Director
Chief Executive
Director of Finance
Director of Contracts
QIPP DirectorDirector of Quality
& SafetyDirector of Public
Health
Director of Transition &
Corporate AffairsBorough Director
Finance
IT
Acute, Community and Mental Health
Primary care
Performance
Informatics
PMO
Strategy
Quality & Safety
Clinical advice
Communications
HR
Governance
Estates
Joint commissioning
Local finance
Safeguarding
Continuing Care
Medicines Management
GP IT
Local functions
• Local, credible, authoritative presence• Development of GP Consortia• Liaison with the Local Authority
– Public health functions
– Local Strategic Plans and joint commissioning
• Relationship management and intervention with GPs• Specific quality assurance and governance, e.g. safeguarding• Financial support for Boards and Practice Based Commissioning /
GP Consortia• Delivery of local savings plans, a real focus for remainder of 2010/11• Delivery of service improvements
Retain focus on key priorities
• These proposals will help us to deliver our current priorities and work through the transition period• improving health outcomes for our population• financial recovery through effective service commissioning• service change and transformation – with a focus on primary care• assuring the quality and safety of services provided to patients in
our communities• managing an effective transition to new commissioning
arrangements for the NHS in North Central London
Timeline
• New North Central London 1 April 2011
• NHS new borough presence (with fewer staff) 1 April 2011
• GP consortium running in shadow form 1 April 2011
• Finally, all PCT functions will likely transfer to: April 2013• National Commissioning Board, or• GP Consortia, or• Local government
