understanding the new commissioning landscape thoughts for future planning dr nick harding
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Understanding the new Commissioning Landscape Thoughts for future planning Dr Nick Harding BSc MFMLM FRCGP DRCOG DOccMedPGDip(Cardiology) February 2012 Botanical Gardens. An introduction. We are passionate about improving healthcare for the people of Sandwell and West Birmingham. - PowerPoint PPT PresentationTRANSCRIPT
Understanding the new Commissioning Landscape
Thoughts for future planning
Dr Nick Harding BSc MFMLM FRCGP DRCOG DOccMedPGDip(Cardiology)
February 2012
Botanical Gardens
An introduction We are passionate about improving healthcare for the people of Sandwell and West Birmingham.
Our vision is for transforming services to ensure excellence for everyone and in everything we do.
We will not be a PCT in new clothing – this is a different kind of organisation that is firmly ground in its membership, relationships and local knowledge.
We will be using local and clinical knowledge for change and improvement in health for our patients.
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Numbers of the day…
35025797152 5010 4539 000 000
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Our health needs
4Health without boundaries - November 2011
• SWBH commissioning area is 530,560 patientsSWBH commissioning area is 530,560 patients• Heart of Birmingham Heart of Birmingham ranked ranked 1010thth most deprived most deprived
Local Authority in England with Local Authority in England with 68% BME 68% BME populationpopulation• SandwellSandwell ranked ranked 1212thth most deprived most deprived Local Authority Local Authority
in England in England with approx with approx 20% BME 20% BME populationpopulation• Health challenges against rising costs and demands Health challenges against rising costs and demands
for healthcarefor healthcare• Absolute commitment to improving quality of careAbsolute commitment to improving quality of care
4
The journey
2002 PCTs arrive
2003 Right Care Right Here partnership forms
2007 Practice Based Commissioning, ICOF
2008 Primary Care Collaborative Clinical CommissioningDirectors appointed
2009 Partnerships form: Vitality PartnershipStrategic Models of Care
2010 GP Consortia Healthworks, ICOF, Black Country Alliance and Pioneers for HealthCare Pathway Reviews
2011 Sandwell and West Birmingham Clinical Commissioning Group
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Our CCGLocal Commissioning Groups* Chair
Practices (approx.)
Population (approx.)
Black Country Dr George Solomon 20 112,228
HealthWorks Dr Nick Harding 22 132,985
ICOF Dr Samar Mukherjee 27 106,953
Pioneers for Health Dr Vijay Bathla 10 46,151
Sandwell Health Alliance Dr Basil Andreou 31 127,519
Clinical Commissioning Group
Sandwell and West Birmingham
Dr Nick Harding(Interim Chair)
111 530,560
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CCG Area covered
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Our Interim StructureInterim Chair
(Currently Chair of HealthWorks)
Board Secretary
Chair and Vice Chair of HealthWorks
Chair and Vice Chair of Sandwell Health Alliance
Chair and Vice Chair of Pioneers 4 Health
Public Health Representative
Secondary care consultant
Lay Advisors
Nurse Representative
Consortia Development: Non-voting membersFinance Lead
Birmingham
Finance Lead Black Country
Lay Advisor Birmingham
Lay Advisor Black Country
Director of Commissioning Birmingham
Director of Commissioning Black Country
Chair and Vice Chair of Black Country
Chair and Vice Chair of ICOF
Deputy Chair(TBA)
Finance Lead
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Our structure
Main SWBCCG Board
Finance & Performance Sub-Committee
Quality & Safety Sub-Committee
Strategic Commissioning & Redesign Sub-Committee
Remit: To have on-going responsibility for the affordability of the local healthcare system, and to receive monthly monitoring reports. This group will highlight concerns to the Board.
Remit: To regularly review providers to ensure that services are safe, and that outcomes are monitored.
Remit: To consider service provision and ensure that services are commissioned for shorter pathways, better value for money, and that provision is appropriate and adequate.
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Delivery through membershipChair and Vice Chair of HealthWorks
Chair and Vice Chair of Sandwell Health Alliance
Chair and Vice Chair of Pioneers 4 Health
Chair and Vice Chair of Black Country
Chair and Vice Chair of ICOF
Sandwell and West Birmingham Clinical Commissioning Group
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Our RoleBy April 2012 - shadow form as a CCG in readiness for 2013.
We want to:• Be clear on the health needs of our population and how we
are going to improve their health• Get the balance right between local and strategic decisions• Show real clinical leadership and development across the
health economy• Do this new role in the most effective way we can• Create a clinical commissioning group that leads by example• Be effective in communications within our organisations and
the people we serve• Be ready to lead and manage the NHS as a system by April
2013.
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New NHS
LicensingLicensing
Department of Health
Department of Health
CQCCQCNHS Commissioning
BoardNHS Commissioning
Board
ParliamentParliament
MonitorMonitor
Patients & PublicPatients & Public
2° and 3° Providers2° and 3°
Providers
PartnershipPartnership
SWBCCGSWBCCG ContractsContracts
Accountability
Funding
Key:
Birmingham HealthWatchBirmingham HealthWatch
Sandwell HealthWatchSandwell HealthWatch
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Estimating the Size of the Challenge - CommissionersA Conceptual Model
The scale of the financial challenge has been estimated by applying demand pressure forecasts by service line and price pressure forecasts to current levels of spend. Cost pressures associated with the planned transfer of funds from NHS allocations to social care are also included.
By 20014/15, there will be a recurrent cost pressure of £2.4bn (£1.3bn demand pressure, £1.0bn price pressure and £100m social care transfer). 44% of this will be offset through increases in commissioner allocations, leaving a residual recurrent cost pressure of £1.35bn in 2014/15.
Forecast Demand Pressure (CAGR – 2011/12 to 2013/14)
G/PMS etc 2.7%Prescribing 5.1%Ophthalmology 2.4%Dental 5.0%Community services 4.0%Ambulance 6.0%A&E 3.2%Outpatients 5.3%In-patent emergency 2.4%In-patent elective 2.4%Non- PbR outpatients 5.3%Non- PbR in-patients 2.4%Specialised Services 2.0%Mental Health 1.9%PCT Management Costs 0.0%Other 2.0%
Forecast Price Pressure
2011/12 2.1%
2012/13 2.1%
2013/14 2.6%
2014/15 2.7%
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Emergency Elective Maternity Other
<18
18-54
55-74
75+
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0% 20% 40% 60% 80% 100%
Beds Days by Admission Method and Age GroupBirmingham Providers 2009/10
Areas we can target
Doing exactly what we should be doing
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Secondary caredelivering
specialist services
Improved patient experience And releasing savings
Better primary care delivering more services
Stop doing things
Different place
Increase efficiency
Different provisionDecrease dependency
Keeping local and clinical engagement at the centre of how we deliver – a grass roots approach
Doing the right things right
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Improving quality
• Improve patient experience and quality of care• Improve health for our population• Working towards delegation/authorisation in 2012-13• Continue to build on good work done so far (RCRH)• Remain committed to the build of the new hospital and
working in partnership• Through continuous improvement, create rewarding
experience for clinicians wherever they are
Our ambition as a CCG
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Getting the best out of services - diabetes
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Over to you
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