Comissioning NIS Commissioning Facilitators Meeting Tuesday 13 - - PowerPoint PPT Presentation

Comissioning NIS

Commissioning Facilitators Meeting Tuesday 13 September 2016

Meeting agenda

Agenda item Lead

Chairs welcome, introductions and aim of the meeting Shah Overview of the Acute Transformation programme & the purpose of the NIS Cheryl Developing the 17/18 Commissioning NIS & the role of commissioning facilitators Shah 16/17 NIS: Calprotectin audit Shah 16/17 NIS: IMAPS audit Victoria 16/17 NIS: Dermatology audit Monir Next steps & AOB Shah

Background to the NIS…

• Running since 2010
• Evolution from Bill Jenks’ referral data
• In 16/17: £560k cost per annum
• Aims of the NIS to date:
• Supporting engagement of GP members as commissioners
• Collating and analysing data in key areas to help understand the

variation in usage of services between different practices’ patient populations to improve commissioning decision making.

• Increasing quality of care delivered in the community in order to

reduce costs further down stream

• Allocating resource via commissioning facilitators

Acute Transformation – previously Planned Care

• Pathway redesign –

Anticoagulation, LTC bundles

• Direct GP access to diagnostics –

dedicated TST Diagnostics project

• Community alternatives –

Ophthalmology & Gynae

• Virtual access to specialists –

Advice & Guidance, non F2F FUps

• Peer review of elective referrals –

Commissioning NIS 17/18

• Pathway redesign –

Gastro Straight To Test (STT)

• Direct GP access to diagnostics –

Calprotectin

• Community alternatives –

Teledermatology & IMAPS

• Virtual access to specialists –

eCKD consultations

• Peer review of elective referrals –

Commissioning NIS?

16/17 NIS structure

Locality engagement Education: Internal & External Audits x 3 Claims validation E-Referrals

Changes from last year

Section under 15/16 NIS Amendments to 16/17 NIS

Engagement in commissioning No change Network Education – Internal Education Mental Health continues to be an important improvement area and as such continues to be

• ne of the priorities. Amendment to the provision of contact details for MH commissioning

managers to assist networks with this (area of feedback by GPs). Network Education – External Education for patients Reduced requirement from 16 hours down to 12 hours of education to be undertaken by each network. This is to reflect the resource required to undertake these sessions. Three areas to be targeted: MH (with contact details for MH commissioning managers to assist networks with this), frequent A&E attenders eg new parents and frequent GP attenders eg offering appropriate self management Clinical audit Increased weighting to 40% of total. This is from GP feedback that the resource required to undertake the audits is considerable. Provided pro formas for audits in three CCG priority areas: Calprotectin, MSK referrals and Dermatology referrals. Each of these reflect new pathways offering faster access to consultant-led care and improved management of patients in the community (under the care

• f their GP). Pro formas designed by CCG clinical leads/Governing Body lead.

Validation and Quality No change Encouraging greater use of Choose & Book for acute referrals Renamed section to “Encouraging greater use of e-Referrals for acute referrals” in line with new name for Choose and Book. Encouraging Use of Technology Removed this section. This was previously allocated 10% of the total NIS which the CCG felt was better used to reward other parts of the NIS (ie audits) and practices have made considerable progress towards this goal already. Furthermore, significant funding and borough-wide approaches are often required to introduce new technologies. Projects such as e-Consult and the technology innovations in general practice planned in Tower Hamlets as part of the Vanguard programme are better placed to support this objective. Commissioning Facilitators No change Payment values/calculation No change

16/17 Funding

Network

• 1. Engagement in

Commissioning 5%*

• 2. Network

Education - External 10%*

• 3. Network Education -

Internal 20%*

• 4. Clinical

Audit 40%

• 5. Validation

and Quality 15%

• 6. E-referrals

10% Total 30% Payment 70% Payment Network 1 £2,857.56 £5,715.13 £11,430.25 £24,671.16 £9,251.69 £6,167.79 £60,093.58 £18,028.07 £42,065.50 Network 2 £2,857.56 £5,715.13 £11,430.25 £25,757.87 £9,659.20 £6,439.47 £61,859.47 £18,557.84 £43,301.63 Network 3 £2,857.56 £5,715.13 £11,430.25 £18,910.43 £7,091.41 £4,727.61 £50,732.39 £15,219.72 £35,512.67 Network 4 £2,857.56 £5,715.13 £11,430.25 £20,048.74 £7,518.28 £5,012.18 £52,582.13 £15,774.64 £36,807.49 Network 5 £2,857.56 £5,715.13 £11,430.25 £18,123.63 £6,796.36 £4,530.91 £49,453.84 £14,836.15 £34,617.69 Network 6 £2,857.56 £5,715.13 £11,430.25 £22,418.84 £8,407.06 £5,604.71 £56,433.55 £16,930.06 £39,503.48 Network 7 £2,857.56 £5,715.13 £11,430.25 £25,604.88 £9,601.83 £6,401.22 £61,610.86 £18,483.26 £43,127.60 Network 8 £2,857.56 £5,715.13 £11,430.25 £27,348.46 £10,255.67 £6,837.11 £64,444.18 £19,333.25 £45,110.93 Total £22,860.50 £45,721.00 £91,442.00 £182,884.00 £68,581.50 £45,721.00 £457,210.00 £137,163.00 £320,047.00 % Split per Element 5.0% 10.0% 20.0% 40.0% 15% 10.0% 100.0% 30.0% 70.0% Split per Element £22,860.50 £45,721.00 £91,442.00 £182,884.00 £68,581.50 £45,721.00 £457,210.00 Commissioning Facilitators Funds per Network Total available fund Total £13,440 £107, 520

Looking forward to 17/18

An emerging challenge awaits the Tower Hamlets health economy

• How can we best support our members as commissioners
• What is the role of commissioning facilitators
• How do we make this role as effective as possible
• Given the Acute Transformation agenda, what could this investment be

directed towards

• How could we re-design the system to enable it to be more responsive

to all of our needs and less bureaucratic

• How could we monitor the quality
• Forming a steering group
• How do we take this work forward

16/17 Audits

Calprotectin: an essential precursor to the new ‘Straight to Test’ Gastroenterology pathway (currently piloting with 3 practices, roll out planned for October 2016) IMAPS: ascertaining the quality of GP musculoskeletal management and identifying areas for local service improvement with the new integrated community MSK service Dermatology: assessing the local management of dermatological presentations and the quality of the new community dermatology service How will we feedback to you on your audits

Next steps

• FAQs from the CCG – please disseminate to your practices
• Complete the audits – you can send these in as soon as they’re done
• CCG to develop a simple template for consistent returns
• Complete the 16/17 return – should be able to return in March or

April 2017

• Contribute to the plans for 17/18 NIS development
• Contribute to the development of the Commissioning Facilitator role
• Finalise and agree 17/18 NIS in early 2017, before start of new

financial year