NHS Haringey and NHS Islington CCGs Provider Information Event 20 th - - PowerPoint PPT Presentation

Value Based Commissioning Programme NHS Haringey and NHS Islington CCGs

Provider Information Event 20th March 2015

Welcome

Alison Blair, Chief Officer NHS Islington Clinical Commissioning Group

Agenda

8.45– 9.15 Registration and coffee 9.15 – 9.20 Welcome / Introduction and aims and

• bjectives

Alison Blair 9.20 – 10.00 The Vision for VBC in Haringey and Islington Dr Katie Coleman and Dr Helen Pelendrides 10.00 – 10.45 Stands 10.45 – 11.00 Feedback and themes from stands Stand hosts 11.00 – 11.10 Provider assurance process – what happens next Sarah Price 11.10 – 11.25 Question and answer session VBC Panel 11.25 – 11.30 Wrap up / close Alison Blair The information on the stands will cover the following areas:

• Older people living with frailty
• People with diabetes
• Outcomes
• Commercial and finance

Introduction on the aims and objectives of the day

• To provide further information on the CCGs’ proposed

value based commissioning programme (VBC)

• To provide further information on the individual projects

(older people with frailty and people with diabetes) across the CCGs

• To provide the opportunity to discuss specific elements

within the VBC process

• To provide an opportunity for providers to meet other
• rganisations that are interested in delivering services for

the population

The Vision for Value Based Commissioning in Haringey and Islington

Why focus on people with diabetes / frailty?

Diabetes prevalence projected to rise significantly in next 15 years

0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 2010 2015 2020 2025 2030

Percentage Year Estimated prevalence of people with diabetes (diagnosed and undiagnosed), Haringey, Islington, London and England resident population aged 16 and over, 2010 - 2030 Haringey Islington London England

Source: Association of Public Health Observatories, 2014

Why focus on people with diabetes / frailty?

• Diabetes is expensive, it costs the NHS £10 billion each year

(10% of the NHS budget)

• Assuming that there is no inflation, the cost will rise to £16.9

billion each year

The cost of diabetes in 2010/11 vs the projected cost for 2035/36

Source: The Cost of Diabetes Report, Diabetes UK, 2014.

Why focus on people with diabetes / frailty?

50% of all Ambulatory Care Sensitive emergency admissions were for patients aged 65 and over.

Source: Quality Watch Health Foundation, Nuffield Trust, Focus on preventable admissions: Trends in emergency admissions for ambulatory care sensitive conditions, 2001 to 2013. figures for England

The clinical vision for People with Diabetes

A clinical perspective from Dr Katie Coleman (Islington CCG):

• What happens now for people with Diabetes?
• Services are fragmented, patients unsure of what is available and how to access
• The needs of particular patient groups aren’t always met
• Clinicians need to make multiple referrals
• Patients report feeling unsupported when newly diagnosed
• Care plans are not regularly shared
• Interface between primary and secondary care can prevent consistent approach
• How will VBC improve this?
• All providers focused on agreed outcomes; increased focus on prevention
• Single point of access: central point for referrals; patients tell their story once;

facilitates coordination

• Many services co-located, with a ‘one stop shop’ approach
• Coordinated approach to empowering patients
• Improved infrastructure: IT, record sharing, communications

The clinical vision for Older People with Frailty

Our present system requires Harry to fit into the service pipelines we currently commission

• LAS and the transport process

to get to his hospital appointments

• acute trust COPD out patient

pathway

• A&E +/- OPAU when he has

falls or exacerbations

• social services thresholds for

help for his daughter, who works full time and is Harry's carer Harry Gray

• 75 year old widower
• Living with daughter
• COPD, dementia, depression,

falls

• 32 A&E visits – 10 admissions
• 11 medications

The clinical vision for Older People with Frailty

BUT Harry and other patients tell us they want:

• Joined up care, preferably in the same place, at the same time
• To be involved and listened to, not part of a fast moving production line
• To take responsibility for their own conditions and prevent exacerbations as

much as possible

• To stay independent with support
• To have a named individual who can help organise their care

They do NOT want:

• To be sent to and fro between different agencies
• To understand why different hospitals, clinics or services do not all have their

up to date medical records

• To understand the barriers between different organisations, and why the NHS

and Social Care work completely differently

What is VBC and why it will make a difference

VBC is more than integration It is a transformational way of commissioning patient care so that all the different organisations which provide services for a defined patient population have a common incentive:

• To deliver the right outcomes for the patient
• To make the pathway as efficient as possible
• To reduce duplication and delay
• To work across all the current barriers
• To enable a live shared patient record
• To coordinate care around the patient with his involvement

Because it is in everyone's best interest to do so

We have listened

What patients have told us

Complications as a result of my conditions will be prevented/managed My diabetes will have the least impact on my life I have the support to manage my condition Working in partnership with the specialist Minimal disruption to my daily life (one stop shop) Co-ordinated / Integrated Care Patient education = self management Prevention

What have we done so far?

Cohort Outcomes Service delivery Financial model Contracting

Who is in and out of scope, how people enter/leave When to measure? Which

• utcomes to link

to payment? What will be different for our population, how will care be organised? What to include and exclude to get baseline? How to balance risk appropriately, contract terms with provider

The lead provider role

• To deliver the best possible outcomes for patients
• To meet the scale and pace of change to deliver outcomes
• To organise an integrated approach to delivering services
• To lead on effective provider management and collective
• wnership of outcomes
• To support the VBC adoption within the existing provider landscape
• To ensure there is a single robust governance across providers and
• rganisations
• To ensure cultural divides are effectively managed to avoid

potential jeopardising of integration and joint working

Information covered on the stands

Stands Post 1 Older people living with frailty Rachel Lissauer (Haringey CCG) Dr Helen Pelendrides (Haringey CCG) 2 People with diabetes Rebecca Kingsnorth (Islington CCG) Dr Katie Coleman (Islington CCG) Dr David Egerton (Islington CCG) Dr Dai Tan (Haringey CCG) 3 Outcomes Dr Will Maimaris (Haringey CCG) Dr Rupert Dunbar-Rees / Juliana Bersani (OBH) 4 Commercial and finance David Maloney (Haringey CCG) Robert McGough (Capsticks) Andrew Lentin (Swan Partners) Jeremy Davies (NEL CSU)

Stands

Feedback and themes from stands

Provider assurance process – what happens next

The next steps

• You need to consider how you would like to be involved in the

process and how you would work with other organisations to deliver better outcomes

• If you are considering being a lead provider, then we are looking

for providers who have the willingness, capability and capacity to be able to successfully lead delivery of the VBC projects for patients

• Please refer to the e-procurement portal for further information
• n the next stages of the process

Further detail on lead provider assurance

• Organisations ‘self-assess’ using the 3 gateway criteria and

provide brief evidence of how they meet these criteria. Responses to be assessed on a pass/fail basis

• Organisations that pass the 3 gateway criteria are asked to

complete a lead provider assessment

• The responses to the lead provider assessment will be scored

and a number will be invited to present to a panel including clinical and patient representatives

• A lead provider will be identified to begin a period of

collaborative preparation with the CCGs and other providers prior to service commencement

Question and answer session

Alison Blair – Chief Officer, NHS Islington CCG Sarah Price – Chief Officer, NHS Haringey CCG Dr David Egerton – Clinical Lead for People with Diabetes, Islington CCG Dr Helen Pelendrides – Clinical Lead for Older People with Frailty, Haringey CCG Dr Katie Coleman – Clinical Lead for People with Diabetes, Islington CCG David Maloney – Chief Financial Officer, Haringey CCG

Thank you for your interest and attendance today