NHSE Meeting 28 th Feb - NHS Ealing CCG submission
QIPP SUMMARY
Ealing CCG QIPP 2014-15 and 2015-16 The next section of the pack describes the QIPP schemes and operating plan trajectories that have been developed by each of the CCGs. Both respond to and reflect Everyone Counts and our Commissioning Intentions. We will be undertaking a mapping exercise to ensure that we have taken account of all of the relevant benchmarking data available. For example, based on a preliminary assessment, many of our schemes overlap with areas presented as high impact interventions and early adopter interventions in Anytown. We will be formalising this assessment in the coming weeks so that we can ensure that we are exploiting the maximum opportunity, and ensuring alignment with our key strategies and collaborating across CWHHE where this offers additional benefit and synergies. We will use the outcomes of this exercise to refine our submission for the 4 th of April.
Ealing CCG QIPP Summary 2014-15 and 2015-16 2014-15 QIPP Summary Plan 2015-16 QIPP Summary Plan Gross Investment Net Risk Rating Net Rated Gross Investment Net Risk Rating Net Rated Saving (£000k) Savings (% Savings Saving (£000k) Savings (% Savings Scheme Type Scheme Code Scheme Name (£000) (£000) Deliverable) (£000) (£000) (£000) Deliverable) (£000) 07W-1415-001 Intermediate Care Service (ICE) £2,952 £2,253 £699 107% £750 £2,010 £525 £1,485 67% £990 07W-1415-002 U&USC Pathway: Ambulatory Care £0 £0 £0 0% £0 £0 £0 £0 0% £0 07W-1415-003 U&USC Pathway: Frail Elderly £0 £0 £0 0% £0 £0 £0 £0 0% £0 Unplanned Care 07W-1415-004 GP Service for Nursing Homes £1,354 £642 £712 81% £576 £301 £165 £136 100% £136 07W-1415-005 Pulmonary rehabilitation £195 £0 £195 50% £97 £200 £100 £100 100% £100 07W-1415-006 Falls Pathway TBD TBD TBD TBD TBD £0 £0 £0 0% £0 07W-1415-007 Referral Facilitation Service (RFS) £1,000 £500 £500 57% £285 £1,499 £0 £1,499 67% £1,000 07W-1415-008 CVD Anticoagulation Schemes £663 £72 £591 40% £236 £200 £70 £130 100% £130 07W-1415-009 MSK Pathway £1,281 £387 £894 100% £894 £1,333 £400 £933 75% £700 Diabetes £371 £324 £47 100% £47 £400 £133 £267 75% £200 07W-1415-010 Planned Care 07W-1415-011 Cardiology £720 £552 £168 30% £51 £4,380 £3,207 £1,173 100% £1,173 Gynaecology £672 £0 £672 39% £261 £0 £0 £0 0% £0 07W-1415-012 07W-1415-013 Dermatology £1,412 £326 £1,087 88% £960 £466 £149 £317 100% £317 07W-1415-014 Ophthalmology TBD TBD TBD TBD TBD £400 £200 £200 100% £200 07W-1415-015 Paediatric Pathways £100 £0 £100 100% £100 TBD TBD TBD 0% TBD Paediatrics 07W-1415-016 Connecting Care for Children £107 £81 £26 0% £0 TBD TBD TBD 0% TBD 07W-1415-017 Mental Health CC £650 £0 £650 100% £650 £0 £0 £0 0% £0 07W-1415-018 Shifting Settings of Care (Mental Health) £750 £0 £750 67% £500 £0 £0 £0 0% £0 Mental Health Mental Health: Productivity; Recovery Houses; Ward £1,280 £0 £1,280 47% £600 £1,250 £0 £1,250 80% £1,000 07W-1415-019 closure & bed reconfiguration 07W-1415-020 Prescribing £1,612 £36 £1,576 79% £1,251 £1,250 £250 £1,000 80% £800 Medicines Management 07W-1415-021 Acute High Cost Drugs Risk Share £100 £0 £100 100% £100 £100 £0 £100 100% £100 Financial NCA Validations £100 £0 £100 75% £75 £75 £0 £75 100% £75 Management 07W-1415-022 07W-1415-023 Emergency Admissions Reduction £2,250 £0 £2,250 50% £1,125 £1,125 £0 £1,125 100% £1,125 Efficiency and Productive Community Services Efficiency 2014-15 £735 £0 £735 50% £368 £368 £0 £368 100% £368 07W-1415-024 Productivity 07W-1415-025 Old Productivity and Efficiency Metrics TBD TBD TBD TBD TBD TBD TBD TBD TBD TBD 07W-1415-026 Diagnostics: Pathlology £100 £0 £100 100% £100 £0 £0 £0 0% £0 07W-1415-027 Diagnostics Cloud £0 £0 £0 0% £0 £275 £0 £275 100% £275 Diagnostics Pathology Services Re-procurement £443 Net £443 78% £344 £1,095 Net £1,095 100% £1,095 07W-1415-028 Totals (roll forward of 2014-15 QIPP schemes) £18,845 £5,172 £13,674 £9,369 £16,727 £5,199 £11,528 £9,784 Net QIPP Target £13,674 £11,528 New Commissioning Intentions High cost appliances £100 £0 £100 100% £100 Planned Care Adoption of Non-Pbr tariffs for all non consultant lead £200 £0 £200 100% £200 Procurement: 111 services £0 £0 £0 0% £0 Unplanned Care MCAP benefit £0 £0 £0 0% £0 BCF 3.2.1 Dementia Care Pathway £900 £469 £431 80% £345 Better Care Fund Schemes BCF 3.2.7 Supportd Discharge and Rehab (non-bedded) Included in ICE Totals (New 2015-16 QIPP schemes) £1,900 £469 £1,431 £645 Net QIPP Target £1,431 Grand Totals £18,845 £5,172 £13,674 £9,369 £18,627 £5,668 £12,959 £10,429 NET QIPP Target £13,674 £12,959
Ealing CCG 2014-15 QIPP Programmes Summary (1/4) Schemes supporting Unplanned Care ( Total £1.6m net saving) Intermediate Care Service (ICE): £750k GP Service for Nursing Homes: £712k Pulmonary rehabilitation: £195k 44% 44% 12% Schemes supporting Planned Care ( Total £4.6m net saving) Referral Facilitation Service (RFS): £500k CVD Anticoagulation Schemes: £591k MSK Pathway: £894k Diabetes: £47k Cardiology: £168k Gynaecology: £672k Dermatology: £1087k Paediatric Pathways: £100k Diagnostics: Pathlology: £100k Pathology Services Re-procurement: £443k 11% 13% 19% 1% 4% 15% 23% 2% 2% 10% Schemes supporting Medicine Management savings ( Total £1.6m net saving) Acute High Cost Drugs Risk Share: £100k Prescribing: £1576k 6% 94% Schemes supporting Effieciency and Productivity savings ( Total £2.9m net saving) Emergency Admissions Reduction: £2250k Productive Community Services Efficiency 2014-15: £735k 75% 25% Schemes supporting Mental Health savings ( Total £2.7m net saving) Mental Health CC: £650k Shifting Settings of Care (Mental Health): £750k Mental Health: Productivity; Recovery Houses; Ward closure & bed reconfiguration: £1280k 24% 28% 48%
Ealing CCG 2014-15 QIPP Programmes Summary (2/4) Schemes supporting Unplanned Care ( Total £1.6m net saving) Intermediate Care Service (ICE): £750k GP Service for Nursing Homes: £712k Pulmonary rehabilitation: £195k 44% 44% 12% Scheme Name QIPP Scheme Description Intermediate Care Service (ICE) An emergency admissions avoidance scheme that provides step up services in the community including step up beds. The scheme takes referrals from GPs, and from A&E departments at both EHT and IHT. GP Service for Nursing Homes An emergency admissions avoidance scheme, that provides for an enhanced primary care service for the 1,100 nursing home residents in Ealing. The contract with the provider stipulated a high frequency of appointments for the patients, and includes high responses times from urgent calls from the nursing homes. Pulmonary rehabilitation An emergency admissions and re-admissions avoidance scheme. GPs refer qualified patients on the COPD long term conditions register for pulmonary rehab services. The provider contract allowed for 900 patients. Schemes supporting Medicine Management savings ( Total £1.6m net saving) Acute High Cost Drugs Risk Share: £100k Prescribing: £1576k 6% 94% Scheme Name QIPP Scheme Description Prescribing A primary care prescribing cost reduction scheme based upon analysis and expert advise to Practices. the Medicine Management team has undertaken a detailed review of the areas of prescribing that do not confirm to best practice and/or guidelines. An evaluation of the opportunity to influence and reduce prescribing in these specific drug categories has identified a total opportunity equivalent to the budget figure. Acute High Cost Drugs Risk Share A secondary care prescribing cost reduction scheme focussed on the" High Cost Drugs" (i.e. excluded drugs under PbR). The scheme is based on combined work of the Trust Pharmacists and the CCG, with both parties incentivised to seek savings via a gain share agreement.
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