Value based commissioning Rachel Lissauer Assistant Director, Clinical Commissioning NHS Haringey Clinical Commissioning Group
Value-Based Commissioning • What does it mean to commission for value? • Why is Haringey doing this? • How are we taking it forward? We want your views about… • Which outcomes do you think matter most? If we were only going target a few which would we measure? • In your experience, how well is our system set up to achieve these outcomes? • What would we do more/less/differently in future to achieve the outcomes? 2
Why is Haringey doing this? • We currently pay for activity not results • So that we can focus on outcomes for people in Haringey that matter • We want to create the right incentives for: – enabling people to remain independent – recover quickly – remain well in mind and body • To do this we need to focus on outcomes 3
Creating a value based system Five interdependent and reinforcing components: Organisation of care around patient populations/medical conditions (not around existing institutions) Measure patient outcomes and cost across the full care cycle (so we understand impact) Move to bundled payments / contracts for full care cycles (payment for independence rather than illness) Integrate care delivery across separate facilities Expand excellent services across geography Underpinned by: Information Technology (access to the right information across organisations) 4
What are we doing? Two projects: Older people with frailty – in partnership with Enfield CCG People with diabetes – in partnership with Islington CCG Patients, carers, clinicians and commissioners have defined outcomes which matter most We want to understand these outcomes with you today We are working with GPs to identify and plan for patients at risk We are thinking about what and how we can measure We are mapping the current service We are designing new ways to deliver through localities and how VBC can help deliver our Better Care Fund vision We will cost out care and develop contracts that support the vision If it all works, pilots will go live in April 2015. 5
Haringey’s locality model GPs Social Services Patient/family/carers Acute Trusts Referral to Single Point of Access SPA Mental Rapid Response / Health hospital at home/ Triage Services GP aligned to group virtual ward of GPs District GP nursing Care Allocation of service care co-ordinator co-ordinator and patient Integrated Care Team, Multidisciplinary, co-located Single Assessment Physiotherapy, Rehabilitation Referral to OT, SALT Services Specialist Services Social Services Within IC Team Within Specialist Services Specialist Services inc: Bladder & Bowel; Diabetes; Geriatrician; Pallative Care; Psychiatry; Tissue viability 6
Seeking your views Round table discussions in 6 groups: Older people and Diabetes: Outcomes • Are these the right outcomes? If we could only measure a few, which should we choose? • Is there consensus in your group or do people’s views differ? Your use and experience of current services? • Have you used any of these services? • If so, what was your experience? How well were they set up to achieve these outcomes? The future • What would need to happen differently in future to help the outcomes be achieved? 7
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