WELCOME
Today’s Webinar
Population Level Commissioning for
the Future
Population Level Commissioning for the Future
Wednesday 3 December 2014
1pm – 1.45pm
Dr Abraham George
Assistant Direc...
Meet the Speakers
Bev Matthews
A nurse by background, Beverley has worked extensively throughout the NHS in a variety of...
Learning Outcomes
Population Level Commissioning for the Future
of Care foundation.
 Understanding the design and deve...
Beverley Matthews
LTC Programme Lead
NHS Improving Quality
Beverley.matthews@nhsiq.nhs.uk
Bespoke Support
Tools and Resources
Links
Long Term Conditions Dashboard
http://ccgtools.england.nhs.uk/ltcdashboard/flash/atlas.html
Long Term Conditions ...
LTC Learning Forum
“Lunch & Learn” Webinar Series
&
Bite Size Master-classes
LTC Learning Forum
“Lunch & Learn”
• 45 minute “real time” Webinar
sessions
• Topics agreed and learning outcomes
ide...
LTC Lunch & Learn Series ….coming soon…
To register email LTC@nhsiq.nhs.uk
Date Webinar Hosted by Bev Matthews &
7 Janu...
POPULATION LEVEL COMMISSIONING
FOR THE FUTURE
Dr Abraham George
Consultant / Assistant Director in Public Health
Kent ...
Context
• Huge NHS and public sector funding gap
• Public sector services expected to discharge
statutory functions wit...
Context (cont’d)
20%
75%
40%
15%
Multiple complex
conditions
Single LTC/ at risk
Healthy / minor
risk
Population...
Context (cont’d)
Acute Community Mental Health Social Care Voluntary/
All PbR
(except YoC or
package
currencies)
Ind...
The challenge
“Shifting the focus away from reactive episodic
care, towards a proactive person centred capitated
fundin...
Local Profile
• >1.5 million population
• Governance of
commissioning at multiple
levels
• 1 County Council, 7
CCGs,...
Progress till date
• Work started in 2012 – QIPP LTC programme
• Whole population profiling using risk stratification
–...
Population Commissioning for the future
• Longitudinal analysis of service utilisation and
costs for a patient cohort ba...
Kent LTC YOC programme
• All providers and commissioners involved
• 2/7 CCGs are the sponsor orgns
• KCC Public Health ...
Identifying patients suitable for YoC
• Risk stratification tool applied
• LTC codes applied (18 in total - QoF)
• List...
The Year of Care dashboard has so far presented 4 months of activity
and costs worth £57 million from 7 different provide...
Issues highlighted
Gap Identified by Date identified Action
No standard definitions for
Integrated Care across
system ...
Key Challenges
• Information Governance is a key challenge
– Current approach to data sharing has been difficult – diffe...
Key Messages
• Opportunity to capitalise ‘big data’ in public sector
• Importance of person level linked datasets using ...
Further contact details
abraham.george@kent.gov.uk
fionuala.bonnar@kent.gov.uk
Beverley.Matthews@NHSIQ.nhs.uk
“Year of Care is a vital component of
Kent’s Integration Pioneer Programme –
with findings being used to underpin Kent’s...
LTC Lunch & Learn Series ….coming soon…
To register email LTC@nhsiq.nhs.uk
Date Webinar Hosted by Bev Matthews &
7 Janu...
Population level commissioning
Population level commissioning
Population level commissioning
Population level commissioning
Population level commissioning
Population level commissioning
of 34

Population level commissioning

Population Level Commissioning for the Future Wednesday 3 December 2014, 1pm – 1.45pm Dr Abraham George Assistant Director/Consultant in Public Health Kent County Council & Beverley Matthews LTC Programme Lead, NHS Improving Quality
Published on: Mar 4, 2016
Published in: Healthcare      
Source: www.slideshare.net


Transcripts - Population level commissioning

  • 1. WELCOME Today’s Webinar Population Level Commissioning for the Future
  • 2. Population Level Commissioning for the Future Wednesday 3 December 2014 1pm – 1.45pm Dr Abraham George Assistant Director/Consultant in Public Health Kent County Council & Beverley Matthews LTC Programme Lead, NHS Improving Quality
  • 3. Meet the Speakers Bev Matthews A nurse by background, Beverley has worked extensively throughout the NHS in a variety of clinical, managerial and strategic roles. Beverley’s current role as Programme Delivery Lead for Long Term Conditions Improvement Programmes: LTC Year of Care Commissioning Model and LTC Framework. Prior to joining NHS Improving Quality in April 2013, Beverley was Director of NHS Kidney Care and NHS Liver Care. Passionate about service transformation through developing networks and leading complex programmes. Providing strategic leadership to partners within health communities, managing stakeholders and working across agencies Dr Abraham George Working in Kent since 2010, undertaking a challenging portfolio focused around commissioning support for urgent care (including a unique countywide hospital bed utilization review), end of life care and older people’s health including multiple morbidities. He is also the public health lead on Individual Funding Requests, Clinical Effectiveness and Kent County lead on the JSNA and Public Health Intelligence. Providing valuable strategic and tactical support to the Kent Integration Pioneer programme. Currently the public health lead for the Kent LTC Year of Care Commissioning Model and, alongside this, has been promoting the importance and use of person level linked datasets, enabling whole population integrated intelligence to support integrated commissioning.
  • 4. Learning Outcomes Population Level Commissioning for the Future of Care foundation.  Understanding the design and development of whole population person level linked datasets  Understanding their application towards commissioning of integrated care  What are the key challenges and inter-dependencies • The potential impact towards whole system transformation
  • 5. Beverley Matthews LTC Programme Lead NHS Improving Quality Beverley.matthews@nhsiq.nhs.uk
  • 6. Bespoke Support
  • 7. Tools and Resources
  • 8. Links Long Term Conditions Dashboard http://ccgtools.england.nhs.uk/ltcdashboard/flash/atlas.html Long Term Conditions House of Care Toolkit www.nhsiq.nhs.uk/improvement-programmes/long-term-conditions-and-integrated-care/house-of-care.aspx SIMUL8: Simulation Model http://www.simul8.com/viewer/download.htm #LTCyearofcare #LTCimprovement @NHSIQ
  • 9. LTC Learning Forum “Lunch & Learn” Webinar Series & Bite Size Master-classes
  • 10. LTC Learning Forum “Lunch & Learn” • 45 minute “real time” Webinar sessions • Topics agreed and learning outcomes identified • Faculty of Speakers identified Open invitation Bite Size Learning Master-Classes • Pre-recorded 20 minute Master-classes • Master-class either as stand alone sessions or pre-requisites for Wednesday “Lunch & Learn” Webinars • Faculty of Speakers identified Open invitation
  • 11. LTC Lunch & Learn Series ….coming soon… To register email LTC@nhsiq.nhs.uk Date Webinar Hosted by Bev Matthews & 7 January 2015 1 – 2pm Self Management Support Return on Investment Renata Drinkwater Chief Executive & Trustee Self Management UK 21 January 2015 1 – 2pm Commissioning for Outcomes Bob Ricketts CBE Director of Commissioning Support Services & Market Development, NHS England 4 February 2015 1 – 2pm Accountable Care Organisations in the USA & England testing, evaluating and learning what works Dr Rachael Addicot Senior Research Fellow, Kings Fund
  • 12. POPULATION LEVEL COMMISSIONING FOR THE FUTURE Dr Abraham George Consultant / Assistant Director in Public Health Kent County Council
  • 13. Context • Huge NHS and public sector funding gap • Public sector services expected to discharge statutory functions with ever shrinking budgets • Growing need for ‘whole system’ understanding how money and resources are being utilised for population health and wellbeing • Greater insight required to develop higher value models of care that can meet the funding crisis
  • 14. Context (cont’d) 20% 75% 40% 15% Multiple complex conditions Single LTC/ at risk Healthy / minor risk Population segments Cost
  • 15. Context (cont’d) Acute Community Mental Health Social Care Voluntary/ All PbR (except YoC or package currencies) Independent Primary care Primary care prescribing NHS England as commissioner Non-PbR block contract • PbR excl drugs • Crit. Care Personal healthcare budget Specialised MH Services Means-tested services (incl. residential) Rehabilitation palliative & end of life Maternity pathway • Reablement • Adult Services PbR MH clusters Children’s services GP services Residential continuing care Age UK
  • 16. The challenge “Shifting the focus away from reactive episodic care, towards a proactive person centred capitated funding model, irrespective of organisational boundaries and disease based pathways of care”
  • 17. Local Profile • >1.5 million population • Governance of commissioning at multiple levels • 1 County Council, 7 CCGs, 12 districts, 4 acute trusts, 1 community health trust, mental health trust, >200 practices • Public Health Observatory team • Well networked with other intelligence teams – JSNA development – Health & Social Care Maps – Local needs assessments – Other analyses • Links with K&M Health Informatics Service – data warehouse
  • 18. Progress till date • Work started in 2012 – QIPP LTC programme • Whole population profiling using risk stratification – Burden of multiple morbidities – Impact on service utilisation - ‘Crisis curve’ – Estimating possible financial benefits of integrated care could be realised http://www.kmpho.nhs.uk/EasySiteWeb/GatewayLink.aspx?alId=382582 • Delivery of national YOC programme in Kent - implementation at sub Kent / CCG level • Kent Integration Pioneer – Key milestone • Submission of linked datasets to national team for analysis • Contribution to national guidance eg. MONITOR report of designing linked datasets • Currently working health informatics service to develop dashboard
  • 19. Population Commissioning for the future • Longitudinal analysis of service utilisation and costs for a patient cohort based on multi-morbidity / risk stratification • A brief look at some of the graphs and charts in the report
  • 20. Kent LTC YOC programme • All providers and commissioners involved • 2/7 CCGs are the sponsor orgns • KCC Public Health manages programme on behalf of whole county • Implementation at sub Kent level • East Kent group first to take part and now finalising shadow testing arrangements • All professionals are involved – commissioner, finance, informatics, etc. • Use of risk stratification dashboard to monitor activity and costs, evaluate integrated care models • Data linkage at person level still not yet finalised, so linkage currently at GP practice level
  • 21. Identifying patients suitable for YoC • Risk stratification tool applied • LTC codes applied (18 in total - QoF) • List segmented by LTC currency (Bands B – E applied - B=2,C=3-5,D=6-8,E=9), • Risk Score over time mapped (looking for rise in risk score in last 6 mths – 4 of 6 show an increase) or • Rapid Riser in last 3 mths (monthly increase in risk score over past 3 mths and overall increase of >15pts). • Kent – 80 GP practices, Band B = 2197, Band C= 3506, Band D =261, Band E= 5 Total 6369 of 729, 275 • Now driving increased engagement in risk stratification
  • 22. The Year of Care dashboard has so far presented 4 months of activity and costs worth £57 million from 7 different provider organisations. Of this £4 million (7% of total spend) represents the proportionate costs for the YOC cohort (0.3% of total population).
  • 23. Issues highlighted Gap Identified by Date identified Action No standard definitions for Integrated Care across system East Kent Project Group Jan 2014 Flag to West Kent Project Group and link to Integrated Care plan work No method to share care plans once MDT completed. (Not even seen by GPs) EK Project Group Feb 2014 Flag to SRO Not all practices submitting data to HISBi East Kent Project Group West Kent Project Group April 2014 May 2014 Flag to SRO Ongoing PLICS and RiO system in Kent Medway P’ship Trust not flowing data correctly KMPT when requested to submit first data submission June 2014 Resolved by KMPT No standard definition for integrated care within Kent Community Health Trust Impact identified by Programme on YoC ability to assess impact of LTC services Vs WP July 2014 KCHT to standardise definition. Recording process agreed Sept 2014 Variable in recording practice of GP codes in Non –NHS data Programme when we introduced “black box” solution Sept 2014 Highlighted to organisations. With 3rd sector provided list to facilitate update.
  • 24. Key Challenges • Information Governance is a key challenge – Current approach to data sharing has been difficult – different expert opinions on how share / link data – National policy on data sharing for ‘indirect care’ is evolving eg. role of ‘DSCROs’, Department Health consultation on ‘Accredited Safe Havens’ • Data quality and accessibility – Good support from provider organisations – Quality / completeness of data variable across different organisations • Commissioner buy-in – Still some way off in application toward CCG plans – Difficult to change mind-set of commissioning capacity towards outcomes. – Long term planning of Business Intelligence provision in Kent uncertain
  • 25. Key Messages • Opportunity to capitalise ‘big data’ in public sector • Importance of person level linked datasets using NHS numbers • Using technology to accelerate the linking of data from disparate sources • Understanding the role of intelligence to develop higher value models of care to incentivise prevention and improve population health and wellbeing • Opportunity for business intelligence teams to work together develop whole system intelligence
  • 26. Further contact details abraham.george@kent.gov.uk fionuala.bonnar@kent.gov.uk Beverley.Matthews@NHSIQ.nhs.uk
  • 27. “Year of Care is a vital component of Kent’s Integration Pioneer Programme – with findings being used to underpin Kent’s Better Care Fund” Jo Frazer – Kent Pioneer Programme Manager - “If this works that’s my job done” - -CCG Head of Finance “Kent have been successful in linking their transformation of services with commissioning through the LTC Year of Care programme which will make that step towards individualised care for people with complex needs.” Beverley Matthews, LTC Programme Lead, NHSIQ “The intelligence from YOC is both informing our thinking on a more progressive contracting approach incentivising real service integration”- Hazel Carpenter, Accountable Officer CCG “This is the first group I have been part of that has moved so far so fast”- AD Finance Provider “The year of care programme has been a great enabler in helping us focus upon and design a holistic ‘health and social care’ model around individual clients rather than individual disease pathways in a value added, integrated manner.”- Sanjay Singh Chief GP Commissioner West Kent CCG
  • 28. LTC Lunch & Learn Series ….coming soon… To register email LTC@nhsiq.nhs.uk Date Webinar Hosted by Bev Matthews & 7 January 2015 1 – 2pm Self Management Support Return on Investment Renata Drinkwater Chief Executive & Trustee Self Management UK 21 January 2015 1 – 2pm Commissioning for Outcomes Bob Ricketts CBE Director of Commissioning Support Services & Market Development, NHS England 4 February 2015 1 – 2pm Accountable Care Organisations in the USA & England testing, evaluating and learning what works Dr Rachael Addicot Senior Research Fellow, Kings Fund

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