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Disrupting the game- how charities can get a commercial edge and improve outcomes for their beneficiaries

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Professor Hilary Thomas, Public Sector Healthcare Advisory Practice, KPMG and vice chair, Breakthrough Breast Cancer …

Professor Hilary Thomas, Public Sector Healthcare Advisory Practice, KPMG and vice chair, Breakthrough Breast Cancer
Changing the game: positioning your charity to succeed in the new health service market conference
www.charitycomms.org.uk/events

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  • 1. A-PDF OFFICE TO PDF DEMO: Purchase from www.A-PDF.com to remove the watermarkDisrupting theGame – how charitiescan get a commercial edgeand improve outcomes fortheir beneficiariesHilary Thomas,KPMGBreakthrough BreastCancer
  • 2. Disrupting the Game - Outline Context – my journey Healthcare globally and in the UK today The unique position of Charities Why engagement is key Examples of public engagement as a disruptive innovation© 2012 KPMG LLP, a UK limited liability partnership, is a subsidiary of KPMG Europe LLP and a member firm of the KPMG network of independent 2member firms affiliated with KPMG International Cooperative, a Swiss entity. All rights reserved. Printed in the United Kingdom.
  • 3. Disrupting the Game - A personal story Age 9 In my 20’s Being a Consultant Being a Patient Moving to the private sector Being a Trustee© 2012 KPMG LLP, a UK limited liability partnership, is a subsidiary of KPMG Europe LLP and a member firm of the KPMG network of independent 3member firms affiliated with KPMG International Cooperative, a Swiss entity. All rights reserved. Printed in the United Kingdom.
  • 4. Disrupting the Game - Healthcare in the UK todayWorld EconomicForum, Davos 2012: “The financing of health systems has increasingly burdened developed economies, which has been exacerbated by the fiscal crisis. Participants agreed on the drivers of the expenditure growth and, since many of these factors are unlikely to recede (e.g. ageing, lifestyles, public expectations), there is a clear need to develop a more sustainable way of managing health systems. The magnitude of health financing challenges suggests that incremental solutions may not be enough; however, a shared vision of new models for health systems does not yet exist.”© 2012 KPMG LLP, a UK limited liability partnership, is a subsidiary of KPMG Europe LLP and a member firm of the KPMG network of independent 4member firms affiliated with KPMG International Cooperative, a Swiss entity. All rights reserved. Printed in Great Transformation: Shaping New Models – World Economic Forum Annual Meeting Davos 2012 Source: The the United Kingdom.
  • 5. We are well aware of the challenges... People and products: Aging Multi-morbidity Rising expectations Lifestyle diseases Technology and devices Process: Poor system and process design Specialisation Organisational culture Problems with the economic model Growing complexity© 2012 KPMG LLP, a UK limited liability partnership, is a subsidiary of KPMG Europe LLP and a member firm of the KPMG network of independent 5member firms affiliated with KPMG International Cooperative, a Swiss entity. All rights reserved. Printed in the United Kingdom.
  • 6. Active strategies to cope are transactional. 85 Major cost reduction % 81 Lean and improvement methods % 82 More focus and specialisation % 78 Investment in Health IT % Question - Which 74 strategies are New workforce models providers likely to % adopt to respond to these changes? 44 Extra income from existing payers %© 2012 KPMG LLP, a UK limited liability partnership, is a subsidiary of KPMG Europe LLP and a member firm of the KPMG network of independent 6member firms affiliated with KPMG International Cooperative, a Swiss entity. All rights reserved. Printed in the United Kingdom. Source: Pre-conference survey Something to teach, Something to learn, KPMG Rome 2012
  • 7. The problems with hospitals: Not specialist enough for complex cases. Not general enough. Not very safe out of hours. Based on some odd design rules.© 2012 KPMG LLP, a UK limited liability partnership, is a subsidiary of KPMG Europe LLP and a member firm of the KPMG network of independent 7member firms affiliated with KPMG International Cooperative, a Swiss entity. All rights reserved. Printed in the United Kingdom.
  • 8. The leadership and governance mechanisms to address all theseproblems are poorly developed The dominance of professional autonomy: the tendency to reject mechanisms of accountability. A reluctance to give or receive feedback or to share information about performance. Emphasis on individual judgment and knowledge rather than on the value of teams. Reluctance to accept the idea that clinical decisions have resource consequences. A paternalist approach to care and inadequate involvement of patients in their own care.The problemswith theorganisational Undervaluing and under investment in management andculture: a divide between clinicians and managers. Leadership not just better management.© 2012 KPMG LLP, a UK limited liability partnership, is a subsidiary of KPMG Europe LLP and a member firm of the KPMG network of independent 8member firms affiliated with KPMG International Cooperative, a Swiss entity. All rights reserved. Printed in the United Kingdom.
  • 9. The design rules needto change. ■ Treat each episode as a single event. Anticipate need and manage years of care ■ Treat patients as though their time is free. Eliminate wasted time and travel ■ Move patients. Move staff and information ■ Batch and queue. Patients flow through the system ■ Patients are passive recipients of care. Patients actively manage their own care.© 2012 KPMG LLP, a UK limited liability partnership, is a subsidiary of KPMG Europe LLP and a member firm of the KPMG network of independent 9member firms affiliated with KPMG International Cooperative, a Swiss entity. All rights reserved. Printed in the United Kingdom.
  • 10. Disrupting the Game - Healthcare in the UK today The Health and Social Care Act 2010 Putting patients at the heart of the NHS - no decision about me without me Focus - improving outcomes, emphasis on high quality care and not on process Empowering local organisations and professionals making NHS services more directly accountable to patients and communities than they currently are© 2012 KPMG LLP, a UK limited liability partnership, is a subsidiary of KPMG Europe LLP and a member firm of the KPMG network of independent 10member firms affiliated with KPMG International Cooperative, a Swiss entity. All rights reserved. Printed in the United Kingdom.
  • 11. Disrupting the Game - Value Based Reimbursement: Focus - on a process, on a procedure or on a disease area. Channel shifting - move services to online, telephone and other modes. Disintermediation - Taking out steps in . the supply chain to reduce costs or increase value. Patients and their networks as a source of value - co-producing or even co-designing the product or service.© 2012 KPMG LLP, a UK limited liability partnership, is a subsidiary of KPMG Europe LLP and a member firm of the KPMG network of independent 11member firms affiliated with KPMG International Cooperative, a Swiss entity. All rights reserved. Printed in the United Kingdom. Source: ‘Transact or transform? The search for new models’ KPMG international, October 2012.
  • 12. Disrupting the Game - Focus on Wellness –: Move from a National Sickness Service , To a National Health Service. Consider Prevention as today’s problem Not something to be deferred until tomorrow See the patient as a source of value Support and .foster self care and better understanding Incentivise the right behaviours Build on behavioural economic understanding© 2012 KPMG LLP, a UK limited liability partnership, is a subsidiary of KPMG Europe LLP and a member firm of the KPMG network of independent 12member firms affiliated with KPMG International Cooperative, a Swiss entity. All rights reserved. Printed in the United Kingdom. Source: ‘Transact or transform? The search for new models’ KPMG international, October 2012.
  • 13. Disrupting the game – Segmentation, Stratification and Personalisation: Segmentation Define the most important segments Stratification - who Agree principles to risk stratify populations Personalisation . Build on voluntary sector experience/ expertise © 2012 KPMG LLP, a UK limited liability partnership, is a subsidiary of KPMG Europe LLP and a member firm of the KPMG network of independent 13 member firms affiliated with KPMG International Cooperative, a Swiss entity. All rights reserved. Printed in the United Kingdom.
  • 14. Summary There is a huge opportunity Be ambitious – identify value added opportunities which are scaleable Work with new commissioners of care to disrupt the system Ensure you measure your impact – Porter principles - Value = Appropriateness x Outcome) ( Cost Engage the public and use the new world order – social media – to advantage© 2012 KPMG LLP, a UK limited liability partnership, is a subsidiary of KPMG Europe LLP and a member firm of the KPMG network of independent 14member firms affiliated with KPMG International Cooperative, a Swiss entity. All rights reserved. Printed in the United Kingdom.
  • 15. Disrupting the Game© 2012 KPMG LLP, a UK limited liability partnership, is a subsidiary of KPMG Europe LLP and a member firm of the KPMG network of independent 15member firms affiliated with KPMG International Cooperative, a Swiss entity. All rights reserved. Printed in the United Kingdom.
  • 16. Hilary ThomasPartner and Industry Expert Global Health PracticeKPMG Health AdvisoryVice ChairBreakthrough Breast Cancer

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