Lucy Moore & Conor Burke: Nuffield Trust Conference: Integrated care
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Lucy Moore & Conor Burke: Nuffield Trust Conference: Integrated care

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Lucy Moore & Conor Burke: Nuffield Trust Conference: Integrated care Lucy Moore & Conor Burke: Nuffield Trust Conference: Integrated care Presentation Transcript

  • Nuffield Trust Conference: Integrated careDr Lucy Moore, Whipps Cross University Hospital Trust Conor Burke, NHS Redbridge March 2010
  • The Landscape  50+ GP practices  40+ Community Pharmacists  300+ Primary Care Professionals  2 Large Acute and 1 large mental health Trusts  Range of community providers  Voluntary Sector  Good relationship with LA  Community & Public  Diverse Politically
  • Decommissioning - Prevent - • 20% of OP • 35% LTC Adms • 6% Electives Shift Acute Activity - Quality - • 40% A&E • ↑Mortality • 12% Electives • ↓Patient Experience • 42% OP • Primary Care Clinical Performance
  • Real improvement comes fromchanging systems, not changingwithin systems. Donald Berwick President & CEO Institute for Healthcare Improvement
  • As an integrated local healthcare delivery network ‘PolySystems’ will: Promote the health & Maximise Independence & Improve service for people wellbeing of all people in quality of life for people with with non-critical acute care the local community long-term needs needsAchieving improved health • Reduce emergency admissions • Reduced waiting RTToutcomes overall and for • Care Navigation & Coaching • Improved patient satisfactionspecific communities e.g. • Improved care coordination & • Better value for money• Childhood obesity dmanagement • Better quality of life measures • Increased Access• Teenage conception • Reduced cost per head• Physical activity
  • Everybody in Redbridge is already a member of a polysystem 5 established and will become the engines driving change at the local level – delivering local services that are clinically and cost effective. Loxford Polysystem
  • Incentives and Performance
  • Underpinned by Aligned Data Aligned and patient focused data GP Systemsfor primary and secondary caredata across the PCT Stratify Data Warehouse Journal entries Risk Stratification  Computes patient risks PCT SUS records Databases  Provides “risk aware” analysis tools for GP and PCT staff Pathway focus and financial Community Services Recordstracking Users Community Records • Practice Managers • Polysystem Managers www.health-analytics.co.uk • PCT Staff
  • Information Driving Change at all Levels
  • Polysystem Clinical Commissioning - Governance X PEC PCT Board CAC Outer North East London Acute Commissioning Unit Clinical Commissioning Unit (CCU) Clinical Commissioning Board Wanstead Loxford Cranbrook Seven Kings Fairlop PolySystem PolySystem PolySystem PolySystem PolySystem Boroughwide Clinical Commissioning Board Clinical Director team accounts to PCT Board Accountability for Polysystem delivery Manage budget and incentive schemes PBC Partner relationship with PCT Underpinned by Community Engagement Panels Social Care involvement at all levels
  • Integrating Design & Delivery • Polysystems are the ‘engine’ which drives local change to meet the wider health and healthcare needs of its community. • Polysystems are accountability for the delivery of high quality and productive services. • Polysystems are held accountable for delivery and in return will be resourced and supported appropriately to enable change earning increased autonomy overtime. “Polysystems will only achieve their full potential if they bring together primary, community and secondary care clinicians together with social care and the consumer to innovate by designing and delivering care models that enable system improvement.”
  • And so what?•Whipps Cross fax discharge summaries to practices within24 hours of discharge•GP Practices are required to contact the patient within 3days of discharge•Patients have a face to face appointment within 10 days atwhich time the clinician will use a standardised checklist toreview patients.•Clinicians have access to data on a patients treatment,diagnostic results and medication changes via email. ….currently getting it right 50% of the time after 2 months
  • Delivering Polysystems…...through People, Processes and Technology Consultants One inclusive Polysystem Collaborative and Budget managed Competitive incentives with support from PCT Comm Nursing, AHPs GPs Pharmacists, Social Care Estate Performance and Specialist Care development – analytics–Combined transformational productivity and change quality measures Not vertical or horizontal ……Clinical Integration