Public Health contribution towards LTC Year of Care Commissioning Model Dr Abraham P. George Consultant / Asst Director in Public Health Kent County Council What is the long term conditions commissioning model?

1. Public Health contribution towards LTC
Year of Care Commissioning Model
Dr Abraham P. George
Consultant / Asst Director in Public Health
Kent County Council

2. What is the LTC Year of Care
Commissioning Model?
“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”

3. What does the programme
involve?
- Currently in Year 3
- 5 sites across England
- Multi-centre hospital bed audit on ‘RRR’
- Analysis of service utilization of multi-morbid
patients across all care settings
- Test-proof / shadow new currencies
- Evaluate local integrated care models
- Data quality improvement
- Design local data sharing arrangements

4. 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

5. Public Health involvement 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’
– Modelling how benefits of integrated care could be realised
• Delivery of national YOC programme in Kent -
implementation at sub Kent / CCG level
• 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

6. Kent whole population dataset
report
http://www.nhsiq.nhs.uk/resource-search/publications/population-level-commissioning-
for-the-future.aspx

9. 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.

10. Vision for integrated
intelligence
• Map data available from rest of public sector orgns
and services beyond NHS – housing, police, fire &
rescue, education
• Working with partners – changing and mind set
about ‘evidence based investment / disinvestment’
• Harness skills and expertise from local intelligence
teams
• Develop technical solutions for IT architecture,
‘safe haven arrangements’, system modelling tools

11. Further contact details
abraham.george@kent.gov.uk
fionuala.bonnar@kent.gov.uk
Beverley.Matthews@NHSIQ.nhs.uk