Commissioning support for London


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Commissioning support for London

  1. 1. Commissioning Support for London – Products and Services Michael Wilson, Assistant Director – Prevention and Wellbeing February 2010
  2. 2. Confidential-3rd February 2010
  3. 3. What we are now Confidential-3rd February 2010
  4. 4. Strategic themes The London Integrated Strategic Plan identified four priority actions for the next financial year: Quality Productivity Putting prevention into practice Acute providers Improving London’s response to urgent Non-acute providers care in the community Prevention, early identification and better management of those with long-term conditions Moving planned care closer to home. Pathways New care settings Staying healthy Polysystems Acute Hospital care, especially implementation of Long-term conditions major acute hospitals. Planned care Confidential-3rd February 2010 3
  5. 5. Key products for Public Health The web based information portal to support London's NHS Quality Agenda. An interactive resource to support London’s health needs assessment and health intelligence analysis. An online suite of tools helping PCTs make informed commissioning decisions by showing commissioners how their providers are performing. Confidential-3rd February 2010
  6. 6. Confidential-3rd February 2010
  7. 7. Confidential-3rd February 2010
  8. 8. Confidential-3rd February 2010
  9. 9. % age < 2 years Le 50% 55% 60% 65% 70% 75% 80% 85% 90% wi sh am C am G de re n en wi So ch ut hw ar Is k lin gt on N ew ha m Be xl ey Ba rn et En f ie H ld ill i ng Ba do rk in n g & Br D national comparator en ag t en ha C m ro yd on Ea l in R H g ic av hm er in on d Br g & om Tw le ic y Immunisation rates at age 2 by PCT Su ke nh PCT 2008/09 Q4 Performance data t to n am & To M we er r H ton W MMR uptake by London PCTs with al am th am l ets Fo re st H ar ro w H Ki ng am st m o er En n sm Ke i gl Confidential-3rd February 2010 an ns th & in d gt Fu on lh & am C he W an lsea ds wo rth
  10. 10. Insight with MMR ‘doubters’ audience The UCL study found that socio-economic status influences uptake of MMR, with low uptake in both low and higher SEG groups. It recommended further examination of why particular audiences do or do not vaccinate. NICE guidance found some evidence that uptake of MMR has declined at a greater rate among children of more highly educated parents and among those living in more affluent areas. This audience accepted other vaccinations (they were not immunisation ‘rejecters’ as such) but had specific concerns about MMR. The primary concern driving their reluctance to accept MMR was the perceived link with autism. Confidential-3rd February 2010
  11. 11. The imbalance of risk • This fear was not limited to the ‘Higher SEG Doubters’ • It seems to have permeated all sections of society The perceived Risk of measles (short term) The perceived risk of autism (Long term) Confidential-3rd February 2010
  12. 12. Key differences higher / lower SEG Higher SEG parents….. Lower SEG parents…. Keeping the MMR under Heard bad things constant review Not agonising about it Interested in up dating their There must be something to it knowledge if all these people think there Torn between the horns of is. their dilemma More comfortable with their Feel guilty, because they decision should vaccinate their Don’t feel guilty children More likely to ignore further And they understood that communications about it there were arguments for and against Did not want to be persuaded Confidential-3rd February 2010
  13. 13. Workshop What approaches would you implement to increase uptake of MMR vaccination? Confidential-3rd February 2010
  14. 14. Effective Immunisation and Vaccination Programmes require: • Active information management • Active patient management • Active performance management Confidential-3rd February 2010
  15. 15. Behaviour Change I • One size fits all communications / messages are not effective • Trust in NHS staff (on this particular issue) is generally poor amongst higher SEG doubter parents, however they are not at ease with their decision and are open to re evaluating it • ‘Doctor knows best’ approach not successful in changing their behaviour. Training for Health Care Professionals (HCP) needed to enter into debate with higher SEG parents? • Lower SEG parents have decided not to have vaccination, influenced by personal networks, not actively concerned about this decision, but do respect HCPs on this issue Confidential-3rd February 2010
  16. 16. Behaviour Change II • Are existing interactions with services fully exploiting trust in NHS staff? Do all staff actively support MMR? • ‘One in ten’ campaign not a great success, how best to communicate risk which is motivational whilst remaining honest and not sensational? Don’t avoid discussing the autism link as will not be effective. • LSMU have commissioned discourse analysis; - reviewing wide range of recent communications inc. invite letters, web coverage and media to understand the language that is used to inform future intervention pilots. Confidential-3rd February 2010
  17. 17. The ‘1 in 10’ campaign Confidential-3rd February 2010