This document discusses commissioning and integration from the perspective of a clinical lead for primary care and commissioning. It outlines three key drivers of integration: (1) joined-up commissioning, (2) commissioning joined-up care, and (3) providing joined-up care. It emphasizes that clinical commissioning groups are well-positioned to improve integration and outcomes for patients by focusing on transitions between services, addressing gaps, and improving navigation for patients.
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General Practice Transformation Champions conference, 22 November 2017
Workshop 3.5 New Business Models and Primary Care Contracting - Led by Ed Waller & Paul Maubach
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Preparing for the Board Assurance framework for 7DS with guest speaker from U...NHS England
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• An opportunity to hear the experience of University Hospitals Plymouth NHS Trust which was one of the pilot sites
• An opportunity to raise queries and share learning
El 12 de mayo de 2017 celebramos en la Fundación Ramó Areces una jornada con IS Global y Unitaid sobre enfermedades transmitidas por vectores, como la malaria, entre otras.
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Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
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Quality in urgent and emergency care: The Barking and Dagenham, Havering and ...QualityWatch
A presentation given to the QualityWatch 2015 annual conference by Conor Burke, Chief Officer, Barking and Dagenham, Havering and Redbridge Clinical Commissioning Groups.
A brief introduction of how Orbis Vietnam treats and prevents blindness, and how it has developed a successful model to carry out sustainable eyecare in Vietnam.
Preparing for the Board Assurance framework for 7DS with guest speaker from U...NHS England
This webinar will provide:
• An update on the requirements of the new Board Assurance Framework for 7 day services
• An opportunity to hear the experience of University Hospitals Plymouth NHS Trust which was one of the pilot sites
• An opportunity to raise queries and share learning
El 12 de mayo de 2017 celebramos en la Fundación Ramó Areces una jornada con IS Global y Unitaid sobre enfermedades transmitidas por vectores, como la malaria, entre otras.
Deep Dive Into Telehealth Adoption Covid 19 and Beyond | Doreen Amatelli ClarkVSee
For more info: visit https://bit.ly/3pt6hp2
How has telehealth adoption changed following the pandemic and what are the implications for the future of telehealth? Join market research expert and owner of Way to Goal, Doreen Amatelli-Clark to talk about her latest findings from her COVID-19 study, covering surveys and in-depth interviews with doctors and healthcare practitioners from around the world.
Provided to you by: https://vsee.com
Collaborative commissioning and devolution for specialised services, pop up u...NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
These slides are from a presentation at the Think Local Act Personal conference on 26th November 2014. The slides and short film provide an introduction to the Coalition for Collaborative Care and its vision for a better deal for people with long-term conditions.
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This slide set is the first of two looking at how commissioners can make the best use of measurement to support commissioning for improved outcomes.
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The high rates of non-communicable diseases combined with large expatriate populations leads GCC countries to use different strategies to control healthcare expenditure among which is the PPP solution. This presentation highlights the formula for PPP success based on international cases.
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Special Thanks to
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Prof Dr Tarek Omar
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Prof Dr Afaf Gaber
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Presentation to Dudley CCG members' meeting, 26 Mar 2019. Looking at the lessons from some of the successes and disappointments of integrated care, and some of the top tips for redesigning general practice to release more of its potential.
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Presentation at Pulse Live, Liverpool 2 Oct 2018. What are the potential benefits of primary care networks for patients and staff? What can we learn about how to approach the process of establishing a productive primary care network?
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The presentation examines the role of five stages in the innovation journey in determining success: the innovators, the innovation, packaging, spread and adoption. Examples are provided of how each can present a barrier, and how the national Time for Care programme has sought to overcome them.
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
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É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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STATEMENT OF NEED
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Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Integration & CCGs
1. Commissioning – a view from the frontline
Dr Robert Varnam PhD MRCGP
Clinical Lead for Primary Care & Commissioning
robert.varnam@institute.nhs.uk
@robertvarnam
3. If our goal is better
outcomes & experience
for patients …
… our focus should be
on transitions, gaps &
navigation …
… not just
individual episodes
or services
4. What do CCGs have?
a) Patient focus
b) Motivation to improve integration
c) Knowledge about the problem
d) Credibility with professionals
e) Trust of the public
f) Part of the solution
5. Three drivers of integration
A. Joined-up commissioning
B. Commissioning joined-up care
C. Providing joined-up care
22. Authorisation domains
A strong clinical and multi-professional focus which brings real added
1
value
2 Meaningful engagement with patients, carers and their communities
Clear and credible plans which continue to deliver the QIPP challenge
3 within financial resources, in line with national requirements (including
outcomes) and local joint health and wellbeing strategies
Proper constitutional and governance arrangements, with the capacity
and capability to deliver all their duties and responsibilities, including
4
financial control, as well as effectively commission all the services for
which they are responsible
Collaborative arrangements for commissioning with other clinical
5 commissioning groups, local authorities and the NHS Commissioning
Board as well as the appropriate external commissioning support
6 Great leaders who individually and collectively can make a real difference
COMMISSIONING DEVELOPMENT PROGRAMME
WORK IN PROGRESS – STRICTLY NOT FOR FURTHER CIRCULATION
25. Key actions for CCGs
Be a positive & proactive member of the Health &
Wellbeing Board
Commission joined-up pathways for complex needs
Use tariff to serve patients
Design incentives & disincentives for providers
Develop care coordination/navigation models & services
Help general practice fulfill its potential
26. Key actions for NHS CB
Develop measures of integration
Pilot Year of Care tariff
Support positive CCG & HWB development
Align outcomes frameworks
Ensure national & local commissioning join up
appropriately
Build a system which supports CCGs’ local autonomy
28. Be your CCG’s best friend
Free staff to collaborate &
innovate
Integrate around the patient
A. Joined-up commissioning
B. Commissioning joined-up care
C. Providing joined-up care
Sisters are doing it for themselves
Editor's Notes
People with long-term conditions and other complex needs usually receive care from multiple different providers, both simultaneously and over a period of time. It is important that each individual episode or service is safe, effective and efficient, and provides a good patient experience. However, the ultimate outcome, safety, experience and cost depends at least as much on the patient journey as a whole, including the transitions and gaps between professionals, teams and providers. Transitions are a key source of patient harm, lost opportunity and effectiveness, delays, duplication and inappropriate resource utilisation. Commissioners have a responsibility to attend to the design of the whole journey, paying particularly attention to transitions, gaps and ease of navigation.
The following 6 slides expand the narrative on these points, and are optional. a) Patient focus -- They begin with a patient orientation. Clinicians naturally bring the patient's perspective to priority-setting and decision-making around service reform. They are grounded in the patient's needs and experience, and committed to improving care and outcomes for patients. b) Motivation to improve -- They are motivated to improve integration. Clinicians have daily experience of the problems caused by poor integration. They witness the impact on the safety, quality, efficiency and experience of what would otherwise be great care. They know the effect poor integration has on patients, carers, the system and themselves as professionals. Improving integration would improve the daily experience for local clinicians, and they need little persuading to collaborate on such work. c) Knowledge about the problem -- They are knowledgeable about the problem. Clinicians understand the reasons why patients experience delays, defects and duplication in the course of their care journey. They have inside knowledge of the problems with culture, communication and collaboration which lead to disintegration. They know the specific reasons why it is hard for patients and staff to navigate the system, and are readily able to identify priorities for rapid improvement. d) Credibility with professionals -- They are credible with professionals. CCG leaders already have working relationships with the staff across health and social care whose collaboration and commitment is needed for integrated service design and delivery. They are better able than even the best managers to form effective coalitions across organisational boundaries, centred around the interests of patients. This ensures the right people are involved in evaluating and redesigning services, and that transformation is driven more by patient than corporate interests. e) Trust of the public -- They are trusted by the public. Improving integration will, in many instances, result in shifts of care from hospital to community and home settings. Explaining the implications for the size, location and type of hospital facilities will not always be an easy task. The public's knowledge of and trust in their local clinicians is an important asset in helping CCGs, in partnership with local people, elected members and the media, achieve the best balance between hospital and community. f) Part of the solution -- They will be part of the solution. CCGs are composed of GP practices, each of whom will be able to contribute to new ways of working designed by the CCG in collaboration with patients and other professionals. Commissioners have often had to design new systems or pathways which largely bypassed general practice, because of the difficulties of making change in that part of the local NHS. With practices now at the heart of the local NHS, it will be easier to think holistically about what is possible and to include general practice as an integral part of delivering improved patient journeys.
Some progress made so far, but evidence & Future Forum interviews confirm that a concerted, coordinated effort is needed by everyone if we’re to roll out integration at scale & pace. There’s no silver bullet, and this is not a problem which will be solved by solo efforts – this is complex and our approach should be comprehensive and sophisticated. $
Hyperlink to map and list of each CCG
Pre-assessment Self-certification Policies & agreements Plans & contracts Stories
Hand over to Jo (2pm)
Message for slide: We’ve evolved with our customers We started off working with PBC clusters, the Health and Social Care Bill introduced GP Consortia and then they became Clinical Commissioning Groups During this time (only just over two years), we were working with customers that were ever changing. Organisations were forming, people were coming and going.
1 Join up commissioning intelligence & priorities & plans & ?budgets with local authority. Be a full, proactive partner in the HWB. 2 Prioritise patients with the greatest need for joined-up care. Start by designing whole pathways for holistic care (not starting with single diseases or services). 3 Be confident & determined in using tariff to serve patients' interests. It isn't perfect, but it IS a tool in your hands – tariff was made for patients, not the other way round. Learn from commissioners who have done innovative things with existing tariff (cf Nuffield/King's report). New tariff models currently being refined will help, too. 4 Make it easier for providers (across the whole pathway) to do the right thing, and harder to do the wrong thing. Evidence & Future Forum’s listening demonstrate it’s not impossible for providers to collaborate in patients’ interests now – it’s just too hard to do it comprehensively & sustainably. 5 Many patients don't need any new services, just support to understand, made choices & join up existing ones. Prioritise the patients most likely to benefit, identify existing local assets (general practice, community nursing, 3rd sector, etc). 6 Successful & sustainable large scale change doesn't just happen. Requires excellent relationships, informpation, strategic planning, leadership skills, innovation development, implementation plans, perseverance. Not an amateur pursuit! Read a book (eg Large Scale Change, Bevan & Easton); learn from others (eg Nuffield/King's report); join with others; use a systematic method (eg NHS Change Model); develop skills (eg shared leadership development, commissioning reliable pathways, leading large scale change)
These are the key Future Forum recommendations for NHS-CB action accepted by SoS.
Some progress made so far, but evidence & Future Forum interviews confirm that a concerted, coordinated effort is needed by everyone if we’re to roll out integration at scale & pace. There’s no silver bullet, and this is not a problem which will be solved by solo efforts – this is complex and our approach should be comprehensive and sophisticated. $
Some progress made so far, but evidence & Future Forum interviews confirm that a concerted, coordinated effort is needed by everyone if we’re to roll out integration at scale & pace. There’s no silver bullet, and this is not a problem which will be solved by solo efforts – this is complex and our approach should be comprehensive and sophisticated. $