The document summarizes the NHS RightCare approach, which aims to reduce unwarranted variation and improve health outcomes. It does this by ensuring the right care is provided in the right place at the right time using available resources. NHS RightCare provides data, tools, and support to help local health systems identify priority areas for improvement, understand variation compared to similar populations, and implement sustainable changes through a three phase process.

1. NHS RightCare
Working together to improve health outcomes
FLS Champions Summit 2017
Liz Lingard
RightCare Delivery Partner

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Learning Outcomes
• Understand the NHS RightCare Approach
• Where to Look, What to Change & How to Change
• Apply NHS RightCare Approach to Fragility Fracture Care
• Use NHS RightCare Approach to build a case for
maintaining or investing in Fracture Liaison Services

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What is RightCare?
NHS RightCare is a programme committed to reducing unwarranted variation to
improve people’s health and outcomes. It ensures that the right person has the right
care, in the right place, at the right time, making the best use of available resources.
NHS RightCare ensures local health economies…..
• make the best use of resources to give better value – better value for patients,
the population and the tax payer.
• understand how they are doing – by identifying variation with demographically
similar populations
• get talking about the same stuff - about population healthcare rather than
organisations
• focus on the areas of greatest opportunity by identifying priority programmes
which offer the best opportunities to improve healthcare for populations
• use tried and tested processes to make sustainable change to care pathways to
reduce unwarranted variation

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NHS RightCare offers health economies:
• practical support in gathering data, evidence and tools to help
transform the way care is delivered for patients and populations.
• intelligence to identify priority areas that offer the best opportunities
to improve healthcare for our population and increase value.
• a range of comprehensive data packs and online tools that act as a
source of insight to support local discussions on agreeing the
starting point for change.
Intelligence resources are available from the NHS RightCare Commissioning
for Value team at www.england.nhs.uk/rightcare/intel/cfv//

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• NHS RightCare works with a wide range of stakeholders,
national programmes and partner organisations to develop and
test new concepts and influence policy.
• Examples of NHS RightCare’s current work include:
- contributing to the national Nursing, Midwifery & Care Staff
Framework;
- developing national thinking on Medicines Optimisation with the
National Institute for Clinical Excellence (NICE) and the Care
Quality Commission (CQC);
- testing and proving concepts around patient and clinician
Shared Decision Making.

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• The NHS RightCare team supports local health economies adopt
the NHS RightCare approach as ‘the way we do things around
here.’
• The proven three-phase process provides a more systematic,
evidence-based methodology to service redesign and
prioritisation.
• It is helping many health economies make sustainable change
to improve their population’s health whilst making the best
investment decisions.

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NHS RightCare Principles

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Our offer to CCGs:
An NHS RightCare Delivery Partner who will work in partnership with you, supporting you
to build on your existing capability of using the RightCare approach so you can:
• Identify unwarranted variation to help focus conversations on population health
• Make the most of the NHS RightCare products and approach.
• Interpret the data in the NHS RightCare commissioning for value packs.
• Design of optimal care pathways and systems.
• Use effective business processes to make the changes you want to see happen.
• Develop systematic improvement and decision making processes.
• Demonstrate progress with embedding or using the RightCare approach.
Your Delivery Partner will also be able to support you by:
• Helping you make the most of national programmes and initiatives to meet CCG
priorities to reduce unwarranted variation.
• Signposting you to examples of how the RightCare approach has helped other
health economies to improve care pathways.
• Being open, honest and transparent and by constructively challenging thinking to
help unpick reasons for non-delivery.

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We ask CCGs to:
• Use intelligence to start and drive discussions about how they can improve value, in
particular the data packs provided by NHS RightCare.
• Appreciate that the NHS RightCare data pack data is indicative - a starting point for
action and to stimulate further data analysis.
• Use local resources, including Commissioning Support Organisations, to delve further
into the intelligence to triangulate with other data sources.
• Proactively work with their local Delivery Partner to understand their health economy’s
data, seeking advice when needed.
• Use the data and tools available, alongside local insight, to ensure decision-making
and change is based on the right intelligence and with the right buy in.

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Time to Vote
Which one is not one of the 3 Phases of NHS RightCare Approach
1. Where to Look
2. Who to Blame
3. What to Change
4. How to Change

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Commissioning For Value
Where to Look Packs – January 2017

15. Commissioning For Value
Where to Look Packs – January 2017
Northumberland CCG

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Northumberland CCG
Northumberland CCG

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Northumberland CCG
Northumberland CCG

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Northumberland CCG
Northumberland CCG

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Northumberland CCG
Northumberland CCG

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Northumberland CCG
Northumberland CCG

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Northumberland CCG

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Northumberland CCG
Northumberland CCG

23. Commissioning for Value
Where to Look Packs – January 2017
Northumberland CCG

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Commissioning For Value – Focus Pack
Musculoskeletal Conditions & Trauma & Injuries
May 2016 (update due March/April 2017)

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Commissioning For Value – Focus Pack
Musculoskeletal Conditions & Trauma & Injuries
May 2016 (update due March/April 2017)

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Commissioning For Value – Focus Pack
Musculoskeletal Conditions & Trauma & Injuries
May 2016 (update due March/April 2017)
Trauma Spend data reported for age groups:
• Under 75s
• 75-84
• 85+
Spend reported for injuries to:
• Hip and thigh
• Knee and lower leg
• Shoulder and upper arm
• Elbow and forearm
• Wrist and hand
• Abdomen, lower back, lumber spine and pelvis
• Thorax
• Head
Spend includes elective and non-elective admissions

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Commissioning For Value – Focus Pack
Musculoskeletal Conditions & Trauma & Injuries
May 2016 (update due March/April 2017)

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The opportunity is what the CCG could save if the spend (£ per 1,000 population) was
the same as the average of the best (lowest) 5 CCGs in the group

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The opportunity is what the CCG could save if the spend (£ per 1,000 population) was
the same as the average of the best (lowest) 5 CCGs in the group

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Time to Vote
On average, across all CCGs in England, the spend on secondary
care for every 1,000 people aged 85+ for injuries to hip and thigh is:
1. £50,000
2. £150,000
3. £500,000
4. £1,000,000

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The opportunity is what the CCG could save if the spend (£ per 1,000 population) was
the same as the average of the best (lowest) 5 CCGs in the group

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Commissioning For Value – Focus Pack
Musculoskeletal Conditions & Trauma & Injuries
May 2016 (update due March/April 2017)

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Commissioning For Value – Focus Pack
Musculoskeletal Conditions & Trauma & Injuries
May 2016 (update due March/April 2017)

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Commissioning For Value – Focus Pack
Musculoskeletal Conditions & Trauma & Injuries
May 2016 (update due March/April 2017)

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Commissioning For Value – Focus Pack
Musculoskeletal Conditions & Trauma & Injuries
May 2016 (update due March/April 2017)

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Time to Vote
In England, what proportion of people aged 75+ who have a fragility
fracture are treated with bone sparing agents:
1. All of them (100%)
2. Two thirds (67%)
3. About half (50%)
4. Less than a third (<33%)

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Commissioning For Value – Focus Pack
Musculoskeletal Conditions & Trauma & Injuries
May 2016 (update due March/April 2017)

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Time to Vote
What do you feel is the most important key ingredient of the NHS
RightCare Approach:
1. Clinical leadership
2. Indicative data
3. Engagement
4. Evidential data
5. Effective processes

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