Developing Strategic Commissioning: the new paradigm for change

Transcription

1 Developing Strategic Commissioning: the new paradigm for change

2 Key issues Integrated care Strategic commissioning defined Defining pathways and resources Developing outcomes Setting quality standards New style contracting arrangements Next steps Summary

3 The journey to integrated care Integrated care seeks to: Bring organisations together to address population health management issues. Tackle the challenges faced by the health and care system in a collective way. Remove organisational boundaries to create a care system that feels joined up to users. Shifts the design emphasis away from organisations to population, system and place based approaches. Foster the development of new care models. Promote significant change in provision and commissioning. Ensure sustainability, now, and for future generations. One Care Partnership (the STP) is the right way to bring commissioners and providers together, to work through and implement the new approach. There is a national and a regional programme to support the development of integrated care systems.

4 What is strategic commissioning? Moving to a more strategic approach is the commissioner's key contribution to the delivery of an integrated care system. Going back to steering not rowing. The key components are: Population health management Defining and articulating a service a population with providers Associating a budget for that population Commissioning and contracting for outcomes Defining the outcomes that are sought; aiming for improvement Defining and monitoring quality standards Moving to a value based contract

5 Defining a pathway and associating a budget Tariff associates a cost to a limited scoped and defined intervention A population consists of many elements; some elements more capable of being scoped than others A whole population approach should include both the primary and specialist ends of the service We know that it is at the interfaces between services and commissioning responsibilities that the gaps, conflicts and duplications arise Some populations and care pathways are easier to define and contain than others May need to return to some of the thinking about year of care costs Need to agree an associated budget for a population in order to contract differently for it Need to establish a fair arrangement to deal with risk and reward especially where cost reductions are achieved

6 Defining outcomes An outcome based approach to setting commissioning objectives means defining improvements and differences in or for a population e.g. what percentage of patients report an improvement as a result of an intervention. This is not about: Measuring inputs Counting contacts Defining headcount, band mix or skill mix

7 Setting quality standards Counting what matters, and not just what is easy to count. Patient focused indicators. Bear in mind the three Five Year Forward View asks: Addressing health inequalities and health improvement and promotion; Reducing unwarranted variation; and Reducing variability in cost improving efficiency. Evidence based approach. Balance between targets, must do s and actual quality

8 Contracting Contracting differently, for example, a provider alliance or prime provider that has service input across the defined population. The entity will: Manage the relationships between participating organisations, smoothing disruption at the boundaries and creating a single service impression for the patient. Be responsible for collating data from all participants to demonstrate the delivery of the required outcomes and the achievement of required standards. Have the flexibility to move incentives, resources and responsibilities around the pathway and between organisations as needed to make improvements and deliver the contract.

9 Next steps Engage in the NHS England integrated care system support programme, as a participant with support from our STP partners, with a focus on health commissioning as phase one. Identify early defined population/place to develop within this approach. Work up a road map to a strategic commissioning approach with: Benefits and risk analysis Prioritisation Dates and allocated responsibilities

10 Summary Better using of scarce resources demands discipline and change in the system; Anything is possible with good will and common purpose; One Care Partnership is the place where common purpose comes together; Integration is an absolutely necessity; from person, service and efficiency perspectives; Strategic commissioning is the CCG s contribution to the delivery of the common purpose; and Disciplines and techniques are emerging and developing; Birmingham and Solihull CCG will be a leader in articulating and shaping them.

11 Thank you for listening. Any questions?