Oldham CCGOur Innovation Strategy

The landscape is changing…

The approach • NHS unchartered territory

• Francis Report, Keogh = tougher inspection systems, changes in performance measures , new ways of reporting

• More focus on transformation and redesign of primary care services

• National, regional and local change programmes eg Healthier Together

• Increased focus on patient engagement, feedback and listening and responding

• Continued removal of funding and reduction of budgets means we’re working under tighter financial constraints every year

• But all of this means that we have a real opportunity…

…to improve population health in Oldham

Innovation is in our hands…The clinical and management leadership teams at Oldham CCG believe in building a culture which encourages our members to innovate and improve at a local level, to:

• empower communities in Oldham around the health agenda

• use our collective assets effectively

• prevent unnecessary costs and duplication of work

• engender innovation in our practices

• work collaboratively across clusters

• win the hearts and minds of our patients and public

• shape our own destiny with regard to Public Service Reform

• ultimately, deliver our triple aim objective

Oldham CCGOur Dragons’ Den Strategy – a summary

As Clinical Commissioning leaders, Oldham CCG will ensure we adopt an innovation based commissioning ethos into everything we do. We respect the following key aspects of innovation:

• That local intelligence, via our CCG members combined with broader partnerships, used effectively will help translate great ideas into action and outcomes

• We will invest in good ideas and support our CCG membership to test them

• We will nurture trust and respect among CCG members, our partners and those who’s interests align with our Triple Aims, we value their ideas and contributions

• The collective wisdom of experienced leaders (clinical, non-clinical, Public and Independent)

• Innovation is part of the fabric of who and what we are, continuous challenge and idea generation will drive triple aim delivery over time

Innovation - Our CCG Ethos

Innovation - Our CCG Beliefs• A culture focused on health adds more value than one focused solely on health care.

• There are many valid approaches to achieving superior health outcomes; we will ruthlessly explore them

• We believe in the capabilities of individuals to manage their own health

• We believe that CCG Members and Partners, correctly supported, can create new and exiting ways to enhance care in Oldham

The Innovation Fund FrameworkThe CCG understands that innovation is not a ‘one size fits all’ concept. We have to explore many aspects, from a number of different markets. In order to enable us to test and explore innovative ideas, technology and relationships the CCG has borrowed the Dragons Den (DD) idea and re-modeled it for our specific purpose.

The 3 Innovation Streams proposed are:

1: General Stream – Anyone / Any Organisation with a drive to improve care and outcomes. Particular suited to Local Innovators from Voluntary, Third Sector & Local Public Interest Organisations

2: Big Pharma – Pharmaceutical based innovations. Ideas, products and services that can drive greater health gain and more productive long-term relationship with the CCG and its Practice Members

3: Technological / Product Innovations – Opportunity for SMEs and larger product developers to test their innovations at industrial scale in Oldham

I• INVENTION• Insights, origins, nucleus of ideas and the means by which we will improve value to our patients (invention is not owned by any specific culture)

A•ADOPTION•The means by which we will execute the proof of concept into reality. Testing, refining, measuring and quality assuring the change for our stakeholders

D•DIFFUSION•Systemising effectively throughout our service systems. Industirialising good ideas for macro benefit (applying well-ground technology)

1: In progress 20+ innovation projects commenced 2014

2: In development – Expected DD exercise Nov / Dec 2014

3: In development – Expected DD exercise Feb / Mar 2015

I• INVENTION• Insights, origins, nucleus of ideas and the means by which we will improve value to our patients (invention is not owned by any specific culture)

A•ADOPTION•The means by which we will execute the proof of concept into reality. Testing, refining, measuring and quality assuring the change for our stakeholders

D•DIFFUSION•Systemising effectively throughout our service systems. Industirialising good ideas for macro benefit (applying well-ground technology)

Dragons’ Den II and III

(3) Desktop Initial Assessment the Via Submission of Business Case Supported by Industry Partner

(1) Set Aside Innovation Development Funds

(2) Set Out the Rules for Application (the conditions we will use to align idea to priorities)

(4) Select A Shorter List of Innovation Partners & Propositions

(6) Select Partners & Determine Partnership OfferDetermine Data and Patient / Customer Experience Outcomes

(determine the offer fund/part fund/accept)

(7) Evaluated Projects & Convert Successful Innovations into Long-Term Partnership Agreements

(determine the deal flow arrangements)

Seeking the Big Ideas via Industry ‘Call to Action’

- CCG advertises its strategic intent into correct PR channels (advised by local APBI partner DD2)

(advised by Trustech partner DD3)

- CCG openly shares its strategic plans

- CCG explains the rules of engagement clearly

The 7 Steps

(5) Run a 2-part DD exerciseMorning Session – Market Place

Afternoon Session – DD Challenge

The Selection Process 6 Steps (1-3)

(1) Set Aside Innovation Funds (£500k)(this would be our contribution to the innovation)

• Is this a real Business Opportunity with real Resources to bid for?

• Is this a real opportunity to enter into a long-term partnership relationship with our CCG?

• CCG Has already set aside £funds to support the Innovation Programme. It’s real & its ready to bid for

• Its not just about seed funding, its also about logic testing at industrial scale that could involve no up front CCG investment

(2) Set Out the Rules for Application(for DD2 & DD3 there are specific ground rules to comply with)

• Bids should be based around the following points:

• How will the idea improve care?• How will the idea improve experience?• How will the idea drive cost effectiveness over time?• Is the innovation achievable?• Can it be explained easily to a set of (mixed) Dragons?• Is the idea T2V aligned?

(3) Test the Ideas & Logic Via a via Market Session & Dragons Den Challenge

Dragons Den – What to expect:

• Dragons will be Clinical Council• Dragons will include experienced business leaders• Dragons will include local patient / citizens• It will work very much like the TV programme• Bidders make a pitch based on their idea• Bidders will be expected to have a thought through innovation

& be ready for challenge

The Selection Process 6 Steps (4-6)

The Dragons Will Select Bids based on:

- The bids that showed greater promise- Those that connected best with our needs- Those that were deemed doable & value based

What happens after successful application:

- The bidder will enter a project initiation phase- Innovation will be pumped through Innovation Model- A data collection process will be set up- The CCG finance team arrange funds/Partnership Agreement- The partner commences delivery of the project

Sharing Evidence & Outcomes:

- At a set time in the project cycle (6-12 months) outcome data will be assessed (through innovation model)

- Those schemes showing greater long term sustainable benefits will be put forward for a longer term partnership agreement / contract

- Diffusion of the innovation idea will take place between the bidder & the CCG

- CCG shares learning with AHSN / GM CCG system

(4) Select A Range of Innovation Projects

(5) Determine T2V Data and Patient Triple Aim Measures

(6) Successful Projects Convert to Commissioned Service

Who Can Apply In DD2 & DD3 ?

• Any Pharma based Organisation affiliated with ABPI

• Any Health Care Related Technology Based Product Developer / Supply

• Any Health Care Related Voluntary and/or Not for Profit (NFP) enterprise, with links with either of the above

• Any healthcare related organisation (NFP or otherwise), who partners with any of the above

• Any of our CCG Membership at any 3M level, who partners with any of the above

• Any combination of the above

What Next? – Next Steps for Applicants

• Read the invite notice (the CCG notice to participate placed into Industry routes )

• Begin conversations with partners, colleagues, patient groups

• Prepare your ‘innovation’ idea

• Fill in the business case application form & submit

• Prepare your materials & pitch to the Dragons

• Hopefully become successful (best of luck!)

• Gear up to test your innovation (& prepare the measures)

14

Technology Diffusion Model – Taking Innovative through to Systematic Execution

Articulation StageIdeation &

Grounded Logic

- Research- Insights & Challenge- Value Propositioning (T2V)- Prioritisation- Doability (inc financials)- External Stakeholder Buy-In- Customer Fit- Internal Membership Buy-In

Go-Ahead Prototyping Test Phase

Test PhaseEvaluation

Modifications Completed -

Fit for Purpose

Adopt & Diffuse

Commercial OfferRegulation & Calibration & Evaluation

Grounded Innovations & Propositions – Proof of Concept Stage(e.g. NICE TAs) Governing, Process Control & Delivery – Execution Stage

8 week turnaround Via Clusters(varied according

to complexity)

Via EQALS / TA group

+ CDS and others

Via TA Working Group (1)Via Clinical Council (2)

Via ERFPQ (3)

Diffusion Incentives + Rules of Engagement

(+ re-offers)

AcceptedNot Accepted

REVIEW

PROPOSITIONARTICULATION

A

Developing IW’s Integrated Framework

Shape KOLS Position?

Check Regulatory

position

Orientation to NUS translate into

Zeitfeist

Compelling vision

HEALTH ECONOMICVALUE APPRAISAL

B

EDUCATIONAL / WORKFORCEAPPRAISAL

C

DEVELOPING METRICS

OF SUCCESS

REVISITING INCENTIVES+ BARRIERS

+APPRECIATIVE INQUIRYRE: SUCCESS

SPREAD STRATEGY

D

E

F

KOLS/ SXIN IN THE GAME

Cash in Benefits out?

Creating financial incentives?

Modelling

Visible comparative data (drives education)

INTO PRACTICE

Sharing with Practices

Education? CPD? Training?New workflow deployment

Consumer PatientExperienceIncentives

Commissioner Incentives

Published

Preview Proficient Behaviour incentives

ACTIO

NS

ORIENTATION

INPUT: e.g. TA / medical device etc

OUTPUT: Fully integrated new technologies

Clinical Council/CDs

Finance

O.D.

Practice/Cluster

Engagement

Partner

AHSN?

? Should come after D

Implementation- CRITICAL

? AHSN

Oldham CCGDragons’ Den for Innovative Healthcare Technologies

The programmeInnovation excellence in primary care

• Mission statement: to identify new technologies to evaluate and adopt to improve the care and lives of the local community.

• Patient involvement; putting patients' voices alongside CCG staff and executive to review and select technologies.

• Open the doors of the CCG to a wide variety of companies that are developing innovative medical technologies – breaking down barriers.

• Utilising the skill and experience of TRUSTECH, the CCG’s innovation partner, to deliver the programme.

The process

1. Call to industry

2. Internal assessment – select best technologies

3. Marketplace – patients and CCG staff review technologies

4. Dragons’ Den – companies pitch ideas

5. Agree and fund evaluations

6. Commission the proven technologies, improve lives in Oldham

The numbers

Applications submitted

Number of countries companies were based in

Technologies demonstrated at the marketplace

849

20

In-situ evaluations in development5

The technologies• d-Nav Insulin Guidance Service – personalised insulin management

• Fall-Safe Assist – helps protect against impact, records falls data and sends alerts

• Patient Monitor – telephone service collects symptoms and physiology data

• Noctura Sleep Mask – light therapy to reduce retinal disease for diabetes patients

• Personal Care Record – empowers LTC patients to own their healthcare record

The future• On-going due diligence • Currently developing evaluation protocols for all evaluations• Next steps for future innovations

Thank you