English Healthcare CommissioningWhat is Primary Care expected to do?

Julian Given17th November 2011

Introduction

Julian Given- Head of Informatics

- Director

- Senior Performance Manager- Cancer Services Commissioner

- Strategic Management- Business Modelling

The English Transition• Why should Primary Care Commission Services?

• How to balance the books

• How to demonstrate responsibility for billions £s

• Authorisation

1. Identify our population’s health needs

2. Note national priorities from the DH

3. Commission service provision to meet 1 and 2

4. Manage provision via contracts

5. Performance manage to ensure “bangs per buck”

6. Keep within budget

7. Maintain public confidence in the NHS

Commissioning simplified

PCT

CCG

April 2013April 2011Dec 2010 April 2012

Authorisationpoint

What is the mean per capita income of a PCT in 2011/12?

£1,693

How much isours?

How much are the various specialtyadmission costs?

PCT Total allocations per head £

Islington PCT 2,350 Newham PCT 2,320 City and Hackney Teaching PCT 2,275 Knowsley PCT 2,246 Liverpool PCT 2,200

Buckinghamshire PCT 1,407 Leicestershire County and Rutland PCT 1,403 Mid Essex PCT 1,399 South Gloucestershire PCT 1,370 Berkshire West PCT 1,367

England 1,693

North East SHA 1,901

North West SHA 1,868

South Central SHA 1,467

South West SHA 1,599

Apr

May Jun Jul

Aug

Sep

Oct

Nov

Dec

Jan

Feb

Mar

Apr

May Jun Jul

Aug

Sep

Oct

Nov

Dec

Jan

Feb

Mar

Apr

May Jun Jul

Aug

Sep

Oct

Nov

Dec

Jan

Feb

Mar

Apr

May

2008/09 2009/10 2010/11 2011/12

1200

1250

1300

1350

1400

1450

1500

1550

1600

1650

Bridges Non Elective admissions 2008/09 to May 2011

Year/Month

Adm

issio

ns

PCT with 500,000 population

Hospital over spendincreasing

Despite £88m (10%) budget increase

Prescribing no longer under spent (budget cut by £2m)

PCT management cost £55m (£11m increase)

Where were they 2 years later?

1856 1784 33

£750,000

Transition Authorisation

Transition:the process through

which the NHS needs to move to new

structures

Authorisation:the process throughwhich the ability to

have statutory status is confirmed

DH

Commissioning Board

Commissioning BoardSector Offices x4

(SHA clusters)

Clinical Commissioning Groups

x200

NHSFTs Other

providers

Primary Care

contractors

Specialised Commissioning

CommissioningSupport

Organisations x50(PCO clusters)

Health and Wellbeing

Boards x 150 Scrutinise CCGs

Clinical Senates Clinical

Networks

Transition

• All CCGs to be authorised by 1st April 2013:

– levels of status – consequences of not making it– statutory body– statutory responsibilities– NHS Employer– PCT assets nb estates

• CSOs and timescales

• Management budget per head - £25?

Monday1st April 2013

Authorisation

• Financial balance:— urgent and emergency care— medicines management

• Lead on 2012/13 contracts

• Patient safety – nb Mid Staffs

• Sustain Bridges way of working:— education and training— service redesign— deliver current projects — outreach and relationships

• Track Record

Authorisation

Authorisation

Clinical and professional focus

that adds value

Patient, carer andCommunity engagement

Clear and credible plan

Constitution, governance and

capacity to deliver

Collaborationfor commissioning

Leadership

What we are doing……

• Self assessment and peer assessment

• Authorisation visits and meetings

• Track record:

— current projects— financial stability— 2012/13 contracts

• True transition plan - future structures, CSO, deeper and broader activity

.. and what we need to do

Thank you for listening

julian.given@nhs.netjulian.given@clarityhealthcareconsulting.com