WELCOME

LTC Year of Care Commissioning Early Implementer Sites Workshop

1 December 2014

Plan for the day:

Events

Date & Time Event & Time Location

8 December 2014 2 – 4pm

EIS Project Leads Forum WebEx

19 January 2015 2 – 4pm

EIS Project Leads Forum WebEx

2 February 2015 10.30am – 3.30pm

LTC Year of Care EIS Workshop Workshop in London

16 March 2015 2 – 4pm

EIS Project Leads Forum WebEx

To register email LTC@nhsiq.nhs.uk

LTC Lunch & Learn Series ….coming soon…

Date Webinar Hosted by Bev Matthews & 3 December 2014

1 – 2pm Population level commissioning for the future

Dr Abraham George Kent County Council

7 January 2015 1 – 2pm

Self Management Support Return on Investment

Renata Drinkwater Chief Executive & Trustee Self Management UK

21 January 2015 1 – 2pm

Commissioning for Outcomes Bob Ricketts CBE Director of Commissioning Support Services & Market Development, NHS England

4 February 2015 1 – 2pm

Accountable Care Organisations in the USA & England testing, evaluating and learning what works

Dr Rachael Addicot Senior Research Fellow, Kings Fund

www.england.nhs.uk

Chronic conditions – a new approach

Dr Martin McShane Director – Domain2 Enhancing the quality of life for people with long term conditions

www.england.nhs.uk

We are facing a rising burden of avoidable illness across England from unhealthy lifestyles: •1 in 5 adults still smoke •1/3 of people drink too much alcohol •More than 6/10 men and 5/10 women are overweight or obese Furthermore: •70% of the NHS budget is now spent on long term conditions •People’s expectations are also changing 4

5YFV: Demand for care is rapidly growing

www.england.nhs.uk

New technologies and treatments •Improving our ability to predict, diagnose and treat disease •Keeping people alive longer •But resulting in more people living with long term conditions New ways to deliver care •Dissolving traditional boundaries in how care is delivered •Improving the coordination of care around patients •Improving outcomes and quality …but the financial challenge remains, with the gap in 2020/21 previously projected at £30bn by NHS England, Monitor and independent think-tanks

5YFV: There are new opportunities

www.england.nhs.uk

The new ‘epidemic’? Number of Conditions1 % self reporting

1 30% 2 13%

3+ 10%

The 15 million people in England with long term conditions have the greatest healthcare needs of the

population (50% of all GP appointments and 70% of all bed days) and their treatment and care absorbs 70% of

NHS and social care budgets in England

1. The percentage of people aged 18 and over self-reporting experiencing long-term conditions in the GP Patient Survey

Overall: 16% of population have multimorbidity (based on 17 QOF diseases) 57% have multimorbidity (based on 115 ACG diseases)

0

5

10

15

20

25

30

35

40

45

50

18-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

%

Age-group

MALE

FEMALE

Percentage with more than one of 17 major chronic conditions, by age and sex

Multimorbidity is very common

Salisbury et al, BJGP, 2011

Annual consultation rate by age and multimorbidity status

0

2

4

6

8

10

12

14

18-24 25-34 35-44 45-54 55-64 65-74 75-84 85+

annu

al c

onsu

ltatio

n ra

te multimorbid not multimorbid

People with multimorbidity account for 16% of the population but account for 33% of all consultations

Salisbury et al, BJGP 2011

Impact on health care system

www.england.nhs.uk

Bridging the gap: Financial Context

7

www.england.nhs.uk

www.england.nhs.uk

Financial and population ‘gearing’

12/12/2014

Primary £200 (6.5k)

Community &

MH £500

Specialist £300

Acute £1000 (330k)

Social Care Public Health

www.england.nhs.uk 10

GP Specialist

1990

Specialist

2014

CARE GAP

Activity

Complexity

www.england.nhs.uk

There are three levels of personalised care and support needed: • People who are without an LTC but who need proactive advice

as they are at risk, e.g. of CVD or diabetes • Those with single or synergistic conditions for whom

standardised care through evidence based practice is generally well established and national incentives, guidance and processes support a focus for this group, although there are still improvements to make.

• However, the group yet for the NHS (and partners) to create the right system for are those with multiple conditions and the rising demand for the prevention and management of multi-morbidity through an individualised approach to care.

Care Context

www.england.nhs.uk

Levels of Care - Stratification

Complex

Simple

No LTCs

12

Stratifying risk Stratifying Care Design Stratifying care delivery

Multiple

Single/ Synergistic Condition(s)

Prevention

Individualised

Standardised

Proactive advice

www.england.nhs.uk

Specialist Functions….for a population

Building generalist

capability and quality

Support for

Generalist

Specialist Services

www.england.nhs.uk

5YFV: Developing new care models

12/12/2014

•We need to take decisive steps to transition towards better care models •There is wide consensus that new care models need to:

Manage systems (networks of care), not just organisations Deliver more care out of hospital Integrate services around the patient Learn faster, from the best examples around the world Evaluate success of new models to ensure value for

money

www.england.nhs.uk

Multispecialty Community Providers What they are • Greater scale and scope of

services that dissolve traditional boundaries between primary and secondary care

• Targeted services for registered patients with complex ongoing needs (e.g. the frail elderly or those with chronic conditions)

• Expanded primary care leadership and new ways of offering care

• Making the most of digital technologies, new skills and roles

• Greater convenience for patients

How they could work • Larger GP practices could bring in

a wider range of skills – including hospital consultants, nurses and therapists, employed or as partners

• Shifting outpatient consultations and ambulatory care out of hospital

• Potential to own or run local community hospitals

• Delegated capitated budgets – including for health and social care

• By addressing the barriers to change, enabling access to funding and maximising use of technology

12/12/2014

www.england.nhs.uk

Primary and Acute Care Systems

What they are

• A new way of ‘vertically’

integrating services • Single organisations providing

NHS list-based GP and hospital services, together with mental health and community care services

• In certain circumstances, an opportunity for hospitals to open their own GP surgeries with registered lists

• Could be combined with ‘horizontal’ integration of social and care

How they could work

• Increased flexibility for Foundation Trusts to utilise their surpluses and investment to kick-start the expansion of primary care

• Contractual changes to enable hospitals to provide primary care services in some circumstances

• At their most radical they could take accountability for all health needs for a register list – similar to Accountable Care Organisations

www.england.nhs.uk 12/12/2014

www.england.nhs.uk 12/12/2014

www.england.nhs.uk

www.england.nhs.uk

Population system approach LTC Framework:

• Empowered patient and carers • Professional collaboration • Best Practice (clinical and organisational) • Commissioning

www.england.nhs.uk

The House of Care

Organisational and clinical supporting processes

Engaged, informed

individuals and carers

Health and

care professionals committed to partnership

working

Commissioning

Person-centred coordinated

care

www.england.nhs.uk

LTC Framework

22

Organisational & Clinical

Processes

Informed and engaged patients

and carers

Health & Care Professionals committed to partnership

working

Commissioning

• Information and technology

• Case finding & risk stratification

• Care Planning • Safety and

Experience • Guidelines,

evidence and national audits

• Care Delivery

• Self Management • Information and

Technology • Group and Peer

Support • Care Planning • Policies for carers • Voluntary sector

patient & carer support

• HSC Integration • Multi Disciplinary

Teams • Culture • Workforce • Technology • Care Co-

ordination • Care Planning

• Needs Assessment and Planning

• Joint Commissioning

• Metrics and Evaluation

• Service User and Public Involvement

• Contracting and Procurement

• Care Planning • Tools and Levers

The table below sets out some of the key components needed to deliver the central aim for LTC Framework - Person Centred Coordinated Care

www.england.nhs.uk

Person centred coordinated care

“My care is planned with people who work together to understand me and my carer(s), put me in control, co-ordinate and deliver services to achieve my best outcomes”

Communication

Information

Decision-making Care planning Transitions

My goals/outcomes

Emergencies

Goal

23

www.england.nhs.uk

http://www.england.nhs.uk/house-of-care/

Resources 1.Toolkit 2.Dashboard 3.Infographic 4.Improvement programme

www.england.nhs.uk

The soft stuff…is the hard stuff

25

Mindsets and beliefs

Values

Individual behaviours

SOURCE: Scott Keller and Colin Price, ‘Performance and Health: An evidence-based approach to transforming your organisation’, 2010.

Needs (met or unmet)

www.england.nhs.uk 26

Community Care

Primary Care

University/ Specialist Facilities

Social Care

General Hospital

ICare

The Future: 2014-2019

www.england.nhs.uk NHS Expo Seminar Domain 2

27

Rob Meaker Director of Innovation, Barking, Havering and Redbridge CCGs

Complex Primary Care Practice in East London

East Of England

Hospital LAS Station

Central London

Cluster 1

Cluster 2

Cluster 3

Cluster 4

Cluster5

Cluster4

Cluster6

Cluster2

Cluster 1

Cluster 1

Cluster 2

Cluster 3

Cluster 4

Cluster 5

Cluster 6

Walk In Centre

Total Population 759,285

BHR Dashboard

£50m non elective admissions

£55m Non elective admissions

£8.8m A&E attendances

Havering

£36.5m Non elective admissions

Barking

£7.6m A&E attendances

£7.6m A&E attendances

Redbridge

Overview of BHR CCGs’ Health Economy

2008 – Polysystems & Person Centred Care 2009 – Risk Stratification 2010 – Integrated data 2011 – LTC management, & The Year of Care 2012 – Integrated Case Management 2013 – Rapid Response & Community Treatment Teams 2014– Complex Primary Care Practice

Health 1000 Ltd, the Complex Primary Care Practice, is a Primary Social and Acute Care System located in King George Hospital, Ilford

BHR CCGs’ Development Timeline

How BHR CCGs are Implementing a Primary, Social and Acute Care System

Health1000 is a new primary care evolved provider organisation operating a new model of care being developed as part of the Prime Minister’s Challenge fund and aligned to the PACS (Primary and Acute Care Systems) models set out in the 5 Year Forward Plan. The Year of care work provided the foundation for the service design and the supporting capitated budget. The model has been designed in collaboration with the users it intends to serve and will be guided by what people with complex needs want to achieve from their health and social care

Aligning the PSACS model with existing services.

EoL / CHC > 5 LTCs

Frail/1-3%/2LTCs

3-6%/1LTCComm

Pharmacy

GP

BHRUTNE

London FT

Cont.HeathCare

111

Urgent Care

Centres

VoluntarySector

Meds Man

Non Year of Care

Year of Care

Social Care

Federated Urgent and

Planned Primary Care

Services

LondonAmbulance

Out of Hospital

Integrated Urgent &

Emergency Care Service

Complex Care model

Implementing a new model of care, it is essential to align the model with other Key services.

Complex Care ServiceIndividual

CareMultidisciplinary

Teams

PatientsChildren Elderly or

Retired Unemployed Full time

mothers or carers

Working Adults

Complex Patients

Online Call2Practice

Planned GP Appointment

Existing urgent care services

Primary Care Prof Support

Non-Direct Emergency Triage

OnlineUnified point of access

Urgent Primary Care Appointments

Walk-in Centres

GP Core Plus Weekend6-10 pm

openingGP core

In the future, a unified urgent primary care service joins patients and clinicians across BHR primary care

New or significantly enhanced services

Patients flow through primary careKey Existing services

Complex Care Practice Patient Selection

Complex Care cohort

Row Labels Cohort Hypertension CHD Diabetes Stroke Depression COPD Heart Failure Dementia LTC 5+ 100 99 96 80 70 80 69 75 36 Scottish modified LTC 4+ 1924 1816 1559 1421 863 793 783 679 303 Grand Total 2024 1915 1655 1501 933 873 852 754 339

211 of the cohort currently receive Integrated case Management Services The Complex Primary Care Practice intends to register 1000, of the 2024 eligible patients Eligible cohort, must have 4 diagnosed long term conditions from Hypertension, CHD, Diabetes, Stroke, Depression, Heart Failure and Dementia.

The costs have increased for these patients over the 7 years, presumably as more of the patients in the cohorts need services and/or patients in the cohorts need greater volumes of services The greatest cost increases over the period for patients in the cohorts were primary care and community care. In percentage terms, the cost of acute care has decreased over the period.

The trend in adjusted cost for all patient in the complex care cohort by service type

Activity Cost (£)

2012/13 2013/14 2014/15 2012/13 2013/14 2014/15

Primary Care Contact 42.1 45.2 45.1 1,897 2,032 2,030

Pharmacy 134.8 134.1 135.5 2,373 2,362 2,387

Acute care A&E 1.2 1.2 1.0 137 144 120

Outpatient 5.7 5.5 5.6 602 742 764

Daycase 0.6 0.5 0.3 424 366 217

Elective 0.1 0.1 0.1 286 194 174

NEL short-stay 0.2 0.2 0.2 246 228 166

NEL long-stay 0.5 0.5 0.4 1,568 1,570 1,254

Community care Face-to-Face 6.0 10.2 12.3 1,092 1,884 2,172

Telephone 0.5 0.9 1.1 27 47 54

Combined average cost per patient (£) 8,652 9,569 9,337

Total annual cost of patient cohort (£million) 17.51 19.37 18.90

Average annual number of events and average annual cost per patient in the cohort - all CCGs

The averages hide a great deal of variation. If we take one example, patient's in the cohorts on average visit A&E once a year but over 50% of patients did not visit A&E at all during 2013/14, and one patient visited 41 times . Perhaps the most striking feature of the data is that large percentages of patient in the complex care cohorts didn't require acute inpatient care at all in 2013/14.

Cost and Activity for the selected cohort

Commissioning the Service, Who, Where, When

Acute Trust Community Trust

Private Provider

Health1000

Voluntary Sector

GP Federation

PSCAS model for implementation 1. Pre-registration Work up 2. Initial Visit 3. Proactive Care 4. Reactive

PSCAS staffing model

ROLE WTE at start up

Start up Cover provided WTE by month 3

MD and Geriatrician (50:50 role)

1.0 20 hours direct patient care plus 17.5 hours management plus on call support as required

1.0

HCS Key workers 5.0 73.5 hours per week 8am to 18.30pm Monday to Sunday. This is a dual function role covering reception and health care support and requires two members of staff to be on duty during 08.00 to 18.30pm Monday to Friday

6.0

GPs 3.0 52 hours per week 08am to 18.30pm Monday to Friday plus On call for 5 hours per week Monday to Friday 6.30 to 8pm and 24 hours on Saturday and Sunday from 8am to 8pm A total of 81 hours per week

3.0

Practice Manager 1.0 37.5 hours per week as required to cover 7 days per week on rota

0.5

Nurse 1.0 37.5 hours per week during 8am to 6.30pm 0

OT 0.5 18.5 hours per week during 8am to 6.30pm 3.0

Physiotherapist 0.5 18.5 hours per week during 8am to 6.30pm 2.0

Pharmacist 0.5 18 hours per week Monday to Friday as required 1

Community Nurse 0.0 Not applicable 4.0

Mental health Nurse 0 Not applicable 0.5

Social Worker 1.0 Seconded from Local Authority

Patient Feedback resulting in design changes

People interviewed about the new Health1000 service told us: “We feel helpless trying to get the best care for our mum.” “The professionals don’t understand all of my needs.” “I just want to be able to go fishing. I don’t want any more operations or medication, I just want to be able to o Fly Fishing again. Why wont anyone help me achieve this ?

Complex Care ServiceIndividual

CareMultidisciplinary

Teams

4+ LTCsMental Health

Social IsolationEnd of Life Needs Complex

Patients

Care plan developed

New and existing services (Sectors including Voluntary, Charities,

Private Sector, Social models, Communities, user developed services etc)

Care Navigator

Scope of existing services Scope of IPC development

Health1000

Care Navigation package

Directory of Services

a

Updated Service updated to meet the registered patient needs

Information Governance: LTC Year of Care Early Implementer Sites

Mark Golledge Programme Lead – Health and Care Informatics Local Government Association 1st December 2014

Background

• Role funded by Department of Health – employed by Local Government Association;

• Aim is to support work of the Integrated Care Pioneer sites around Informatics – liaising with Government to help unblock challenges, barriers and encourage sharing, learning and joined up approaches (previous roles in CSU and before that Local Authority Informatics – although not directly IG);

• Pioneer Informatics Network – one of four work-streams across the Pioneer programme (others are provider development; workforce and leadership; pricing and finance led by Monitor);

• Eight areas of focus for the Pioneers on Informatics – my role is to coordinate amongst all eight:

1. PSN / N3 Interconnect; 2. Secure Email; 3. IG Toolkit (Health and Local Gov); 4. People Driven Citizen Services; 5. Whole Place Analytics; 6. Access to NHS Number; 7. Integrated Digital Care Records 8. Info Sharing for Commissioning;

Information Sharing for Commissioning

• Acting as a link between Integrated Pioneer Sites and DH / HSCIC / NHSE / IG Alliance given existing challenges – including engagement in IG Forum;

What do we know about where we are? • Information Sharing doc consulted on over the summer currently being reviewed by DH;

• Various S251 arrangements in place until March 2015 including risk stratification covering

health flows although doesn’t cover social care (unless legal basis);

• Challenges around social care flows;

• Monitor guidance around whole place data linkage (including IG section) & Risk Stratification work underway;

• Southend application to CAG in Dec – element of consent / fair processing;

• Options available (but pros and cons of these e.g. data quality, re-identification limitations): consent (“gold standard”), pseudonimisation at source, pseudonimisation on landing, applying for support under section 5 of S251 regulations (Southend), work through HSCIC using it’s power to collect (but only flows in, not out);

• Best practice / requirement for informing people what is happening with their data;

Information Sharing for Commissioning

What Next? • DH response to consultation on information sharing – we hope will provide details on end-

state and transition arrangements;

• Southend application for S251 (December) and then clarity on next steps for others with DH (consideration in light of the above) – sessions over next couple of weeks (will continue to push Year of Care point);

• Seek resolution of social care flows into HSCIC - consideration in light of the above (but need to also address flows out);

• Sharing of examples where flows are legally happening – pseudonymisation / consent (whilst recognising limitations of approaches);

• Continuation on work re. informing clients / patients – again sharing examples of good practice;

• Continue to flag up specific challenges with us so we can raise with DH / IG Alliance; ……What have we missed?

Long Term Conditions Improvement Programme Your Local House – EI Sites perspective on Lessons

Learnt & Knowledge Capture

Lesley Callow & Jill Lockhart Delivery Support Manager

Improving health outcomes across England by providing improvement and change expertise

Long Term Conditions House of Care • The 15 million people in

England with long term conditions have the greatest needs of the population

• People living with long term conditions report that they require person centred coordinated care

• The House of Care provides a framework for this to be delivered

The House of Care in value to people/patients: The House supports National Voices ‘I’ statements

My goals/outcomes All my needs as a person were assessed and taken into account.

Communication I always knew who was the main person in charge of my care.

Information I could see my health and care records at any time to check what was going on.

Decision-making I was as involved in discussions and decisions about my care and treatment as I wanted to be. Care planning

I had regular reviews of my care and treatment, and of my care plan.

Transitions When I went to a new service, they knew who I was, and about my own views, preferences and circumstances.

Emergencies I had systems in place so that I could get help at an early stage to avoid a crisis.

The House of Care in value to NHS:

£1.2bn: Avoid ambulatory care sensitive admissions though e.g. following NICE guidelines (1)

£0.8bn: Reduction of hospital admissions for common LTCs through integrated care esp frailty, comorbid (2)

£0.8-1.2bn: Reduce use of low value drugs, devices and elective procedures using commissioning analytics and clinician education (3)

£0.2-0.4bn: Empower people in supportive self-management (4)

£1-1.6bn: Shift activity to cost effective settings e.g. pharmacy minor ailments (5)

£0.4-0.6bn: Avoidance of drug errors e.g. through electronic records/e-prescribing (7)

Over to you:

As an Early Implementer team please now: • Rate you status with regard to implementation

of each component • Considering each component, please populate

the A3 table with your recommendations for actions that will need to be taken

25 mins

Component Key Messages

Foundation

Left Wall

Right Wall

Roof

Making self-management work for people with

long-term conditions

LTC Year of Care: Early Implementer Sites (EIS) workshop

Renata Drinkwater

Chief Executive

Agenda

� What is self management uk?

� What are the evidence based benefits of self-

management to patients?

� What do patients say they want in relation to self-

management?

� Zev Taylor’s self-management story

� What are the benefits to clinicians, healthcare

professionals and the wider system?

� Discussion

self management uk

� Formerly the Expert Patients Programme Community

Interest Company, now a registered Charity

� Over 12 years’ experience working within/for the NHS

� At the forefront of self-management education and training

� Facilitated delivery of programmes to 100,000+ patients with

long-term conditions

� Also programmes for clinicians/healthcare professionals

� Delivered face-to-face or online

Benefits of self-management to patients

� Increased self-confidence and reassurance

� Increased control over own health and wellbeing

� Better involvement in shared-decision making about own

health and wellbeing

� Reduced time off work

� Better symptom management, such as reduction in pain,

anxiety, depression and tiredness

� Improved physical symptoms and clinical outcomes in people

with arthritis, asthma, diabetes, hypertension, heart disease,

heart failure, stroke, cancer and other conditions

Asking patients what they

want

Our 2013 survey

Patients want to help themselves!

62%

38%43%

25%Say ‘Being able to connect with

others living with my condition’

Say ‘Having a GP that

understands the difficulties of

living with a long-term condition’

Say ‘Healthcare professionals

treating me as an equal with a say

in my treatment’

Say ‘Getting the right advice to

support me in managing my

condition’

but the healthcare system is still reluctant to

help them to help themselves …

11% 10% 9% 10%6% 7%

48%

Less then 6

Months

6 - 12

Months

1-2 Years 2-3 Years 3-4 Years 4-5 Years More then

5 Years

How much time elapsed between the first diagnosis of your condition and you

being offered a place on a self management course?

Asking patients what they

want

Our 2014 survey

Self-management does make a difference

55%

30%

11%

4%

Strongly Agree Agree Disagree Strongly Disagree

The self-management course had a positive impact on my life?

Self-management boosts patient confidence

37%

18%

35%

6%4%

Strongly Agree Agree Stayed the same Disagree Strongly

Disagree

The self-management course has improved my confidence?

Overwhelming endorsement from participants

39%

49%

9%

3%

Strongly Agree Agree Disagree Strongly Disagree

Would you recommend a self-management course to your friends or family?

The tangible impact of self-management

Reduced use of NHS resources

“The course has made a major difference to the way I approach all health professionals with self-confidence and self-belief. The number of times I need to visit health professionals has been reduced massively. Over the last two years my medication has reduced by about 25%, and I believe this is due to the knowledge I gained from attending the course.”

Self-confidence & wellbeing

“The course makes people more aware of how their symptoms/condition affect their day-to-day health and wellbeing. If you have more control over your condition, you have more choice. You can’t let your condition run your life.”

The tangible impact of self-management

Helping people get back into work

“I am now able to spend time with my family, go out with my friends and socialise, and go away on holidays, which I never thought I would be able to do. I have also created an opportunity for myself to get back into work and I am extremely proud of this achievement.”

Supporting healthcare professionals

“The course promotes respect and empathy for doctors and the pressure they are under. I remember one instance where I was taken to A&E and the triage nurse was amazed at how quickly I was able to describe my symptoms and tell her about my medication. She told me she often spent 20 minutes on the patient’s medical history. She said it would save the NHS a fortune if everyone could do what I did that night.”

Zev Taylor’s Story

Benefits to clinicians, healthcare professionals and the wider system

Percentage savings delivered by self management

programmes [1]

GP visits 2.3% Inpatient visits 50%

Nurse visits 13.8%Outpatients

visits6.2%

A&E visits 12%Medication

saved5.4%

[1] Department of Health (2005). Supporting People with Long-term Conditions: An NHS and social care model to

support local innovation and integration. London: Department of Health

Benefits to clinicians, healthcare professionals

and the wider system

� New self management uk tool developed for Commissioners to

demonstrate benefits

� Based on model originally co-developed with the Department of

Health, now significantly enhanced

� Shows financial benefits of delivering our programmes patients

(e.g. Self Management for Life/Expert Patients Programme)

� Uses Department of Health/Office for National Statistics figures

and evidence from other key studies

� Calculates impact for any Clinical Commissioning Group

Typical return on investment

For ever £1 spent: £2.24 is

saved!

CCG Case Study - Typical system usage and medication spend

Statistics for CCG Value

People with a Long-Term Condition 61,539

People Newly Diagnosed (Per year) 4,308

Total GP Visits 300,347

Total Nurse Visits 165,191

Total A&E visits 67,941

Total Emergency Admissions 17,015

Total Hospital Admissions 40,004

Total Outpatients Visits 203,576

Total Medication Spend £27,968,172

Typical Savings

� Population with long-term conditions: 61,539

� If training delivered to just 240 patients per

annum

(15 x 7 week programmes)

� Potential gross saving due to reduced

healthcare utilisation: £210,000 per annum

Yes, £2.24 saving per £1.00 spent

Cost Benefit Default Costs

Total Cost of Programme £93,750

Total Practice and Commissioner Savings £210,073

Total Saving over Contract Length £116,323

Saving per Year £116,323

Return on Investment: For every £1 spent: £2.24 is saved

Typical Return on Investment

Benefits to clinicians, healthcare professionals

and the wider system

Finally, we calculate if self management uk

programmes were commissioned across England

for just 10% of people with Long Term Conditions

(c1.57m), there would be:

�Gross potential system savings of some £1.38bn

per annum

�Net potential savings of some £763m pa

Enabling patients

How can we make sure self-management training is offered to

more patients diagnosed with a long-term condition at the earliest

opportunity in their care pathway?

Group Discussion

Thank you

�Questions?

Renata Drinkwater

Chief Executive

T: 03333 445 840

M: 07500 039 736

renata.drinkwater@selfmanagementuk.org

hello@selfmanagmentuk.org