NHS Budgets 2011/12
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Transcript of NHS Budgets 2011/12
Introduction National Policy for Health
Organisational change
Quality Innovation Productivity and Prevention (QIPP)
Salford Service impact
National Policy for NHS
April 2011 > PCTs merged into Clusters (10>1 GM)
April 2011 > GP Commissioning Pathfinders active
April 2012 > SHA abolished
April 2012 > Health & Well Being Boards
April 2012 > National Commissioning Board
April 2013 > PCTs abolished
April 2013 > Public Health statutorily LG responsibility
April 2013 > GP Commissioners statutory Orgs
Title here Page 4
Challenge for PCTs
Reducing Real Time Resources - £
Technology & New Drugs Emerging
Population Health issues— Tobacco
— Alcohol & Drugs
— Obesity
— Lifestyle
Consumer access ‘free service’ issues— Eg Bariatric Surgery
National Context
Funding Growth — ‘c. 0.1% growth next 3 years v 5.2% 10/11
Uniqueness of Health Care inflation
Reducing Management Capacity
Developing GP Consortia
Local Government Funding Reductions
State of The Local Health System
HealthSlow improvement to mortality/morbidity indicesPoor Cancer outcomesThe IndicatorsA&E attendances increasingOutpatient (new) slowingOutpatient (F/up) acceleratingUrgent Admissions increasing (fast!)Elective work volumes stablePrescribing – High volumes but improving cost effectivenessThe system approachIntegrated (Urgent) Care WorkCommunity Services TransformationGP Commissioning now well under wayFinancesRelatively stable now But Pressure Building!!
Title here Page 7
Specific Areas For Cost Reductions Hospital Services - £16M annually for 4 years (£64M) Urgent / Unscheduled Care - £7.2M in 3 years Community Services – c£5M in 4 years Drug Budgets - £8M in 4 years Management Costs - £5M in 3 years Total c £90M in 4 years
What it means for patients C 15% real terms reduction in NHS expenditure Greater choice over treatment ‘no decision about me without me’ Greater involvement (co-production) with the public including
determining priorities Leaner ‘back office’ More focus on prevention & early intervention Supporting individuals & communities to manage own health better Health promotion and education at every opportunity Doing what's most cost effective (Prevention is a better investment
than treatment)
Title here Page 9
Economics of Health Care Techniques to measure health benefit Quality Adjusted Life Years (QALY)
— Treatment of end stage Diabetes Very expensive— Need to understand cost effectiveness of:— Prevention:
— Lifestyle interventions c £11,600 QALY— Metformin c £15,000 QALY
— Screening— Blood Lipid Secondary Prevention c £22,000 QALY— Retinopathy screening c £17,000 QALY
— Hospital Treatment— Hospital Dialysis c £30,000 QALY— Erythropoietin (EPO) c £50,000 QALY
— Disability and Social Economic Costs !