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DERBYSHIRE COUNTY PCT

DERBYSHIRE COUNTY PCT . A Business Strategy for the Provision of a County Wide Cardiac Rehabilitation Service. Who we are. Janet Whitehead – Public Health Specialist. Derbyshire County PCT. Ciara Scarff - LTC Commissioning Manager. Derbyshire County PCT.

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DERBYSHIRE COUNTY PCT

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  1. DERBYSHIRE COUNTY PCT A Business Strategy for the Provision of a County Wide Cardiac Rehabilitation Service

  2. Who we are • Janet Whitehead – Public Health Specialist. Derbyshire County PCT. • Ciara Scarff - LTC Commissioning Manager. Derbyshire County PCT. • Dr Clare Hawley - GPwSI in Cardiology, Chesterfield, Derbyshire.

  3. Aims of our presentation • Setting the scene and understanding the issues • Developing a business strategy from a Commissioner point of view • Influencing the business strategy from a clinical perspective

  4. Introduction to Derbyshire County PCT • Derbyshire County is one if the largest PCTs in the County – it has a population of 712,000 and covers 1,025 square miles • There is a Spearhead area within the County which reflects the health inequalities within Derbyshire. • The County is diverse. There are rural areas, urban areas, ex-mining areas and affluent areas which often conceal pockets of deprivation.

  5. Our Providers • There are a small number of community providers represented by the blue stars • There are two acute Trusts within Derbyshire delivering phase 3 • There are a large number of providers of phase three outside of the County • 11 external providers leads to great difficulty when it comes to commissioning an agreed, equitable service Cheshire

  6. North Phase 2 - Community staff provided support Heart Manual offered as part of choice for phase 3 Phase 3 – 4 programmes CRHFT x 1 - Community Hospitals x 2 - Leisure Centre x 1 South Phase 2 – Community Cardiac Liaison Nurses Angina Plan Phase 3 – 6 programmes - DRI x 3 - Derby City x 2 - Community Hospital x 1 Models of service provision across the County PCT

  7. North of the County 859 patients 572 (67%) admitted CRHFT of these: 55 (10%) died 260 (46%) not recruited to a programme 186 (33%) recruited to CRHFT programme 71 (13%) chose Heart Manual South of the County 1256 patients of these: 283 (23%) not recruited to a programme 699 (56%) recruited to a programme 202 (16%) followed up with Angina Plan Who is offered a Phase 3 Programme?

  8. Key points • Services not properly commissioned and developed in a piecemeal fashion • Variation in service delivery resulting in inequalities across the County • Lack of capacity of existing providers particularly in the north of the County • Variation in investment across the County • Low profile prior to merging of 6 PCTs • Difficulty in contracting for an equitable service across the County • Poor data and poor data quality

  9. Stuck in a rut!

  10. The process

  11. Moving forward! • Commissioners cannot work alone. Involve the right people from the start: • Clinicians including a lead clinician • Patient representatives • Finance and data analyst support • Public health • Leisure services Let us through! We’re NHS Managers!

  12. Understand the current picture • Starting point is to define your baseline. What capacity do you need and who are you currently providing for? • Can be complicated if you have multiple providers • Get analyst support • Use NICE Commissioning Tool to help with demand • Face the fact you may not be able to get all the data you would ideally like to have!

  13. Get a handle on your finances • Understand what you are paying for…..not as easy as it sounds! • Payment for cardiac rehab often have developed incrementally and can be hard to identify in large contracts with acute trusts • Get finance on board and start the process early • You may find out you are overpaying but you may also end up with a bill like we did when investigation by the Trust identified the PCT hadn't been paying!

  14. Build your case! • Make use of tools and evidence available • Learn from other areas • Make the changes attractive to the PCT!

  15. Define your specification • Opportunity to ensure quality and reduce gaps in service • Allow for innovation • Define strong health outcomes • Get buy-in

  16. To summarise… • Get the right people together • Understand what is currently happening • Identify improvements • Build your case or work within existing resources • Produce a service specification that identifies key performance measures

  17. The clinical perspective

  18. Team Engagement

  19. ‘Necessity, who is the mother of invention’ Plato - Greek author & philosopher Athens (427 BC - 347 BC)

  20. You have got to be in it to win it

  21. Playing the game – the strategy

  22. Ask the audience?

  23. Phone a friend Ggfbfggggggggggg

  24. Competencies - feedback

  25. The strongest link wins the prize

  26. Any questions? Contact details: Derbyshire County PCT Long Term Conditions Commissioning Team Tel: 0115 9316161

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