“Sharing the Vision – Taking Healthcare Finance into the Future” 27 th –29 th July 2005, St. Andrew’s, Scotland. HFMA UK/USA EXCHANGE 2005. Dr. Patricia Oakley Director, Practices made Perfect Ltd Teaching and Research Fellow Organisational Psychology and HRM Kings College London.
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“Sharing the Vision – Taking Healthcare Finance into the Future”27th–29th July 2005, St. Andrew’s, Scotland
HFMA UK/USA EXCHANGE 2005
Dr. Patricia Oakley
Director, Practices made Perfect Ltd
Teaching and Research Fellow
Organisational Psychology and HRM
Kings College London
Reform, modernise & focus a complex mix of service providers.
Develop service commissioning to drive up quality, operational gearing & value for tax payers’ money.
Develop more flexible working practices, and evidence-based quality assurance procedures.
The NHS and Social Care Policy Framework
Reform acute and primary care service provision to improve access, reduce waiting times, and build more focused programmes of evidence-based clinical care.
Increase the operational gearing, intensity and performance of how clinical care is organised and managed.
Develop new ways of working to reduce bureaucracy.
Shift incrementally from fixed to more variable cost structures.
Embed quality assurance and risk management within the service’s design and provision including the education and training “pipeline”.
The Policy Objectives
Acute – Emergency Care
Human Resource Management Policies
Community - Long Term Care
Reforming, Modernising & Focusing Service Providers
PolicyGoal –Develop morefocused & integratedcare organised in coherent expert systems that reduce risk and satisfy patients
Emergency Surgical Services
Specialist Surgical Services
The District General Hospital –
?At Biggest Risk?
Servicing Emergency Care, Organising Cross Cover and Training
Primary Care Led NHS
Specialist Mental Health
X-ray & Imaging
The New General Medical Services and Community Pharmacy Contracts
Care Planning & Management InvolvingPatients & Carers
Complex Case Management Programmewith a Case Manager who coordinates care from several groups of experts joining up care for patients and carers.
c. 20% of chronic Care Management
(but c.80% of resources).
Level 3:Highly complex patients who need case management.
Disease Care Management Programmeand Proactive support from Multi-disciplinary Teams using Care Protocols & shared information.
Level 2: High risk patients who need disease management support e.g. diabetes.
70-80% of Chronic Care Management.
Level 1: right support, many people can look after themselves, living with and managing their condition(s).
“Expert Patient” Programmesand Carer Support involving Voluntary Groups eg. BDA, Age Concern etc.
Health Promotion Programmeseg. Diet, exercise, and education.
*Practices made Perfect Ltd., Alpha House, 100 Borough High Street, London SE1 1LB Tel: 0870 241 9937; Fax: 0870 241 9938; email: firstname.lastname@example.org
What can GPs and social services do to promote independence and well-being?
What can GPs do to develop effective emergency and high-level interventions that increase people’s chances of survival?
What can GPs and social services do to ensure that the vast majority of people successfully complete their rehabilitation?
What can GPs and social services do to support end-stage management whenthis arises?
Caring for Older People
(#Stroke, Dementia, Falls)
The Office of the Regulator
The Health & Social Care Commission
The Marketing Unit
The Auditor & Comptroller General
The National Audit Office
Developing Service Commissioning
Developing Contestability in Public Services
Political context: “small government”; “regionalisation”; “going local”;
“public involvement”; “value for money”;
Developing Commissioning Practices
5-levels of Commissioning
National Commissioning Schemes
Regional Group Commissioning Schemes
eg.Genetics Services Emergency Services Intensive Services
Specialist Care Group Commissioning Schemes
eg.Mental Health Services Children’s Services Cancer & CHD Services
GP Group Commissioning Schemes
GP – individual level choice
H.M. TREASURY ALLOCATION
GP Commissioning Group (100k - 300k)
Community Care Services
Financial allocation reconciliation and audit
Contract management and administration
Public Health Agency
HRG/HBG National Case Mix Office
National networks of Drug Information Centres, MCA, PPB, Med. Man. Centre
Clarify Roles, Authority and Relationships
Education and Training
Professional Accreditation & Validation
Post-Shipman Review-December 2005
Fitness to Practice