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Outline. Update on localities establishment System Integration Clinical Framework Global Budget Setting Whanau Ora Networks Next Steps Questions?. Locality General Manager’s. Kathy de Luc Franklin (2 nd Dec). Geoff Smith Franklin (30 th Dec). Lynda Irvine Manukau. Linda Bryant

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Outline

Outline

  • Update on localities establishment

  • System Integration Clinical Framework

  • Global Budget Setting

  • Whanau Ora Networks

  • Next Steps

  • Questions?


Locality general manager s

Locality General Manager’s

Kathy

de Luc

Franklin

(2nd Dec)

Geoff Smith

Franklin

(30th Dec)

Lynda Irvine

Manukau

Linda Bryant

East

Sarah Marshall

Mangere/Otara


Outline

More Detail about the Work Programmes


Outline

1. AT RISK INDIVIDUALS PROGRAMME

The At Risk Individuals Programme is about

more planned, proactive care


Outline

AT RISK INDIVIDUALS PROGRAME

1. Lots of programmes into one

A number of programmes will be merged into the new ARI programme, including:

  • CarePlus

  • High Risk Individuals

  • Chronic Care Management

  • CCM Depression

  • Self Management Education

  • Refugee Services

  • Diabetes Care Improvement Package


Outline

AT RISK INDIVIDUALS PROGRAME

1. AT RISK INDIVIDUALS PROGRAMME


Outline

2. SERVICE REDESIGN

2. SERVICE REDESIGN


Outline

3. QUALITY IMPROVEMENT IN LCPs

Evaluation Framework

Confirm and begin implementation of an evaluation framework for Counties Manukau Health System Integration Programme

Performance Metrics

Develop a dashboard for system integration that will collate key quality and performance data by LCP.

Learning System

Clinical Audit

LCPs undertake regular clinical audit programme to monitor improvementsin patient outcomes

Quality

  • Quality improvement systems are established and developed in each LCP

  • Develop quality indicators for LCPs

  • Support LCPs to collect and analyse indicator data


Outline

The Global Budget


Objectives

Objectives

  • Sharing accountability for whole of system outcomes

  • Enhance and incentivise integrated clinical decision-making

  • Better align service delivery with desired population health outcomes

  • Enable improvement in capacity and capability


The global budget

The Global Budget

Health Services Programme Budget

Operational

Budget

Locality Primary and Community Health Services

Shared Accountability Services (SAS)


Shared accountability services

Shared Accountability Services

  • From July 2013, we will share accountability for reducing utilisation of:

    • Acute Medical inpatient bed days

    • Acute non-medical inpatient bed days

    • Emergency Department non-admitted events

    • Medical Outpatient events

    • … what about ARC?


Sas method

SAS - Method

  • What are our baseline utilisation rates for each service?

  • What is the average cost of providing that service?

  • How will demographic change affect demand for hospital services?

  • What will be the cost of providing these services?

  • What is a realistic target?


Locality x population

Locality X - Population


Locality x utilisation

Locality X – Utilisation

Rates per 1,000 enrolled population


Locality x targets

Locality X – Targets

  • Population growth is applied to baseline figure to estimate future volumes

  • Utilisation rates are reduced by 20% across five years, to derive ‘planned’ volume targets


Locality x fy2018

Locality X – FY2018


Locality x wash up

Locality X - Wash-Up

  • ED Attendances (not admitted)

    FY2018 planned = $2,102,765

    Actual ‘spend’ = $1,960,750

    Total conserved resource = $142,015


So how are we tracking

So how are we tracking?

After Q1 3 out of 4 Localities would owe us !

4th locality (favourable):

50% to LCP Leadership Group = $810,911

40% to CMDHB = $648,728

10% to PHO partners = $ 162,182

PHO A (80%) = $129,745

PHO B (20%) = $32,437


Outline

Region-Wide Governance Group

DHB Clinical and Management/PHO Clinical Management/Iwi

Locality Governance

(Active Clinical Network x 2, Whaanau Ora Network

x2, Community, x2 PCN?, Iwi)

Locality Network

(Virtual – No Entity or discrete funding)

Local Service Change

Local Performance

Maintaining collegial relationships

Active Clinical Network

(Providing Local Clinical Governance

Whaanau Locality Network

(Providing Local Whaanau Ora Governance)

Providing Services & Funding

PCN Providers Services & Funding

Whaanau Ora Services & Funding

DHB Services & Funding

Service Integration


Outline

Key Roles in Whaanau Ora in Localities

Funded by Lead Agency with a m/ment fee

Funded by CMDHB As Lead Agency

  • Leading case management systems & tools

  • • Integrating WO and primary care service delivery

  • • Training & developing the workforce

  • • Monitoring performance

  • & CQI processes

  • • Developing network Lead contracting and performance processes

WO Network

Lead

  • WO Practitioner providers;

  • Integrated WO service

  • providers

  • NGOs & other social services as part of networks

  • Contracted to WO Network Lead

  • Developing networks of NGO and social service providers;

  • Linking WO practitioners and Whaanau to useful services;

  • Developing solutions to service gaps in localities;

  • Monitor locality performance and improve services

WO Providers

WO Lead

Agency


The nhc

The NHC

  • Implementing a Lead Agency that delivers;

  • Collaborates with four localities and the lead PHOs;

  • (Mangere, Manukau & Otara)

  • Builds Whānau Ora Networks in each Locality;

  • Implements a transparent accountability and performance model;

  • Ensures a high standard of WO service delivery and practise;

    • Training & development of WO Practitioners;

    • Standardised assessment & case management tools;

  • Attracts other funders and agencies to support Whānau Ora service delivery;

  • Operates a CQI process and collaborates with PHOs and DHBs to build more integrated and effective services to address social determinants based on evidence.


Locality partnerships

Locality Partnerships

  • CMDHB to fund the NHC Lead Agency in line with Lead PHOs in Localities

  • NHC to establish Whaanau Ora system in priority localities

  • An open system

  • Giving effect to the CMDHB agreement and building the system for:

  • Measuring impact & benefit consistently

  • Sharing the gain and incentivising services that work within and across localities

How investment

decisions are made?

WO Lead Agency

WO Service

Investment

Host PHOs

Locality Service

Investment

How investment is shared?


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