Commissioning a Patient Led NHS PCT Reconfiguration

1. Commissioninga Patient Led NHSPCT Reconfiguration Malcolm McCann CEO Transition Lead South East Essex PCT

2. Content of Presentation • Background to the changes • The Department of Health’s vision • Roles of the new PCTs and SHA • Process and timeframes • Managing the Transition • Other issues • Expectations of OSC • Extend Audit of Transition

3. Background • Letter from Sir Nigel Crisp - July 2005 • National policy framework • Payment by results • Choice • Independent sector provision • Creation of Foundation Trusts • White paper – Our Health Our Care Our Say • Better prevention, earlier intervention • More choice • Tackling inequalities and improving access to community services • More support for people with Long Term Conditions • Contestability / plurality of provision

4. Commissioning a Patient Led NHS – Department of Health’s vision (1) • Delivering a better, more responsive health service that gives people control and choice • Better engagement with local clinicians in the design of services • Faster, universal roll out of “Practice Based Commissioning” (PBC) – by December 2006 • Developing PCTs to support PBC and take on the responsibility for performance management through contracts with all providers, including those in the independant sector • Reviewing the functions of SHAs to support commissioning and contract management.  STRENGTHENED COMMISSIONING

5. Commissioning a Patient Led NHS – Department of Health’s vision (2) • Partnership working with Local Authorities to deliver “Choosing Health” • Commitment to make £250million of savings in management costs, to be reinvested into front line services Changes in function required consideration of optimal configuration of PCTs

6. PCTs - 3 FUNCTIONS Engaging with its local population to improve health and well-being Commissioning a comprehensive and equitable range of high quality responsive and efficient services, within allocated resources Directly providing high quality responsive and efficient services where this gives best value

7. PCTs – RELATIONSHIPS & ACCOUNTABILITY • Perform their functions for, and with, their local population, • in pursuit of equality, quality, responsiveness, innovation, efficiency • and affordability • Lead their local health system; and develop, and deliver their • functions through, effective partnerships - particularly • practice-based commissioners; and with Local Authorities eg in • developing Local Area Agreements; and with the full range of • different types of providers • 3. Hold providers to account through commissioning and contracting • Are accountable to their local population directly and through OSC • scrutiny; and to Strategic Health Authorities. PCTs operate • within the framework of Department of Health policy; they are held • to account for this by SHAs, not directly by the Department.

8. PCTs – MAIN ROLES

9. SHAs - 3 FUNCTIONS Strategic leadership Strategic leadership Organisational and workforce development Ensuring local systems operate effectively and deliver improved performance

10. SHAs – RELATIONSHIPS & ACCOUNTABILITY • In discharging these functions, SHAs must work in partnership with • their PCTs, and regional organisations, particularly Government • Offices for the Regions • 2. Hold PCTs to account for their performance • Are held to account by the Department of Health for ensuring their • local health systems operate effectively and in line with Government • policy

11. SHAs – MAIN ROLES

12. Process and timeframes (1) • Informal consultation by Essex SHA July – October 2005 • Organisations asked to take soundings and respond • 2 or 5 PCTs in Essex was prevailing view • Formal consultation by Essex SHA December 2005 – March 2006 • Range of responses • Considered by SHA Board and recommendation made for 2 PCTs in Essex (one for South Essex and one for North Essex)

13. Process and timeframes (2) • May 2006 - approval given by Secretary of State for 5 PCTs in Essex: • Mid Essex • North East Essex • South East Essex • South West Essex • West Essex • To be formed on 1 October 2006 • 1 July 2006 – East of England Strategic Health Authority commenced

14. Process and timeframes (3) • PCT Chair appointment process underway (to be announced July) • PCT CEO appointment process underway (to be announced August) • PCT Directors appointment process underway (to be announced October) • ?Decision in relation to provision of services (for new PCT to determine)

15. Managing the Transition • Transition Lead identified for each new PCT • Transition Board established for each new PCT (membership = CEOs, Chairs, Executive Committee chairs and leads) • Overseeing development and implementation of transition action plans to ensure minimal disruption to services • Workstreams: • Business Continuity • Performance Management • Human Resources • Communications

16. Other issues • Key stakeholder involvement – including Local Authority & OSC • Patient involvement (inc. establishment of LINks) • DoH Fitness for Purpose Assessment and Development Programme - Organisation development • Staffing issues • Provision of services – various options which the new PCT could consider • Continued integration of health and social care