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South Birmingham PCT

South Birmingham PCT. Registered population – 387,000 Allocation £500 million PBR live for almost 2 years High Quality Primary Care 244 GPs in 65 practices High Social Capital. This is what we have done so far.

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South Birmingham PCT

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  1. South Birmingham PCT • Registered population – 387,000 • Allocation £500 million • PBR live for almost 2 years • High Quality Primary Care • 244 GPs in 65 practices • High Social Capital

  2. This is what we have done so far • Completely re-vamped our Governance arrange ments, integrated governance, Standards for Better Health • Abolished commissioning : System Reform Service Reform • Strengthened public health and public accountability functions • Developed a locality structure • Extended our ‘Managing Admissions Programme’ • Information function

  3. Reorganising Primary Care • Engagement with PBC • Invest to save / or save to invest • Management Costs • Cluster size / risks

  4. Levels / Incentives • To improve information use • Middle level seen as transitional • Step Change in incentives to engage in Emergency Admissions • A higher level of PBC • Public Health Targets • The future – Adult Social Care?

  5. Incentives /disincentives • Choose & Book – is conditionality really in our interest • How quickly could we use PBC to address inequalities • Why would a capitation losing GP engage • Open Lists • Minimum QOF score • GP response to directives and budget top slices e.g. ISTC contracts

  6. Other issues • Geography v like minded GPs • South Doc – an APMS provider • South Doc – a PBC budget holder • Contestability in Primary Care

  7. There is no right level ! • PCT 3,800 elective waits • So average GP has 16 waiters • Issues: • 1st to Follow up • Consultant to Consultant • Bigger Issue: • Emergencies

  8. Joining up Strategy • Focus Enhanced Services investment to improve PBC results: • GPs and prescribing in nursing homes • Optimise role of UHB and SouthDoc • Unplanned care • Ambulance Trust • Referral Management Centres • Out of Hours – our next big success • Contestability in Primary Care

  9. Practice Benchmarking Data:What is provided? • Comparisons between practices of:- • Non-elective admissions rates • Elective referrals rates • First:Follow Up Outpatient Attendances Ratios • Conversion Rates (percentage of outpatient referrals which results in an elective procedure) • Data sourced from NHS-Wide Clearing Service (to be replaced by SUS - Secondary Uses Service) • Rates use weighted practice populations

  10. Practice BenchmarkingHow provided? • Quarterly Information at Practice Level • Emailed to each Practice Based Commissioning Lead • Posted onto PCT website • Routine agenda item at Locality and commissioning cluster meetings NB: No longer anonymised

  11. First Outpatient Attendances per 1,000 Weighted Patients and Conversion Rates 2005/06 EXTRACT: LOCALITY B 400 70% 350 60% 300 50% 250 40% Conversion% 200 First OP attendance/1,000 Weighted Patients 30% 150 20% First Outpatient attendances 100 2005/06 (Left Hand Axis) Conversion rates 05/06 10% 50 0 0% 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Practice

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