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Locality clinical partnerships – principles for contracting & funding Martin Hefford. 8 December 2011. Locality Clinical Partnership Objectives. Deliver Better, Sooner, More Convenient Healthcare Improve patient health outcomes Reduce avoidable hospitalisations
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8 December 2011
Locality Clinical Partnerships to commission and review the work
Source: PHO enrolment register Quarter 3, 2011, analysed by CMDH, December 2011
PHO funding and monitoring frameworks include proportion of enrolled population defined as ‘high need’ – Maaori, Pacific or living in area defined as high socioeconomic deprivation (NZDep, quintile 5)
Note, crude rate not age standardised,
PHO 1, 2, 3
Locality clinical network
Management support – enablers, IS, reporting, project management
Funds that would have been used for extra hospital staff/resources will be invested in primary & community settings to buy additional services.
Net gains to be re-invested in extra primary / community services – locality clinical leadership groups to advise on use.
Risk of poor outcome to be shared between DHB and primary care partners (say 75:25).
Acute demand targets & gains to be allocated by locality.
Develop locality clinical leadership groups
Use 20,000 better care days as an initial programme for contracting
Use Better Sooner More Convenient Business cases to develop alternative models of care & service integration plans for localities
Develop shadow budgets
Put in place partnership agreements
Monitor performance, evaluate, and adjust over time.
Do we want to share some risk with primary care?
Do we agree to take the largest share of risk?
Do we agree that LCPs should decide on the use of any conserved resources?
Locality Clinical Partnerships could be as an alliance agreement or a formal joint venture – thoughts?
Proposed that the agreement is with PCOs (or PHOs?) but the network is wider. Thoughts?
Do we consider that future employment of community health staff could change?