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Flexible Healthcare

Flexible Healthcare. Dr Donal Hynes, Chair of Professional Executive Committee. What is it?. No wait for anything Everything done in a single encounter Everything done in the patient’s home. How do we communicate it?. I only mentioned a twinge – I don’t want my hip replaced NOW!.

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Flexible Healthcare

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  1. Flexible Healthcare Dr Donal Hynes, Chair of Professional Executive Committee

  2. What is it? • No wait for anything • Everything done in a single encounter • Everything done in the patient’s home

  3. How do we communicate it?

  4. I only mentioned a twinge – I don’t want my hip replaced NOW!

  5. Communication Strap Line Right Care Right Here Right Now

  6. Narrative • Clinicians are good at telling stories

  7. F/U RoRx Oncol MDT Stage Scan Refer OPD Result Biopsy Cancer Narrative

  8. That Morning Consultation Biopsy Histology Diagnosis Scan Staging MDT Oncology Plan Cancer Narrative Refer

  9. Narrative • Make a narrative for your specialist area

  10. Challenges • Capacity • Vertical Integration • Horizontal Integration • Management of capitated budgets • Safeguarding Choice and Competition • Financial Implications • Employment status

  11. Capacity • Steady line state 18 weeks

  12. Capacity 0 weeks

  13. Capacity • Clinicians do not work harder • It is the system that needs to be changed to meet clinicians’ needs

  14. Vertical Integration • Generalist: Risk Management • Specialist: Discriminatory skills Gen Spec Gen Spec

  15. District Councils Social Services Mental Health Vol Organiztns Horizontal Integration • Depression and Housing • Cancer and Benefits • Post Cardiac Mortality and Deprivation NHS

  16. Capitated Budget • How much do we spend per individual per year? • What level of risk? • What formula to apply? • How to apply the funds?

  17. Safeguarding Choice

  18. Safeguarding Competition • Cosy Collusion • What is competition? • Competition with or competition in • AWP or AWPI • Strategic development partnership with gainshare

  19. Financial Implications • PbR, PBC, FTs • Customer (commissioner) • Currency Transaction (Tariffs and PbR) • Provider (FTs, GPs)

  20. Financial Implications • One Stop Shop • Primary Specialist split • Social and Health resource streams

  21. Doctor Employment Status • National GP contract • FT contracts • Nascent organizations

  22. Our Challenge • In the most perfect world we all know what we would like to do (and receive) • How to use Flexible Healthcare to achieve this

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