Leodis Practice Manager’s Development Programme

1. Leodis Practice Manager’s Development Programme Chris Reid Chief Executive

2. New Commissioning Landscape Clinical Commissioning Groups Local Authority NHS Commissioning Board

3. CCGs - The Burden of Expectation Local Population NHSCommissioning board Leodis Leodis

4. Dr Johnny Marshall NAPC Chair However we, ……… know where waste exists, which tests are duplicated by secondary care, which hospitals deliver good outcomes, which patients need attention most urgently and which practices are underperforming.'

5. Primary Care Know About • GPs Clinical decisions impact on the use of resources- absorbing clinical and financial risk • GPs know how to cut costs safely • GPs deliver the patient experience • GPs deliver Clinical effective interventions • GPs deliver patient safety • GPs know where the waste is (Productivity) • Most GP’s want to do it all better (Innovative)-’make more and but less’

6. Creating our Legacy Leodis Values Patient Centric – we will put patients at the centre of everything we do Safety and Quality – we will never compromise safety and quality at the expense of cost savings Evidence Based – we will be committed to promoting adherence with evidence based guidelines Best Use of Public Money – we will demonstrate strong governance and accountability to assure we are achieving best value for money Partnership Working – we will be proactive in seeking opportunities to advance our cause through joint collaboration with neighbouring commissioners; acute, mental health & community trusts; local authority; and other key stakeholders.

7. Transforming our Health Care System – 6 Priorities "If you always do what you've always done, you'll always get what you've always got." Henry Ford (1863-1947), American founder of the Ford Motor Company

8. Integrated Care Closer to Home Why? Current system often fragmented High rate of avoidable acute admissions Demography & incidence of LTCs major service & financial challenge How? Integrated Health & Social Care Teams aligned to Practice population – eg, Garforth/Kippax Demo Site Risk Strat clinical data shared across multi-professional teams Act on data with a range of interventions to meet needs – eg, case management, telehealth & personalised health care plans Impact? Better outcomes Higher patient satisfaction Lower cost

9. Developing Strong Practice Engagement through Localities Why? Scale of referrals and cost to the health system (65K referrals/£11m) Variation between Practices need to be tested as a quality issue (ENT 6 fold variation) Good practice should be shared as part of continuous improvement How? Not Referral Management Centres Open sharing & use of comparative information between Practices and between GPs within individual Practices Systematic review and audit and retrospective review to measure impact Impact? Improving referral quality can impact on Health outcomes Positive impact on patient experience by avoiding unnecessary visits & improving timeliness of treatment Referral audits can improve the quality & cost effectiveness of clinical care

10. Self Management & Self Care Why? At the heart of the LTC Programme is the informed patient with access to continuous self management support 70% of people with LTCs can be supported to manage their own conditions (DoH 2005) Can help change the patient – care giver relationship into a collaborative partnership How? Maximise use of patient & carer education programmes Patient access to their own records Training for clinicians in consultation skills that help engage patients Impact? Potential to improve health outcomes Improve patient experience in terms of general confidence & reduced anxiety Reduce unplanned hospital admissions and improve adherence to treatments & medication

11. Promoting Health & Wellbeing Why? Estimated that 80% of cases of Heart Disease, Stroke & Type 2 Diabetes could be avoided if common lifestyle risk factors were eliminated (WHO 2005) Primary prevention is cost effective when compared to treatment & curative interventions Financial sustainability of NHS depends on primary prevention to reduce the overall burden of disease in the population How? Ensure equitable access to specialist services – eg, obesity programmes Use Risk Strat to identify “at risk” patients Ongoing systematic management Impact? Improve outcomes - eg smoking quit rates Reduce costs Reduce inequalities

12. Effective Medicines Management Why? Prescribing costs are rising at a relentless rate at a time of no growth funding Medication errors occur and adverse drug reactions can lead to hospital admission Estimated that one third of all medication prescribed for LTCs are not taken as recommended/wasted How? Embrace the support of the Leodis Medicines Management Team attached to your practice Providing practices with benchmarked information on prescribing performance Medication reviews through audit and peer review Impact? Helps patients manage their medications better Improve the quality and safety of prescribing Major impact on costs through cost effective prescribing and reducing drug waste

13. “At the heart of an excellent CCG are excellent practices”