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Strategic Business Plan for the Joint Commissioning Unit

Strategic Business Plan for the Joint Commissioning Unit. A Business Plan to reduce the current c.£140 million/yr by 20% over 3 years. Commissioning Matrix.

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Strategic Business Plan for the Joint Commissioning Unit

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  1. Strategic Business Plan for the Joint Commissioning Unit A Business Plan to reduce the current c.£140 million/yr by 20% over 3 years

  2. Commissioning Matrix • A Commissioning Matrix has been developed to gain a panoramic overview of expenditure across the JCU – both NHS and Council. This reveals: • comparative spend between service areas e.g. OP, MH LD, PD, Carers • comparative spend between prevention and core services • comparative spend between service types e.g residential v community • comparative spend between NHS and Local Government • Comparative spend between in-house (e.g. NHS) and external • distribution between providers • distribution in/out of Borough • provides opportunity to improve value for money e.g. unit costs • provides opportunity for service and provider rationalisation

  3. Version 4 05.07.10 Agenda Item 7.4 Supporting citizens to stay independent longer Those not eligible for a package can get further information Review may suggest enablement Assessment and Resource Allocation Enablement Validate Resource Allocation Support plan Authorise & Validate Go live Monitor & review Universal Services, Prevention And early Intervention First contact advice and signposting Meet immediate needs and enable Council Self-directed support Continually look for opportunities to enable, signpost or give advice to increase independence Encourage to the left, not inevitable drift to the right Early intervention and prevention

  4. Shift demand to lower cost interventions • High focus on value for money on core high Core Prevention tertiary Cost Enablement secondary Universal primary low high low Number of citizens

  5. JCU as an engine of change for improvement and value for money • Clear assignment of lead roles/duties within overall commissioning matrix • Prioritise workloads so that challenging but achievable – manage individual performance • Leave enough room for relationship building • Publish clear commissioning plans based on ongoing annual cycle with involvement of all main parties • Set grounds for de/re-commissioning – use procurement wisely and effectively

  6. Benefits The JCU Business Plan will aim to reduce the current c £120 million per year of spend by 20% over 3 years. We shall do this by obtaining: 1) Value for money (VFM) from the Core services that do meet needs effectively (i.e. standard fee levels instead of individually negotiated) 2) Savings from keeping Service Users in high cost services for as long as they need to be (i.e. emphasis on rehabilitation, recovery, intermediate care) 3) Savings because citizens will be signposted/diverted to alternative services, rather than to the core, costly services 4) Savings because there will be a range of interventions to help people stay independent longer 5) Further commissioned prevention services which the resultant savings will be reinvested in further prevention services

  7. Roles and responsibilities • Clear recognition of both strategic and operational roles/activities • Each Joint Commissioner working on a discrete set of work objectives • Each to develop a core set of skills and competencies

  8. Structure Chart

  9. Next Phase Each commissioner to be set goals for: • Developing preventive services with explicit cost savings for the core matrix • Challenging and achieving Value for Money from within the core matrix All to be brought together as a single cohesive Cost Improvement/Business Plan for the JCU

  10. Service Developments Historical Service Model Target Operating Model

  11. Historical Operating Model • Services purchased by Councils • Traditional approach – legacy services • Narrow range of choice • Special Relationships • ‘Cottage Industry’ – “small, inexperienced providers” • ‘Open Cheque Book’ – provider led fees • Workforce problems • Short sighted and ineffective commissioning

  12. Target Operating Model • Services purchased directly by consumers • Individual budgets – self funding • ‘Menu’ of services with clear tariffs/fees (RAS) • Wider range of care and support – wider choice • Independent brokerage, navigation, advice and advocacy – shifts focus from inputs to outcomes • Strategic procurement – framework agreements • No special relationships • Smarter Commissioning

  13. Strategic Context

  14. Commissioner led Developments - General

  15. Commissioner Led Developments - specific

  16. Prevention 1 of 2 System Component Allocated Lead QIPP Value 1 - Domiciliary Care/Community Support procurement Tracy Simcox £16.7m 2 - 3rd Sector Development/co-production Tracy Simcox/Anne Doyle 3 - Housing Related Support Toolkit Tracy Simcox/Carol Jones 4 - JCU Contracts Register Tracy Simcox/Carol Jones Prevention Agenda 5 - Prevention Strategy Tracy Simcox 6 - Procurement Flowchart and supporting documents Tracy Simcox/Carol Jones 7 - Micro Markets Co-ordinator Tracy Simcox 9 - JCU Contract/range of schedules Tracy Simcox/Carol Jones 8 - Key Ring Living Support Networks Tracy Simcox Tracy Simcox 10 - Business Support

  17. Prevention 2 of 2 System Component Allocated Lead QIPP Value 11 – Community Meals Anne Doyle 12 – Benefits Based Charging Anne Doyle 13 – OP Panel Tracy Simcox/Carol Jones/Anne Doyle 14 – Electronic Monitoring System Tracy Simcox Prevention Agenda

  18. Complex Care System Component Allocated Lead QIPP Value Screening for Continuing health Care Hazel Wilkes Full Assessment- Decision support tool- MDT Hazel Wilkes Combined QIPP Value Commissioning CHC Providers residential and home based Hazel Wilkes Rehabilitation (Traumatic brain injury) Hazel Wilkes Improving the Quality of Life in Continuing Health Care Funded Nursing Care-process Jane Robinson Commissioning CHC assessors in Hospital DLT Hazel Wilkes Eligibility Panel Weekly Tracey Everitt/Caroline Adams Embedding Transition Tracey Everitt Commissioning Outreach Assessment Team Hazel Wilkes Hazel Wilkes/Caroline Adams Personalisation

  19. Mental Health 1 of 4 System Component Allocated Lead Value Enhanced Primary Care Anet Baker £1,839,204 Community Mental Health Teams (transformation project) home treatment/crisis Anet Baker £2,331,469 Combined QIPP Value = TBC Resolution (transformation project) £1,663,789 Anet Baker Early Intervention £503,728 Anet Baker Prevention Agenda Early Interventions Eating Disorders (Black Country project) £41,652 Anet Baker Day and Vocational Services (transformation project) £489,122 Marcus Law Day Services Older People (transformation project) £620,952 Michael Hurt £4,721,503 Individual Packages of Care/Social Care Marcus Law Community Rehab/Assertive Outreach (transformation project) £1,170,621 Anet Baker Anet Baker TBC Electro Convulsive Therapy

  20. Mental Health 2 of 4 System Component Allocated Lead QIPP Value Psychiatric Liaison (transformation project) Anet Baker £128,779 Carer Support Service Anet Baker £34,125 Combined QIPP Value = TBC Memory Clinic (transformation project) £601,159 Michael Hurt Older Peoples Mental Health Teams (transformation project) £1,901,415 Michael Hurt Prevention Agenda Early Interventions Older Peoples Rapid Access Team – new procurement project £352,000 Michael Hurt Older Peoples Inpatient Services – (transformation project) £3,290,810 Michael Hurt Adult Inpatient Services (Black Country Capacity Planning Project) £15,734,563 Anet Baker Marcus Law TBC Out of Area Placements/NHS funded (QIPP) Community Development Workers (Transformation project) £124,039 Anet Baker

  21. Mental Health 3 of 4 System Component Allocated Lead Value Accommodation Market Development Mark Williams TBC Accessing suitable housing options Mark Williams TBC Combined QIPP Value = TBC Consultant Services Adult £1,493,112 Anet Baker Consultant Services Older People £271,267 Michael Hurt Prevention Agenda Early Interventions Adult Mental Health Employment Service(transformation project) £36,387 Marcus Law Criminal Liaison Service £72,988 Anet Baker IMCA/IMHA £77,000 Anet Baker/ Michael Hurt TBC Out of Area Placements Marcus Law/ QIPP Lead Dementia Prevention & Early Intervention TBC Michael Hurt/ QIPP Lead Anet Baker/ QIPP Lead TBC Early Interventions in Psychosis

  22. Mental Health 4 of 4 System Component Allocated Lead Value BUPA Elmore Michael Hurt £622,752 WPH (transformation project)) Anet Baker £107,000 Combined QIPP Value = TBC Walsall Black Sisters £50,000 Anet Baker IMCA (Black Country procurement project) £47,000 Anet Baker Prevention Agenda Early Interventions ReThink - transformation project TBC Marcus Law New Project – Pro Vision IALT Campaign TBC Helen Cook Alzheimer’s New Project – Information Service for GPs (web based) TBC Helen Cook Age Concern Dementia Michael Hurt £107.000 £12,300 Michael Hurt Anet Baker £600 Asian Womens Support

  23. Unscheduled Care 1 of 2 System Component Allocated Lead QIPP Value Frail & Elderly Crisis PID Jane Hayman Urgent Care Centre Joyce Bradley Combined QIPP Value = £2.9mil Unique Care Mike Johnson Rehabilitation (Step Up / Step Down ) Jane Hayman Prevention Agenda Winter Pressures Community Nursing Services JCU Led Telehealth / Telecare Gill Grigg Hospital Discharge Jane Hayman Falls / Osteoporosis / NoF De-prioritised Patient Education Peter Mitchell Paulette Myers & Jane Hayman Stroke

  24. Unscheduled Care 2 of 2 System Component QIPP Value Allocated Lead Winter Pressures Development Sub Acute Unit Jane Hayman Residential & Nursing Homes H21 Extra Care Non H21 Extra Care Residential & Nursing Care Lloyd Brodrick Quality In Care Homes Lloyd Brodrick Sally Roberts Combined Value £38.2mil Extra Care Housing 21 Contract Management Lloyd Brodrick Reprovision Project Management Lloyd Brodrick Non H21 Extra Care Lloyd Brodrick H21 Contract Monitoring Peter Blackburn Claire Hammond Service Development JCU Support Tracey Martin Care Homes Closure Prog: Peter Blackburn Tracey Martin Performance Management

  25. Disabilities 1 of 2 System Component Allocated Lead QIPP Value Care pathways All 3 disabilities commissioners Forensic step down service NHS Walsall Stuart Lackenby Combined QIPP Value = £ Assessment and treatment service Stuart Lackenby Transforming community services Ian Staples Disaggregation of Pooled budget Ian Staples Information and Advice Natalie Borman Stuart Lackenby Personalisation In house day service development All 3 disabilities commissioners Autism Ian Staples Transitions Ian Staples Natalie Borman ICES/telecare/telehealth

  26. Disabilities 2 of 2 System Component Allocated Lead QIPP Value RAS development Stuart Lackenby Centre for Independent living Natalie Borman Combined QIPP Value = £ Extra care Housing Stuart Lackenby User led organisation Natalie Borman Stuart Lackenby Personalisation Employment Ian Staples Out of Area All 3 disabilities commissioners HollyBank redevelopment Natalie Borman Personal Budgets Stuart Lackenby Residential – Supported living All 3 disabilities commissioners Natalie Borman Reablement pathway

  27. Focus “Everything we do will improve the experience of using the service, and value for money”

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