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Equity and Excellence: Liberating the NHS What does it mean for North Somerset?. Chris Born Chief Executive. No decision about me, without me Best outcomes not targets Empower clinicians New Health P artnership Patients empowered through transparent information.
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Equity and Excellence: Liberating the NHSWhat does it mean for North Somerset? Chris Born Chief Executive
No decision about me, without me • Best outcomes not targets • Empower clinicians • New Health Partnership • Patients empowered through transparent information
Local authority leads the Health & Wellbeing Board from 2012 • New Healthwatch to replace the Local Involvement Network (LINk) - 2012 • Public health department moves to the Council - 2013
GP Commissioners (GPC) • North Somerset GPC Consortium - 2012 • Shared commissioning of hospitals (and mental health?) across wider area • National Commissioning Board for some services - 2012
All existing PCT community services • New social enterprise from April 2011 • Focus on integrating care with social services and hospitals • www.northsomerset.nhs.uk • Comments by 23 February
PCTs abolished 2013 • NHS South West (SHA) abolished 2012 • PCTs will work as a cluster as management reductions occur • Stronger external regulation of the system as now
Operating Framework 2011/12 • Mental Health Strategy due out 2011 • Public health • Better service outcomes • Early intervention and prevention (e.g. offenders) • Drug services • IAPT expansion to young, old, severe mi, long term conditions • Victims of violence
Operating Framework 2011/12 • Greater choice of treatment and provider • Improve services for veterans • Support for carers • Fines for mixed sex accommodation (including day areas) • Key measures (e.g. early intervention, crisis/home treatment, CPA, IAPT) remain for 2011/12
New outcomes for 2012/13 (e.g. preventing premature death in people with severe mi, employment, experience of service)
Finance • Service providers: 4% efficiency per year • Commissioners: similar amount via service redesign • Total: £20bn savings over 4 years (e.g. £12m for NS in 2011/12) • North Somerset: 4.1% growth (vs. average of 2.2), but 7.2% below target (£22m) • Management reductions • Pay freeze if earning > £21k • Mandatory use of mental health clusters
WORKING AGE ADULTS AND OLDER PEOPLE WITH MENTAL HEALTH PROBLEMS Non-psychotic Psychosis Organic Mild/ moderate/severe Verysevere and complex Substancemisuse Firstepisode Severeongoing Acuteemergency Verysevereengagement Cognitiveimpairment 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
THREEKEY BENEFITS FROM PBR : • BECAUSE CURRENCIES ARE NEEDS BASED THEY SHOULD GIVE COMMISSIONERS A CLEAR IDEA OF THE BALANCE OF NEED AMONGST THOSE ACCESSING SECONDARY SERVICES AND HELP SERVICE PLANNING/PRIORITISATION • PBR SHOULD ENSURE A REGULAR AND TIMELY FLOW OF INFORMATION TO THE COMMISSIONER ON WHAT IS HAPPENING TO THEIR USERS AND ON INDIVIDUAL USER OUTCOMES • BY THE USE OF STANDARDISED CURRENCIES AND POTENTIALLY TARIFFS, VFM CAN BE BETTER EVALUATED, COMPARED WITH BENCHMARKS AND IMPROVED