Flexible Healthcare Breaking Down Barriers

1. Flexible HealthcareBreaking Down Barriers Judith Newman Director of Secondary Care Development NHS Somerset Peter Lewis Deputy Chief Executive / Finance Director Taunton and Somerset May 2009

2. Potential Barriers to Success • Payment by Results • Organisational Boundaries • “Blockers” • Existing processes – flexibility / complexity • Targets / standards • Payment ‘rules’ / Contracts • Complexity of need / service provision • Organisational interfaces • Alignment of organisational objectives

3. Drivers for Change • Patient Experience • Waiting Times • Changing Economic Context

4. NHS Growth

5. Approach • Based on needs of patients • What do pathways look like? • Responsiveness and Flexibility

6. Payment by Results • Mechanism to support and drive change • Potential to drive ‘wrong’ behaviour • Necessary framework to support complexity • What is the need • How can the need be met • What are the implications and risks

7. Targets and Standards • Best practice / quality / safety • Targets as drivers for change (i.e. waiting times) • New levers for change - validation

8. Care Pathways Referrer Outpatient Attendance Pre – Op Assessment Elective Spell Discharge Diagnostics Referrer Outpatient Attendance Pre – Op Assessment Elective Spell Discharge Diagnostics

9. Care Pathways Referrer Outpatient Attendance Pre – Op Assessment Elective Spell Discharge Diagnostics Referrer Outpatient Attendance Pre – Op Assessment Elective Spell Discharge Diagnostics

10. Care Pathways Referrer Outpatient Attendance Pre – Op Assessment Elective Spell Discharge Diagnostics Referrer Outpatient Attendance Pre – Op Assessment Elective Spell Discharge Diagnostics

11. What is Important? • Leadership • Doing the right thing for the right reasons • Commitment = Ability to Overcome Barriers