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ELIC. PAUL HAIGH - EXECUTIVE DIRECTOR. WHAT?. E ast L ondon I ntegrated C are City & Hackney ELIC Society Ltd BENCOM Registered in July 2006 Industrial & Provident Societies Act 247 members; represent 232,000 patients/34 practices 2 roles PBC support service Direct service provision.
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ELIC PAUL HAIGH - EXECUTIVE DIRECTOR City & Hackney ELIC Society Ltd.
WHAT? • East London Integrated Care • City & Hackney ELIC Society Ltd • BENCOM • Registered in July 2006 • Industrial & Provident Societies Act • 247 members; represent 232,000 patients/34 practices • 2 roles • PBC support service • Direct service provision City & Hackney ELIC Society Ltd.
WHY? • Size matters • Work together; strengthen provision; equity • Opportunity of PBC to develop primary care • Unified commissioning plan • Harness the enthusiasm of the front line • Organisational clout • Bid for and provide services; compete City & Hackney ELIC Society Ltd.
ORGANISATION • Membership - 247 • GPs; Practice Managers; Practice Nurses; Practice staff; employees?; Public • Organised into constituencies (for GPs based on Consortia) • Elect representatives onto quarterly Council • Overall policy and direction • Includes PEC Chair • Day to day management by monthly Clinical Executive • Council Chair + 2 GPs + Exec Director (paid roles) • Leadership, implementation, thinking City & Hackney ELIC Society Ltd.
PBC SUPPORT SERVICE • 89% Hackney practices - 7 Consortia • 95p per patient from practices • Covers 100% of infrastructure (small!) • Business support - plans; data; ideas • Uniform approach • Commissioning “clout” • Pooling of 50% PBC savings City & Hackney ELIC Society Ltd.
ELIC ROLE • Bureaucracy relating to PBC • Business cases • Data analysis • What’s best done at individual practice and what done “corporately” • Practice – new opd referrals, patient education/A&E, follow pathways, interpractice referrals, ?community matrons/emergencies City & Hackney ELIC Society Ltd.
PHILOSOPHY • Support practices through education and training • Care pathways with Homerton- 12 to date • Education, audit, education • Sharing best practice and ideas - Consortia • Maximise primary care services • Consultant advice/support and outreach City & Hackney ELIC Society Ltd.
ACHIEVEMENTS • Savings £2.5m over 2 years • Pathways and education • Specifications for services – with all PBCers • Community nursing • Urgent Medical Clinic • Heart failure, diabetes, COPD, Cardiology • New practice/Consortia services planned this year • Practice physio; Obesity support; Investigations • Advocacy; Active patient monitoring • Support practices to provide primary care/new lists City & Hackney ELIC Society Ltd.
DIRECT SERVICES • Contract from PCT for ENT • Delivered via 4 subcontracts • Pooled savings - 2007/8 (900k) under development • At risk COPD • Obesity • Antenatal services • Drug monitoring • “Willing provider” • Surgery • Heart failure team • COPD team City & Hackney ELIC Society Ltd.
RELATIONSHIPS • PCT • Represented on monthly PBCE • Commissioning framework input • Renegotiate PBC Framework • Commissioning plans/performance indicators • Homerton • Bimonthly Liaison Group • Individual clinical and managerial meetings City & Hackney ELIC Society Ltd.
HACKNEY POLYCLINIC • Primary Care Resource Centre • Networked practices • Intermediate services • Chronic disease management to back up primary care • Antenatal • Surgery • Consultant advice and outreach • Pathways City & Hackney ELIC Society Ltd.
QUESTIONS FOR FUTURE • Commissioning PCT services • GPSI, specialist nursing • Define service standards • Specify where fit into pathways • ?More direct provision • NHS Pensions - ELIC “trading arm”? • Primary care services – support vs provide • Organisational capacity/growth • VFM City & Hackney ELIC Society Ltd.