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CCG Perspective on Integrated System Redesign Tim O’Donovan September 17th 2013

CCG Perspective on Integrated System Redesign Tim O’Donovan September 17th 2013. The existing MSK system. MSK System Redesign: the redesign of services that diagnose and treat bone, muscle , and tissue conditions and disorders, and associated pain (ICD-10 Chapter XIII, M00-99)

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CCG Perspective on Integrated System Redesign Tim O’Donovan September 17th 2013

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  1. CCG Perspective on Integrated System Redesign Tim O’Donovan September 17th 2013

  2. The existing MSK system • MSK System Redesign: the redesign of services that diagnose and treat bone, muscle, and tissue conditions and disorders, and associated pain (ICD-10 Chapter XIII, M00-99) • Includes elective orthopaedics, rheumatology, physiotherapy, podiatry and chronic pain • Excludes trauma and non-elective activity • MSK patient population approx. 45,000 • Over 25 different provider contracts • Total budget circa £25 million

  3. The challenge: the patients’ view • Referred to the wrong service/clinician • Frustrated by no direct referral from part to the system to another: “ping ponged back to GP” • Continual onward referral to different elements of care until diagnosis is received • Poor co-ordination of information and administration across the system • No integration with social care at assessment • Long waits for and within outpatient clinics • Difficult to get in contact with team post-op

  4. BCCG MSK Strategic Vision • The White Paper: Liberating the NHS, provides an opportunity to move towards integrated systems of care • BCCG response to the opportunity and challenges highlighted • Encourage integration of services through a system contract with aligned incentives, improving the co-ordination of patient care through a PRIME CONTRACT • Commissioning for outcomes, better value and less waste, with patients getting the right care in the right place, first time • Empower clinical leadership to challenge and champion, and to develop new ways of providing care across the pathway

  5. Specification • Single budget, prime contract for 5 years • Four main types of care: • Patient support and empowerment • Support, education and advice for primary care • Community-based MSK service • Use of hospital facilities only when those facilities are needed • Incentivised game-changing outcome measures

  6. Prime Contractor

  7. National Context • Prime Contracting • Alliance Contracting • Integration • Incentives • Payment/Capitation/PBR • Outcome Focus • System Approach

  8. Members Involvement • Approach your local CCG/s, overview and scrutiny, opportunities, good ideas e.g. joint injections • Opportunity to get involved through workshops, clinical networks – Output is influencing specifications, KPIs, outcome measures • Check supply to health – advertising market engagement workshops, procurements • Are you linked in locally? Discussion with local colleagues on provision, federation, consortia, stand alone practice

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