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DacCom PbC Ltd Patient Activity Reporting Service

DacCom PbC Ltd Patient Activity Reporting Service. Gerry Bulger Mark Jones 2 July 2007. SUS DATA: it asks the questions. Dacorum Practice X Dacorum Practice Y Standardised comparator rate 2005/6 Accident and Emergency Use

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DacCom PbC Ltd Patient Activity Reporting Service

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  1. DacCom PbC LtdPatient Activity Reporting Service Gerry BulgerMark Jones 2 July 2007

  2. SUS DATA: it asks the questions Dacorum Practice X Dacorum Practice Y Standardised comparator rate 2005/6 Accident and Emergency Use The latest data available on NHS comparators is the first two quarters of 2006/7 PARS DATA provides the answers for PBC to act Mark Jones

  3. Why PARS • Why the difference and how? • Is it coding? Is it accurate? • How to change it? • Similar, but unknown, processes are going on within larger practices. • What is the nature of the referrals? • What are the processes involved and how can we act to change it? • What are the learning needs? • What new services are needed, if any? • We do not know of changes that occurred last month, nor of the current month’s activity and we have no prospective activity data. • PBC is a clinical process, not simply a contractual one. PBC requires clinical data. Mark Jones

  4. Why do we need PARS? • Objective: savings of at least £1.2 million per annum: • Referral managementContinuous learning through analysis of PUNs & DENs • Patient pathwaysUnbundle the tariff – provide only those parts of the service the patient needsCare shared between secondary and primary providers • Service provisionPrimary care led services provided on average 20% below tariff • We need accurate, real time data, trusted by GPs with full clinical detail Mark Jones

  5. Why is PARS different? • Database is derived from the referral letters • Not last quarter’s activity, not even current activity, but current and projected activity • Allows intervention where appropriate via PUNs & DENs • Allows efficient validation of hospital activity data • Allows analysis of clinical outcomes, which we will use to create new pathways • Prevent increase in activity caused by new service provisions. Immediate data will enable limits on Practice Based Providing. PARS will aid PBP business cases. and…. Mark Jones

  6. Why is PARS different? • Supports the development of accurate business cases • Prevents cost increases arising from development of new services / increased capacity • Provides real-time monitoring of GP responses to referral management initiatives • Enables rapid improvement cycle times • Data is trusted, promoting GP engagement and ownership Mark Jones

  7. Mechanisms for action • Intervention in the individual referral where appropriate • Monthly report of activity, issues and priorities assessed with the practices • Participation is mandatory, actions are agreed and followed up • This is effective because data is timely, accurate and trusted • Quarterly demand management workshops to generate new initiatives • Close liaison with the commissioners to initiate pathway redesign and create opportunities for primary care providers Mark Jones

  8. Costs & funding • Activity in the practices funded by the PBC LES • Central costs of £1.33 per patient in 2006/7 = £186k • £29k pump-priming from 2006/7 DES • £157k from top-slice of DacCom’s indicative budget • For comparison…..….. funding for the patient survey in Dacorum is £210k pa Mark Jones

  9. Governance • A separate legal entity • With its own contract, responsible for success or failure and bearing the financial risk regarding its own costs • Clinically led and controlled • Reporting to an independent project board Mark Jones

  10. What if it works? • A cheaper, more effective model than CAS / CATS • Engaged and empowered GP community • Preventing new services increasing activity • Dramatic financial savings • Rapid progress with secondary to primary shift • National visibility Mark Jones

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