“Reported improvements in the UK tracked with recent reforms”

1. “Reported improvements in the UK tracked with recent reforms” Cambridge Centre for Health Services Research University of Cambridge

2. Reported improvements in the UK tracked with recent reforms: Overall rating Cambridge Centre for Health Services Research University of Cambridge

3. Reported improvements in the UK tracked with recent reforms: Coordination Cambridge Centre for Health Services Research University of Cambridge

4. Reported improvements in the UK tracked with recent reforms: Access Cambridge Centre for Health Services Research University of Cambridge

5. How can we explain these results • Major policy focus on reducing specialist waiting time. • Policy focus and financial incentives to reduce waiting time for primary care appointments. • Continued focus on primary care as building block of healthcare • Increased use of electronic records • Initiatives to improve coordination of care: mostly primary care led, e.g. disease management protocols in P4P scheme, case management of frail elderly • (….surprise) • (….and do we need another major reform?) Cambridge Centre for Health Services Research University of Cambridge

6. Complex patients don’t necessarily account for a disproportionate share of spend – just a high proportion Cambridge Centre for Health Services Research University of Cambridge

7. John Øvretveit (2011)asked the question “Does clinical coordination improve quality and save money” Answer: Yes it can, but that the answer depends on the approach used, how well it’s implemented and the environment in which it’s introduced. www.health.org.uk/publications/does-clinical-coordination-improve-quality-and-save-money/ Cambridge Centre for Health Services Research University of Cambridge

8. Summary of a systematic review on the effectiveness of interventions to improve coordination in health care • 55% of interventions improved care • 45% of interventions improved patient experience • 18% of interventions reduced cost http://aphcri.anu.edu.au/research-program/aphcri-network-research-completed/stream-four-translating-evidence-policy/coordination-care-within Cambridge Centre for Health Services Research University of Cambridge