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How do you innovate when the NHS budget is no longer growing?

Online Learning Series Right Care for Populations. How do you innovate when the NHS budget is no longer growing?. Sir Muir Gray Joint National Director, Right Care August 2013. Five major problems . ..all health services, world wide, still face 5 major problems.

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How do you innovate when the NHS budget is no longer growing?

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  1. Online Learning Series Right Care for Populations How do you innovate when the NHS budget is no longer growing? Sir Muir GrayJoint National Director, Right Care August 2013

  2. Five major problems.. ..all health services, world wide, still face 5 major problems • failure to prevent preventable disease • inequity • patient harm, even when quality is high • waste of resources • unwarranted variation in: • - activity • - quality, safety • - outcome & cost = value

  3. A Paradigm shift is needed…

  4. The third healthcare revolution… …clinicians as “stewards”

  5. Triple Value Programme Individual & Personalised Allocativeresourcesdistributed to optimise value Technical, resources used to best effect

  6. A New Culture Focus on value Patient Centred Population Based Systems Clinicians as Stewards

  7. Allocating resources - Commisioners Mental Health Cancer Respiratory Programme Budgeting, & the use of Marginal Analysis for reallocation is a commissioner responsibility, with public involvement Gastro- intestinal

  8. Complexity and Complications Mental Health Cancers Respiratory Gastro- intestinal Many people have more than one problem ; GP’s are skilled in managing complexity

  9. Allocating resources - Clinicians Asthma COPD (Chronic Obstructive Pulmonary Disease) Apnoea Cancers Respiratory Gastro- instestinal Triple Drug Therapy Rehabilitation Smoking cessation Within Programme, Between System Marginal analysis is a clinician responsibility O2

  10. The STAR Tool http://www.health.org.uk/areas-of-work/star/

  11. Innovation Asthma COPD (Chronic Obstructive Pulmonary Disease) Apnoea Cancers Respiratory Gastro- instestinal Triple Drug Therapy Rehabilitation Smoking cessation O2

  12. Technical efficiency Value = Outcomes / CostsOutcome = Good – Bad Outcome = Effectiveness (EBM + Quality) – Harm (Safety) Costs = Money + time + Carbon

  13. The future • Need and demand will always increase faster than resources • More of the same is not the answer – we need innovations# • Programme Budgeting • Within Programmes – Marginal Analysis • Clinicians and patients as “stewards” of the resource • Innovation, not only in technology, but in the way we think

  14. Online Learning Series Right Care for Populations • Follow Right Care online • Subscribe to get a weekly digest of our blog alerts in your inbox, • Receive occasional eBulletins • Follow us on Twitter @qipprightcare Find the full series at: www.rightcare.nhs.uk/resourcecentre

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