Adult HIV Outpatient PBR Tariff Development National Reference Group Meeting 21/05/10

1. Adult HIV Outpatient PBR Tariff DevelopmentNational Reference Group Meeting21/05/10

2. Welcome and Introductions

3. Chair Opening RemarksRecap:DH SponsorshipNRGTask/Working GroupsInitially covering Birmingham, Greater Manchester and LondonCommissioners, Clinicians, Finance, HPA, BASHH, BHIVAIncrease in SHA region participation in costings and working groupsBroadening expertise, input and participation prior to national consultation

4. Project Principles RecapNational mandatory tariff based on open access with appropriate reimbursements for providersAdult service outpatient tariffAgreed national pathway based on national standards of care and ensuring quality of care and outcomesBased on patient year of careHigh cost diagnostics includedSystem will validate in year movement in patient caresubsequently: (PWC evaluation recommendations)ARV drugs options considered through scoping and feasibilityPotential data flow through SUSReview of national standards within service provision

5. Rapid Assessment Feedback and Project Way Forward

6. Rapid Assessment(in acknowledgment of lack of project management and leadership and potential project drift)PM and PL undertook a series on one to one and small group consultation on status of project and key issues with current NRG and other stakeholdersIncreased links to other regions and participated in SHA or network meetings to provide information on project and solicit key participants and contacts

7. Rapid assessment feedback:Still strong support for project and strong commitment by current participantsWillingness to increase and involve new stakeholders with people keen to be involvedClear need for strengthened project plan, key outcomes and better communication both within current stakeholders and externallyStability with project team and DH commitment Restate project aims and key outputsFocus on developing currency and robust consultation

8. Project Way ForwardContinued DH commitment and solution to project management and financial situationProject Plan with new timelines developed with key roles and responsibilities for delivery to project teamProject Lead and Project Management roleStrengthen links and involvement of PBR teamTask orientated working groups and better communication New members of working groups and where appropriate NRGCollation of national contacts for commissioning and clinical input and future consultationDevelopment of communication strategy and consultation planScoping and feasibility of ARV inclusion

9. Scoping and feasibility of ARV inclusion if tariff developmentRecommended by PWCPbR future development is to limit exclusions and therefore we consider ARV costs in tariff DevelopmentAgreed to undertake feasibility of this for HIV tariff and make recommendationsProject lead to manage process and set up small working group under same conditions as other groups

10. ARV inclusion feasibility to include:Produce HIV drug feasibility study by - collect and collate trust and consortium Drug dataproduce drug analysis and comparative reportsmake decision on way forwardProduce HIV drug costs - Produce HIV drug costs optionsConsult on Drug Cost optionsproduce drug measures and data itemsWork in infancy although requires early solutionSmall sub/task group to be formed asap to consider options and initial considerationsNRG discussion required with key areas and points of view expressed

11. ARV inclusion NRG discussionOptionsDo not include ARV in any tariffARV tariff developed in line with PbR options:National Currency/National PriceNational Currency/Local priceLocal Currency/Local price

12. What is achievable and acceptable when considering ARV inclusion in tariff?What are the main areas for consideration – e.g maintaining levers and competitive pricesif ARV tariff is not feasible at National currency/national price then what can we do to support services and commissioninge.g guidance, regional or local benchmarking, commissioning data set, consortium arrangements

13. Website and Communication Strategy UpdateCommunication Strategy in development – required input from all stakeholders especially BASHH and BHIV and also requires rapid consultation on requirements or processes for pubic patient consultationThe strategy will outline:Objective of projectCommunication objectives, principle and key messagesKey audiencesPreferred/Appropriate channel of communicationRequires comments on draft and shaping of process and key messages to key audiencesDraft to be sent out for comments early next week

14. Proposed key Communication Tool will be HIV PbR WebsiteAgreed that English Commissioner Website managed by NAT will be developed to provide key website serviceThree Levels of Access EnvisagedPublic – non securedProfessional – non secured and securedStakeholder/project participants – secured

15. Both public and secured pages will contain:Project background and identified documentation for viewingPbR FAQ sectionHIV Outpatient FAQ sectionAbility to send in comments and queries via a specific email address and will be managed externally for responseA section specifically for potential consultation questions that stakeholders can be refered too as appropriateDownloading facilityNotification facility for/of questions or enquiries sent to specific email addressRegistration facility for further information and notificationsLinks to other websites such as DH, BASSH,BHIV etc

16. Secured Pages will contain:Ability for the creation, editing and commenting on identified documentationProject stakeholder contact detailsMinutes and working papers for comment and viewingAbility for password protection and specific user names ( currently up to 50 individuals but may increase)Ability for on line discussion and sharing of perspectives and questions (tbc and dependant on cost)Monthly project updatesDownloading and uploading facilitiesCalender and key event for project and locally and regionally