Practice Based Commissioning

1
Practice Based Commissioning

• District Nursing
• Cathleen Manancourt PCT Primary Care Development
  Coordinator Birmingham, Sandwell and Solihull

2
Benefits of Practice Based Commissioning

• Greater variety of services
• Greater number of providers
• Closer to home
• More efficient use of services
• Greater clinical involvement

3

• Moving Services and Investment
• from Secondary to Primary Care

4
Practice Based Commissioning a tool for
developing services which-

• 1.
• Reduce health inequalities
• Ensure fairer access
• Improve access to preventative interventions
• Increase speed convenience of access to
  diagnosis

5
Practice Based Commissioning a tool for
developing services which-

• 2
• Actively support people with Long Term Conditions
• Avoid needless admission to hospital
• Ensure hospital stays only for clinical reasons
• Support patients at home

6
How Practice Based Commissioning is developing in
your area

• and what does the Technical Guidance tell us
  about
• Budget Setting
• Risk Management
• Management Costs
• Use of Efficiency Gains
• Governance and Values

7
Terms of Engagement

• PCTs must have practice based costing in place
• Practices expected to balance budget over 3 year
  cycle
• 100 of efficiency savings available to practice
• Savings used to support service development
• PEC oversees costs and use of efficiency savings

8
PEC Principles

• Contribution that service changes make to
• demand management,
• key NHS targets,
• implementation of white paper on public health
• and overall financial position of the PCT.
• Benefits to patients
• Extent to which proposals demonstrate a whole
  system solution
• Management of risk without stifling innovation

9
PEC Principles continued

• Anticipated health gain
• Appropriate and effective care
• Value for money
• Agreement / backing of other health professionals
  (GPs AHPs)
• Front line staff involved in commissioning
  decisions and use of resources freed up

10
Payment by Results

• Risk
• HRG
• 2005/2006 National tariff
• Efficiency savings
• Unbundling

11
Developing Nursing Led Services

• Range of Services
• Range of Settings
• Contract Model

12
Range of Services

• Specialist outpatient
• Therapies
• Diagnostics
• Day surgery
• Rapid assessment service
• Primary care in AE
• Elderly care case management and community
  hospital
• Community nursing therapy and intermediate care
  service collaboration

13
Integrated Working in a Range of Settings

• Hospital, Community and Home
• Management and coordination of care
• More responsive and flexible service
• Choice for patients with long term conditions

14
Contract Model

• Commissioning a patient led NHS
• SPMS and APMS
• East Elmbridge and Mid Surrey PCT

15
Critical success factors in developing Nurse led
Services

• Working closely with GPs
• Multidisciplinary working across the whole system
• Knowing how Practice Based Commissioning (PBC) is
  being implemented in your area