Southwarks Governance, Accountability

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Southwarks Governance, Accountability
Operating Framework for PBC

• Developed by the PBC Project Board, LMC PBC
  Executive

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Southwarks Aims for PBC

• To facilitate clinical engagement in
  commissioning decisions and processes
• To improve outcomes for patients through the
  development of improved pathways of care
• To promoting the overarching objective of
  providing patients and the public with
  personalised care close to home.
• To ensure efficient use of NHS resources by
  managing demand

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Levels of Engagement in PBC
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Information

• PBC Commissioning Groups can commission all areas
  than other than those exclusions identified
  nationally.
• To support PBC the PCT will provide practices
  with a monthly information pack.
• Reporting will commence in July for April
  activity and monthly thereafter

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Information
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PBC Budget Setting

• In 06/07 SPCT will provide practices with budgets
  for acute services (Tariff) prescribing
• Longer term budgets include Community Services,
  Mental Health etc
• SPCT proposes setting budgets using historic
  usage scaled down to an affordable level
• On average budgets will be scaled down by 10
  -15, however this will be sensitive to
  individual practice utilisation rates for
  outpatients, A E attendances and emergency
  admissions.

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Freed Up Resources (FUR)

• The extent to which planned reductions in
  expenditure are achieved could result in FUR
• In absence of FUR DES LES
• However if FUR released PCT will comply with
  national guidance return up to 70 in future
  years, subject to financial balance
• FUR maybe spent on equipment, training,
  clinical/non clinical staff and premises
• FUR not detail in Plans is Unplanned FUR and
  will not be returned to PBC Groups

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PBC Contingency Fund

• SPCT propose to also hold 1 to 2 as a PBC
  Contingency Fund.
• If this reserve is unused at the end of the
  financial year it will be carried forward on
  behalf of the PBC Commissioning Groups to manage
  risk over future years.

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PBC Incentives

• DES Component 1
• Practices will receive an award of 95p per
  registered patient for producing a Commissioning
  Development Plan
• DES Component 2
• Practices will receive a further payment of 95p
  per registered patient for achieving the
  objectives in their Commissioning Development
  Plan
• Local Incentive Scheme
• An additional 1 per patient for recognition of
  management costs

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PCT Support for PBC

• SPCT will support PBC with a number of generic
  functions
• Public health
• Finance - provision of regular financial and
  activity reporting.
• Commissioning
• Quality professional development expertise
• Patient public involvement expertise

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Governance Accountability

• Practices
• Level 1 - Sign PBC Letter of Engagement
  accountability agreement
• Levels 2 and 3 - Sign PBC Letter of Engagement
  accountability agreement plus submit a business
  case.
• PCT
• Level 1 To performance manage adherence to
  commissioning development plans sign off DES
• Level 2 PCT to sign off business cases
  authorise implementation

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Process of Approval
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Process of Approval

• In event of local failure to reach agreement we
  will seek internal resolution
• 1. Process chaired by PEC Chair
• 2. Internal Review Panel
• If we are still unable to find a resolution
  Arbitration
• As in guidance referred to STHA

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Next Steps

• PEC/Board/LMC Approve Operating Framework for PBC
  2006/07
• Clarifying membership of emerging PBC Groups
• Strengthening PBC Group Commissioning Development
  Plans
• Distributing practice budgets information packs
  May 18th PBC Event
• Work starts!