Trent SHA Standard Powerpoint Template

1
Where are we going? A glimpse of services in 2010
Dr David Dawson Director of Organisational and
Clinical Development Trent Strategic Health
Authority
2
Overview
Key Messages This is really about business
change This is really complex This is real

• Aim to Cover
• One view of the system reform agenda
• Implications
• The role of SHAs

3
Pan-European Problems

• Health care spending growing faster than GDP
• Huge variation in quality outcomes
• Customers are changing more proactive
• Evidence based growing response lagging

4
FOUR KEY AREAS OF GOVERNMENT REFORM
Changes to the financial system payment by
results and a fixed price tariff
Introduction of a commissioning function in
some cases at the level of individual consumers
to create a market place in healthcare
Improved quality, improved efficiency of
healthcare provision
New freedoms for state run provider organisations
Opening up of market place to private sector
providers
5
Creating a Patient-Led NHS

• New Service Models
• Greater choice
• Better commissioning
• Networks
• Health promotion and improvement
• A Changed Culture
• Impact on patients and empowered staff
• Shared values and codes of conduct
• Support to frontline staff and clinical
  leadership
• Continuous learning
• New model of managing change
• Clearer leadership at all levels
• Better Support
• Trust and PCT development
• Integrated incentives
• Integrated IT and HR infrastructure
• Better risk mitigation

6
Changing Organisations by 2010

• Providers
• All-rounder hospitals will not survive
• Survival dependent upon clear market tested
  strategy and alliances/networks
• Mergers are inevitable
• Commissioners
• Driving improvement from customer perspective
• Increase in capability and capacity
• Managing demand and managing costs

7
Changing Organisations by 2010

• Primary Care and Community services
• Larger primary care units and alternative
  providers
• Differentiated services
• Vertical integration
• Commissioning separated from provision
• Professionals
• Population perspective
• Gradations in service (stepped care)
• Quality assurance of self- and nurse led-care
• More flexible use of staff

8

• Advantages
• Choice/convenience
• Competition
• Income guarantees
• Quality explicit

• Risks
• Fragmentation
• Duplication
• Discontinuous care
• Confusion
• Organisational risk

9
Functions of SHAs

• Co-ordination
• Building Capacity
• Performance Improvement

10
Role of the SHA

• Strategic planning
• Population-based needs assessment
• Alternative providers and models of care
• Contestability
• Building capacity
• Leadership programmes
• Devolved resources
• Organisational development
• Strategic HR
• Mitigating risk
• Vision and values
• Stepped care pathways
• Quality Assurance
• Supporting and aligning infrastructure
• Cultural and leadership change
• (Simple) rules of engagement

Enable organisations and LHCs to do it themselves
11
So What Might This Really Mean?

• Some Current Actions in Trent

12
Strategic Planning

• Dr Foster analysis of Spearhead PCTs
• Public Health network development
• Developing commissioners
• Kaiser Permanante work in Lincolnshire
• SHA-wide work with United Health Europe
• APMS providers
• LTC Oversight Board

13
Oversight Board

• Composition
• Locally owned
• All sectors
• PCT CE Chair
• Vision
• Build on best-practice and local patient surveys
• Trent-wide solutions
• Delivery
• Across the whole LHC
• Agreed frameworks
• Systematic application
• Evaluation
• Independent
• Service-driven
• Link to new MA (and NILSI?)

14
Building capacity

• Leadership
• Targeted support (Talent Management, TMDI, York
  multidisciplinary programme) aimed at strategic
  priorities
• Local personal development (via TIN)
• Centre for Health Improvement and Leadership in
  Lincoln (CHILL)
• Devolved resources
• Service improvement Transformation teams
• Workforce development
• IMT
• Organisational Development
• Linked to leadership framework
• Opportunities of new service models
• The Improvement Network (TIN)

15
Mitigating risk

• Now
• SHA-wide approach
• Aligning service improvement/NPfIT and workforce
  development
• Network development
• Knowledge management
• Further work
• Values
• Quality assurance
• Using data and information
• Care pathways
• Clinical/managerial conversations
• Rules of engagement

16
David will . tell us how chronic disease
management programmes will fit with the existing
services such as cardiac rehabilitation,
specialist cardiac nursing services and primary
care CHD clinics.

• That is for you to decide. An SHA should only
  ensure you have the capacity and capability to do
  it.

17
Never doubt that only a small group of
thoughtful, committed citizens can change the
world. Indeed it is the only thing that ever has.

• Even though the ship may go down the journey
  goes on.
• Margaret Mead