Clinical Engagement in NHS Bradford

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• Clinical Engagement in NHS Bradford
  Airedale
• Dr Jan Lee, Dr Andy McElligott, Matt Neligan

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Our journey

• Legacy of clinical leadership in commissioning
  over a number of years
• Practice based commissioning
• Moving from PEC to Clinical Executive
• Creating district-wide clinical leads
• Forging links with secondary care clinicians
  (Darzi reviews)
• Clinicians driving commissioning programmes
• Developing the culture and commitment

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Our journey overarching themes

• Quality and safety
• Improving patient experience
• Addressing health inequalities
• Effective use of resources

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How we work today

• Systems and structures
• Culture and commitment

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Systems and structures

• Clinical Executive
• PBC Alliance leads
• District-wide clinical leads
• Ten commissioning programmes
• Other work including innovation pot

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Systems and structures

• Governance
• Separation of commissioning from provision,
  managing conflicts of interest
• Funding
• PBC Incentive Scheme, sessional payments to
  leaders, high number of sessions, innovation pot
• Approach
• Use of workshops, joint development with the
  Board
• Information support PBC web-based tool, targeted
  service reports, budgetary information by
  Alliance / practice and by programme, JSNA and
  practice profiles, quality standards in secondary
  care

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Commissioning bodies
Contract management
Clinical networks
NHS Bradford Airedale Board
W Yorks Cardiac Network
W Yorks Stroke Network
Contract Management Boards
Yorkshire Cancer Network
Renal Local Implementation Group
Clinical Executive
Service development sub-groups
Learning Disabilities Partnership Board
Mental Health Modernisation Board
Clinical quality sub-groups
Acute Care Network
Acute pathways
Planned care
Long term conditions
Cancer Local Area Network
Activity and performance sub-groups
Planned Care Network
Diabetes Working Group
Staying Healthy
Primary and community
ICG (Children)
Intermediate Care Group
Stroke Working Group
Maternity and newborn
Children
ICG (Adults)
Intermediate Care
End of life care
Mental health
Learning disabilities
and more
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Developing the culture and commitment

• Commitment from the top
• Building relationships / managing conflict and
  power
• Promoting integrated working
• Roles, responsibilities accountability
• Developing leaders
• - learning together
• - the Bradford Leadership Programme
• Getting decision making right
• Collaborative partnership working

9
PBC making real change
10
Outcomes

• Over 200 new business cases approved through PBC
• Vibrant market with multiple providers
• Benchmarked low use of acute secondary care
• Ability to translate strategic priorities and
  plans into real service change
• Cultural commitment to an effective way of
  working

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Future challenges

• Developing our secondary care clinical engagement
• Succession planning for clinical leaders
• Linking clinical leadership model into local
  authority strategic partnerships and
  neighbourhood / locality structures
• Aligning performance management of primary care
  with PBC and assessing use of the whole health
  budget for a population
• Maintaining good practice and innovation in a
  challenging financial environment
• Applying learning from successes in clinical
  engagement to other areas

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Questions and discussion