Dr Jacky Chambers

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Dr Jacky Chambers
TOWARDS A CLEARER SET OF OUTCOMES- LOCAL STRETCH
TARGETS
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Purpose

• To consider
• big health challenges for this PCT
• national vs local outcomes framework
• implications for WCC commissioning
• PCTs need to
• Develop a clear understanding of the needs of
  different groups within their community in order
  to target resources to achieve equality of
  outcomes

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LOCAL STRETCH TARGETS

• Health of a population determined by
• demography
• physical and social environment
• economic wealth
• access to health care

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HEALTH OF HOBtPCT

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Getting worse / much worse than average

• Infant deaths
• Morbidity from congenital disease
• Childhood obesity
• Child and Adolescent health
• Drugs and alcohol misuse
• Sexual health /TCs
• Patient experience
• Hospital admissions for conditions Rx in 1ary
  care
• Mental health - incapacity benefits
• deaths before age of 70
• persons dying in hospital end of life care

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Working assumptions local health needs

• Stable population
• Age structure similar to E W
• Resident not registrant population
• Diversity Pakistani dominant
• Adding years to life priority
• 2010 service models gt health benefits
• Clinical engagement gt public engagement
• Needs of localities similar
• Costs of care similar social need and
  vulnerability

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DEMOGRAPHY
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National versus local framework

• Q1 Targets vs indicators ?
• Q2 Depth or breadth ?
• Q3 Criteria for choice ?
• Q4 Which 5- 6 ?
• Q5 What are implications

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NEW PERFORMANCE FRAMEWORKS
JOINT OUTCOME FRAMEWORK FOR HEALTH SOCIAL
CARE (40?)
LAA
(198)
6-9 TARGETS PLUS
Joint Health and Social Care Framework Local
Area Agreement Local Outcomes /Targets
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LOCAL STRETCH TARGETS

• Selection criteria
• Important health issue for HOB
• Potential for health gain small gain /large
  benefits large gain /small numbers
• Unlikely to have national /LAA priority but
  locally important
• Relevant and important to public and patients
• Meets SMART / FABRIC criteria for performance
  measurement and accountability Significant
  commissioning challenge service
  redesign/partnership working

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PRIORITIES

• Children and young people
• Vulnerable individuals
• Adding life to years
• Lifestyle (smoking)
• Avoidable hospital admissions

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PROPOSALS

• Infant mortality and morbidity
• Sexual health
• Mental health
• Deaths under 70
• Avoidable hospital admissions

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WORKED EXAMPLE 1
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WORKED EXAMPLE 2
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WORKED EXAMPLE 3
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WORKED EXAMPLE 4
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• Implications
• Better information and intelligence step change
  
• Time to think , reflect and challenge - agree
  process
• Inclusive process professional/public/partners
  but timescales?
• Partnership context national vs StHA vs city vs
  PCT vs localities
• Cross Directorate working information
  /commissioning /clinical governance /provider

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National versus local framework

• Q1 Targets vs indicators ?
• Q2 Depth or breadth ?
• Q3 Criteria for choice ?
• Q4 Which 5- 6 ?
• Q5 What are implications?