Intelligent Commissioning Federation

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Intelligent Commissioning Federation
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11 World Class Competencies
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ICOF functions

• Demand management
• Locality Commissioning
• PMS Provider development

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Demand Management Function
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Screenshot of ICOF data recording sheet
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Screenshot of ICOF data recording sheet
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Screenshot of ICOF data recording sheet
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Referral managementPhase 1

• The practices agree to
• Send copy of referral to ICOF
• Send AE audit sheets

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Phase 1

• ICOF agrees to
• Complete component 2b of incentive scheme
• Provide practices feedback on referral trends
• Cross refer ICD10 diagnoses with Acute trust
  returns
• Provide GPs with documentation for Revalidation
  purposes
• Run training days to support the process

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Phase 2

• The practices agree to
• Use Map of Medicine pathways
• List patients choice of hospital
• Create a formatted, quality referral letter
• Channel all their referrals through a central
  gateway.

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Phase 2

• ICOF agrees to
• Re-categorise referrals by Read codes
• Divert referrals to community services where
  appropriate
• Discuss alternatives with referring GP if
  appropriate
• Forward referral to chosen hospital when asked
• Help patients with completing booking where they
  are unable to do so

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Communication platforms

• Common Telephone platform-0345 facility
• IT solutions-Graphnet

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Delivery

• Badger Medical Services
• Administrative support
• Premises and IT (ICD10/Adastra)
• Practices
• FOH and Access pilot
• PBC collaborative
• Call centre
• Urgent Care

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Governance arrangements

• Articles of Association
• Inter-Practice Statement of Intent

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Commissioning Function
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Locality Development

• Examples-Practice Members support-Develop
  implement Communications Strategy-Establish
  corporate governance systems-Pathway development
  and implementation-Referral Management-Commissio
  n services and develop pathways in order to
  deliver year 1 of new Urgent Care Strategy-Roll
  out Health Inequalities Strategy and Locality
  working-Develop implement Training
  Development Strategy

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Locality Commissioning Function

• Examples
• -Redesign Primary Care Long Term
  Conditions-Community Audiology
  Service-Restructure Medicines Management-Develop
  ment of Primary Care Facing Diagnostics-Mobilisat
  ion and development of Tier 2/CATs/IS
  CATs-Reduce Outpatient Appointments-Termination
  of Pregnancy Pathway-Reduce Follow Ups-Weight
  Management Pathway-End of Life Pathways-Stroke
  Pathway Development-Cancer Pathway
  Improvement-Early Intervention
  Service-Maternity Pathway Development

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Proposed Administrative Structure

• Practices 24(-2)
• No meetings, but receives visits from Data
  Analyst monthly
• Council 24(-2)
• One member per practice Meets quarterly, evening
  
• Board 6 GPs
• Selected from Council PCT Director
• Meets monthly as Executive
• Medical Directors 6
• Selected from Council, for review function
• Each one session/week

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Governance arrangements

• Accountability agreement
• Commissioning contract

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PMS provider development function

• High quality Collaborative PMS
• Standardised Front of House
• Transfer of care into the community (RCRH)
• Collaborative preventive health care
• Integrated care

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Finance arrangements 1

• Setup costs
• Project management support - 20,000
• Steering committee meetings - 2,000
• Developmental meetings - 1,000
• Telecom audit - 3,500
• Election of Board - 2,250
• 
  28,750

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Finance arrangements 2

• Referral Management
• GP reviewer salaries - 83,200
• Opportunity costs reimb. - 52,000
• Accommodation - 2,400
• Operations management - 40,000
• Training Development - 1,000
• Accountancy - 500
• Company secretarial duties - 600
• 
  179,700

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Finance arrangements 3

• Locality Commissioning Executive
• 6 GP board members salary
  -39,000
• 6 GP board members opportunity costs -39,000
• Meetings management - 5,000
• Developmental days
  - 5,000
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  - 88,000

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Finance arrangements

• Set up costs
  - 28,750
• Referral management - 179,700
• Commissioning executive - 88,000
• 
  285,450

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Future funding

• LCO Board from Component 1 of PBC Incentive,
  collaborative use of FURs
• Referral management from a 1 reduction in New
  OP,FU OP,C 2 C and Unplanned Admissions
• Intangibles Patient designed services 'could save
  the NHS 20bn. Allowing doctors and patients to
  design healthcare services could save the NHS
  20bn by 2014, according to the National
  Endowment for Science, Technology and the Arts.

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Short-term benefits realisation

• GPs can get support advice on referrals
• Financial incentives for many GPs
• Pooling of resources which can improve services
  to patients

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Medium term (6-18 months)

• Impact on some specialty referrals to benefit of
  many patients
• Better choice for a number of patients
• Reduction in some unnecessary follow up
  appointments
• Some development of practice based services which
  complement the reductions in secondary care
  services

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Long term (18 months 5 years )

• Clear benefits to patient in terms of usage of
  range of services
• Better working relationships and understanding of
  common goals between primary and secondary sector
• More significant savings from reductions in both
  new and follow up activity
• Patients see and experience improved pathways of
  care and more efficient (less time consuming)
  services

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