BUILDING PARTNERSHIPS TO DELIVER NEW SERVICES

1
BUILDING PARTNERSHIPS TO DELIVER NEW SERVICES

• Dr Tim Richardson
• GP Partner
• Integrated Care Partnership
• Director Epsom Day Surgery

2
CURRENT GOVERNMENT OBJECTIVES FOR PATIENT SERVICES

• Treatment of choice by doctor of choice in place
  of choice at time of choice.
• 2008 18 weeks from referral to treatment.
• Plurality of provision/NHS pays

3
LEVERS FOR CHANGE

• Practice based commission the Fundholding
  lessons have been learnt!
• Patient CHOICE December 2005.
• Payment by Results Elective April 2005.
• All other 2006.
• Private Sector Concordat 15 of referrals.
• Care Out of Hospital White Paper? 10 of services
  by independent sector.

4
NEW CONTRACTING ARRANGEMENTS PERSONAL MEDICAL
SERVICES

• PMS/GMS New Contracts for GPs.
• PMS Plus GPs providing secondary care to their
  registered patients.
• Enhanced services.
• SPMS Specialist Services in Primary Care by
  current NHS healthcare professionals.
• APMS Alternative (Private) provision of medical
  services.
• Foundation Trusts. Will all providers soon be
  independent?

5
ICP / PMS Plus 1998 - 2005

• Services Provided
• Therapies Physio / Chiropody / Dietetics /
  Audiology.
• Diagnostics X-Ray / USS / Anticoagulation.
• Direct Access Endoscopy.
• Wide range of specialist clinics all main
  medical and surgical specialities, chronic
  diseases, GPs, nurse specialists.
• Day surgery both GPSI and consultant led.
• Older patient risk management.
• Medical management of inpatients in community
  hospitals.

6
ICP / PMS

• Lessons Learnt
• More cost effective.
• Team work.
• Improved access and speed of service.
• No barriers to cross.
• Demand managed (within fixed total budget).

7
SPMS/EPSOM DOWNS INTEGRATED CARE SERVICES

• Multi GP Practice Company. (121,000 patients)
• NHS Shareholders GPs and practice staff raised
  75,000 share capital.
• Services in Primary Care to include
• - Specialist out patients
• - Therapies
• - Diagnostics
• - Day Surgery

8
FUTURE SPMS SERVICES

• Rapid Assessment Service.
• Primary Care Stream in A E.
• Elderly Care case management and community
  hospital.
• Community Nursing Therapy and Intermediate Care
  Services collaboration.

9
OTHER SPMS PROVIDERS

• Therapists.
• Nursing / Community Hospitals.
• Specialist Groups Single or Multi-speciality.

10
WHERE DOES THAT LEAVE ACUTE CARE PROVIDERS?

• European Working Time Directive.
• Specialist Training.
• Centralising Services i.e. Acute Coronary Care.

11
CRITICAL CARE CENTRES

• Populations 500,000 1,000,000.
• Low volume high intensity services.
• Short stays.
• Health Campuses.

12
SUMMARY

• Current provision of services not sustainable
  clinically.
• Not affordable.
• Need for new investment for new more local
  services.
• Good examples already exist why havent they
  been expanded/built upon?
• PBC and new provision must be supported and
  accelerated.