WHAT IS TRANSFORMING COMMUNITY SERVICES ?

1
WHAT IS TRANSFORMING COMMUNITY SERVICES ?
Transforming Community Services

2
TCS Programme What is it?
Transforming Community Services

• A national programme
• Define what community services to look like in
  the future
• PCTs to move to a Commissioner only
  organisation
• Provider arm could move to a different
  organisational form
• Need to assess the current and potential provider
  market
• Need to develop a strategic response

3
Commissioning Cycle
Transforming Community Services

4
Process
Transforming Community Services
Formal SLA in place
Need to prioritise which areas we analyse first
PCT Commissioning arm would look to retaining
premises

5
Review Services under 7 Pathways
Transforming Community Services

• Health and wellbeing/health inequalities
• Children and families
• Long term conditions
• Mental health
• Rehabilitation (including neurological rehab)
• Acute care in the community
• End of life care

6
PCTs 5 year TCS Strategy (Oct)
Transforming Community Services

• Informed by service reviews market analysis
• Develop procurement strategy and procurement plan
• Agree how we want to develop the estate
• Share with providers
• Work with providers to develop organisational
  form (Oct 2009)

7
Transformational change taking a personalised
approach?
Transforming Community Services

• Take the perspective of the service user
• Needs and drivers
• Identify the main service elements the user may
  have to access
• Not about individual professions or buildings
• Integrated, broad approach across agencies,
  across boundaries
• A chance to re-design services?

8
Possible direction for future services
Transforming Community Services

• Flexible pathways with various entry points
• Integrated social and health care pathways
• Personalised care
• Personalised budget various providers at points
  in the pathways
• Defined quality outcome measures

9
NHS Central Lancashire
Transforming Community Services

• Sue Mason
• Associate Director
• Collaborative Commissioning

10

Transforming Community Services
Our vision for commissioning services

• Focused on prevention, case and disease
  management
• Seamless and holistic care, particularly for
  those with chronic, multiple conditions.
• Timely and targeted services in home or
  community environments to meet individuals
  needs and lifestyles
• Strengthen community and primary care to
  provide real alternatives to acute care.

11
Transforming Community Services

• Achieving our vision

• Proactive management of the flow of elective
  patients into acute settings
• New and better information
• Development of informed and empowered patients
  and proactive, multidisciplinary teams

12
Transforming Community Services

• Prioritising the three pathways

• Reviews of need and existing services in three
  areas
• Long term conditions
• Rehabilitation
• End of Life care pathways.
• These reviews support the work already being
  undertaken through local Clinical Pathway Groups
  and the development of service line management.

13
Transforming Community Services
Long Term Conditions diabetes, respiratory
disease, CVD, rheumatology

• Future disease patterns will be dominated by long
  term conditions, rather than acute episodes of
  need.
• Focus resources and attention on high need and
  high cost patients to achieve the greatest
  impact.
• Commissioning personalised programmes of services

14
Transforming Community Services
End of Life

• Baseline review of end of life care services
  completed May 2008
• Health needs assessment
• Review of care services provision and cost
• Examine the quality of care
• A gap analysis
• Results from the baseline review highlighted
  that
• Incidence of death declining as people live
  longer - 82 of deaths in 65 yrs
• In 2006, 56 of people died in hospital, 19 in
  their home
• Approx. 95 of palliative services are utilised
  by people with cancer
• Inequities in service provision exist

15
Transforming Community Services
End of Life

• May 2008 review identified the following
  commissioning priorities,
• which will form the basis of our future plans for
  end of life care
• Build workforce capacity
• Provide flexibility in the provision of services
  with attention to out
• of hours services
• Increase support to enable death at home
• Monitoring of outcomes

16
Transforming Community Services
Rehabilitation services

• Positive developments in rehabilitation and
  neurological conditions services
• 33.1 projected increase for late onset dementia
  by 2020.
• Need comprehensive re-design and re-alignment of
  older people services.
• Market analysis and provider segmentation of
  Rehabilitation Neurological Conditions
  community services determined health need against
  service status.

17
NHS Central Lancashire contact details
Transforming Community Services

• Sue Mason
• Associate Director, Collaborative Commissioning
• Sue.mason_at_centrallancashire.nhs.uk
• (Commissioning Strategy and Community Contract)
• Matt Gaunt
• Project Leader Transforming Community Services
• Matt.gaunt_at_centrallancashire.nhs.uk

18
NHS East Lancashire
Transforming Community Services

• Michael OConnor
• Procurement Manager

19
Improvement Framework
Transforming Community Services

20
3 Key Priority Pathways
Transforming Community Services

• Long Term Conditions
• Diabetes Vascular Risk Assessment Underway.
• Hospital avoidance/Development of Integrated
  case Management for High Intensity Service Users
  i.e. COPD and End of Life
• Health Well Being
• Assess improved models of provision to enable
  improved performance effectiveness i.e. Smoking
  Cessation, Vaccination Immunisation Obesity
  provision
• Mental Health
• CAMHS (16-18) underway
• Development of integrated Dementia provision
  linked to case management.
• Work continues on remaining pathways

21
Engaging the market
Transforming Community Services

• The PCT will look to develop the market and the
  range of potential providers including the third
  sector
• Where services need to be substantially improved
  where there are major gaps in capacity or
  services or where new approaches are required
• By holding Engage the market events
• By posting tender opportunities on the PCT
  website and Supply2Health and professional media
  where applicable
• What do PCTs need to do improve engagement
  please tell us.

22
Transforming Community Services
Response to Informal Expressions of Interest

• ELPCT recognises it may be approached by
  providers outside the normal tender process
  wishing to provide services to the PCT
  population
• For services where ELPCT has AWP arrangement
• For new services
• For services where other providers are in
  contract with the PCT

23
NHS East Lancashire contact details
Transforming Community Services

• www.eastlancspct.nhs.uk/
• TCS
• - Colette Crowther Associate Director for
  Strategic
• 
  Commissioning
• email colette.crowther_at_eastlancspct.nhs.uk
• Procurement
• - Michael OConnor Procurement Manager
• email procurement_at_eastlancspct.nhs.uk

24
NHS North Lancashire
Transforming Community Services

• John Butterworth

25
3 Key Priority Pathways
Transforming Community Services

• Long term Conditions
• Chronic Obstructive Pulmonary Disease (COPD)
• Mental Health - Depression
• End of Life

26
Transforming Community Services
Admissions Avoidance of long term
conditions Funding the shift
Potential commissioning shifts by locality -
Based on data for 2007/08
Group Fylde Wyre Fylde Wyre Lancaster Morecambe Lancaster Morecambe Total Total
Group Spells Tariff Spells Tariff Spells Tariff
Cardiac 956 1,270,243 729 920,842 1,685 2,191,085
Respiratory 358 664,224 279 456,551 637 1,120,775
Skin 240 395,968 250 362,267 490 758,235
Urology 163 396,975 145 368,108 308 765,083
Musculoskeletal 71 96,467 24 51,063 95 147,530
Diabetes 38 59,371 39 63,066 77 122,437
Hepato-Biliary 37 73,043 58 90,837 95 163,880
Stroke/TIA 33 50,114 21 31,856 54 81,970
Total 1,897 3,006,405 1,544 2,344,590 3,441 5,350,995
Source Teamwork. (2008). Patient Activity
Analysis for North Lancashire PCT Report update
based on 2007/08 Patient Activity.
27
Remaining Pathways
Transforming Community Services

• Health and wellbeing/health inequalities
• Rehabilitation
• Acute care in the community
• Children and families
• Sexual health

28
NHS North Lancashire contact details
Transforming Community Services

• Jon Hayes
• Contracting Officer
• North Lancashire Teaching PCT
• Trust Headquarters
• Moor Lane Mills, Moor Lane
• Lancaster, LA1 1QD
• Tel - 01524 519446

29
NHS Blackpool
Transforming Community Services

• Priority care pathways
• Children and families
• Health and wellbeing (esp. smoking, alcohol
  drugs)
• End of life care
• Long term conditions

30
NHS Blackpool
Transforming Community Services

• Potential new providers should
• Register their interest or address queries to
  service.procurement_at_blackpoolpct.nhs.uk
• View our website www.blackpool.nhs.uk

31
NHS Blackburn with Darwen
Rob Bellingham - Director of Governance and
Engagement
32
Transforming Community Services
Blackburn with Darwen Care Trust

• PCT working with Blackburn with Darwen
  Borough Council to
• create a Care Trust Plus
• Commissioning Health Services, Adult /
  Children's Social Care

33
Transforming Community Services
Big Ticket areas 1

• The PCT has prioritised the following areas
• Long Term Conditions
• Acute Care Closer to Home

34
Transforming Community Services
Big Ticket areas 2

• The PCT has also prioritised
• Children and Families
• Maternity and Early Years
• School Age Children
• Young People
• Complex Acute Health Care Needs

35
NHS Blackburn with Darwen contact details
Rob Bellingham - Director of Governance and
Engagement Rob.bellingham_at_bwdpct.nhs.uk Vanessa
Hollings Associate Director of Planning and
Performance Vanessa.hollings_at_bwdpct.nhs.uk NHS
Blackburn with Darwen Guide Business
Centre School Lane Blackburn Lancashire BB2
4DW 01254 282000