WHAT IS TRANSFORMING COMMUNITY SERVICES ? Transforming Community Services

WHAT IS TRANSFORMING COMMUNITY SERVICES ?

Transforming Community Services


TCS Programme – What is it?

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


Commissioning Cycle


Process

Formal SLA in place

Need to prioritise which areas we analyse first

PCT Commissioning arm would look to retaining premises


Review Services under 7 Pathways 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


PCT’s 5 year TCS Strategy (Oct)

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+)


Transformational change –taking a personalised approach?

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?


Possible direction for future 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

NHS Central LancashireSue Mason

Associate DirectorCollaborative Commissioning


The Corporate “Day”The Corporate “Day”


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 individual’s needs and lifestyles

Strengthen community and primary care to provide real alternatives to acute care.

Our vision for commissioning 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


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.


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


End of LifeBaseline 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


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


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.


NHS Central Lancashire contact details

Sue Mason

Associate Director, Collaborative Commissioning

[email protected]

(Commissioning Strategy and Community Contract)

Matt Gaunt

Project Leader – Transforming Community Services

[email protected]


NHS East Lancashire

Michael O’Connor

Procurement Manager


Improvement Framework


SUPPORTING FEATURES:

Commissioning Strategic Plan SERVICE STAGE 1Transforming Community Services PRIORITISATIONPrioritisation Matrix REVIEW

Matrix project teamWork package methodology

Process mapping DEEP DIVE STAGE 2Value stream analysis SERVICEBenchmarking REVIEW 'PARK'

Draft service specificationService review steering group

THE STAGE 3Contestability framework CONTESTABILITY

GATEWAY

IMPROVEMENT STAGE 4

STRATEGY

DECISION

DisinvestImprovement Plan

Final service specification (Co-operative)Procurement strategy

Implementation plans Service re-design(Competitive or co-operative)

New service(Competitive or co-operative)

3 Key Priority Pathways

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


Engaging the market

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.


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

NHS East Lancashire contact details

www.eastlancspct.nhs.uk/

TCS- Colette Crowther – Associate Director for

Strategic

Commissioning

email – [email protected]

Procurement- Michael O’Connor – Procurement Manager

email – [email protected]


NHS North Lancashire

John Butterworth


3 Key Priority Pathways

Long term Conditions

– Chronic Obstructive Pulmonary Disease (COPD)

Mental Health - Depression

End of Life


Potential commissioning shifts by locality - Based on data for 2007/08

Admissions Avoidance of long term conditionsFunding the shift

Source: Teamwork. (2008). Patient Activity Analysis for North Lancashire PCT: Report update based on 2007/08 Patient Activity.

GroupFylde & Wyre

Lancaster & Morecambe

Total

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


Remaining Pathways Health and wellbeing/health inequalities

Rehabilitation

Acute care in the community

Children and families

Sexual health


NHS North Lancashire contact details

Jon Hayes

Contracting Officer

North Lancashire Teaching PCT

Trust Headquarters

Moor Lane Mills, Moor Lane

Lancaster, LA1 1QD

Tel - 01524 519446


NHS Blackpool

Priority care pathways:

Children and families Health and wellbeing (esp. smoking, alcohol &

drugs) End of life care Long term conditions


NHS Blackpool

Potential new providers should:

• Register their interest or address queries to [email protected]

• View our website www.blackpool.nhs.uk


NHS Blackburn with Darwen

Rob Bellingham - Director of Governance and Engagement


PCT working with Blackburn with Darwen Borough Council to create a Care Trust Plus

Commissioning Health Services, Adult / Children's Social Care

Blackburn with Darwen Care Trust +


The PCT has prioritised the following areas:

Long Term Conditions

Acute Care Closer to Home

‘Big Ticket’ areas 1


The PCT has also prioritised:

Children and Families

– Maternity and Early Years– School Age Children – Young People– Complex & Acute Health Care Needs

‘Big Ticket’ areas 2

NHS Blackburn with Darwen contact details

Rob Bellingham - Director of Governance and [email protected]

Vanessa Hollings – Associate Director of Planning and [email protected]

NHS Blackburn with DarwenGuide Business CentreSchool LaneBlackburnLancashireBB2 4DW01254 282000

Documents

WHAT IS TRANSFORMING COMMUNITY SERVICES ? Transforming Community Services