copyright 2011 right care integrating pathway hub: a prime contractor model dr. alan nye director...
TRANSCRIPT
Copyright 2011 Right Care
Integrating Pathway Hub: A Prime Contractor Model
Dr. Alan Nye
Director Pennine MSK Partnership LtdJanuary 2014
Online Learning Series
Right Care for Populations
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What’s the Problem?
System of Care
• Micro-commissioning complex care pathwayso Perverse incentives – PbRo KPIs process driven not population
level improvement or patient experience
o No effective performance management of care
• Lack of true clinical leadership • Separation from clinical accountability
from financial responsibility
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Integrating Hub Model
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Oldham
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Pennine MSK
• Primary Care based organisation commissioned by NHS Oldham to provide non admitted care in rheumatology, orthopaedics and chronic pain
• Consultant led – provide 97% rheumatology and take patients to point of listing in Orthopaedics
• From May 2011 control £23m programme budget for MSK using prime vendor model
• Psychological medicine for chronic pain• 9,500 new referrals a year• Deliver traditional hospital based services
from community – biologics and infusions• GP and Registrar training
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Programme Budget Commissioning
Different from standard care
• Commission for defined population with a defined budget
• Commissioners have population quality based KPIs
• Have prime contractor which shares responsibility for care co-ordination and performance management
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NHS Oldham Programme Budget’s
MSK - £23m - Pennine MSK 1st May 2011
Primary Care• Local enhanced services
Community Care• Pennine MSK• Physiotherapy, podiatry
Secondary Care• All activity included
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Delivering Integration
• Commissioner will focus on clinical outcomes rather than process metric
• Patients at the centre of our redesign
• Work with third sector• Use self management and self
referral were clinically appropriate
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Pennine MSK Impact
Reducing per capita cost whilst maintaining quality
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Pennine MSK ImpactReducing per capita cost whilst maintaining quality
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Building on success…
• In 2013 Oldham has developed Programme Budget Commissioning for a Mental Health programme
• Over the coming year the CCG will develop this approach over a whole range of programmes.
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Online Learning Series
Right Care for Populations
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