East of England

East Midlands

London

North East

North West

South East Coast

South Central

South West

West Midlands

Yorkshire & the Humber

NHS Integrated Care – implications for professional development

Angela Lennox

GP and Associate Director of Primary Care

Department of Health

•Expectations

•Population

•Information society – and its implications

•The changing nature of disease

•Advances in treatment

•A changing health workplace

The opportunities

High quality care for all- NHS Next Stage Review Final Report

Quality at the heart of

the NHS

High quality care for

patients and the public

Freedom to focus on quality

High quality care for all

NHS Next Stage Review: vision for primary and community care

People shaping services

Continuously improving

quality

Promoting healthy lives

Leading Local Change

Patient Power & Choice

Clinical Leadership & Engagement

World Class Commissioning

NHS Next Stage Review: vision for primary and community care

People shaping services

Continuously improving

quality

• Listening and responding to people’s views

• Services that fit together & make sense

• Informed choices for patients and families

• More control for people with long-term conditions

• Piloting personal budgets

Promoting healthy lives

NHS Next Stage Review: vision for primary and community care

People shaping services

Continuously improving

quality

• Partnerships with local government and other sectors to promote health and wellbeing

• Staying healthy throughout life

• Access to healthy living services

• Reducing health inequalities

• Stronger QOF focus on public health

• Listening and responding to people’s views

• Services that fit together & make sense

• Informed choices for patients and families

• More control for people with long-term conditions

• Piloting personal budgets

Promoting healthy lives

NHS Next Stage Review: vision for primary and community care

NHS Next Stage Review: vision for primary and community care

NHS Next Stage Review: vision for primary and community care

Examples of LIFT centres

NHS Next Stage Review: vision for primary and community care

Bingfield Primary Care CentreIslington, North London.

NHS Next Stage Review: vision for primary and community care

3 GP Practices Community Nursing Base Pharmacy Genito-Urinary Outpatients Podiatry Family Planning/Health Living

Services Dentistry Adult and Children’s Audiology ENT Outpatients Speech and language therapy Musculoskeletal Therapy

St Peter’s Health & Leisure Centre, Burnley, East

Lancs.

NHS Next Stage Review: vision for primary and community care

3 GP Practices Minor operations Podiatry Pharmacy Audiology Physiotherapy and

hydrotherapy suite Paediatric clinical services Catalyst for re-development

Platt Bridge Health Centre Wigan

NHS Next Stage Review: vision for primary and community care

Shared site with extended school

SureStart Family support centre Library Housing office

Platt Bridge Health Centre Wigan

NHS Next Stage Review: vision for primary and community care

Barking & Havering

NHS Next Stage Review: vision for primary and community care

Barnsley

NHS Next Stage Review: vision for primary and community care

NHS Next Stage Review: vision for primary and community care

People shaping services

Continuously improving

quality

• Partnerships with local government and other sectors to promote health and wellbeing

• Staying healthy throughout life

• Access to healthy living services

• Reducing health inequalities

• Stronger QOF focus on public health

• Listening and responding to people’s views

• Services that fit together & make sense

• Informed choices for patients and families

• More control for people with long-term conditions

• Piloting personal budgets

Promoting healthy lives

• Transforming community health services

• Systematically measuring quality

• Independent process for QOF

• Practice accreditation

• Registration with Care Quality Commission

NHS Next Stage Review: vision for primary and community care

People shaping services

Continuously improving

quality

Promoting healthy lives

Leading Local Change

Patient Power & Choice

Clinical Leadership & Engagement

World Class Commissioning

Leading local change

World Class Commissioning for primary care

• World class commissioning guide for primary care• understanding needs of local communities• clinical leadership and clinical engagement• incentives for integrated care and upstream prevention• information for patients and the public• applying system rules• stimulating innovation and choice (market making)

• Support and development• predictive modelling and risk stratification• public engagement and social marketing• dataset development (including equality monitoring)• contract management• estates strategies

Leading local change

World Class Commissioning for primary care

• World class commissioning guide for primary care• understanding needs of local communities• clinical leadership and clinical engagement• incentives for integrated care and upstream prevention• information for patients and the public• applying system rules• stimulating innovation and choice (market making)

• Support and development• predictive modelling and risk stratification• public engagement and social marketing• dataset development (including equality monitoring)• contract management• estates strategies

Supporting integration of health and social care

• Joint strategic needs assessment & LAAs• More integrated working between SHAs and GOs• Ministerially-led group to identify how to support

organisations that want to go further

Leading local change

Reinvigorating PBC

• Repositioning PBC: clinical leadership & health outcomes• Incentives for more multi-professional engagement• Entitlement to management and financial support• Holding PCTs to account through assurance framework• Different levels of engagement

entry-level PBC (dependent on quality of primary care) increasing freedoms for high-performing, multi-

professional and accountable PBC groups

Leading local change

Reinvigorating PBC

• Repositioning PBC: clinical leadership & health outcomes• Incentives for more multi-professional engagement• Entitlement to management and financial support• Holding PCTs to account through assurance framework• Different levels of engagement

entry-level PBC (dependent on quality of primary care) increasing freedoms for high-performing, multi-

professional and accountable PBC groups

Piloting new models of integrated care

• Clinical collaboration across primary, community and secondary care

• Integration between health and social care• ‘Integrated care organisations’ managing capitated budgets• Testing safeguards for choice and competition• Specifying service quality and financial management

Leadership for quality- making change happen

Expectations how people will have to change

Vision where we are

going

Methodthe way that improvement will happen

Embed in training. Leadership will be included in undergraduate curricula for nurses and doctors

New standards. Accredited health leadership standards for both clinicians and managers

NHS Leadership Council. Support all leadership, with strong focus on top 250 in the NHS

Support Boards. New development programme for trust boards to be commissioned

NHS Leadership Model

Interprofessional Education – opportunities

Interprofessional Education – opportunities

Patient Access, Choice and Empowerment

Interprofessional Education – opportunities

Patient Access, Choice and Empowerment

Integrated Pathway Redesign - Quality, Outcomes, Productivity and Efficiency

Interprofessional Education – opportunities

Patient Access, Choice and Empowerment

Promoting Healthier Lives

Integrated Pathway Redesign - Quality, Outcomes, Productivity and Efficiency

Interprofessional Education – opportunities

Patient Access, Choice and Empowerment

Promoting Healthier Lives

Continuously Improving Quality

Integrated Pathway Redesign - Quality, Outcomes, Productivity and Efficiency

Interprofessional Education – opportunities

Patient Access, Choice and Empowerment

Promoting Healthier Lives

Leadership and Innovation

Continuously Improving Quality

Integrated Pathway Redesign - Quality, Outcomes, Productivity and Efficiency

Interprofessional Education – opportunities

Patient Access, Choice and Empowerment

Promoting Healthier Lives

Leadership and Innovation

Continuously Improving Quality

Integrated Pathway Redesign - Quality, Outcomes, Productivity and Efficiency