@Meridian_HIE

#Meridian

Dr Christopher Parker, Managing Director

Welcome

@Meridian_HIE

#Meridian

Housekeeping

• The Vox do not have a fire alarm test scheduled today. In the event of

a fire please make your way to the South 2 car park, which is located

to the rear of Resorts World.

• Toilets can be found near the entrance to our conference room.

• Please ensure all mobile phones and devices are turned to silent.

• Canapés, wine and soft drinks will be served during the networking

portion of this evening’s event.

• Wifi – register at The Vox Free Wi-Fi – enter name and

email details to access wifi

• Tweet #Meridian or tag @Meridian_HIE

David Johnson

A carer perspective

Thomas

PHB

Profile - Thomas

• PMLD

• Epilepsy – difficult to manage. Seizures most days

• Scoliosis – increase risk of chest infection etc.

• Wheelchair user

• Multisensory impaired – registered blind

• Tactile defensive – cannot hold objects

• Incontinent

Innovation

• Leadership by patients – commissioners

• Different way of working – genuine shift in direction

• Leap of faith – willingness to experiment

• Co-production – carers as entrepreneurs

PHB in a nutshell

• Different conversation – clear roles and responsibilities

• Understanding a persons health / well-being

• Working together to agree money available

• Making a care plan – owned by service user

• Co-ordinating / organising care and support

• Monitoring and review – light touch

PHB key stages

The person

• knows how much money they have

• agrees health and wellbeing outcomes

• is able to create their own care plan

• chooses the way their budget is held and

managed

• spends the money in ways and times which

makes sense to them, as agreed in plan

Outcomes

• Thomas’ outcomes based around keeping

him safe, healthy and happy

• Clinical outcome – freedom from pain.

Reduced need for hospital

admission/referrals

• Early intervention/prevention – keep Thomas

away from acute services

• Wellbeing outcome – make him smile

through sensory activities/therapies

Outcomes

• Living independently, he chooses who supports

him (dedicated, well trained carers), how he is

supported and is given the freedom to make

changes to his life

• His budget is spent in ways and at times that

make sense to him, as agreed in care plan

• Budget can be notional, third party or

direct payment. Thomas chose third

party provider to run payroll and provide

HR support

Innovation – creativity

• Established technology – used in different way

(iPad)

• Procurement – individual and cost effective

• Accommodation – built around patient

• Recruitment and training – applied at point at

which care is delivered

Seismic shift in culture ‘the way we do things around here’

• Behaviour – command and control had it’s day

• Expectations changing-better quality/value for money

• Patient power - responsibility to design and deliver – ‘co-

production’

• Markers of progress – measure what matters

• Peer network – people with lived experience establish

local offer

• Step change – be ambitious

Urban myths

• PHBs are more expensive?

• PHBs carry greater risk?

• PHBs are right for everyone?

• People do not have capability/capacity to have

PHB?

• Personalisation longstanding promise – not

going to last?

NHS Confederation

‘Personal Health Budgets are here to stay.

The issue is no longer whether to implement

them, but how and for whom.’

Scaling up

• By April 2016 CCGs required to lead major expansion of

PHBs

• People with long term conditions (mental health key

cohort)

• Children and young people with special educational

needs

• People with learning difficulties (integrated)

• Joint Health and Wellbeing Strategies to include

clear goals for expansion of PHBs / PBs

The numbers

• NHS England estimate 0.1% - 0.2% of the

population

• 200 – 600 people with PHB/PB per CCG over

the next 3-5 years. This represents major

progress

• Worcestershire alone – minimum 600 PHBs

/PBs

Progress in Worcestershire

• Steering group established

• Co-production embedded

• Peer network in place

• Communication plan – internal/external

• Strong leadership/commitment

It’s a different conversation

On 9th July 2014 Simon Stevens announced a new form of radical, people powered commissioning of

health and social care, including the extended use of personal health budgets and integrated personal

budgets.

‘We stand on the cusp of a revolution in the role that patients – and also

communities – will play in their own health and care. Harnessing this

renewable energy is potentially the make it or break-it difference between the

NHS being sustainable or not’

Simon Stevens

Brave new world

• Compelling case for change – shift in culture is

critical

• Current model too fragmented – incapable of

meeting demand and rising expectations

• The prize – early intervention, safer care, value

for money and better outcomes for everyone

• Innovation and creativity will drive change

• Thomas is safe, healthy and happy

Dr Damian Williams

GP at Hall Green Health

Importance of a collaborative

approach to innovation

Dr Damian Williams

#PatientOnline

Clinical Lead Digital ClinicalChampion

GP atHall Green Health

Clinical Lead for IT

25

Your Care

ConnectedThe first local patient record

sharing service for Birmingham,

Sandwell & Solihull

Your Care Connected

“If you stand up and be counted, from time

to time you may get yourself knocked

down. But remember this: a man flattened

by an opponent can get up again. A man

flattened by conformity stays down for

good.”

Thomas J. Watson

It’s been a long road…

We’re not alone…

Before we even

started, we spoke to

• Manchester

• Leeds

• Hampshire

• Oxfordshire

• Cumbria

• NHS London

More recently

• Wigan

• Nottinghamshire

• Gloucestershire

• Staffordshire

Lessons learnt from other big

data sharing initiatives

Care.data

• Need for clear scope

• What is the data being used for?

• Who has access?

• Writing out to patients

• Strong patient information programme

Summary Care Record

• Not reliant on smartcards

• Integrated into existing clinical system

• Barriers within an emergency setting

• Local Medical Committee support

• Wider stakeholder support

Who we’re working with

Clinical System Suppliers

Governance and accountability

Technical infrastructure

Who we’re working with

Who we’re working with

318

GP Practices

Who we will be sharing information with

Eleven provider organisations…

Who we’re working with1.8 million registered

patients

Working alongside patients is the way

forward

The results of collaboration

What’s next?

Phase Two

PatientOnline

Programme

Online appointment booking

98.7% of practices offering the service

8.5 million patients signed up

12% of all appointments are made available online

Online repeat prescriptions

97.4% of practices offering the service

8.3 million patients signed up

4% of all repeat prescriptions requested online

Online access to records

97% of practices offering access to a summary of the record

2.9 million patients signed up

5% of practices offering access to the detailed record

What is Patient Online?

-

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar

Practices that have enabled patients to view full medical record online

Practices enabled for Patients to View Full Medical Record Online (Est) Actual Linear (Actual)

8 Digital

champions

12 Implementation leads 16 Patient

representatives

Programme support

www.england.nhs.uk

User group

www.england.nhs.uk

New practice

baselines

What we are doing to support practices

Detailed interviews

with patients

Promotion to the

publicBuilding

benefits

evidence

Case studies and

videos preparation

For other suppliers

focus on preparation

Focus on enabling record

access where system in

place

Answering practice

and patients queries

Developing

guidance &

policies

Engagement (CCG and LMC

engagement,

workshops for

practice managers,

training for

CSUs/HISs)

Collaboration

42

• Support and Resource Guide updated

• RCGP revised and new guidance

published

– Coercion (updated)

– Proxy access and proxy access on behalf of children (updated)

– Protecting the Safety of Patients and Practice

– Data Quality Guidance 2016

– Detailed Coded Records Access 2016

• CSU learning and guidance

• Case studies and videos

• Presentation to National Information Board

Thank you!

Dr Damian Williamsdamianwilliams@nhs.netTwitter @drdamoLinkedIn www.linkedin.com/in/drdamo

www.midlandsyourcareconnected.nhs.ukwww.england.nhs.uk/patient-online

www.bhamcrosscityccg.nhs.ukwww.hallgreenhealth.co.uk

Tammy Holmes, Innovation and Adoption

Programme Manager

Innovation and adoption service

@Meridian_HIE

#Meridian

Purpose

To support the identification, development and deployment of

innovation to meet the health and well being needs of the WMAHSN

membership and other stakeholders as well as supporting the

improvement of health outcomes, patient experience and creation of

wealth in the community across the the region

Strengths

51

126,000

13

£94bn

130,000

Innovation and adoption service brought to you by:

Innovation &

Adoption Service

Practical advice

Support activities

Promote innovation & adoptions

Ready made innovation tools

Opportunities for

innovation

Innovation and adoption

network

Outcome-focussed

innovation proposals

Generic content introduction and headings in Arial Bold

Lucy Chatwin, Business Manager

Health innovation exchange

@Meridian_HIE

#Meridian

Innovation genome project• I = What could you imagine that would create a great experience for

someone?

• L = What can we look at in a different way?

• U = What can we Use for the first time or in a different way?

• M = Move is re-contextualising in time or space.

• I = What can we interconnect, or connect, that we’re not connecting now?

• A = What can we alter or change?

• M = What can we make or create that is

completely new?Bill O’Connor, Founder of the Innovation Genome Project

Meridian innovation pull example

Meridian innovation pull - detail

First on Meridian

Share your innovations with us

Innovation – online discussion

Follow, share,

email or get in touch

Innovation (detail)

Innovation warehouse

Voting and point scoring

Be an active contributor

Tony Davis, Commercial Director

Deliverables and outcomes

@Meridian_HIE

#Meridian

Virtuous circleSuccess and network effects

attract more innovators, adopters

and third party service providers to

the service

Service helps more

innovations be

adopted by

members

More users results in

increased demand and

supply of innovations

Quick and objective

evaluation and development

of innovations results in

more successful and in-

demand innovations being

created

MORE MEMBERS &

INNOVATORS

USING THE

SERVICE

MORE SUCCESSFUL

INNOVATIONS

DEVELOPED

MORE

INNOVATIONS

ADOPTED

MORE

INNOVATIONS &

DEMAND

CAMPAIGNS

SUBMITTED

Outcomes1. Increased number of innovations identified, formal collaborations, innovation

activity and adoption levels

2. A strong inclusive and diverse networked community with high levels of

interaction and sharing leading to improved patient outcomes

3. Reduction in health inequalities

4. An improved knowledge community translated into health and wealth impact

5. Increased levels of inward investment

ROI = Return on involvement

In summary

“Ultimately, the imperative for innovation is to improve people’s lives,

against the natural human instinct to resist change”

Mark Sanders (Engineer, designer, investor and MD of MAS Design Products Ltd)

Refreshments, networking and time

to explore Meridian health

innovation exchange

@Meridian_HIE

#Meridian

Thank you and

good evening