practice-based commissioning courage, conviction and culture
TRANSCRIPT
Practice-based commissioning
Courage, conviction and culture
What’s PBC about PCTs have paid bills - not commissioned PBC ‘handed’ GPs 50%+ of PCT spend – in
Sheffield over £500 million! PBC gives GPs and PCTs finance/activity
data so can see where patients and money going
Spend not matched to need - Wanless says focus on long-term care of elderly/ LTCs
GP-led redesign to help realign spend
Courage
From a PBC Manager view… Barriers
How do I engage busy GPs? What I found works
Ask GPs to help you improve quality of patient care – not save money. But show them where the spend is now.
Find your lead GPs. Back them to the hilt practically. Get business cases for redesign approved – its why GPs do PBC.
From a GP Point of View-Barriers
-Time-Relationships-Organisational culture-Organisational boundaries-Lack of support-Poor data
From a GP point of view -Enablers
PBC Lis PBC Support Patient support Knowing your stakeholders Organisational relationships Clinical Leadership
Conviction
“You don’t need an engine when you have wind in your sails” Paul Bate, 2004
Over 75yrs
7.4% population
£106 million on Emergency admissions43% of which was on over 75yrs age group
Falls = £6million1/10 over 85yrs
Crisis
How you might persuade and influence PBC clinicians
Knowing and being passionate about the patient journey
Understanding the context in which PBC takes place
Creating a clear vision for your patients journey and the pathway they take
Ensure congruency between the people and the delivery mechanism
Culture
Framing Infection ControlBad frame? Good frame?
Doctors Halving MRSA rates is a Government Target
Focus on the basics of excellent clinical care (peer to peer)
Nurses You must balance the need for beds with infection control
Patients’ safety and dignity come first
Infection Control Staff
Changing staff behaviour is your responsibility
You have CEO/Board support to do what needs to be done to eradicate infections
The Board It will be mandatory for a senior nurse to report rates at every Board meeting
Preventing avoidable infections tops the Boards’ strategic objectives and supports the achievement of other objectives
The Public Avoidable infections are caused by visitors and the public
Help us, help you
Send the message 10 times in 10 different ways
What have we done to date in Sheffield
Lis Unscheduled Care Les Care Homes Women's Continence Pathway Falls Dementia pathway Community Nursing for the over
75years
Direction
Prevention
Early identification
Working with Community and Hospital Geriatricians
A Citywide Strategy
High Level buy in
Across the Health Economy
Project management support
How PBC can help you Back in your constituency find out who
your consortia leads are and talk to them If you don’t know who they are email your
PEC Chair Tell them what can be fixed. If you have
data even better! Get consortia leads to champion reform
and put business case/pathways into PCT
