sc&i mgrs forum strategic business plan for the joint commissioning unit a business plan to...
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SC&I Mgrs Forum
Strategic Business Plan for the
Joint Commissioning Unit
A Business Plan to reduce the current c.£140 million/yr by 20% over 3 years
SC&I Mgrs Forum
Commissioning Matrix
Older People
Physical Disability
Mental Health
Learning Disability
Carers
Care Homes
CHC Funded
Council Funded
Home Care
Day Care
Respite Care
Prevention:
Supporting People
Equipment
Third Sector
A Commissioning Matrix has been developed to gain a panoramic overview of expenditure across the JCU – both NHS and Council. This reveals:
•comparative spend between service areas e.g. OP, MH LD, PD, Carers•comparative spend between prevention and core services•comparative spend between service types e.g residential v community•comparative spend between NHS and Local Government•Comparative spend between in-house (e.g. NHS) and external•distribution between providers•distribution in/out of Borough•provides opportunity to improve value for money e.g. unit costs•provides opportunity for service and provider rationalisation
SC&I Mgrs Forum
Meet immediate needs and enable
Universal Services, Prevention And early Intervention
Assessment and
Resource Allocation
Enablement
Early in
terv
ention and
preventio
n
Self-directed support
Encourage to the left, not inevitable drift to the right
Continually look for opportunities to enable, signpost
or give advice to increase independence
Review may suggest enablement
Those not eligible for a package can
get further information
Supporting citizens to stay independent longer
Validate Resource Allocation
Support plan
Authorise&
ValidateGo live
Monitor & review
First contact advice and signposting C
ou
nci
l
Version 4 05.07.10 Agenda Item 7.4
SC&I Mgrs Forum
Core
Prevention tertiary
Enablement secondary
Universal primary
•Shift demand to lower cost interventions•High focus on value for money on core
Number of citizens highlow
Cost
low
high
SC&I Mgrs Forum
JCU as an engine of change for improvement and value for money
• Clear assignment of lead roles/duties within overall commissioning matrix
• Prioritise workloads so that challenging but achievable – manage individual performance
• Leave enough room for relationship building• Publish clear commissioning plans based on ongoing annual cycle
with involvement of all main parties• Set grounds for de/re-commissioning – use procurement wisely and
effectively
SC&I Mgrs Forum
Benefits
The JCU Business Plan will aim to reduce the current c £120 million per year of spend by 20% over 3 years. We shall do this by obtaining:
1) Value for money (VFM) from the Core services that do meet needs effectively (i.e. standard fee levels instead of individually negotiated)
2) Savings from keeping Service Users in high cost services for as long as they need to be (i.e. emphasis on rehabilitation, recovery, intermediate care)
3) Savings because citizens will be signposted/diverted to alternative services, rather than to the core, costly services
4) Savings because there will be a range of interventions to help people stay independent longer
5) Further commissioned prevention services which the resultant savings will be reinvested in further prevention services
SC&I Mgrs Forum
Roles and responsibilities
Strategic Commissioning
RAS
Brokerage
•Operational Commissioning•Integrated Health and Social Care Teams•Assessment and Care Management•Support Planning for personalisation•Care Navigation
Menu of Services
Prevention
Market Shaping
• Clear recognition of both strategic and operational roles/activities
• Each Joint Commissioner working on a discrete set of work objectives
• Each to develop a core set of skills and competencies
SC&I Mgrs Forum
Structure Chart
SC&I Mgrs Forum
Next Phase
Each commissioner to be set goals for:• Developing preventive services with explicit cost savings for the
core matrix• Challenging and achieving Value for Money from within the core
matrix
All to be brought together as a single cohesive Cost Improvement/Business Plan for the JCU
SC&I Mgrs Forum
Service Developments
HistoricalServiceModel
TargetOperating
Model
SC&I Mgrs Forum
Historical Operating Model
• Services purchased by Councils• Traditional approach – legacy services• Narrow range of choice• Special Relationships• ‘Cottage Industry’ – “small, inexperienced providers”• ‘Open Cheque Book’ – provider led fees• Workforce problems• Short sighted and ineffective commissioning
SC&I Mgrs Forum
Target Operating Model• Services purchased directly by consumers• Individual budgets – self funding• ‘Menu’ of services with clear tariffs/fees (RAS)• Wider range of care and support – wider choice• Independent brokerage, navigation, advice and advocacy – shifts
focus from inputs to outcomes• Strategic procurement – framework agreements• No special relationships• Smarter Commissioning
SC&I Mgrs Forum
Strategic ContextFinancial Climate – National, Local and Individual
Comprehensive Spending Review – Health £20 billion savings
NHS White Paper – Liberating the NHS
GP Commissioning and Council joint working
Transformation – Personalisation, Choice and Control
Walsall population – health and wellbeing, increase in obesity, poorer health and wealth inequalities
Living profile – age and health
Longevity of complex health needs
Increase in co-morbidity
Big Society – Voluntary Sector
Strategic shift of investment towards reablement.
Reduction in residential & out of borough placements
Reduction in Hospital Accident and Emergency attendees
Transition towards Adults and Children's commissioning
Social Care packages need to change
Commissioning practice needs to change
Black Country collaborative groups e.g. Mental Health, NHS Ambulances
Shared Services
Uncertainty – resources and where they sit
SC&I Mgrs Forum
Commissioner led Developments - General
•Care Home Market shaping
(self assessment workbook)•Homecare market shaping•Day care market shaping•Third sector market shaping•Prevention Strategy (PCT/LA)•Workforce Planning•Culture change•Contract monitoring•Improved procurement
•Quality assurance / compliance•Market relationships – revitalise commissioning forums•Commissioning specifications for Programmes and Pathways•Holding NHS provider Trusts to account via cost and volume contract monitoring against nationally defined pathways•Set framework for operational/ micro commissioning via RAS and menu of services – (panels)
SC&I Mgrs Forum
Commissioner Led Developments - specific
Psychological Therapies
Frail Elderly Pathway
Housing 21 extra care
Centre for Independent Living
Hollybank as joint rehab ctre
Community equipment to retail
Goscote Centre / day services
AgeWell in Walsall
Clarification and contracting for extra care
Urgent Care Centre
In Control principles to CHC
Rapid Assessment Treatment Team – OPMH/Dementia
Community Meals to retail
Charging arrangements
SC&I Mgrs Forum
1 - Domiciliary Care/Community Support procurement
4 - JCU Contracts Register
5 - Prevention Strategy
6 - Procurement Flowchart and supporting documents
7 - Micro Markets Co-ordinator
3 - Housing Related Support Toolkit
2 - 3rd Sector Development/co-production
8 - Key Ring Living Support Networks
System Component Allocated Lead QIPP Value
£16.7mTracy Simcox
Tracy Simcox/Carol Jones
Tracy Simcox
Tracy Simcox/Carol Jones
Tracy Simcox
Tracy Simcox/Carol Jones
Tracy Simcox/Anne Doyle
Tracy Simcox
9 - JCU Contract/range of schedules
Tracy Simcox/Carol Jones
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entio
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enda
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entio
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enda
Prevention 1 of 2
10 - Business Support Tracy Simcox
SC&I Mgrs Forum
11 – Community Meals
14 – Electronic Monitoring System
13 – OP Panel
12 – Benefits Based Charging
System Component Allocated Lead QIPP Value
Anne Doyle
Tracy Simcox
Tracy Simcox/Carol Jones/Anne Doyle
Anne Doyle
Prev
entio
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enda
Prev
entio
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enda
Prevention 2 of 2
SC&I Mgrs Forum
Screening for Continuing health Care
Rehabilitation (Traumatic brain injury)
Funded Nursing Care-process
Commissioning CHC assessors in Hospital DLT
Eligibility Panel Weekly
Commissioning CHC Providers residential and home based
Full Assessment- Decision support tool- MDT
Commissioning Outreach Assessment Team
System Component Allocated Lead QIPP Value
Combined QIPP
Value
Hazel Wilkes
Hazel Wilkes
Jane Robinson
Hazel Wilkes
Tracey Everitt/Caroline
Adams
Hazel Wilkes
Hazel Wilkes
Hazel Wilkes
Embedding TransitionTracey Everitt
Impr
ovin
g th
e Q
ualit
y of
Life
in C
ontin
uing
Hea
lth C
are
Impr
ovin
g th
e Q
ualit
y of
Life
in C
ontin
uing
Hea
lth C
are
Complex Care
PersonalisationHazel
Wilkes/Caroline Adams
SC&I Mgrs Forum
Enhanced Primary Care
Early Intervention
Eating Disorders (Black Country project)
Day and Vocational Services (transformation project)
Day Services Older People (transformation project)
Resolution (transformation project)
Community Mental Health Teams (transformation project) home treatment/crisis
Community Rehab/Assertive Outreach (transformation project)
System Component Allocated Lead Value
Combined QIPP
Value =
TBC
£1,839,204
£503,728
£41,652
£489,122
£620,952
£1,663,789
£2,331,469
£1,170,621
Anet Baker
Anet Baker
Anet Baker
Marcus Law
Michael Hurt
Anet Baker
Anet Baker
Anet Baker
£4,721,503
Early
Inte
rven
tions
Early
Inte
rven
tions
Prev
entio
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enda
Prev
entio
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enda
Mental Health 1 of 4
Electro Convulsive Therapy Anet Baker TBC
Individual Packages of Care/Social Care
Marcus Law
SC&I Mgrs Forum
Psychiatric Liaison (transformation project)
Older Peoples Mental Health Teams (transformation project)
Older Peoples Rapid Access Team – new procurement project
Older Peoples Inpatient Services – (transformation project)
Adult Inpatient Services (Black Country Capacity Planning Project)
Memory Clinic (transformation project)
Carer Support Service
Community Development Workers (Transformation project)
System Component Allocated Lead QIPP Value
Combined QIPP
Value =
TBC
£128,779
£1,901,415
£352,000
£3,290,810
£15,734,563
£601,159
£34,125
£124,039
Anet Baker
Michael Hurt
Michael Hurt
Michael Hurt
Anet Baker
Michael Hurt
Anet Baker
Anet Baker
Out of Area Placements/NHS funded (QIPP)
Marcus Law TBC
Early
Inte
rven
tions
Early
Inte
rven
tions
Prev
entio
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enda
Prev
entio
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enda
Mental Health 2 of 4
SC&I Mgrs Forum
Accommodation Market Development
Consultant Services Older People
Adult Mental Health Employment Service (transformation project)
Criminal Liaison Service
IMCA/IMHA
Consultant Services Adult
Accessing suitable housing options
Dementia Prevention & Early Intervention
System Component Allocated Lead Value
Combined QIPP
Value =
TBC
TBC
£271,267
£36,387
£72,988
£77,000
£1,493,112
TBC
TBC
Mark Williams
Michael Hurt
Marcus Law
Anet Baker
Anet Baker/Michael Hurt
Anet Baker
Mark Williams
Michael Hurt/QIPP Lead
TBC
Early
Inte
rven
tions
Early
Inte
rven
tions
Prev
entio
n Ag
enda
Prev
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enda
Mental Health 3 of 4
Early Interventions in PsychosisAnet Baker/
QIPP Lead TBC
Out of Area Placements Marcus Law/QIPP Lead
SC&I Mgrs Forum
BUPA Elmore
IMCA (Black Country procurement project)
New Project – Pro Vision IALT Campaign
New Project – Information Service for GPs (web based)
Walsall Black Sisters
WPH (transformation project))
System Component Allocated Lead Value
Combined QIPP
Value =
TBC
£622,752
£47,000
TBC
TBC
TBC
£50,000
£107,000
£12,300
Michael Hurt
Anet Baker
Marcus Law
Helen Cook
Helen Cook
Anet Baker
Anet Baker
Michael Hurt
Early
Inte
rven
tions
Early
Inte
rven
tions
Prev
entio
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enda
Prev
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enda
Mental Health 4 of 4
Asian Womens Support Anet Baker £600
Age Concern Dementia Michael Hurt
ReThink- transformation project
Alzheimer’s
£107.000
SC&I Mgrs Forum
Frail & Elderly Crisis PID
Rehabilitation (Step Up / Step Down )
Community Nursing Services
JCU Led Telehealth / Telecare
Hospital Discharge
Unique Care
Urgent Care Centre
Patient Education
System Component Allocated Lead QIPP Value
Combined QIPP
Value =
£2.9mil
Jane Hayman
Jane Hayman
Gill Grigg
Jane Hayman
Mike Johnson
Joyce Bradley
Peter Mitchell
Falls / Osteoporosis / NoF De-prioritised
Win
ter P
ress
ures
Win
ter P
ress
ures
Prev
entio
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enda
Prev
entio
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enda
Unscheduled Care 1 of 2
StrokePaulette Myers &
Jane Hayman
SC&I Mgrs Forum
Development Sub Acute Unit
Extra Care Housing 21Contract Management
Reprovision Project Management
Non H21 Extra Care
H21 Contract Monitoring
Quality In Care Homes
Residential & Nursing Homes
Care Homes Closure Prog:
System Component Allocated Lead QIPP Value
Combined Value
£38.2mil
Jane Hayman
Lloyd Brodrick
Lloyd Brodrick
Lloyd Brodrick
Peter BlackburnClaire Hammond
Lloyd BrodrickSally Roberts
Lloyd Brodrick
Peter Blackburn
Service Development JCU Support Tracey Martin
Winter Pressures
Winter Pressures
Unscheduled Care 2 of 2
Performance Management Tracey Martin
SC&I Mgrs Forum
Care pathways
Transforming community services
Disaggregation of Pooled budget
Information and Advice
In house day service development
Assessment and treatment service
Forensic step down service
Transitions
System Component Allocated Lead QIPP Value
Combined QIPP
Value = £
All 3 disabilities commissioners
Ian Staples
Ian Staples
Natalie BormanStuart Lackenby
All 3 disabilities commissioners
Stuart Lackenby
Stuart Lackenby
Ian Staples
NH
S W
alsa
llN
HS
Wal
sall
Disabilities 1 of 2
ICES/telecare/telehealth Natalie Borman
Autism Ian StaplesPers
onal
isati
onPe
rson
alis
ation
SC&I Mgrs Forum
RAS development
User led organisation
Employment
Out of Area
HollyBank redevelopment
Extra care Housing
Centre for Independent living
Residential – Supported living
System Component Allocated Lead QIPP Value
Combined QIPP
Value = £
Stuart Lackenby
Natalie BormanStuart Lackenby
Ian Staples
All 3 disabilities commissioners
Natalie Borman
Stuart Lackenby
Natalie Borman
All 3 disabilities commissioners
Pers
onal
isati
onPe
rson
alis
ation
Disabilities 2 of 2
Reablement pathway Natalie Borman
Personal Budgets Stuart Lackenby
SC&I Mgrs Forum
Focus
“Everything we do will improve the experience of using the service, and value for money”