transforming community services commissioning information for community services stakeholder...

Transforming Community Services

Commissioning Information for Community Services Stakeholder Workshop

14 October 2009

Coleen Milligan – Project Manager


Aim of the Presentation

• Welcome

• Provide an overview of the Transforming Community Services Programme

• Outline the Community Information project

• They provide essential care to many, often vulnerable, people, families and communities along the full spectrum from health promotion to end of life care

• This is on a large scale - community services represent 10% of NHS spend and 250,000 staff

• They are essential for delivering major strategic change and efficiency improvements in other sectors e.g. hospital utilisation

Transforming Community Services is important because…Transforming Community Services is important because…

The case for change

Services do not have capacity and capability to meet the challenges facing health and care• £10bn annual spend with largely unmeasured outcomes• Lack of robust data, tariffs and currencies• Large variation in quality, care pathways, productivity, costs and activity• Infrastructure outdated - technology, buildings, workforce• Confusing referral routes, lack of awareness of what’s available• Variable focus, limited innovation

Facing rising demands• 57% of those over 85 are in contact with a district nurse• 31% increase in people over the age of 85 in the next ten years • 15 million people with chronic long term conditions and increasing• Rising obesity rates amongst children storing up longer terms problems

In a financially difficult climate, with hospital and social care systems also under pressure and growing consumer expectations!

The case for change

The potential benefits of transformation are substantial

• Increased quality of life, health and well being for many

• Reduction in variations in quality and access

• More equal access• Promotion of equality• More efficient use of hospital

and social care sectors• Better productivity (potentially

10-20%) and value for money

Potential for substantial benefits

Transforming Community Services – Phase 1

Reforming Systems

Developing People

Improving Services

• Transformational Guides in 6 areas• Quality Framework Community Services• Productive Community Services NHSII• Publishing the evidence of what works

• 6 Transformational Attributes • Workforce and organisational

development • Innovation and Leadership fund

• ‘Enabling new patterns of provision’• Approaches to Currency and Pricing• National community services contract• Community information models and

datasets• Improving commissioning

Transforming Community Services – Phase 2

Developing People

• Innovation• Embedding TCS

Guides• Adoption of proven

methodologies• Leadership and

‘TCS Attributes’• Workforce and

curriculum• Provider

development

Improving Services

• Commissioning support and development

• Quality Framework and indicators

• Whole System Pathfinders

• Service user engagement

• Equality and diversity

Reforming Systems

• Currency and Pricing

• National Contract• Community

information• Investment/asset

strategy• Impact

measurement PVP• AHP offer data

collection

Quality Innovation Productivity Prevention

Linked and ‘hosted’ programmes


Community Information Project

• Community Information Model

• Community Information Dataset

• AHP – Referral to Treatment Data Reporting

• Mobile Solutions


Community Information Model

• Developed with 35 PCT pilot sites

• Provides the foundation stone for the Community Information Project

• Assists providers and commissioners to develop their local plans to further improve community information collection and reporting

• So what is the model?


MaturityHow well the model is embedded in the

organisation

FunctionalityWhat data and information is

produced

StakeholdersWhose information

needs the model meets


….Process

….People

….Data

….Technology

….Business Objectives

Tier 5Leading

Tier 4Advanced

Tier 3Sustained

Tier 2Evolving

Tier 1Basic

Information Model Maturity Assessment

Information systems do not reflect business objectives eg. lack of service line definitions

Organisational processes are not supported by timely, accurate and relevant information

Data is incomplete, inconsistent and unvalidated

Manual paper based systems

The information team is under-resourced and remote from management and front-line staff

Information systems poorly aligned to business objectiveseg. service line definitions based on staff groups

Organisational processes make use of ad-hoc information

Local definitions exist but data quality is variable

Bespoke or local systems based on spreadsheets or databases with manual input

The information team is under-resourced but has some engagement with management and front-line staff

Information systems partially aligned to business objectiveseg. service line definitions based on health needs

Information to support organisational processes is produced to meet routine requirements

Data is consistently collected to local standards and routinely validated

Some NPfIT products but limited integration across different systems

The information team has a good range of skills and has regular engagement with management and front-line staff

Information systems strongly aligned to business objectives, service line definitions reflect local health economy

Regular accurate information is supplemented by ad-hoc reports to meet specific requirements

Data meets national standards and is held centrally

Full implementation of NPfIT products with full system integration

The information team work alongside management and front-line staff

Information systems completely aligned to business objectiveseg. service line definitions based on outcomes

Accurate, timely and relevant information is produced pro-actively to influence organisational processes

Data meets national standards and links to other centrally held datasets

Fully integrated IT system with advanced use of secure field-based mobile technology

Members of the information team are fully integrated with management and front-line staff

….Process

….People

….Data

….Technology

….Business Objectives

Tier 5Leading

Tier 4Advanced

Tier 3Sustained

Tier 2Evolving

Tier 1Basic

Information Model Maturity Assessment

Information systems do not reflect business objectives eg. lack of service line definitions

Organisational processes are not supported by timely, accurate and relevant information

Data is incomplete, inconsistent and unvalidated

Manual paper based systems

The information team is under-resourced and remote from management and front-line staff

Information systems poorly aligned to business objectiveseg. service line definitions based on staff groups

Organisational processes make use of ad-hoc information

Local definitions exist but data quality is variable

Bespoke or local systems based on spreadsheets or databases with manual input

The information team is under-resourced but has some engagement with management and front-line staff

Information systems partially aligned to business objectiveseg. service line definitions based on health needs

Information to support organisational processes is produced to meet routine requirements

Data is consistently collected to local standards and routinely validated

Some NPfIT products but limited integration across different systems

The information team has a good range of skills and has regular engagement with management and front-line staff

Information systems strongly aligned to business objectives, service line definitions reflect local health economy

Regular accurate information is supplemented by ad-hoc reports to meet specific requirements

Data meets national standards and is held centrally

Full implementation of NPfIT products with full system integration

The information team work alongside management and front-line staff

Information systems completely aligned to business objectiveseg. service line definitions based on outcomes

Accurate, timely and relevant information is produced pro-actively to influence organisational processes

Data meets national standards and links to other centrally held datasets

Fully integrated IT system with advanced use of secure field-based mobile technology

Members of the information team are fully integrated with management and front-line staff


Community Information Dataset

• A national dataset to support the efficiency of service planning, management and commissioning of community services.

• Therefore supporting Quality, Innovation, Productivity and Prevention gains to deliver consistently higher quality care in the community setting

Multi Agency Project Roles

Community information dataset development- NHS Information Centre

Infrastructure to ensure recording and reporting – NHS Connecting For Health

Approval of developed dataset – Information Standards Board

Approval of project controls – OGC Gateway team


AHP Referral to Treatment Data Reporting

Developed to deliver the mandate of ‘Framing the contribution of allied Health Professionals (2008) - mandates the collection of RTT from 2010

Pilot sites being established to test the current definitions and processes used by some organisations

18 week RTT definitions

Expert Reference panel


Mobile Solutions

•Significant evidence is available which demonstrates the benefits to be secured through the adoption of mobile solutions

•Some evidence of excellent local adoption but not widespread

•Further support required to accelerate learning and adoption of mobile solutions


Mobile Solutions

•Undertake a costs and benefits analysis of mobile technology in supporting community services to demonstrate the role of mobile solutions in delivering QIPP and Improving Working Lives

•Review evaluation of mobile solutions already deployed

•Produce State of Readiness Guidance

•Establish a number of adoption sites

•Support the wide scale adoption of mobile solutions


Community Information Project Supporting QIPP

QualityEnhanced patient experienced due to the availability of the clinical record at the point of care. Having the clinical record available at the point of care reduces the necessity to repeat questions and makes test results, which are available, accessible.

InnovationMonitor improvements in health outcomes and identify contributory factors by capturing accurate, comparable data


Community Information Project Supporting QIPP

ProductivityAllows measurement of clinical activity and benchmarking against other services / organisationsReducing travel time to and from bases to input clinical activity into desktop computer. Increase in the number of home visits per day due to the reduction in travel time to base

PreventionAnalysis of impact of lifestyle and other risk factors, e.g. smoking, on clinical outcomes in order to plan early intervention


Thank you


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