value based healthcare in nhs wales…… value based approach to procurement will encourage true...
TRANSCRIPT
Value Based Healthcare
in NHS Wales……
Alan Brace
Director of Finance
Health and Social Services Group
Welsh Government
What’s a
Good
Outcome
Worth ?
NHS Finance - The Alligators
Jaw…..
Scenario modelling suggests a cumulative financial gap of between £1.3bn and £1.9bn over the next five years
£6.753bn
£6.385bn
£5.043bn
£4.838bn
£3.5bn
£4.0bn
£4.5bn
£5.0bn
£5.5bn
£6.0bn
£6.5bn
£7.0bn
2004-05 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15
Annual grow th in costs (high)
Annual grow th in costs (low )
3% reduction in annual funding
4% reduction in annual funding
£1.9bn
gap
£1.3bn
gap
Esimated range of
financial challenge
Improving Healthcare Value
• The case for change has never been stronger.
• Health Spend is over 50% of the Welsh Government Budget and
growing.
• We have what is needed to achieve increased value - an
integrated system, capable of data measurement and directed
change
• Our Health system is planned, more agile and integrated, we can
effect change more easily and at scale
• University Health Board designations allow for joined up thinking,
greater ambition and working across sectors in new ways
Health and Wealth
• Health spend is also a huge lever for economic value
• Welsh Government can create an environment, for business
activity that impacts on Welsh economic growth.
• Foster closer relationships between suppliers and the NHS
• Value Based Healthcare provides a common platform to
achieve this.
So how have we gone about this ……
Our Value Journey.
Aneurin Bevan Health Board...
Achieved to date
Outcomes Collection Costing
Parkinson’s Neurology TDABC
Parkinson’s COTE TDABC
Dementia Patient level and TDABC
Primary Care Mental Health TDABC
Inflammatory Bowel Disease TDABC
Heart Failure Patient level costing
Pulmonary Rehab/COPD Programme Budgeting
Cataracts TDABC
Reviewing scope Prostate Cancer TDABC
Aneurin Bevan Health
Board...Currently Developing
Scoping Opportunities
Vascular Surgery
Dermatology Psoriasis
Endoscopy Breast Services
Diabetes Alcohol Liaison Service
Adult Autism with Social
Services Inflammatory Arthritis
NHS Wales Developments
Lung Cancer Heart Failure
Time Driven Activity Based Costing,
in progress.
All Cataract Pathways in NHS
Wales -TDABC
Outcome Measurement in Progress
Value Based Procurement
Procurement Challenges:
• A siloed-approach and
misaligned goals
• Strong pressure to reduce
Costs
• A price only approach and
• A lack of consideration for the
quality of care or longer-
term economic implications
WHY THIS APPROACH NOW?
Procurement Opportunities:
• Industry are showing signs of
readiness
• Keen to develop partnerships
• New EU Directive gives more
support to value
• Tendering is ripe for reshaping
• Growing demand to
systematically measure
outcomes and costs
System suffers from a lack of incentives, tools and expertise to consider the
complete value which products and services can offer, at different levels and
across stakeholders.
Delivering Value for Wales –
Placing Outcomes at the heart of
Procurement
Assessing Value and measuring what matters -
Placing clinical and patient reported outcomes at
the heart of the procurement decision making
process.
PARTNERING FOR VALUE
A Value Based approach to Procurement will encourage true partnership with
Academic and Industry partners, adopting a risk-sharing approach which will be
measured on the outcomes that are achieved.
We will look to:
Measure specific healthcare outcomes and assess value in the goods
and services that we pay for.
Look to agree guarantee models that tie prices to specific
predetermined outcomes.
Look to triangulate outcomes capture, patient and clinical costing
and contracting to access the opportunities to redesign services
across the whole cycle of care, driving efficiency, outcomes and
potentially significant savings.
Reducing clinical variation by ensuring that product choice is based
upon robust considered evidence.
A Joint Collaboration between –
Swansea University Medical School,
Erasmus Holland,
Cascais Portugal and
ICHOM
Value Based Health Care –
Medical Undergraduate Curriculum
Health and Social Care -
Leadership and Innovation
Academy
Diolch yn fawr.
Thank you.