Strategic Options for Costing

The first webinar in the series will focus on the concept of value in healthcare whilst delivering value for money. Against an environment of constrained finances and the extensive reforms underway, this is a significant challenge for the NHS, however improving productivity and quality is key with trusts needing to dliver more ambitious cost improvement plans and at the same time drive efficiencies through radical service reconfiguration. Alongside system change and financial challenge, the NHS must continue to deliver high-quality and value services to patients.

This session will cover:

•What we mean by value in healthcare
•Why it is important to consider value in healthcare and how this requires a different approach
•Reference to Michael Porters four key elements for delivering value in healthcare
•Understanding the importance of the role of clinicians on delivering value
•Experience in practical examples from the speakers

This is the last in a series of 5 webinars supporting trusts with cost improvement programme planning and will focus on monitoring, reporting and evaluating arrangements.

The session will cover:

•Sharing good practice examples from organisations who have effective CIP monitoring, reporting and evaluation systems in place
•Examples of how effective monitoring and evaluation supports delivery and ensures sustainability
•Ensuring the board has the right level of detail in order to monitor and challenge CIP performance effectively
•Ensuring the data underpinning performance is fit for purpose
•How quality metrics, including patient experience, patient safety and quality of services feed into the monitoring and reporting system
•Understanding the importance of the role of clinicians and clinical policy groups in peer support and challenge particularly around potential quality impact of CIPS
•Examples of effective evaluation of CIP schemes and sharing learning across the organisation
•Engaging staff in the CIP process and ensuring buy in across the organisation
•Experiences of what works and what doesn’t
•Tips for success going forwards.

Any Qualified Provider (AQP) is a means of delivering choice, increasing quality of services and driving innovation. In 2012/13, following local engagement with patients and the market, PCTs selected at least three services to deliver choice for patients from Any Qualified Provider and the implementation of these services is now well under way. In 2013/14 and henceforth, CCGs will decide if, when and how to use competition to drive up quality, enable innovation and improve services for patients.

Andrew Smith, the Any Qualified Provider Programme Lead will take you through a session to help commissioners to understand some of the background to where we are with AQP and when, how and why to use AQP to commission quality services, focusing closely on:

•Some of the services that are more suitable for AQP and those which are not – as well as looking at some of the other options for securing services that exist beyond AQP

•Using the AQP Qualification Process to ensure that providers are rigorously and consistently assessed

•Reviewing services selected for extension of AQP so far, and sharing best practice

•Outlining the resources and tools available to commissioners to assist them in procuring services using AQP

The Clinician’s role in service delivery and cost improvement programmes is the 4th in a series of 5 webinars supporting trusts with cost improvement programme planning, identification, delivery and monitoring. We are particularly keen for medical and clinical directors to join in this webinar.

The fourth session will cover the following:

• Experience from Medical Directors in how they ensure clinical involvement and engagement in the CIP delivery process

• Detail of how clinicians can support the board, executive directors and divisions in successful service delivery

• Practical ways that medical and clinical directors have been involved in service delivery and cost improvement programmes with clear examples of the benefits

• The challenges and what to avoid

• The positive impact clinicians can have on the process

• The potential impact of medical engagement and leadership

• The importance of clinicians supporting the development of the organisation culture required to achieve sustainable and safe CIPs

• Why clinical engagement is critical for organisations going forwards.

- Understanding where your business is going and what risks this exposes

- Market segmentation and establishing buying criteria

-How to vet prospective and current vendors

- What style of relationship you should adopt

- Understanding contestability

The development of Payment by Results to cover best practice and year of care national tariffs are key priorities for the DH in moving the payment system to incentivise the quality of patient care rather than maximise activity. Best practice tariffs have been gradually introduced over a number of years but are increasing in number, in size, incentivising appropriate clinical care settings and pathways. Year of care tariffs are being implemented ‘quickly but carefully’ for patients with long term conditions.

This session will discuss how health ec
eonomies prepare for the introduction of these tariffs and in particular:

- Review the impact of current best practice tariffs, the service and financial implications and what key issues commissioners need to consider in managing both current and future developments in this area.

- Outline considerations when planning for the introduction of year of care tariffs, including identifying qualifying patients, estimating costs and the impact on admissions.

- How the quality of activity and financial data will have an impact on their implementation.

This is the 3rd in a series of 5 webinars supporting trusts with cost improvement programme planning, identification, delivery and monitoring.

The third session will cover the following:

• Experience from two organisations in how they optimise NED involvement and engagement in the CIP delivery process

• Detail of how NEDs can support the board and executive directors with clear, consistent messaging, accountability, support and challenge

• Practical ways that NEDs have been involved with clear examples of the benefits

• The challenges and what to avoid

• The positive impact NEDs can have on the process

• How NEDS support the development of the organisation culture required to achieve sustainable and safe CIPs

• Why this is important for organisations going forwards

-Identify high risk patients and implement explicit, targeted interventions;
-Proactively manage transitions (discharge) to reduce readmissions;
-Establish a proactive care coordination model focused on key pathway segments within “Longitudinal Care Plans” (clearly define services in the context of what, how, who, where and when care is delivered).

- Select an improvement methodology and provide training for mid-level managers and clinicians to support redesign and implementation work;
- Establish a culture and capacity of continuous improvement and learning; Embrace high reliability design and identify accountable clinicians with explicit responsibilities within integrated care teams;
- Feed process measures into governance oversight processes

This is the second in a series of five webinars supporting trusts with cost improvement prgoramme planning, identification, delivery and monitoring.

The second session will cover the following:

Identifying CIPs

• How you enable staff, both clinical and non-clinical, to produce new ideas for service change (does the organisation give staff dedicated time out?)

• The use of benchmarking performance data to help identify saving opportunities and to engage clinicians – how the information is used

• How schemes are rigorously appraised for achievability and appraised appropriately for impact on quality – what is the process for this?

• How organisations check that schemes are consistent with the overall strategic direction of the organisation and the plans of partners

• How the organisation engages clinicians and other staff to achieve change that is both transformational and genuinely produces realistic, sustainable cost savings

Delivering CIPS

•How the organisation ensures that strong leaders are in place whom are capable of driving sustained change – how was this achieved?

•Do you use a PMO or is reporting and accountability devolved to ensure the organisation keeps CIP delivery on track? Who provides challenge where needed?

• How staff are supported to manage risks to delivery?

• How CIP information is communicated to support clinicians and front-line staff

• How the trust focus’s on service transformation and improvement rather than cost saving – has this been hard to achieve?

• How the trust ensures organisational culture promotes the interests of patients as well as finance and performance targets?

•How those responsible for CIP delivery are clearly identified – how accountability works in practice?

• How action is taken in CIPs which are not having a positive impact ?

The economy and demographic trends indicate that we cannot continue to work as we do. The system needs to change as the current one is not viable. The webinar will be a review of 7years experience of delivering telemedicine in the form of tele-consultation in several sectors; prisons, nursing and care homes, patients own homes, hospices, GP surgeries and remote consultations. It will explain the different forms of telemedicine to clarify what this model is and could be and what it is not. It will look at the financial and clinical issues regarding tele-consultation and how when implemented at scale it can offer significant benefits for a sustainable local health economy.

It will demonstrate how it can:

• Improve the quality of care and patient experience

• Save on admissions and A&E attendances

• Save clinical time

• Save money for commissioners

• Balanced by savings for providers

The webinar will also cover the benefits and challenges of implementation

The learning outcomes will allow participants to:
-Risk adjustment and segment high risk patient populations;
-Embrace a philosophy of transparency for quality and cost-effectiveness for all providers (and patients);
-Align the needs of all health economy stakeholders (patients, tax payers, commissioner, GPs. Community, specialty and acute providers) and create a win-win situation for all by aligning financial payments and incentives supportive of integrated, proactive, value-based care.

Session for graduates and other trainees across the South West to get a better understanding of how to put together their records and look at some examples