Upload
tejana
View
32
Download
0
Tags:
Embed Size (px)
DESCRIPTION
Big Health Day. THE VOLUNTARY SECTOR, THE BIG SOCIETY AND THE GREATER MANCHESTER HEALTH SYSTEM WARREN HEPPOLETTE JANUARY 20 TH 2011. Overview. Context The Greater Manchester NHS and the Voluntary & Community Sector. A Challenging Present - PowerPoint PPT Presentation
Citation preview
Big Health Day
THE VOLUNTARY SECTOR, THE BIG SOCIETY AND THE GREATER MANCHESTER HEALTH SYSTEM
WARREN HEPPOLETTEJANUARY 20TH 2011
OverviewContext
•The Greater Manchester NHS and the Voluntary & Community Sector
A Challenging Present
•QIPP, the efficiency challenge and deficit reduction
•Liberating the NHS – the NHS White Paper
A Positive Future
•Population health and Greater Manchester’s Assets
•A thriving social market for health
Context
The Greater Manchester NHS and the Voluntary & Community Sector
A population of 2.8m people served by 10 PCTs, 10 Acute Trusts (8FTs), 10 Metropolitan Councils (now operating collectively as a Combined Authority).
Oldham
Bolton
M/cr
ALW
Salford
T&G
Trafford
Stockport
HMR
Bury
PCT
CMFT
Provider
UHSM
Trafford
PENNINE
Salford
WWL
Bolton
Tameside
Stockport
36.05%
46.14%
59.15%
71.98%
70.65%
50.90%
82.67%
77.66%58.26
%
65.30%
28.50%
30.33%
24.85%
12.91%
12.94%
23.87%
8.69%
14.07%
28.51%24.23
%
24.30%
8.72%
11.57%
6.17%
8.54%
17.93%
6.56%
8.35%
6.12%
4.60%
GM Elective Admissions 2009/10
1st
2nd
3rd
Greater Manchester is marked by significant cross boundary acute flows, which provides the rationale for much of the work which has defined collaboration in recent years
The voluntary sector of Greater Manchester is the largest outside London with over 11,000 organisations (6% of the national sector).
• The sector directly employs 67,000 staff (5% of the workforce)
• This does not include around 235,000 unpaid staff and trustees and over a million volunteers
•It contributes at least £1.6 billion to the Greater Manchester economy (much more if the value of unpaid work is included).
•There are over 5,000 registered charities
Greater Manchester’s Voluntary Sector
Greater Manchester has the most developed system of cross-city collaboration in the UK outside London.
This is most expressly illustrated through the recent agreement of Combined Authority status for the 10 Councils. This now provides for accountable political leadership operating at the Greater Manchester level.
Since 2004 the 10 PCTs have pursued formal collaboration, underpinned by a governing Constitution, providing a means of collective decision making for health care commissioning.
Since 1975 the GMCVO has existed to promote a thriving, effective and influential voluntary sector
History of Collaborative working
Since 2004 these arrangements have delivered:
•A major reconfiguration of maternity and children’s services as part of Making it Better building on the biggest public consultation in the NHS’s history.
•Reconfiguration of acute stroke services introducing three hyper acute centres providing service to the whole of the GM population, winning the HSJ Award last year for World Class Commissioning.
•Development of a leading edge Public Health Network overseeing evidence based practice, joint screening programmes, marketing and communications and major prevention programmes on tobacco, alcohol, and healthy weight.
•Establishment of the GM Health Commission representing a formal partnership between the 10 Councils and the NHS under the auspices of the Combined Authority
•Development of the Health Partnership between the PCTs and the GMCVO and the emergence of the UK’s largest VCS procurement consortium
History of Collaborative working
GM Health PartnershipInforming Commissioning
•Support to Psychological Therapies Tender process
•Voluntary sector health website and service directory
Supporting Commissioning
•Hepatitis C Tender
•VCS Health & Wellbeing Consortium
Building Partnerships
•Health & Community Transport
•Representing the sector in GM work
Supporting Localities
•Delivering Racial Equality in Mental Health
•Synergy’ the open forum for local infrastructure staff with a specialism in health and social care
A Challenging Present
Trends in NHS Expenditure (Source:- King's Fund & IFS "How Cold Will It Be?")
0 1 2 3 4 5 6 7
Annual real spend increasesince 1948
20th century average annualincrease
21st century average annualincrease
Lowest annual average byGovernment administration
(1951 - 63)
Highest annual average byGovernment administration
(1997 - 2011)
Budget commitment for realgrowth across public sector
beyond 2010/11
Percentage Real Growth in NHS Expenditure
The financial challenge facing the NHS is without precedent.
This will be a hugely challenging scenario given the continued increases in demand for NHS services over a long period of time. This is a complex multi-factorial issue relating to supply, technological advance, fresh entitlements and the changing population demographics. It is difficult to conceive that this demand will reduce. Furthermore, there are a number of baseline inflationary pressures within the NHS system which, if unaddressed, may require further funding – pay (both pay awards and incremental points), non-pay and estate costs. It is estimated that the “stand-still” inflationary pressures could be of the order of 5% per annum, thus making flat cash, in effect, a real terms reduction in funding
QIPP – The Productivity & Efficiency Challenge
We estimate the size of the gap to be addressed across Greater Manchester is £1.4bn
Financial Picture – Acute Funding
Efficiency Prospectus
NHS White Paper – Liberating the NHS
•GP led commissioning
•Information Revolution
•HealthWatch
•NHS Commissioning Board
•Public Health Transfer
•Health & Well-Being Boards
•Place Based Budgeting
2010/11 2011/12 2013+
10 PCTs
NW SHA
Local GP Consortia
GM NHS Commissioning Board?
Wind Down
Ramp upManaging transition – containment & creativity
PCT Clustering
•Maintain quality, safety, performance and financial balance•Oversight of QIPP Plans•Closedown of the PCTs•Handover to consortia
•Commissioning & contracting for the NHSCB
•Development of initial commissioning support arrangements
Various support arrangements
Creating the New
Commissioning Architecture
10 PCTs
10 Health & Wellbeing Boards
GM Combined Authority
GM H&WB Board
Healthy Lives Healthy People
•Transfer of function
•Ringfenced budgets
•Public Health England
Embedding Leadership for Public Health
10 Local Authorities
The crisis consists precisely in the fact that the old is dying and the
new cannot be born; in this interregnum a great
variety of morbid symptoms appear
A Positive Future
Health & Well Being Boards
•The space to reframe the health partnership between public services, the voluntary sector and communities. The contribution of the voluntary and community sector…
Leadership, Voice & Advocacy
Inform and shape commissioning strategy
Design, deliver and support services
Joint Strategic Needs Assessment – Big Society, Asset Based Approach
•Tackling the deficiency model
•Mapping the strengths and assets of our communities
•Proving the effectiveness of the social market to inform longer term commissioning
•Public Health Responsibility Deal
A Thriving Social Market
•Securing a social finance architecture
•Recognising shifts in funding principles – Payment for Success
•Bridging national policy with local ownership – eg tackling worklessness
•Rethinking procurement – the opportunity of the Consortium
•Meaningful engagement in Community Budgeting
• Aligns directly with GMS approach
• Continued GM influence on government policy
• Potential to develop our four themes: 0-5 Worklessness Offender Management Child Poverty
And other social challenges that need more joining up
Community Budgets
Real joint investment: ‘Table stakes’ Secured commitment to pool/flex local resources
DWPJobcentre
Plus
GM PROBATI
ON
GM POLICE
DWPPrime
contractor(s)
HealthAGMA/
Combined
Authority
Spare seats CVS?
e.g. Local commissi
oning budgets
e.g. Public health
GP budgets
Range of LA place based
resources
e.g. Neighbou
rhood Policing
e.g. Local commissi
oning budgets
e.g. PremisesDiscretionary Funds
Other public servicesPrivate SectorSocial Impact Bond Investors
TrustsLottery
Etc..
e.g. Social Impact Bonds
‘Asks’ of Whitehall DeptsRe: flexibilities, barriers, incentives, targets
Community Budget
DWPJobcentre
Plus
GM PROBATI
ON
GM POLICE
DWPPrime
contractor(s)
HealthAGMA/
Combined
Authority
Spare seats CVS?
Proposed Interventions‘Business case’
‘Gateway’ assessmentPlausibilityCapacityReturns on investment (to who, how, when) Align investor resourcesMainstreaming plan Intervention
deliveryInvestor alignment
Evaluation: outcomes/cost benefits‘Dividend’ distribution (Whitehall, Agency, Community, replenish fund) Roll out decisions Mainstreaming De commissioning
Integrated Commissioni
ng Model
• Your knowledge, connections and ‘reach’ are an asset
• You need to be able to quantify, describe and sell those benefits
• There may be opportunities to make some early running during the significant transition
Concluding messages for the sector