Planned Care : Getting a Grip

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Planned Care : Getting a Grip. How can we deliver the same quality of care while making savings?. CHANGES IN THE NHS. To see a video produced by The Kings Fund which was watched in the workshop, please click on this link: . AGENDA. - PowerPoint PPT Presentation


<p>Planned Care Workshop</p> <p>Planned Care : Getting a GripHow can we deliver the same quality of care while making savings?CHANGES IN THE NHS</p> <p>To see a video produced by The Kings Fund which was watched in the workshop, please click on this link: AGENDAWelcome and introductions (10)Setting the context: (15)Why Planned Care matters?The financial and demographic picture in North SomersetWhat do we intend to do?How can you get involved?</p> <p>Introduction to group activity (10)BreakGroup activity: A Vision for Planned Care (30)Next Steps (10)CLOSING</p> <p>Setting the contextThe NHS has been asked to find savings of 20bn by 2015 to cope with rising demands.In North Somerset, we need to find 11m of savings over the next 2 years.We are dealing with 15 to 20bn (in reduced costs), you dont save that by not providing biscuits at a board meetingGerry ODwyerRoyal College of Nurses Nursing Times 2009What is Planned Care?Planned care covers all services provided for adults, 18 years or over, which are planned (scheduled), including all primary care, community and hospital services. </p> <p>This does not include emergency (unscheduled) care.THE LOCAL CONTEXTPlanned Care: Getting a Grip</p> <p>North Somerset Total SpendingKey messagesTotal Spend 252m Nearly 90% of acute spend is with local acute providers Fastest growing areas of spend are acuteMedical Emergency admissionsA&amp;EElective OrthopaedicsNICEDiagnostic scopes</p> <p>Accounts for 59% of all spendingHow does this compare?</p> <p>0.37% of NHSE budgetA cataract operation on one eye costs the NHS about 900. A hip replacement costs the CCG more than 5,000.Local InformationNorth Somerset population 202,566 (2011 census) </p> <p>214,068 are officially registered with a GP97% White Ethnic Two thirds live in Weston-super-Mare, Clevedon, Nailsea and Portishead. One in five are over age 65</p> <p>88,200 households of which 29% are single owner occupied We have Lower Super Output Areas in the most and least deprived 1% Nationally </p> <p>THE CASE FOR CHANGEPlanned Care: Getting a GripThe need for change in North SomersetOur acute hospital spend is increasing at a faster rate than our funding and faster than our growth in population.Our acute hospital spend is increasing relative to our neighbours or our peers.Our acute spend is increasing in the areas that we are trying to reduce.Non acute spend is beginning to accelerate.Not only is our spend higher than our allocation it is now higher than our target allocation.We have signed up to deliver changes in service delivery that will save 11m over the next 2 years.These savings are still largely embryonic.</p> <p>Acute hospital spend is increasing faster than our funding and faster than our growth in populationGROWTH IN SPENDING 2012/13 - 2013/14</p> <p>The problem is getting worseIn 2013/14 growth in acute hospital spend is 8m (6%) In 2012/13, our unfunded growth in acute spend was 5m (4%) </p> <p>This is well above what we would expect for overall population growth of 0.6%. </p> <p>Even allowing for our aging population we would expect the impact of demographic change to be around 2.5m</p> <p>Note: Based on M11 Contract PerformanceNon-acute spend is broadly flatThis is our key cost driverFocus AreasTrauma &amp; Orthopaedics/ Musculo-SkeletalOphthalmologyUrologyDermatologyDiabetes and other general medicineDiagnostics</p> <p>Our spend is not only higher than our actual allocation it is now higher than our target allocation ---- </p> <p>NORTH SOMERSET NEEDS BIG IDEAS AND BIG CHANGEIn 2011/2012, our expenditure met our funding allocationIn 2012/13, the financial picture shifted into a less favourable positionIn 2013/14, we find ourselves with a gap of 7% between spending and our funding. We are in the process of understanding the change.HOW WE INTEND TO GET A GRIPPlanned Care: Getting a Grip</p> <p>A real time exampleDermatology: Keeping more of the work in GP practices1636 referrals into Acute (April- December 2013)Advice and GuidanceTele-dermatologyRedesign the pathway and enable the pathway with Map of MedicineExplore developing GPs with special interest in dermatology and specialist nursesEnsuring appropriateness of referrals and prescribingDermatologyPresentPathways not clearHigh numbers of referrals into acute and growing waiting listVariation in skills and confidence of doctors to treatHigh demand on primary care appointmentsShortage of dermatologists nationally</p> <p>FutureEffective pathwayReduction in number of inappropriate referralsGreater skill and confidence in primary careImprove speed of access to specialist treatmentsReduced variation in standards of careImproved prescribing</p> <p>THE CHALLENGES ARE SIGNIFICANTOur elective T&amp;O hospital spend is increasing relative to our neighbours and our peers</p> <p>Key Messages:Trauma &amp; Orthopaedics spend accounts for around 18m ( 20% ) of hospital spend on outpatients/admissions There has been a sharp increase in more complex high cost procedures locally which is not mirrored nationally </p> <p>Key MessagesWe have a big challenge but we are getting a gripWe are NOT going to reduce costs by slashing qualityThe first year as a CCG was a period of stabilisation but there is a renewed focus and energyWe are seeking innovative solutions to old problems</p> <p>FINAL THOUGHTIf every GP took out one referral a week, we would save a 1m.The challenges are not intractableThe solutions are within reach</p> <p>HOW CAN YOU HELP Us?PLANNED CARE: GETTING A GRIPNext StepsExercise to gather reaction and feedback3 questions10 minutes timed discussion on eachFacilitator at each table</p> <p>3. You are here!1. North Somerset is embarking on an ambitious programme to reduce unnecessary acute activity by introducing greater efficiencies in clinical pathways, improving the quality of referrals and engaging active patient citizenship. 2. Planned Care Programme BoardQuestionsWhat, in your understanding, were the top 3 issues the Planned Care presentation?How can we engage patients and the public in transforming Planned Care in North Somerset?Is there a role for you/your organisation in this agenda? What can you contribute and how would you like to be involved?</p>