ccg perspective on integrated system redesign tim o’donovan september 17th 2013
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CCG Perspective on Integrated System Redesign Tim O’Donovan September 17th 2013. The existing MSK system. MSK System Redesign: the redesign of services that diagnose and treat bone, muscle , and tissue conditions and disorders, and associated pain (ICD-10 Chapter XIII, M00-99) - PowerPoint PPT PresentationTRANSCRIPT
CCG Perspective on Integrated System Redesign
Tim O’Donovan September 17th 2013
The existing MSK system• MSK System Redesign: the redesign of services that diagnose and
treat bone, muscle, and tissue conditions and disorders, and associated pain (ICD-10 Chapter XIII, M00-99)– Includes elective orthopaedics, rheumatology, physiotherapy,
podiatry and chronic pain– Excludes trauma and non-elective activity
• MSK patient population approx. 45,000• Over 25 different provider contracts• Total budget circa £25 million
The challenge: the patients’ view• Referred to the wrong service/clinician
– Frustrated by no direct referral from part to the system to another: “ping ponged back to GP”
– Continual onward referral to different elements of care until diagnosis is received
• Poor co-ordination of information and administration across the system
• No integration with social care at assessment• Long waits for and within outpatient clinics• Difficult to get in contact with team post-op
BCCG MSK Strategic Vision
• The White Paper: Liberating the NHS, provides an opportunity to move towards integrated systems of care
• BCCG response to the opportunity and challenges highlighted– Encourage integration of services through a system contract with
aligned incentives, improving the co-ordination of patient care through a PRIME CONTRACT
– Commissioning for outcomes, better value and less waste, with patients getting the right care in the right place, first time
– Empower clinical leadership to challenge and champion, and to develop new ways of providing care across the pathway
Specification• Single budget, prime contract for 5 years• Four main types of care:
– Patient support and empowerment– Support, education and advice for primary care– Community-based MSK service– Use of hospital facilities only when those facilities
are needed• Incentivised game-changing outcome measures
Prime Contractor
National Context• Prime Contracting• Alliance Contracting• Integration• Incentives• Payment/Capitation/PBR• Outcome Focus• System Approach
Members Involvement• Approach your local CCG/s, overview and scrutiny,
opportunities, good ideas e.g. joint injections• Opportunity to get involved through workshops, clinical
networks – Output is influencing specifications, KPIs, outcome measures
• Check supply to health – advertising market engagement workshops, procurements
• Are you linked in locally? Discussion with local colleagues on provision, federation, consortia, stand alone practice