A business critical briefing from HSJ’s Commissioning and Delivering Integrated Care conference

Speakers

  • Gary Belfield, director of commissioning and system management, DH
  • Dr Ian Williams, director of integrated commissioning, Herefordshire PCT
  • Heather Mitchell, joint director of commissioning and deputy chief executive, Swindon PCT
  • Cathy Hamlyn, director, National Support Teams
  • Charly Goldman, senior health policy and research officer, Audit Commission
  • Heather O’Meara, chief executive, Redbridge PCT, London lead for polyclinics. Download Ms O’Meara’s presentation.
  • Neil Matthewman, director of commissioning and planning, NHS Blackburn with Darwen
  • Clare Todd, chief operating officer, NHS Blackburn with Darwen
  • Vicky Bailey, general manager, Principia Partners in Health

Examining the national vision for integrated care, Gary Belfield, director of commissioning and system management, DH

  • The aim of the integrated care pilot programme is to help strengthen the business case for integrated care by collecting evidence on it.
  • There were more than 700 expressions of interest to participate in the programme, with 36 proposals shortlisted and 16 proposals finally chosen.
  • The pilots are spread across England and cover a population of 2 million people in rural and urban areas.
  • More effort needs to be directed at spreading learning across organisations.
  • Six monthly evaluations of the programme are being completed.

Exploring the impact of Lord Darzi’s High Quality Care for All on the NHS to date, Dr Ian Williams, director of integrated commissioning, Herefordshire PCT

  • There is a general aspiration to “be doing more at community level”.
  • Organisations should identify which services are needed, then develop incentives.
  • They should promote links between key players to make new policies and structures useful.

Maximising the potential of tools available to facilitate integration, Heather Mitchell, joint director of commissioning and deputy chief executive, Swindon PCT

  • Tools to help integrate health and social care commissioning functions include: joint strategic needs assessments, joint directorships for public health, joint community engagement strategies, joint embryonic intelligence and information networks, joint market and intelligence strategies, joint economic modelling of services, using outcomes as common measures.
  • A “new logo” only goes so far; when integrating organisations, organisational cultures need to be addressed, joint aims and challenges developed.
  • Achieve this through joint market management tools, a joint client experience function or a joint carers strategy. Address people issues that could affect the integration of teams (such as terms and conditions).

World class commissioning and integrated care, Cathy Hamlyn, director, National Support Teams

  • The National Support Teams have performed around 350 visits to organisations.
  • The most interest has been around joint commissioning for smoking cessation, reducing alcohol-related hospital admissions and CVD mortality.
  • Integrated care can increase the capacity and performance of services, improving health outcomes and tackling health inequalities.

How joint financial arrangements have been used across health and social care to improve care, Charly Goldman, senior health policy and research officer, Audit Commission

  • There are different financial arrangement tools for commissioning integrated care, such as pooled funds, aligned budgets and integrated provision.
  • Drivers for using these include improving patient experience, increasing efficiency, protecting funding for vulnerable groups and enabling local initiatives.
  • Pooled funds are commonly used to support integrated care.

Delivering integrated care in practice: polyclinics, Heather O’Meara, chief executive, Redbridge PCT, London lead for polyclinics

  • Redbridge PCT created the first purpose-built polyclinic, which had more than 8,000 visits in its first opening week.
  • There are now seven polyclinics.
  • They focus on health and wellbeing and monitoring people at risk of hospital admission.
  • 40 per cent of secondary care is expected to move to polyclinics at an 80 per cent lower cost.
  • GP ownership has been key in the project’s success.

 

 

Integrated care solutions from NHS Blackburn with Darwen, Neil Matthewman, director of commissioning and planning, NHS Blackburn with Darwen, Clare Todd, chief operating officer, NHS Blackburn with Darwen

  • When integrating care, use social marketing to increase community awareness and involvement.
  • Use governance to manage risks adequately and promote good innovation.
  • Plan for changes in policy while remaining focused on patients.
  • Do not underestimate the time that it takes to achieve change, plan for a decrease in performance, and remain focused on outcomes.

Social enterprise, Vicky Bailey, general manager, Principia Partners in Health

  • Principia undertakes practice based commissioning. It has 120,000 beneficiaries, covers 100 GPs and 60 practices in a rural context.
  • It developed a pilot project to improve management and outcomes in long term conditions and the COPD pathway.

Senai Jimenez, Bocconi University Intern at South Central SHA, June to October 2009, MSc in International Healthcare Management.

Commissioning and Delivering Integrated Care