Equity and Excellence: Liberating the NHS What does it mean for North Somerset? Chris Born Chief...

North SomersetNorth Somerset

Equity and Excellence: Liberating the NHS

What does it mean for North Somerset?

Chris Born

Chief Executive

North SomersetNorth Somerset

• No decision about me, without me

• Best outcomes not targets• Empower clinicians• New Health Partnership• Patients empowered

through transparent information

North SomersetNorth Somerset

• Local authority leads the Health & Wellbeing Board from 2012

• New Healthwatch to replace the Local Involvement Network (LINk) - 2012

• Public health department moves to the Council - 2013

North SomersetNorth Somerset

GP Commissioners (GPC)• North Somerset GPC

Consortium - 2012• Shared commissioning

of hospitals (and mental health?) across wider area

• National Commissioning Board for some services - 2012

North SomersetNorth Somerset• All existing PCT community

services• New social enterprise from

April 2011• Focus on integrating care

with social services and hospitals

• www.northsomerset.nhs.uk• Comments by 23 February

North SomersetNorth Somerset

• PCTs abolished 2013• NHS South West

(SHA) abolished 2012• PCTs will work as a

cluster as management reductions occur

• Stronger external regulation of the system as now

North SomersetNorth SomersetOperating Framework

2011/12• Mental Health Strategy due out

2011– Public health– Better service outcomes– Early intervention and prevention

(e.g. offenders)– Drug services– IAPT expansion to young, old,

severe mi, long term conditions– Victims of violence

North SomersetNorth Somerset

• Greater choice of treatment and provider• Improve services for veterans• Support for carers• Fines for mixed sex accommodation (including

day areas)• Key measures (e.g. early intervention, crisis/home

treatment, CPA, IAPT) remain for 2011/12

Operating Framework 2011/12

North SomersetNorth Somerset

• New outcomes for 2012/13 (e.g. preventing premature death in people with severe mi, employment, experience of service)

North SomersetNorth SomersetFinance• Service providers: 4% efficiency per year• Commissioners: similar amount via service redesign• Total: £20bn savings over 4 years (e.g. £12m for NS

in 2011/12)• North Somerset: 4.1% growth (vs. average of 2.2),

but 7.2% below target (£22m)• Management reductions• Pay freeze if earning > £21k• Mandatory use of mental health clusters

WORKING AGE ADULTS AND OLDER PEOPLE WITH MENTAL HEALTH PROBLEMS

Non-psychotic

Psychosis Organic

Very severe and complex

Substance misuse

First episode

Severe ongoing

Acute emergency

Very severe engagement

4 5 6 8 9 10 12 13 14 15 16 17 19 2018117

Mild/moderate/severe

321 21

Cognitive impairment

North SomersetNorth SomersetTHREE KEY BENEFITS FROM PBR :

1. BECAUSE CURRENCIES ARE NEEDS BASED THEY SHOULD GIVE COMMISSIONERS A CLEAR IDEA OF THE BALANCE OF NEED AMONGST THOSE ACCESSING SECONDARY SERVICES AND HELP SERVICE PLANNING/PRIORITISATION

2. PBR SHOULD ENSURE A REGULAR AND TIMELY FLOW OF INFORMATION TO THE COMMISSIONER ON WHAT IS HAPPENING TO THEIR USERS AND ON INDIVIDUAL USER OUTCOMES

3. BY THE USE OF STANDARDISED CURRENCIES AND POTENTIALLY TARIFFS, VFM CAN BE BETTER EVALUATED, COMPARED WITH BENCHMARKS AND IMPROVED