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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