“Multi-specialty Community Providers” (MCPs)

Tuesday 19 July 2016

Brixworth Country Park

Development Session

Councillor Sylvia Hughes

Cabinet Member for Public Health & Wellbeing

Northamptonshire County Council

Welcome

Northamptonshire Health and Wellbeing Board

Cllr Sylvia Hughes, Northamptonshire County Council

Chair of Northamptonshire Health and Wellbeing Board

The Board Development Sessions

• Health and Wellbeing Board meets six times a year

• Board Development Sessions include the opportunity of extending the reach of the Board

• Each session hosted by the Chair or a Vice Chair, with invitations relating to the theme of the session

Chair and Vice Chairs

Cllr Sylvia Hughes Chair

Prof Nick Petford Vice Chair

Dr Darin Seiger Vice Chair

Cllr Chris Millar Vice Chair

Today’s development session

Multi-specialty Community Providers

(MCPs)

Introduction and Purpose of the Event

Richard McKendrick

Chief Operating Officer

Northamptonshire Healthcare NHS Foundation Trust

Purpose of the Event

1. Explore the national and local context – Five Year Forward View and Sustainability and Transformation Plans (STPs)

2. Develop a shared understanding of the Multi-specialty Community Provider (MCP) model of care

3. Identify individual impact and contributions

The National Context

Angela Hillery

Chief Executive

Northamptonshire Healthcare NHS Foundation Trust

The Five Year Forward View Identified 3 Widening Gaps in the national NHS

• Unless we get serious about prevention: Recent progress in life expectancies will stall Health inequalities will widen Ability to fund beneficial new treatments will be crowded out by the

need to spend billions of pounds on wholly avoidable illness

1 – Health & wellbeing

• Unless care delivery changes: Patients’ changing needs will go unmet People will be harmed, who should have been cured Unacceptable variations in outcomes will persist

2 – Care & quality

• If we fail to match reasonable funding levels with system efficiencies: Worse services Fewer staff Deficits Restrictions on new treatments

3 – Funding & efficiency

SOURCE: ‘Five Year Forward View’ (NHS England, October 2014)

44 areas have created their own Sustainability and Transformation Plan to close these gaps’

Sustainability and

Transformation Plan

(STP)

Health and

Wellbeing

Care and Quality

Finance and

Efficiency

1

2 3

Healthier populations will reduce

demand for NHS services and

improve quality of life

New models of care will

reduce unwarranted variations

in quality and safety

Reducing the demand for, and

cost of, NHS services will

deliver more efficient care

Northamptonshire is one of the 44 areas – some areas comprise several counties

The STP gives us an opportunity to shape our future

• Never been more complex period

• Challenges are different

• Financial climate

£20bn efficiencies by 2021

Front loaded NHS settlement

• Increasing Demand

• Workforce

• Five Year Forward View – Alignment

of system

• STP – shared sense of leadership

across organisations

• Variance across country is ok

• Broader thinking required

What is a Multi-specialty Community Provider (MCP)?

Richard McKendrick

Chief Operating Officer

Northamptonshire Healthcare NHS Foundation Trust

15

Nationally, the Multi-specialty Community Provider (MCP) model of care is

characterised by Five Features

SOURCE: NHS Confederation

2 3 4 5 1

16

Our local model is based on the shared ambition for primary care developed by

primary care federations, the LMC and NHFT

1

2

3

4

5

6

A multi-disciplinary approach to managing

same day demand

Extensivist approach for patients with long-

term/complex conditions

Scheduled care closer to home through

greater clinical collaboration (where possible)

Integrated health and wellbeing services

Primary and community care workforce

working as MDTs

New roles and portfolio career options

across organisations

10

11

12

A network of fit-for-purpose, strategic

sites across the county

Opportunities for secondary care

consultants to be part of the model

Tiered model of care with interventions

delivered at the right level

9

7

8

Models exploiting telehealth, telecare and

communication technology

Lean, shared back office functions to

reduce overhead costs

Integrated, electronic patient records

17

The model targets segments of our population with specific services

designed to meet their needs

63

54

62

30

32

17 21

16

5

16-64 0-15 >65

SOURCE: McKinsey team analysis (2016)

2%

2-50%

50-100%

Age Profile What they need from the system

▪ Intensive care in home/hospital/community

▪ Continuity of care

▪ Knowledge sharing across organisations

▪ Minimal duplication of visits/paperwork

▪ Medication reviews

▪ Proactive integrated care plan

▪ Navigation/signposting between services

▪ Effective referral between services

▪ Social care support where needed

▪ Knowledge sharing across organisations

▪ Voluntary sector support where needed

▪ Accessible care in the community

▪ Health prevention and promotion

▪ Signposting to relevant activities/support

Very

High

Risk

High/

Moderate

Risk

Mostly

Healthy

%

18

The model comprises four pathways and several ‘enablers’

Complex care

▪ Extensivist care for

complex patients:

▪ Collaborate care for

moderate risk patients:

▪ In-reach for acute

admissions & discharge

interface:

▪ Self-management:

Urgent Care

▪ Single point of access

▪ Rapid response:

▪ Same day urgent care:

Scheduled care

▪ Integrated outpatient

services

Prevention and self-care

▪ Prevention & self-care

D C

B A

1

2

3

8

4

5

7

9

6

Enablers:

▪ Information sharing

▪ Workforce capacity/capability

▪ Aligned payment/incentives

▪ Effective estate

Session 1: Developing a Shared

Understanding of MCP Models

REFRESHMENT BREAK

Session 2: Identifying Individual

Impact and Contributions

Richard McKendrick

Chief Operating Officer

Northamptonshire Healthcare NHS Foundation Trust

Group Feedback

Next Steps and Closing Remarks

Dr Akeem Ali

Commissioner of People

Northamptonshire County Council

Thank you