Clinical Commissioning Group

NHSR Case Management Pilot VCS Role

Sarah WhittleAssistant Chief Operating Officer

NHS Rotherham

Purpose

• Explain background• What is case management?• Implications and opportunities for VCS• Commissioning and delivery model• Next steps

Clinical Commissioning Group

Background• Increasing numbers with long term conditions• Above average unplanned hospital admissions• 70% of health and social care costs• 60% increase in number with more than 1 LTC• Overall significant increase in numbers with a

LTC

Aim of pilot

• Reduce hospital attendance• Improve quality and co-ordination of care• Improve patient outcomes• Improve patient experience• Increase capacity in primary care• Reduce health inequalities

Integrated case management

• Risk profiling / stratification of patients• Integrated care plan• Promotion of self management• GP to lead as pro-active care co-ordinator• Multi-disciplinary case management team• For the first time VCS integral part of team

Integrated care team

VCS Model

Implications and Opportunities

• Direct funding• Raised profile• Sustainability• Increased demand• Income• Evidence base• Prevention and early intervention

Commissioning and delivery model

Criteria for lead organisation

• Track record of managing complex projects• Ability to provide independent brokerage• Ability to develop and maintain service directory• Track record of supporting collaborative approaches

to service delivery• Understanding of LTC strategy and integrated case

management• Experience of capacity building and supporting new

service development in the VCS

Next steps

1. Staff recruitment Consultation on job descriptions Nominations for interview panel

2. Process for making funding decisions Patient focus group/citizen’s jury Agreement of panel Development of / consultation on evaluation criteria

3. Establishment of steering group Nominations for steering group