conor burke & lucy moore: learning from an integrated care organisation
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Learning from an integrated care organisation
Where next for commissioning and integrated care: Can the NHS rise to the challenge?, The Kings Fund
Dr Lucy Moore CEO Whipps Cross University Hospital TrustConor Burke, Borough Managing Director
March 2010
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Decommissioning -• 20% of OP• 6% Electives
Shift Acute Activity -• 40% A&E• 12% Electives• 42% OP
Prevent -• 35% LTC Adms
Acute Quality -• Weak & Weak AHC• ↑Mortality• ↓Patient Experience
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Real improvement comes from changing systems, not changing within systems.
Donald BerwickPresident & CEOInstitute for Healthcare Improvement
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As an integrated local healthcare delivery network ‘PolySystems’ will:
Promote the health & wellbeing of all people in
the local community
Maximise Independence & quality of life for people with
long-term needs
Improve service for people with non-critical acute care
needs
Achieving improved health outcomes overall and for specific communities e.g.
• Childhood obesity
• Teenage conception
• Physical activity
• Reduce emergency admissions• Care Navigation & Coaching• Improved care coordination & dmanagement • Better quality of life measures• Reduced cost per head
• Reduced waiting RTT
• Improved patient satisfaction
• Better value for money
• Increased Access
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Everybody in Redbridge is already a member of a polysystem
5 established - the engines driving change at a local level – delivering local services that are clinically and cost effective.
Loxford Polysystem
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Delivering Change…
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Focusing on CHD
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And so what?
•Whipps Cross fax discharge summaries to practices within 24 hours of discharge •GP Practices are required to contact the patient within 3 days of discharge •Patients have a face to face appointment within 10 days at which time the clinician will use a standardised checklist to review patients.•Clinicians have access to data on a patients treatment, diagnostic results and medication changes via email.
….currently getting it right 50% of the time after 2 months
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Underpinned by Aligned Data
Aligned and patient focused data for primary and secondary care data across the PCT
Risk StratificationComputes patient risks Provides “risk aware” analysis tools for GP and PCT staff
Pathway focus and financial tracking
GP Systems
PCT Databases
SUS records
Stratify DataWarehouse Journal entries
Users
• Practice Managers• Polysystem Managers• PCT Staff
Community Records
CommunityServices Records
GP Systems
PCT Databases
SUS records
Stratify DataWarehouseStratify DataWarehouse Journal entries
Users
• Practice Managers• Polysystem Managers• PCT Staff
Community Records
Community Records
CommunityServices Records
www.health-analytics.co.uk
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Information Driving Change at all Levels
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Delivering Improvement…...through People, Processes and Technology
Comm Nursing, AHPs Pharmacists, Social CareC
onsu
ltant
sSp
ecia
list C
are
GPs
One inclusive Polysystem Budget with pathway at cost
Collaborative and Competitive incentives
Estate development –transformational change
Underpinned by data - Combined productivity and quality measures
……Clinical Integration
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The Acute Provider perspective
Key incentives• Better patient experience.
• Better supports the management of capacity.
• Reduces waste and duplication.
• Integrated delivery without changing structures.
Risks• Financial ….but we have a burning platform for change together.
• Governance…addresses issues rather than creates issues.
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Thank You for Listening