lsp consultation event: resourcing of the public sector and its response to the recession : denise...
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LSP Consultation Event:Resourcing of the public sector and
its response to the recession :
Denise McLellan, Chief Executive NHS Walsall 8 February 2010
• Commissioning challenge
• Investment shift
• Manage illness
• Invest in equality
Raise levels of
general health
• Health not
illness
1
2 3
NHS Walsall Long Term Strategic Aims
Demographic Change NHS Walsall and NHS West Midlands 2007 – 2018
Life Expectancy by Ward
• manifest as eight year difference in life expectancy between most and least deprived wards
• Within Walsall the widest gap in male life expectancy is 8.4 years
Significant geographic divide between the health experiences in the East and West of the Borough.
NHS Walsall Revenue Allocation Growth
(2)%
0%
2%
4%
6%
8%
10%
12%
Financial Year
Allo
cati
on
Gro
wth
(%
)
Walsall is up to the challenge
0
100
200
300
400
500
600
700
800
900
Rate per 100,000
Walsall West Midlands England
CHD Mortality Rate – Persons aged 65-74
Rate more than halved in ten years and inequalities gap against national avge. rate closed by 2007.
109 fewer people dying each year.
Lung Cancer Mortality Rate - Persons under 75
0
5
10
15
20
25
30
35
40
45
Rate per 100,000
Walsall West Midlands England
22.5% reduction in ten years and inequalities gap against national avge.rate narrowing.
24 fewer people dying each year.
Source: NCHODSource: NCHOD
Walsall is up to the challenge‘Our Healthier Nation’ Progress in Walsall
• All circulatory disease:
41.5% mortality rate reduction, 209 fewer deaths each year, on track for 2010 target.
• Cancer:
13.6% mortality rate reduction, 53 fewer deaths each year, 2010 target may be achieved.
• Accidents:
28.8% reduction, 11 fewer deaths each year, Walsall has lowest accident mortality rate in the West Midlands.
• Mental Health (Suicide rate)
Walsall has struggled to reduce suicides further, as the suicide rate has been below the national rate in most years in the last decade and remains below the national rate.
272 fewer deaths each year already achieved by 2005-7
Over 390 fewer deaths each year when targets are achieved in 2010
NHS Walsall Long Term Financial Modelling
Key Financial Assumptions– Resource Allocation– Changes in the national tariff – Inflation
Key Cost Drivers:– Demographic Change– Disease Prevalence– Medical Technology– Access Rates/Activity Changes– Prescribing Rates
Saving Strategies– Demand Management– Service Redesign– Upstream Interventions
Base Scenario
• Reasonable expectation (pre-budget) regarding:
– Financial Assumptions
– Cost Drivers
• Demand Management and Service Redesign
– Based on top 25% benchmarked best practice nationally
NHA Walsall High Priority Outcomes 2010-2015
• Life expectancy• Deprivation score (IMD)• Infant mortality• Obesity• CVD mortality• Smoking• Teenage conception• Alcohol related harm• Stroke • Patient Experience
Final comments
• Health inequalities remain significant
• NHS Walsall is committed to retaining local, high quality services
• Clinical and financial sustainability is critical
• Need to work together to create the right levers and incentives for rapid change
Workshop questions
• How can different organisations in Walsall work better together to improve outcomes in a tighter financial environment?
• What principles should guide this?
• What are your group’s top three ideas to make a difference to the most important outcomes at same or less costs?