whole systems integrated care whole systems integrated ... · • using the latest data...

WHOLE SYSTEMS INTEGRATED CARE

(WSIC) DASHBOARDS

COLLABORATION OF NWL CCGS

North West London Collaboration of Clinical

Commissioning Groups

Amanda Lucas, Programme Director. On behalf of the Collaboration of North West London Clinical Commissioning Groups August 2017

Whole Systems Integrated Care

Product Strategy v0.2 Draft February 2018

Ian Riley Director of Business Intelligence 0203 350 4152 – [email protected]

Whole systems integrated care vision

Our vision

To use the power of integrated information, technology and advanced analytics to improve health and social care outcomes in North West London

Our role

To develop the data sets, analytical tools and offer business intelligence expertise to support STP’s, ACS’s and all health and care partners in North West London

Patient

Direct Care

Population Health

Research

WSIC Delivery Domains

Infrastructure and data management Enable information to move securely across all health and care settings by providing and maintaining robust and future-proofed systems.

Public trust and security

Comply with all national directives and respect the data sharing preferences of patients, keep their data secure in all settings.

Direct Care analytics for health and social care Use advanced analytics to support decision making in direct care settings, support new care pathways and clinical decisions across the whole health and care systems

Information Governance - Data Sharing & Integrated data sets

Continuously develop an integrated care dataset reviewing new data sets and working with data controllers to establish more frequent flows.

Patient engagement Self-care and prevention Give patients access to data, analytics and resources to more effectively manage their own health and social care.

Data availability for research and evaluation of healthcare management Make data available to enable the discovery, adoption and evaluation of emerging innovations in healthcare across NWL.

Population health analytics

Use data to understand the health and care needs of our population, target preventive care, support the STP and other initiatives most efficiently, and to monitor improvements over time.

Improve data quality

Ensuring high quality data flows for better patient care, patient safety and also play a key part in improving services through informed decision making.

1 2 3 4

5 6 7 8

Patient engagement in self-care and prevention Give patients access to data, analytics and resources to more effectively manage their own health and social care.

1

AIMS Supporting the "Patient Access Purpose" within the NWL digital ISA by enabling patients to access their integrated care record, care plans. Patients will be able to see their health data in context with others in the population to enable them to benchmark their outcomes. • Share bidirectional data with the care information exchange (CIE) to

support patients accessing their data and managing their own LTC’s. Explore getting more frequent and richer clinical data into WSIC.

• Support the recording of patient activation measures (PAM) scores in the GP record with regular reporting.

• Support patient generated data to flow into clinical systems (mobiles, devices, wearables) and share WSIC data back through to patient apps.

• Allow patients to analyse their health in relation to overall population health, to help them make decisions, identify improvement and preventative opportunities’ Source: NWL STP

Source: NWL STP

Initial Program Deliverables (final priorities to be decided by patient groups) Begin and deliver in 2018/19

▪ Develop Integration with the NWL care information exchange (CIE)

– Enable WSIC data and visualizations to be presented to patients within the patient portal (patients know best – PKB) element of the CIE.

– Work with the CIE program to develop more frequent data flows from providers into WSIC and support the vision of getting to real time data flows for patients (but accepting there will be steps towards this when moving from the current monthly data feeds from secondary care and social care providers).

– Review any wider data sets contained in CIE and how WSIC (and clinicians) could benefit from these in terms of creating a richer record.

– Review feasibility of flowing unstructured data from providers to WSIC and how it could be utilised.

Supporting the "Patient Access Purpose" within the NWL digital ISA by enabling patients to access their integrated care record

Partner with technology apps to enable patient interaction with their integrated care data.

Support the recording of patient activation measures (PAM) scores in the GP record with regular reporting.

1a

1b

1c

Patient engagement self-care and prevention 1

▪ Integration with patient facing mobile applications (Apps)

– Work with approved NWL apps to determine how we can present patients integrated care data

– Apps can support health coaching, structured self-management education programmes and peer support.

– Enable patients to benchmark their own health outcomes against a wider population with similar attributes

• Support to deliver tailored interventions for patients by reporting on patient activation measurements which are recorded by primary care and record a patients skills, knowledge ad confidence in managing their health and long term conditions:

• Use WSIC dashboards to display PAM score in a patients longitudinal record

• Provide regular reports to CCG’s and primary care leads on levels of PAM recording to help target areas for support.

Projected delivery date

Q3 2018/19

Q1 2018/19

Q3 2018/19

Public trust and security Comply with all national directives and respect the data sharing preferences of patients, keep their data secure in all settings.

• All health and adult social care organisations must, by law, share information with each other about patients they are caring for directly, to improve the care provided.

• There has been significant anxiety from care professionals and patients about how to safely share data and for which purposes.

• The Caldicott Review found that in some cases this anxiety meant patient information was not shared, even when sharing would have been in the best interest of the patient.

2

AIMS Initially the NWL integrated care record (WSIC) is built using informed, implied consent and so we need to ensure that patients are heavily involved in the program and aware of how their care data will be used in NWL: • Patients kept informed of how their data is being used with extensive

fair processing. • Patients to be involved at all levels of the WSIC program and

governance meetings. • Regular program updates to NWL patient groups (e.g. Healthwatch,

etc…) • Undertake regular privacy impact assessments. • Regularly review the NHSE and national data guardian guidelines on

patient data & consent. • Review and Implement new 2018 general data protection regulations

(GDPR)

Public trust and security Comply with all national directives and respect the data sharing preferences of patients, keep their data secure in all settings.

Data sharing in North West London Key facts • Over 2 Million People • Over £4bn Annual Health & Care Spend • 8 Local Boroughs • 8 CCGs & Local Authorities • Over 370 GP Practices • 9 Acute & Specialist Hospitals • 2 Mental Health Trusts • 2 Community Health Trusts

2

Public trust and security Program Deliverables

Citizen involvement & communications

National data sharing guidelines

2a

2b

2

• Regularly review national data guardian guidelines on sharing citizen data and consent.

• Review and implement any changes to comply with GDPR and data protection legislation.

• Undertake annual privacy impact assessments (PIA) • Ensure all decisions on additional data sets, system users and wider uses of

the data are approved and authorised by the NWL Digital Information Governance group

• Ensure the subject access request (SAR) process is understood by all data controllers who share data with WSIC.

• Engage with care information exchange programs which have a patient consent function and move towards greater use of explicit consent

• Work with existing patient groups in NWL to define a full citizen / patient engagement strategy

• Establish a twice yearly citizen conference to share case studies of integrated care and discuss benefits to the health economy and ways the program can be improved.

• Commence regular program attendance at Health Watch & any other NWL citizen groups

• Develop a citizen advisory group (PPAG) or utilise an existing NWL one • Ensure citizen involvement in the NWL IG governing group is maintained and

patients fully involved in the ISA re-write. • Regularly review the fair processing materials to ensure they reflect

everything the program is undertaking. • Ensure the WSIC website is regularly updated around program updates and

decisions (including minutes of the IG group). • Utilise social media and multimedia channels to keep citizens informed

Begin and deliver in 2018/19 Projected delivery date

Q2 2018/19

Q1 2018/19

Direct Care analytics for health & social care

AIMS

• The primary purpose of the whole systems integrated care work is to support ‘care planning’ and ‘case finding’ as described in the NWL ISA for direct care of patients within North West London.

• This will be achieved through developing a series of analytical tools and dashboards to support care professionals in the following ways:

– Risk stratification / patient selection / case finding

– Care planning across the whole system and multiple care settings

– Supporting decision making for Long term condition management

– Pro active and preventative – new models of care

– Linking back population health analysis into direct care support

• The current and future developments of the WSIC system will be clinically led by a Clinical Advisory Group (CAG)

Use advanced analytics to support decision making in direct care settings, support new care pathways and clinical decisions across the whole health and care systems

3

“Care professionals will be at the centre of organising and coordinating peoples care so that care is accessible and in the most appropriate settings”. Whole systems integrated care toolkit

Direct Care analytics for health & social care Use advanced analytics to support decision making in direct care settings, support new care pathways and clinical decisions across the whole

health and care systems

3

Long term conditions

Diabetes Asthma AF / Stroke Etc……

Descriptive Analytics

Prescriptive Analytics

Predictive Analytics

e.g. how many diabetic patients are there in the NWL population,

where are they located & what is the cost of

their care

e.g. using risk strat tools & dashboards to support

clinicians to identify the right patients for proactive

interventions to manage the diabetic care processes and

thus their condition

e.g. using algorithms and advanced analytics to identify patients at risk of developing

diabetes. Also modelling future impacts of diabetes on the

health economy & modelling the potential impacts of

interventions.

Program Deliverables

Care Planning Purpose: Provision of a suite of dashboards

and analytics to support clinicians in the development of

individual patient care co-ordination and

management

Case Finding Purpose: Proactive identification of patients for intervention

3a

3b

Direct Care analytics for health & social care 3


• Develop a full suite of analytics / dashboards which cover all long term conditions and are prioritised by the Clinical Advisory Group (CAG).

• Develop priority list • Plan into upcoming development release cycle

• Use the analytics to support multi-disciplinary teams to access an integrated, longitudinal record of a patient’s health and wellbeing. Clinicians will then implement individual care and support plans.

• Enable access to clinicians across providers and care settings • Ensure training and development is planned accordingly

• Develop interoperability between the key primary care, secondary care & social care clinical systems and WSIC (where practical) to enable clinicians to launch the dashboards ‘in context’ with the relevant patients details.

• Use risk algorithms on the data set to flag patients for potential interventions and to trigger alerts.

• Continue to evaluate and review risk strat solutions (including costs and benefits)

• Develop analytics to identify optimal patient pathways and flag them to providers of care, also flag packages of care where the outcomes appear to be suboptimal.

• Work with partners to develop more advanced pathway analytics • Ensure alignment with national programs such as ‘Right Care’

The proactive identification for practices of patients for intervention: analytics combined with interpretation and local knowledge to identify where the most impact can be made on patient outcomes: • Using the latest Data analysis/risk stratification tools • Patient Radar (simple flags around DNA’s in any location, recent diagnosis of a LTC

etc….) • ‘Red Flags’ in each of the long term condition dashboards (e.g. Asthma

exacerbations) • Patient activation and frailty data combined with interpretation and local

knowledge to identify where the most impact can be made on patient outcomes

On-going through 2018/19

Priority set by CAG


Priority set by CAG

Direct Care analytics for health & social care Use advanced analytics to support decision making in direct care settings, support new care pathways and clinical decisions across the whole

health and care systems

3

Proposed list of dashboards in WSIC for Long term conditions

Diabetes Asthma Severe Mental Illness Atrial Fibrillation Patients with Multi-morbidities Hypertension COPD Common Mental illness Heart Failure Kidney Disease Hepatitis Arthritis Epilepsy

Cancer • Head and Neck • Upper GI • Lower GI • Lung • Skin • Breast • Gynaecological • Urological • Haematological Social Isolation

Currently available

Available in next release (Mar18)

Population health analytics

• The NHS Five Year Forward View ‘triple aim’ set out to achieve – improved health and wellbeing, transformed quality of care delivery, and sustainable finances. WSIC will aim to support STP’s and emerging ACP’s to develop a data driven approach through:

• Population analytics and segmentation capability – understanding the current & future care needs and utilisation of the population, better definition of care models & support outcomes.

Use data to understand the health and care needs of our population, target preventive care, support the STP and other initiatives most efficiently, and to monitor improvements over time.

4

“How can we organise around people and their needs?... …Dividing the population into groups of people with similar needs is an important first step to achieving better outcomes through integrated care”. Whole systems integrated care toolkit

• Performance analytics – an ability to track at a network level the delivery of outcomes and costs from each of the providers

• Payment & costing calculation capability – understanding of the capitated budgets for a selected population including commissioner and provider costs.

• Care pathway modelling – providers will require an ability to model the upside and downside of potential changes to care pathways for all partner organisations.


Population analytics and segmentation capability

Identifying & Measuring Outcomes

Care pathway modelling

Payment & costing calculation capability

4a

4b

4c

4d

Population health analytics 4


Work with STP’s and ACP’s to understand the costs of care across various settings and population groups.

• Evaluate the suitability and accuracy of costs in WSIC to support work towards capitated budgets

• Develop or procure actuarial & modelling capability to assess impacts of new pathways or interventions on overall care costs.

Work with NWL stakeholders to ensure that as outcome frameworks are designed that WSIC is well placed to provide the data required to measure the objectives

• Work with STP delivery areas and ensure WSIC data can support them

• Work with emerging ACP’s in NWL to support development of Outcome Frameworks

• Work with public health across NWL to support their reporting requirements

• Support Health and Wellbeing boards and identify any outcomes which WSIC can support

Developing effective risk stratification and impactability modelling for the entire population or defined segments to enable early intervention and preventive care in NWL. • Development of predictive risk models tools, algorithms and analytics to sit on the

WSIC database that can be used to identify the most impactable patients in NWL. • Segmenting and stratifying the NWL populations by allocating risk scores to patients. • Initial focus on patients with multimorbidities and long term conditions, also review

patients who are predicted to become unwell or have issues with their conditions. • Review data sets on wider determinants of health to bring into WSIC • Link to Right Care initiatives around identifying unwarranted variation in provision or

outcomes. Support the evaluation of current pathways and new models of care

• Enable anonymised data for patients on new care pathways to be flagged in the WSIC system to support service evaluation and monitoring of outcomes.

• Use analytical techniques and visualisations to show current pathways and enable review and re-design (e.g. Bowtie analysis)

Q2 2018/19

Q2 2018/19

Q2 2018/19


Population health analytics (2) 4

Population Segments

Data availability for research and evaluation of healthcare management

Make data available to enable the discovery, adoption and evaluation of emerging innovations in healthcare across NWL.

5

• The NHS continuously conducts high-quality research and adopts new treatments. Clinical research and service evaluation is a vital part of the work of the NHS, helping improve treatments for patients now and in the future

• Clinical Commissioning Groups (CCGs) have a legal duty to promote research and the use of evidence obtained through research. Many other NHS organisations also have responsibilities for research and the adoption of innovation.

AIMS • To partner with academic health partners & NWL care providers to

use the anonymised WSIC data sets to evaluate new models of care and new care pathways • it is vital that we can support providers of care to monitor and

evaluate the quality & effectiveness of health and care services and change clinical pathways when necessary.

• Supporting initiatives which aim to ensure every patient is offered opportunities to be involved in research. • Supporting ICHP to Generate a cohort of NWL patients who

have given their explicit consent to be contacted for research. • Reviewing WSIC data in terms of research feasibility studies.


Support the use of de-identified data to drive research and innovation across health and social care

5a

Data availability for research and evaluation of healthcare management

5


WSIC aims to partner with both academic and commercial health partners and NWL care providers to utilize the unique data assets within NWL (the deidentified data set) to benefit service users through improvements in care provision (supported by research findings).

• Imperial College Health Partners (ICHP) are developing a consent to contact database in order to build up a register of patients who are interested in sharing their data for research purposes. This will be in the form of explicit consent from the patients and will link to WSIC in order to access the integrated care data for each of the consented patients.

• Develop the technical infrastructure with WSIC, NELCSU and ICHP

• Support the service Go Live and ensure that NELCSU are tracing patients effectively.

• Ensure WSIC data can be retrieved for the consented patients.

• ICHP would also like to work with NWL to explore the following uses of the data set: • Non commercial academic trials (college and primary care) • Commercial trials • Access to the data for feasibility studies for clinical trials • Suitability for Digital, Med tech and/or combinations (single or combo) • Analysis, retrospective & prospective studies • Potential for genomics and biobank

• Algorithm Validation – There are a number of risk strat algorithms on the market and ICHP will support the evaluation of these products.

• Review commercial and NHS risk strat tools for their suitability to be added to the WSIC database.


Priority set by Information

Governance Group


Support ACP’s & STP’s to monitor outcomes and undertake actuarial analysis and intervention modelling

5b

Data availability for research and evaluation of healthcare management (2)

5

Planning and evaluation, needs assessment and opportunity analysis

5c

Using WSIC data to support the review and transformation of current health and social care service provision across NWL: • Support the understanding the impact of wider determinants of

health on populations. • Defining and identifying relevant segments and cohorts within

populations driving cost, utilisation and quality challenges • Evaluating and implement the best risk stratification approaches. • Evaluate pathways using analytics and diagrams (“Bow Tie

diagrams”) • Support the evaluation of different care pathways and preventive

interventions in NWL.


Work with the STP and emerging ACP’s in NWL to analyse WSIC data to support: • Develop dashboards to measure defined outcomes and also analyse spend,

costs , quality and clinical outcomes of the population across the entire care settings in NWL

• Develop a suite of analytics to support whole system planning, strategy development, management, assurance and evaluation (cost, quality, clinical outcomes):

• statistical modelling to evaluate current and predict future utilisation • effectiveness and cost of care providing insight and analytics to

support care design / redesign / optimisation and modelling the impact of an intervention.

• Provision of analytics to support the ‘right care’ principles and identify unwarranted variation and to support management of pooled / shared capitated budgets at both a patient and population level

Q3 2018/19

Q3 2018/19

Infrastructure & data management • The technology which supports enterprise data

warehouses continues to rapidly evolve and their usage and features have changed drastically. Data warehouse systems are increasingly moving to be more cloud based and now often have in-built analytical capabilities.

• It is vital the whole systems program utilises the latest technology, is agile & responsive and works with partners to provide and maintain robust, secure and future-proofed systems.

6

AIMS • Best of breed data warehouse and analytical technology –

partner with specialist organisations to deliver and improve the data warehouse framework and deploy the latest analytical technology

• Infrastructure - To work with an approved partner to ensure: • Managed Service – utilising the latest data storage

technology to deliver high levels of scalability, speed and reliability.

• Security – high levels of protection from cyber attacks, unauthorised access and security breaches.

• Data Management – Utilise a provider who has expertise in handling large amounts of health and social care data, expertise in data linkage and can offer resilience and economies of scale.


6a

Infrastructure & data management 6

Have successfully moved the WSIC system from SECSU to NELCSU in 2017/18 and are exploring increasing the CSU’s remit for data management within the program. Also working with the CSU to ensure that plans for new data feeds are understood and costed accordingly under the SLA. Review with the CSU the future storage requirements for WSIC and procure adequate storage. • Refresh the current SLA Contract with the CSU (for 2018/19) which

covers infrastructure and data management. • Continue to review virtualised infrastructure offerings with the

CSU and emerging technology cloud providers outside of the CSU (IG permitting) to ensure best value for money from the infrastructure contracts.

• Deliver the de-identified data set into a Microsoft Azure environment and ensure costs and risks are understood (as agreed with IG group).

• Taking the learning from the de-identified, scope the costs, benefits and risks of a movement of the patient identifiable data (PID) / direct care analytics into a cloud environment

• Work with the CSU to ensure the speed of the system for end users is sufficient and does not cause complaints or issues (have increased the fixed storage infrastructure multiple times to accommodate for the increasing data flows).

• Undertake annual infrastructure penetration tests to ensure the provider has high levels of protection from cyber-attacks, unauthorised access and security breaches.

Effective Infrastructure


Q2 2018/19

Q4 2017/18



Best of breed data warehouse & analytics

6b

Infrastructure & data management (2) 6

Continue to develop the current data warehouse • Review and document the future requirements for the data warehouse. • Procure a replacement technology stack for the Mckinsey's original data

warehouse / framework. • Develop open API’s to allow data to flow in and out of WSIC more easily • Review the analytical software deployed against the WSIC data warehouse

for its continued suitability, value for money and strategic alignment (currently using Tableau on WSIC but Power BI against BAU NWL commissioning data).

• Develop NWL analytical teams to develop more advanced data scientist skills to undertake actuarial analysis.

• Work with BI partners such as ICHP to bring in analytical skill sets as gaps are identified (health economists etc….)


Effective Data Management

6c

• Develop and agree with the CAG a data priority / road map to enable more real time feeds from providers either by obtaining direct feeds or via a care information exchanges (CIE’s).

• Review the suitability of closer integration with the CIE providers in terms of data flowing from WSIC (and into WSIC)

• Work to obtain these additional data from providers in the third sector and also data on wider determinants of health, these are often identified in stakeholder meetings as important and a priority.

• Revise the current SLA Contract with the CSU (for 2018/19) to reflect any additional data sets

• Create a roadmap to obtain unstructured and uncoded data to support analysis.

• Ensure the CSU provider works with data controllers to identify and rectify any data quality issues at source.

Q2 2018/19

Q2 2018/19

Information Governance - Data Sharing & Integrated data sets Continuously develop an integrated care dataset reviewing new data sets and working with data controllers to establish more frequent flows.

7

• For integrated care to be successful we must be able to link health and social care data sets at a patient level, this then enables a longitudinal view of the patients record and supports both direct care and population health interventions.

• It is vital the data controllers have confidence to share data across the system and that data sharing is covered by robust information sharing agreements (ISA’s).

AIMS • Information Sharing Agreements (ISA) and correct governance -

• Regularly review the NWL Digital ISA to ensure it is fit for purpose and supports the data sharing objectives of all the providers in NWL.

• Have regular meetings of data controllers to oversee the data sharing programs and approve any new data sets or uses of the data.

• Linked data sets across health and care providers – Work to integrate multiple data sets (NHS, social care, third sector, wider determinants of health & patient generated data) at a patient level. This data can then be used for direct care (patient identifiable) and also for population health management (anonymised data).


Information Sharing Agreements (ISA)

Undertake a review of GDPR and make necessary adjustments

Expand the linked data set to support clinicians.

7a

7b

7c

Data Sharing & Integrated data sets 7


Regularly reviewing the NWL Information Sharing Agreements (ISA) and ensuring the correct IG governance - • Re-write the current NWL Digital ISA to ensure it is fit for purpose and supports

the data sharing objectives of all the providers in NWL. • Ensure regular meetings of the data controllers are convened and that they

effectively oversee the data sharing programs and approve any new data sets or uses of the data. Ensure decisions of the group are widely circulated.

• Support any new organisations which want to join the NWL data sharing to both share data and access the integrated care record (ensuring all the correct governance is followed).

• Link to the patient communications workstream to ensure that adequate ‘fair processing’ is undertaken to reflect all current uses of the data

The EU's General Data Protection Regulation (GDPR) came into force on 24 May 2016 and organisations have until 25 May 2018 until the law actually applies to them. It introduces tougher fines for non-compliance and data breaches, gives potentially new fines for data processors and gives people more say over what organisations can do with their data. • Undertake a review of impacts of GDPR on the current data sharing across NWL

(links to the ISA re-write) • Implement and recommendations • Ensure all stakeholders are aware of the changes and implications

Work with the Clinical Advisory Group (CAG), STP, ACP, Primary care leads and all other stakeholders to ensure the range of data and frequency of flows into WSIC meet their requirements • Develop a roadmap of data sets to be added to the integrated care record • Work with care information exchange to develop more frequent flows with an

ambition to achieve real time data where possible. • Also map data from wider determinants of health that can be used to give a richer

picture to clinicians, providers and commissioners in NWL

Q1 2018/19

Q1 2018/19


Improve data quality Ensuring high quality data flows for better patient care, patient safety and also play a key part in improving services through informed decision

making.

8

• High quality data flows mean better patient care and patient safety. They also play a key part in improving services through informed decision making and can be used to identify trends and patterns, draw comparisons, predict future events and outcomes, and evaluate services.

• Data quality can be complex to monitor and resolve but data quality is a vital component of the WSIC programme and a continuing challenge for health and social care.

AIMS • The WSIC programme receives data from a variety of different

sources and of varying quality. Some will be from nationally defined data sets used for payment and others will be less well defined.

• The WSIC programme will look to develop and introduce data quality checks that can be applied across different datasets and highlight where data quality is a concern.

• These checks will, initially, focus on: • the completeness • validity • timeliness


Work with data controllers and clinicians to review the data quality within WSIC

8a

• Develop some initial DQ dashboards (possibly based on PRIMIS type reports) to support easy identification of issues around:

• Completeness • Validity • Timeliness

• Review existing DQ tools on the market to assess their suitability and costs of deploying into WSIC.

• Deploy a third party DQ tool on WSIC (following evaluation and procurement)

• Ensure that a DQ review is undertaken to highlight any DQ impacts / issues is a key part of reviewing new additional data sets being scoped (this is key with moving to more frequent data flows into WSIC).

• Develop a process for identifying and resolving data quality (DQ) issues picked up by users of WSIC.

• Validate the cost / financial information in WSIC to determine its suitability for capitated budgets and supporting ACP’s & STP’s

• Ensure any system fixes which address DQ are planned into the release cycle.

• Ensure common DQ themes are communicated as a key part of WSIC training and deployment.

• Feed back any common DQ themes to the clinical systems team to support feedback and improvement.

Improve data quality 8



Secure long term Funding Ensuring partners across the whole system recognise the value and benefits of the system and secure sufficient recurrent funding

9

• The WSIC system has been identified as an important asset and a key enabler of the STP and ACP/ACS work in NWL, it is already supporting a number of delivery areas and new care models.

• Traditionally the entire costs of the system have been met by the eight CCG’s in NWL on a non-recurrent basis (a subset of the strategy & transformation funding), however due to financial pressures this funding has been reducing over the past three years.

AIMS • To review the future direction of the WSIC system and how much

funding is required to support it. • Secure and agree future funding sources which are recurrent and

protected. • Review potential external (to the CCG) funding sources which

would include contributions from provider partners, research bodies and academic institutions.

• A number of these funding sources could come with advantages and disadvantages in terms of public and clinical engagement.

whole systems integrated care whole systems integrated ... · • using the latest data...

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