Commissioning Plan and Intentions April 2016 – March 2017 Working with the people of Camden to achieve the best health for all
Introduction This document sets out the Strategic Commissioning Plan and Commissioning Intentions of Camden Clinical Commissioning Group (CCG) for the period April 2016 – March 2017. Aimed primarily at current and prospective providers, it describes how the CCG will use its commissioning budget to deliver the CCG’s strategic vision. Publication of this document forms part of the CCG’s strategic planning process. This involves working with partners, patients and the public in Camden, within North Central London, the wider NHS and the Local Authority. The commissioning plan and intentions are aligned to the CCG’s Business Plan , the Health and Wellbeing Strategy and the Joint Strategic Needs Assessment for Camden. This year the CCG’s intentions are also formed from the strategic commissioning review undertaken by the five CGGs (Barnet, Camden, Enfield, Haringey and Islington) in north central London (NCL). Working with the people of Camden to achieve the best health for all
Commissioning Context It is recognised by all partners that the scale of the financial challenge within the local health and social care system is significant and that we have to commission effectively in order to prioritise the improvement of health outcomes. Demand for services is predicted to rise and it is clear that without further wide-scale transformation the current system is not sustainable. Nationally, the recently published NHS England Five Year Forward View recognises the financial challenges facing the NHS over the coming years and indicates a drive towards closer integration of services and a strengthening of joint commissioning arrangements between health and social care services, the development of different models of provision and the transformation of primary care services. The plan also describes a stronger role for the voluntary sector with more emphasis on putting patients in control of their own care. There is also a strong importance on the use of technology and the role of public health in securing better outcomes for communities. Within this context, the CCG published its Business Plan earlier this year to guide planning and delivery. Work is continuing with NCL partner organisations and the London Borough of Camden Council to commission both strategically and operationally, to ensure improved outcomes for the Camden population. Working with the people of Camden to achieve the best health for all
Camden Story – Why Action is Needed Outcomes National Outcomes Framework: • Above-average results related to preventing people dying prematurely • Below-average for helping people recover and live with illness Value • 2 nd highest spend per weighted population of London CCGs with variable outcomes • Spend on acute highest in London Needs • Primary care spend among • Life expectancy gap lowest in London but good 11.6 years in men (CVD/Cancer) outcomes • 2nd prevalence of SMI in • Mental health spend highest in England London • High proportion 19-40s • Utilisation Community care spend average access to urgent care • Demand increasing greater than population • Poor outcomes in under 5s growth • By 2017 over 85s 35% • e.g. in excess of 87,000 A&E attendances per year for Camden Registered patients
Camden CCG’s Strategic Vision The challenges 1. Population level 3. Individual • • Predictably poor health outcomes Complex patients mirror complex system • Lack of focus on prevention • Primary care needs support to manage • Lack of personal responsibility for health • Health and social care not integrated • Too little supported self-management • IT systems need developing 2. Systems level • Reactive, poorly co-ordinated services, little integration • Focused on organisations’ needs not patients’ • Fragmented, duplicative and inefficient • Reliance on unplanned care • Payments and incentives that do not support integration Working with the people of Camden to achieve the best health for all
Camden CCG’s Strategic Vision The vision 1. The emphasis of the NHS will have 3. For integration of care to be driven by shifted • Shared digital record for clinical records, • Developing a systematic approach to data sharing, measurement and evaluation prevention • Services to be commissioned and • Earlier diagnosis of disease contracted in ways that drive partnership and integration • Reducing inequalities in health outcomes targeting vulnerable groups • Encouraging individuals to take greater 4. Long-term financial sustainability will be responsibility for their health achieved by • • Supporting self-management of illness Clinically-driven focus on the quality of services • Delivery of effective (evidence-based) and 2. All patients will experience efficient (right first time care) with savings • Compassionate, high quality, effective and achieved through cutting the ‘cost of chaos’ efficient care pathways shaped by them • Care that is integrated and focussed around delivery of outcomes defined by them • Easy access to services delivered in ways and places convenient to them Working with the people of Camden to achieve the best health for all Working with the people of Camden to achieve the best health for all
Key Strands High Integrated Identification quality Care services …of people at high risk of Good care in the right place Health and social care built around people’s needs illness or complications at the right time - Creating an environment that - Clearly defined pathways - Adequately resourced services promotes collaboration responsible for identifying - Sufficient capacity and skills between existing services people at high risk - Quality of care information - Investing in services/roles that measures & feedback - Training promote integrated care - Maximum use of IT capability - Contractually incentivising an integrated care approach Improved Outcomes Working with the people of Camden to achieve the best health for all Prevention where possible - Early diagnosis - Consistent quality - Patient consultation - Review and reconfigure if necessary
Future State Upscale 1. Extend approach to focus on prevention, self supported care, out of hospital services and in hospital services 2. Wider geographical coverage 3. New structures/contracts to deliver new models Key messages 1. Integration of the whole system to deliver improved outcomes to populations and individuals 2. Measurement and evaluation drives quality and adoption 3. The clinical case for change can happen at pace Working with the people of Camden to achieve the best health for all
The Organisation Has Aligned on Eight Objectives Objectives agreed by the Governing Body: Population segment addressed Commission the delivery of NHS constitutional rights and Children Adults Older people A pledges B Improve the quality and safety of commissioned services Improve health outcomes, address inequalities and achieve C parity of esteem Integrate and enable local services to deliver the right care D in the right setting at the right time Work jointly with the people and patients of Camden to Enablers E shape the services we commission Involve member practices and commissioning partners in F key commissioning decisions Maintain financial stability and ensure sustainability through G robust planning and commissioning of value for money services Build a high performing organisation that attracts, develops H and retains a skilled and motivated workforce Working with the people of Camden to achieve the best health for all
Commissioning Drivers – Business Plan Objectives The CCG utilises the Business Plan to shape each commissioning intention to achieve individual objectives which in turn contribute to the achievement of our overall vision through the strategic planning process. For the purposes of publishing our commissioning intentions plan, the first four business plan objectives below are used as the main drivers, segmented by our population groups. Commission the delivery of NHS constitutional rights and pledges A B Improve the quality and safety of commissioned services Improve health outcomes, address inequalities and achieve parity of C esteem Integrate and enable local services to deliver the right care in the right D setting Working with the people of Camden to achieve the best health for all Working with the people of Camden to achieve the best health for all
Business Plan Objective A – Specific Intentions Commission the delivery of NHS constitutional rights and A pledges Agree a framework of financial penalties and non-financial incentives for contract performance with all acute providers. Review diagnostic services at UCLH to ensure standard waiting times are achieved, commissioning additional services where required. Commission to ensure that there is sufficient capacity in the system to treat patients in a timely manner, working on the three most challenged specialties in 2016/17, with further added during the year. Improve management of drugs excluded from tariff through advanced notification procedures. Working with the people of Camden to achieve the best health for all Working with the people of Camden to achieve the best health for all
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