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CHIM
5 November 2008
World Class Commissioningand
Diverse Providers
Objectives of the session• To develop an awareness and understanding of
what commissioning is• To understand the D.O.H. approach to World
Class Commissioning and why it has been introduced
• To understand WCC and Diverse Providers in the wider context of government policy towards the NHS
• To understand the implications of WCC for PCT’s and the wider NHS
• To consider the implications for information management
CHIM – 5/11/0810.00 am – 1.00 pm10.00 Introductions
Objectives of the session10.05 The WCC Quiz10.15 Presentation – NHS Policy & Structure10.30 Group Work 111.15 Feedback11.30 Presentation – World Class Commissioning and
Diverse Providers12.00 Group Work 212.30 Feedback12.50 Review
NHS
Annual Spend 2007/08 £104 billion
Employs 1.3 million staff
10 SHAs
152 PCTs
262 Hospital Trusts
1.5 million patient contacts/day
Where taxpayer’s money is spent
Total managed expenditure - £587bn
Other expenditure £59bn
Housing and Environment £22bn
Public order and safety £33bn
Industry, agriculture, employment and training
£21bn
Debt interest £30bn
Defence £32bn
Education £77bn Health £104bn
Personal social services £28bn
Social protection £161bn
Transport £20bn
NHS
Key Issues
How do you improve
efficiency
quality
within budget
In context of
- Increasing no.s of elderly
- Improvements in medical technology
Structure of the NHS
Parliament
Sec. Of State
D.o.H.
S.H.A.
Trusts PCTs
£
Parliament
Sec. Of State
D.o.H.
S.H.A.
Foundation
Trusts
PCTs
£
Board of Governors
Members
Regulator
Before After
North East
North West
Yorkshire and The Humber
East Midlands
West Midlands
East of England
London
South East Coast
South Central
South West
What are Primary Care Trusts? PCTs are responsible for:
- ensuring people can get access to treatment when they are ill- improving health and well being
PCTs receive funding from the Department of Health via weighted capitation. This is around £1,560 per capita, egNewcastle PCT = £428.4m, and then they:
1. Identify the local health needs of their population
2. Receive guidance on national priorities and policies from DH
3. Commission service provision to meet population needs and meet national requirements
4. Establish LBC and SLAs based on activity required, funding levels and quality standards
5. Manage LBC and SLA contracts through Performance Management Systems to make sure they are delivered as planned
NHS North of Tyne
Where The £1.2billion Goes
New castle Upon Tyne Hospitals NHS Trust
22%
Capio Healthcare Ltd0%Voluntary
Organisations/Charities1%
All other inc. Private Sector1%
Primary Care Prescribing11%
PMS/GMS7%
Primary Dental Service2%
Out Of Hours Services0%
Commissioning Consortium/Public
Health/Other2%
Contractor Service Agency0%
Public Health0%
LDP Commitments4%
Public Bodies - Local Authorities
6%North East Ambulance Service NHS Trust
1%
North Tyneside Primary Care Trust Provider
2%
New castle, North Tyneside and Northumberland Mental
Health NHS Trust10%
Northumberland Care Trust Provider
2%New castle Primary Care
Trust Provider3%
Other NHS Trusts w ith SLAs/LBCs
1%
Northumbria Healthcare NHS Trust18%
All other NHS Trusts inc. NCAs
2%
Specialised Commissioned Services (NORSCORE)
4%
Group Work
1. Look at the slide – ‘Where the £1.2 billion goes’What % of total spend goes on Secondary Care?What % of total spend goes on Primary Care?What % of total spend goes on PCT provider services?Why is the money spent in this way?How do you think the PCT has decided to spend these sums of money on these services?
Group Work
2. What is Commissioning?
Discuss and come up with an agreed definition