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FOCUS ON THE FUTURE – THE STRATEGIC REFORM AGENDA AND IMPLICATIONS
Friday 14th February 2014
Dr Patricia OakleyDirector, Practices made Perfect Ltd.
Teaching and Research FellowPublic Policy and Management
King’s College, London
THE MODERNISATION AGENDA 2015–2025What are the implications for workforce development?
14b07479aso1 © Practices Made Perfect Ltd.*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: [email protected]
FINANCIAL ADJUSTMENTS
1. The Depression – 30/34 : c. 50 months
2. 1st Oil Shock – 73/76 : c. 40 months
3. 2nd Oil Shock – 79/83 : c. 48 months
4. DotCom Bust – 90/93 : c. 36 months
4. Banking Bust – 08/? : Projected c. 120+ months
New Reality – Tight Fiscal Regime; Real Incomes; Size of State
14b07479aso1 © Practices Made Perfect Ltd.*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: [email protected]
Care of the Elderly – physically well and mobile, socially engaged and psychologically content.
Chronic Disease Management including Mental Health and Carer Support.
Specialist Surgical and Therapeutic Interventions.
New Science: Pharmaco-Therapeutics and Genetics, Molecular Imaging and Diagnostics.
Building technologies and flexible designs underpinned with real-time information e.g. Electronic Transfer of Prescriptions, Digital X-ray, Just-in-Time Training Programmes.
The Next 30 Years
14b07479aso1 © Practices Made Perfect Ltd.*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: [email protected]
Genetic Profiling and Therapeutic Targeting.
Proton Beam Therapy and Novel Treatments.
High-speed informatics and cooling technology.
Stem-cell based research and new science.
Prosthetics, regeneration and bio-engineering developments.
BIG SCIENCE COMING TO YOU SOONRCTs, Cash Flow, Research New Ways of Working
14b07479aso1 © Practices Made Perfect Ltd.*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: [email protected]
Build a fabric of dense social networks within which good quality health and social care interventions are delivered in a timely and sensitive way.
Supporting Getting Old and Managing Long Term Conditions
The Goals of Integrated Care Programmes
14b07479aso1 © Practices Made Perfect Ltd.*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: [email protected]
Support for family, friends and community self-help groups.
Support for collectivising events and activities.
Support for patient-focused charities and enabling groups.
Supporting Getting Old and Managing Long Term Conditions
Reducing Social Isolation
?What is the Role of the State?
14b07479aso1 © Practices Made Perfect Ltd.*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: [email protected]
Assertive Public Health Strategies and Public Engagement.
Technology-supported Homes and Communities.
Early Health Risk Screening, Diagnostics and Interventions.
Advanced Pharmaco-therapeutics and Genetic Profiling.
Technology-supported Clinical Decision-making and Work Designs.
New Service Design Assumptions
14b07479aso1 © Practices Made Perfect Ltd.*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: [email protected]
New Service Design Principles
GP Well-being Practices andManaged Care Centres
(Cancer, Stroke/Cardio, Mental Health)
Community Activity Centres
and The Gym
Re-enablement, Rehabilitation and
Resettlement Centres
“High Street” Screeningand Diagnostic Centres (high science and technology)
Single-people enabledHomes and Campuses
Trauma CentresUrgent Care Centres
Planned Care CentresNursing and Care Homes
Step-down/Convalescent Homes
Hospice@ Home Service
Hospital @ Home Service
13h21321aso1 © Practices Made Perfect Ltd.*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: [email protected]
? Local Diagnostic Services?? Local Imaging Services?? Local Genomics Services?
“The Place in the Middle”
High Street
Social Care Services
Hospice and Hospital at Home Services
Community Pharmacy and Medicines Services
GP Surgeries and Out of Hours Services
Community Nursing and Midwifery and Therapy Services
? Regional Diagnostic Services?? Regional Imaging Services?? Regional Genomics Centres and Predictive Analytics Services?
? The Home Tests?? The Gym Tests?? Point of Testing
Services?
Maternity & Neonatology Care Services
(including children’strauma service)
(includes current A&E “minors” service)
Regional TraumaServices
UrgentCare
Services
Cancer, Cardiac, StrokeCare Services
Mental Health Care Services(inpatients)
• Convalescent, Observation and Place of Safety Beds and Services.
• Minor Injuries and “Off-legs” Front Door Services.
• Planned Care and Rehabilitation Services.
• Outpatients and Long Term Care Support Programmes including Self-Care Workshops and Self-Help Networks Support Programmes.
• End of Life Services.
Local Care Services(including mental health and planned care services)
Genetics Services
Social & Probation and Police Services
(including children’surgent care service)
Paramedic/Blue Light Service
Services
14b07479aso1 © Practices Made Perfect Ltd.*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: [email protected]
Service commissioning development.
Tariff and rewards payment development.
Service reviews and development of service networks.
Policies to reduce integrated service delivery hurdles.
Policies to build robust QA and inspectorate processes.
Supporting Getting Old and Managing Long Term Conditions
The Role of the State – Progress Report
14b07479aso1 © Practices Made Perfect Ltd.*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: [email protected]
Independent Reconfiguration
Panel
CareQuality
Commission
Monitor-Market Regulator
Workforce Regulators
Pay Review Bodies
• Local Authority and Primary Care Trust Service Commissioning Agency:− economies of scale
service commissioning;− Public Health
Programmes;− “residual” services
commissioning.
• Clinical Commissioning Groups – Managed Agencies for majority of local people’s needs.
• GP-Patients Commissioning Partners:
− Individual Choice;− Co-Payment Choice;− Means-Tested
Services.
• Foundation Trusts and Academic Health Science Centres.
• Social Enterprises.
• Companies.
• Partnerships.£ £
Service Providers Network
• Dept. of Health and Social Care Permanent Secretary andChief Medical Officer.
£
Independent NHS Board and its Regional
Directorates
Service Commissioning
Agencies£
£
• Chief Executive.
• Commissioning Director.
• Medical Director
? Chief Officers
• Nursing Director
? WorkforceDirector.
? R&DDirector.
• £ Controller.
• Clinical Senates’ Guidelines and Advice.
• New “NICE”.
• National Specialist Commissioning Group e.g. Transplant Programmes, Proton Beam Therapy and “Orphan”Drugs. Local Education Training Boards
Workforce – Human Resources Development
Workforce – Strategic Planning and E&T Investment
• Deanery Schools, HIECs and All SCs.
• Assessment Centres.• Leadership and
Organisational Development Consortia.
• Recruitment and Payroll Agencies.
• Workforce Planning and Information Consortium.
• Education and Training Commissioning Consortium.
Health Education England
Focus on the Future – The Wheel Turns AgainPossible Streamlined Public Service Architecture*
14b07479aso1 © Practices Made Perfect Ltd.*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: [email protected]
“Professionalism” Goals: Good, Safe, and Accurate Patient Care
Good, Safe and Accurate Patient Care
Practice Standardsand Quality Assurance
Education and Trainingand Supervision
Staff’s Behaviours, Attitudes, Aptitudes,Skills and Knowledge
Professionalism in Healthcare Staff
? Who builds E&T specification and Curriculum?
? Who validates teaching programmes?
? Who develops teachers and supervisors?
? Who sets them?
? Who develops metrics and QA methodology?
? Who inspects?
? Who develops and QAs the clinical placements?
