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The fundamental values of the NHS:

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Presentation on theme: "The fundamental values of the NHS:"— Presentation transcript:

1 The fundamental values of the NHS:
a universal, tax funded service, with equal access for all, free at the point of use, provided according to clinical need not ability to pay. These are enduring values and will not change.

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5 Public Sector Reform a transformational agenda across health, social care and other public services to shift from a welfare based to a citizen based model of service delivery

6 The stages to our journey Where we have been and where we are going
3 High quality care for all NHS Next Stage Review local clinical visions, national enabling report and NHS Constitution 2 Introducing the reforms Patient choice and payment by results Foundation trusts Stronger commissioning 1 Building capacity in the system NHS Plan saw greatest investment in the history of the NHS More doctors, more nurses, better facilities

7 Our health, our care, our say – a new direction for community services
Ambition Enabling health, independence and well being Better access to GP Better access to community services Support for people with longer term needs Care close to home Ensuring reforms put people in control Making sure change happens

8 Keeping it Personal Build on the best of traditional General Practice Primary Health Care more than general practice …but registered population and 80% of all NHS clinical consultations 90% of care solely undertaken in primary care Support for self care Long term conditions management Care Closer to home The practice can link the wider public’s health and bio-clinical care The practice as the local micro yet strategic health organisation

9 High quality care for all NHS Next Stage Review Final Report
Raising standards Stronger involvement of clinicians in decision making at every level of the NHS Fostering a pioneering NHS Help to stay healthy Empowering patients Most effective treatments for all Keeping patients as safe as possible Quality at the heart of the NHS High quality care for all Empowering frontline staff to lead change that improves quality for patients Valuing the work of NHS staff High quality care for patients and the public Freedom to focus on quality

10 The journey of the NHS Next Stage Review July 2007 – June 2008
Leading local change Clinical visions launched High quality care for all Review launched Interim report July October May May-June Today Prime Minister, Chancellor, Secretary of State request NHS review Following many visits around the country, the Interim Report is published New pledges on change in the NHS ensuring focus on quality The work of 2,000 frontline clinicians to improve quality for patients Report to enable local change to deliver high quality care for all Largest local engagement in the history of the NHS underpins the whole process

11 What we heard from you Overview of findings of clinical pathway groups
Support people to take responsibility for their own health, through reaching out to disadvantaged groups Staying healthy Women want greater choice over place of birth and a more personal experience, with care provided by a named midwife Maternity & new born Services needed to be more effectively designed around the needs of children and families, delivered in schools and children’s centres too Children’s Saving lives by creating specialised centres for major trauma, heart attack and stroke care, supported by skilled ambulance services Acute care

12 What we heard from you Overview of findings of clinical pathway groups
More care should be provided closer to people’s homes, with greater use of technology and outpatient care not always meaning a trip to hospital Planned care Extending services in the community, benefits to general wellbeing and to physical health arising from stronger mental health promotion Mental health Need for true partnerships between people with long-term conditions and the professionals and volunteers caring for them Long-term conditions Necessity for greater dignity and respect and desire to have round the clock access to palliative services End of life

13 All advanced health systems face significant challenges Changes in healthcare and society
Ever higher expectations Changing NHS and Social Care workplaces Demand driven by ageing Health in an information age Advances in treatments Changing nature of disease

14 High quality care for patients and the public Overview of proposals
Context What we will do Help people to stay healthy. Effective partnerships, more health promotion, better access to prevention services It is the quality of care that matters most to patients, public and staff Today, NHS is high quality many aspects Next stage is to go to being high quality in all aspects 1 Empower patients. More choice and control to patients to promote quality 2 Provide the most effective treatments. Fair access to the best treatments for all 3 Keep patients as safe as possible. Patients in environments that are safe and clean, avoiding harm 4

15 Helping people to stay healthy High quality care for patients and the public
Context What we will do A new Coalition for Better Health. With Government, private and third sector organisations ‘Reduce Your Risk’ campaign. Raise awareness of biggest killer – vascular diseases and how to reduce risk Challenges of 21st century are ‘lifestyle diseases’ NHS has a responsibility to promote good health as well as tackling illness Real focus on primary care to improve health 1 2 Support for people to stay healthy at work. We will pilot integrated Fit for Work services 3 Support family doctors to help individuals and their families stay healthy. Changes to QOF and PBC to promote prevention 4

16 Empowering patients More choice and control over their health and care
Context What we will do Extend choice of GP. Fairer rewards for practices taking on new patients, electronic registration New right to choice. Draft NHS Constitution contains new right to choose treatment and providers with quality information Personalised care plans for people with long-term conditions. Service organised around people Pilot personal health budgets. Learn from social care to give greater control to individuals & families Guaranteeing access to NICE approved drugs. NICE appraisals will be speeded up Patients want more control rather than being passive recipients of services Patients want services that are personal to their needs Giving more control for health services should encourage more responsibility for health 1 2 3 4 5

17 Quality: Define, measure, publish, reward… High quality care throughout the NHS
Bring clarity to quality Expanding NICE so it selects the best available, or fills the gaps, and runs a new NHS Evidence service 1 Quality Metrics across service line (Patient experience and patient related outcomes) Clinical dashboards for teams Measure quality 2 Publish quality performance All providers of NHS services will publish ‘Quality Accounts’ from April 2010 Comparative information on NHS choice 3 Recognise and reward quality improvement New Commissioning for Quality and Innovation scheme Multi-year tariff projections, tariff for mental health 4

18 Improve, regulate, and innovate High quality care throughout the NHS
Stronger clinical engagement in commissioning Medical Director and Clinical Advisory Group at every SHA Quality Observatory in every region National Quality Board Raise standards 5 Strong role for regulation by the Care Quality Commission Regulation extended to primary care for first time Safeguard quality 6 Best Practice Tariffs programme from 2010/11 SHAs to promote innovation, new fund, & prizes Health Innovation & Education Clusters Academic Health Science Centres Stay ahead 7

19 Freedom to focus on quality New accountability and empowering staff
Unlocking talents Empowering staff Healthcare is delivered by a team Everyone needs to pull in the same direction Clinicians should be practitioners, partners and leaders in the NHS This will enable us to unlock talents of all NHS staff This is the new professionalism If clinicians need to be empowered to improve the quality of care for patients This means they should set the direction for the services they deliver, make decisions on resources and on people Practice-based commissioning will be strengthened to empower primary care clinicians

20 Freedom to focus on quality Unlocking talents and greater freedom to the frontline
New accountability Commitment for all NHS organisations to become foundation trusts More freedoms for community services Right to request new professional-led model such as social enterprise will retain pension rights More autonomy for high performing PCTs With greater freedom must come new and enhanced accountability Achieved through openness on quality performance New accountability is for whole patient pathway Applies to care in all settings Commissioners accountable for health outcomes of populations

21 Leadership for quality Making change happen
NHS Leadership Model Embed in training. Leadership will be included in undergraduate curricula for nurses and doctors Vision where we are going New standards. Accredited health leadership standards for both clinicians and managers NHS Leadership Council. Support all leadership, with strong focus on top 250 in the NHS Method the way that improvement will happen Expectations how people will have to change Support Boards. New development programme for trust boards to be commissioned

22 First NHS Constitution Secured today for future generations
Why a constitution What it says Secure the NHS for the next generation Empower all patients and the public Value and empower NHS staff Create a shared understanding of purpose, values and principles Strengthen accountability through national standards for patients and local freedom to deliver Key principles stated Rights for patients articulated Pledges to staff and patients Decision-making explained Every organisation will have legal duty to take account of the Constitution Requirement for Secretary of State for Health to renew every 10 years

23 Case for change Challenges Strengths
Personal continuity of care & strong ties to local communities Services that do not fit together and are confusing to navigate Professional ethos and high levels of patient trust Unwarranted variation in quality of care & access to services Improvements in quality of care, e.g. for people with LTCs People want more involvement in their health and care Progress in bringing together health and local government Changes in public expectations, technology, demographics, and nature of disease

24 Primary and community care strategy: key themes
Not a national blueprint Setting a clear vision … … and creating the right environment for leading local change Shaping services around individuals Promoting healthy lives Continuously improving quality of care Patient power and choice Clinical leadership World class commissioning

25 Leading local change Reinvigorating PBC
Repositioning PBC: clinical leadership & health outcomes Incentives for more multi-professional engagement Entitlement to management and financial support Holding PCTs to account through assurance framework Different levels of engagement entry-level PBC (dependent on quality of primary care) increasing freedoms for high-performing, multi-professional and accountable PBC groups Clinical collaboration across primary, community and secondary care Integration between health and social care ‘Integrated care organisations’ managing capitated budgets Testing safeguards for choice and competition Specifying service quality and financial management Piloting new models of integrated care

26 Leading local change World Class Commissioning for primary care
World class commissioning guide for primary care understanding needs of local communities clinical leadership and clinical engagement incentives for integrated care and upstream prevention information for patients and the publci applying system rules stimulating innovation and choice (market making) Support and development predictive modelling and risk stratification public engagement and social marketing dataset development (including equality monitoring) contract management estates strategies Supporting integration of health and social care Joint strategic needs assessment & LAAs More integrated working between SHAs and GOs Ministerially-led group to identify how to support organisations that want to go further

27 The Primary Care ‘Home’
Population based primary care is where the needs of the individual and of the community can be met Care closer to the patient’s home Where bio-clinical focus and addressing the social determinants of health can be the responsibility of one provider organisation The ‘home’ for extended skills and services


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