Wheelchair currency development project NHS England Sue Nowak Head of Pricing Development NHS England 15 July 2015

Context and background Testing the currency model and future direction Content

Context and background 1 Currency models bring transparency to healthcare about which services are being commissioned and where from They allow comparisons to be made about services, prices to be set on a common basis, and can be combined with quality and outcome measures that can be used to reward providers that are providing effective services

Context and background 2 Deloitte was commissioned by the Department of Health to develop a currency model for wheelchair services The report proposed a currency model based around need, and suggested some prices but made it clear that further testing was required NHS England has set up a programme of testing which is currently underway

The model

Testing the currency model We are working with commissioners and providers to pilot the model We are collecting anonymised data on a monthly and quarterly basis The quarterly collection provides us with more detailed information about a number of cases reflecting the various level of needs Data analysis will inform any further development of the model and the way the dataset develops

Top down costs Ref cost collection 1 Informs Bottom-up costs Ref cost collection 2? Deloitte report Pilots Needs based Tariff (BPT)  Gain share(?)  CQUIN(?) Evidence Modelling Preferred mechanism The tariff will need to be underpinned by a strong evidence base and a range of models Going from a model to developing a tariff

We are building the pilot into our planning process for the national tariff Link to policy timelines 2015 Commence pilot Pilots Prep June Analysis Signal intent in tariff engagement document 2016 Sept/Oct Refine Publish in tariff consultation Publish in national tariff final document DecemberJuly Refine  Guidance  Templates  Governance Continue data collection?

Tools have been developed to support the pilots, including agreed data templates Example of data requirements Please complete fields outlined in YELLOW only Submitted by (name, title & organisation) Submitted by ( address) Name of Commissioning Organisations Activity PeriodMar-15 If you cannot submit activity please state in the comments box why and when a solution and submission can begin. Categorisation and activity bundling Activity and Cost Deloitte Activity CodeActivity Tariff for activity based on Deloitte's report (£) Unit Cost to Provider (£)Volume of Activity Cost of Activity (£) using Deloitte's tariff (£) Cost of Activity (£) using Unit cost to Provider tariff (£) LO00ALow Need - Assessment£92 £0 ME00AMedium Need - Assessment£253 £0 HI01AHigh Need - Manual - Assessment£324 £0 HI02AHigh Need - Powered - Assessment£364 £0 LO00ELow Need - Equipment£318 £0 ME00EMedium Need - Equipment£839 £0 HI01EHigh Need - Manual - Equipment£2,564 £0 HI02EHigh Need -Powered - Equipment£3,491 £0 AA01MAll Needs - Manual - Repair and Maintenance£22 £0 AA02MAll Needs - Powered - Repair and Maintenance£197 £0 AA00RAll Needs - Review£46 £0 AA00C All Needs - Review substantial accessory (a review followed by a modification/new accessory or resulting in a complete follow assessment if a new wheelchair is required) £180 £0 SPEC COMMAssessmentNo currency £0 SPEC COMMEquipment allocationNo currency £0 SPEC COMMRepair and maintenanceNo currency £0 SPEC COMMReviewNo currency £0 ExceptionsExceptional equipment costs that exceed equipment tariffsNo currency £0 Total0£0 Unmet demand Rationale Deloitte Activity CodeActivity Baseline activity (no. of wheelchairs issued in 2013/14) No. of wheelchairs issued in the reporting month The objective of collecting the number of wheelchairs issued per year is to ascertain the year on year increase in demand arising from unmet need. We intend to collect the number of wheelchairs issued (by classification of need) in the current reporting month. This will then be compared against a 2013/14 baseline position to determine the % changes and will help inform future commissioning decisions and budgets. LO00ELow Need - Equipment ME00EMedium Need - Equipment HI01EHigh Need - Manual - Equipment HI02EHigh Need -Powered - Equipment

What is the data telling us?

Questions ?