Adult HIV Outpatient PBR Tariff Development National Reference Group Meeting 21/05/10

Welcome and Introductions

Chair Opening Remarks Recap: DH Sponsorship NRG Task/Working Groups Initially covering Birmingham, Greater Manchester and London Commissioners, Clinicians, Finance, HPA, BASHH, BHIVA Increase in SHA region participation in costings and working groups Broadening expertise, input and participation prior to national consultation

Project Principles Recap National mandatory tariff based on open access with appropriate reimbursements for providers Adult service outpatient tariff Agreed national pathway based on national standards of care and ensuring quality of care and outcomes Based on patient year of care High cost diagnostics included System will validate in year movement in patient care subsequently: (PWC evaluation recommendations) ARV drugs options considered through scoping and feasibility Potential data flow through SUS Review of national standards within service provision

Rapid Assessment Feedback and Project Way Forward

Rapid Assessment (in acknowledgment of lack of project management and leadership and potential project drift) PM and PL undertook a series on one to one and small group consultation on status of project and key issues with current NRG and other stakeholders Increased links to other regions and participated in SHA or network meetings to provide information on project and solicit key participants and contacts

Rapid assessment feedback: Still strong support for project and strong commitment by current participants Willingness to increase and involve new stakeholders with people keen to be involved Clear need for strengthened project plan, key outcomes and better communication both within current stakeholders and externally Stability with project team and DH commitment Restate project aims and key outputs Focus on developing currency and robust consultation

Project Way Forward Continued DH commitment and solution to project management and financial situation Project Plan with new timelines developed with key roles and responsibilities for delivery to project team Project Lead and Project Management role Strengthen links and involvement of PBR team Task orientated working groups and better communication New members of working groups and where appropriate NRG Collation of national contacts for commissioning and clinical input and future consultation Development of communication strategy and consultation plan Scoping and feasibility of ARV inclusion

Scoping and feasibility of ARV inclusion if tariff development Recommended by PWC PbR future development is to limit exclusions and therefore we consider ARV costs in tariff Development Agreed to undertake feasibility of this for HIV tariff and make recommendations Project lead to manage process and set up small working group under same conditions as other groups

ARV inclusion feasibility to include: Produce HIV drug feasibility study by - collect and collate trust and consortium Drug data produce drug analysis and comparative reports make decision on way forward Produce HIV drug costs - Produce HIV drug costs options Consult on Drug Cost options produce drug measures and data items Work in infancy although requires early solution Small sub/task group to be formed asap to consider options and initial considerations NRG discussion required with key areas and points of view expressed

ARV inclusion NRG discussion Options Do not include ARV in any tariff ARV tariff developed in line with PbR options: National Currency/National Price National Currency/Local price Local Currency/Local price

What is achievable and acceptable when considering ARV inclusion in tariff? What are the main areas for consideration – e.g maintaining levers and competitive prices if ARV tariff is not feasible at National currency/national price then what can we do to support services and commissioning e.g guidance, regional or local benchmarking, commissioning data set, consortium arrangements

Website and Communication Strategy Update Communication Strategy in development – required input from all stakeholders especially BASHH and BHIV and also requires rapid consultation on requirements or processes for pubic patient consultation The strategy will outline: Objective of project Communication objectives, principle and key messages Key audiences Preferred/Appropriate channel of communication Requires comments on draft and shaping of process and key messages to key audiences Draft to be sent out for comments early next week

Proposed key Communication Tool will be HIV PbR Website Agreed that English Commissioner Website managed by NAT will be developed to provide key website service Three Levels of Access Envisaged Public – non secured Professional – non secured and secured Stakeholder/project participants – secured

Both public and secured pages will contain: Project background and identified documentation for viewing PbR FAQ section HIV Outpatient FAQ section Ability to send in comments and queries via a specific address and will be managed externally for response A section specifically for potential consultation questions that stakeholders can be refered too as appropriate Downloading facility Notification facility for/of questions or enquiries sent to specific address Registration facility for further information and notifications Links to other websites such as DH, BASSH,BHIV etc

Secured Pages will contain: Ability for the creation, editing and commenting on identified documentation Project stakeholder contact details Minutes and working papers for comment and viewing Ability for password protection and specific user names ( currently up to 50 individuals but may increase) Ability for on line discussion and sharing of perspectives and questions (tbc and dependant on cost) Monthly project updates Downloading and uploading facilities Calender and key event for project and locally and regionally