World Class Commissioning for Improved Healthcare Gary Belfield Director of Commissioning Department of Health

Commonwealth Fund – Mirror, mirror on the wall AUSTRALIACANADAGERMANY NEW ZEALAND UNITED KINGDOM UNITED STATES OVERALL RANKING (2007) Quality Care Right Care Safe Care Coordinated Care Patient-Centered Care Access Efficiency Equity Long, Healthy, and Productive Lives Health Expenditures per Capita, 2004$2,876*$3,165$3,005*$2,083$2,546$6,102 * 2003 data - Source: Calculated by Commonwealth Fund based on the Commonwealth Fund 2004 International Health Policy Survey, the Commonwealth Fund 2005 International Health Policy Survey of Sicker Adults, the 2006 Commonwealth Fund International Health Policy Survey of Primary Care Physicians, and the Commonwealth Fund Commission on a High Performance Health System National Scorecard.

Infant mortality England, EU countries and selected averages, latest data (2004*), ranked EU weighted averages EU-12 new (member countries from 2004) EU-15 (member countries before 2004) England Rate per 1,000 Live births * Denmark, Italy – 2001; Belgium Health Profile of England 2007

What is commissioning? “Commissioning is using the available resources to achieve the best outcomes by securing the best possible health and care services for local people”

Vision  Better health and well being for all  People stay healthier for longer – “adding life to years.”  People live longer and health inequalities are dramatically reduced – ”…and years to life”  Better care for all  Services are of the best clinical quality and evidence based  People exercise choice and control over the services that they access so they become more personalised.  Better value for all  Informed investment decisions  PCTs work across organisational boundaries to maximise effective care.

Assess needs Review current service provision Decide priorities Strategic planning Design service Shape structure of supply Specify outcomes & procure services Manage demand and ensure appropriate access to care Clinical decision making Managing performance (quality, performance, outcomes) Managing demand and performance

VISION AND COMPETENCIES ASSURANCE SYSTEM SUPPORT AND DEVELOPMENT MODEL SUPPORT AND DEVELOPMENT MODEL

Learning from others

10-15 Indicators e.g. Chronic Heart Disease Vital Signs Popn ‘x’ NHS Upper Quartile Best NHS World Leading Determined by: PCT PBCs Local population Stretch target Clinical staff, IS and Vol Sector drive innovation to deliver

11 Competencies 1. Locally lead the NHS 2. Work with community partners 3. Engage with public and patients 4. Collaborate with clinicians 5. Manage knowledge and assess needs 6. Prioritise investment 7. Stimulate the market 8. Promote improvement and innovation 9. Secure procurement skills 10. Manage the local health system 11. Make sound financial investments

NHS Input Review of board controls and processes, strategy, and long term financial controls Measures quality in health care and ability to deliver key health outcomes and services A commissioner assurance system Assessment against three domains: Measures whether the organisation possess the competencies associated with world class commissioning Competencies Health outcomes and quality Governance

What will success look like? Vibrant, effective partnerships Population actively engaged Clear local priorities and long term strategy, to tackle local health issues Innovative practice based commissioners working to an agreed PCT wide strategy... But leaving room for very local initiatives People are staying healthier for longer People are living longer The inequalities gap is narrowing

NHS Next Stage review – areas under consideration Strengthening the focus on staying healthy Supporting people to manage their long term condition Integrated health and social care services Tackling health inequalities Quality of care

What next? Provider arm Personalisation Health & Social care Learn, share & buy Greater IS input Constitution Next stage review Primary & Community focus Events

The Goldilocks Circle

Envisioning in a Box - What is it? Peter Askew Business Development Manager

Envisioning in a Box - Demonstration Nick Umney and Tim Gee

Strategy for Customer and Partner success Presented by Tim Gee Healthcare Business Manager Nick Umney Lead Account Technology Strategist

Segmentation for Success Strategy Deployment Services (Resource) Procurement

Infrastructure Extend Protect & Secure Deploy & Manage Windows Server Virtualization Connected and Extended

Knowledge Driven Health

NHS Needs? DOH Local Information Management &Technology Plans The objectives for 2008/2009 “Individual organisations will work collaboratively within country wide governance arrangements to produce a inclusive IM&T plan that effectively supports the delivery of high quality service for patients and provide frontline staff with the tools and information they need to provide these services;” “Progress towards the achievement of the mature IM&T Environment required to support integrated care across health settings;” – Longer term plans 2010/11 “It is vital that to meet the NHS commitment to maintain appropriate confidentiality of patient data, Information Governance (IG) policy and practice reflects the increases in the potential to share information afforded by the programme. “ “NHS providers will need to include in their plans the substantial business transformation and infrastructure readiness required to exploit these technologies” “....drive improvements in data quality”

Knowledge Driven Health Quick and easy access to data and information via enhanced analytical tools, dashboards and business intelligence Share citizen records as appropriate to speed services and avoid duplication, using security-enhanced technologies Improved access to information and services including Search View data from multiple agencies in a single repository Improve Patient outcomes with more informed decision-making. Improved decision-making through increased real-time collaboration, using data from across multi- disciplinary or distributed teams Improved content and data management reducing the time spent searching for info Maximize Enterprise Search capabilities that help people find and share information Integrated collaboration capabilities such as automated workflow Enable care givers to collaborate seamlessly virtually anywhere on any device. Create electronic client records, providing a single unified view of the client Pull records from multiple agencies into one client record via common client ID Create interoperability within IT infrastructure, to tie into older systems, and to move data between old and new systems Share and integrate data appropriately with security-enhanced technologies Connect via a Healthcare service-oriented architecture.

ENTERPRISE AGREEMENT Envisioning Session License & Partner Services Revenue

QUESTIONS

Marketing in the NHS for Partners Mark Treleaven NHS Marketing Manager

Microsoft NHS Resource Centre Arif Govani Online Business Manager