1. Neurological Services Deep Dive Workshop Understanding “what to change” using the NHS Right Care methodology
Part of the NEW Devon Way

2. Deep Dive Workshop Structure
Activity
timing
Introduction and Purpose of Today
25 mins
The purpose of today’s workshop
Why NEW Devon CCG has adopted NHS Right Care
How NEW Devon CCG uses NHS Right Care in QIPP planning
Deep Dive Feedback
50 mins
Presentation of the findings of the deep dive review
Q&A on deep dive findings
QIPP Theme Selection
1hr 30 mins
Work in groups to define:
Selected themes for QIPP projects to be turned into a mandate
Design Principles
Data requirements
Outline plans and objectives
Workshop Feedback
10 mins
Feedback to make workshop a better learning experience
Questions
5 mins
Final opportunity for questions

3. Deep Dive Workshop
Introduction &
Purpose
of Today
25 minutes

4. Deep Dive Workshop Purpose
To introduce the use of NHS Right Care for NEW Devon CCG
To understand the theory behind NHS Right Care
To understand the findings of the service deep dive
To design a QIPP programme around the service deep dive including:
Design Principles
Data requirements
Outline plans and objectives
To learn a standardised approach to evidence based change in the NHS

5. Systematic QIPP Development Adoption of NHS Right Care
NHS NEW Devon CCG must maintain a continuous list of improvement opportunities to ensure that QIPP requirements can be met each year
To do this we must adopt a standardised approach to QIPP development that will bring clarity and assurance to the QIPP proposals
NHS Right Care is designed for CCGs to tailor to their purposes using the overall methodology as a blueprint
NHS NEW Devon CCG will develop its use of the Right Care system in outline and refine it as the QIPP programmes develop, effectively testing it with delivery and improving as we go
5YFV “closing the gap” target for NEW Devon is to be upper quintile across the board, therefore all opportunities will be valued at a top 20% indicator
The deep dive packs we are about to review show opportunity ranges between peer and national average to peer and national upper quintile
We are here to identify a series of projects that will move the service to the upper quintile in quality, cost and performance while contributing a targeted value to system recovery

6. Systematic QIPP Development NHS Right Care Overall Methodology
We are here
“What to change”

7. Systematic QIPP Development Phase 1 - Where to look
Where to look will happen once each year to produce a high level ranked list of opportunity to pursue
We do this using a series of nationally available indicative data comparing our performance against a selected peer group of health economies
The output of this phase is a scoped and ranked list of opportunity
Commissioning for Value
Atlas of Variation
Programme Budgeting
Local Interpretation
Benchmark, value, rank and prioritise themes using agreed national and local data.
Identify opportunity of top ranked themes.
Produce a scope per theme.
Present scope to steering
group for go/no go decision.
Themes ranked
With a scope
per theme
Programme budgeting

8. Systematic QIPP Development Phase 1 - Where to look (2013/14 data)
We have ranked all services by value (a combination of demand, outcomes, cost and performance)
For 2015/16 NHS Right Care shows a total value against peer of £116M and against the national upper quintile position of £268M
16 of the 22 categories have been selected for deep dive review in 4 waves in 15/16
These are not the QIPP targets but an indication of where our services are sub optimal compared with other health economies

9. Systematic QIPP Development Phase 2 part 1 - What to change – today’s workshop
What to change starts with a deep dive exercise focusing on the selected theme
The deep dive pack is analysed (today’s exercise) and QIPP plans are defined with sufficient evidence to produce a project mandate.
The output of this phase is a project mandate
NHS Right Care deep dive is completed (6 weeks)
Detailed deep dive is analysed and prioritised and planned targets defined (3 days )
Implementation plans are drafted, business cases defined and project mandate produced (2 days)
Mandate assessed at steering group for go/no go decision
Note:
An example mandate is in your handouts

10. Systematic QIPP Development Phase 2 part 2 – What to change
Once the mandate is approved we can undertake deeper analysis of the selected QIPP projects (next step)
This deeper analysis culminates in an optimal service design workshop including providers, patients and CCG members
The output of this phase is a project initiation document including the new service design, strategy and implementation plans
Assess gaps to best in class
Clinically led pathway redesign
Strategy for theme
Complete Strategy to action plans, full business case & full PID
Test against target and initial objective
Full PID assessed at steering group for go/no go decision

11. Systematic QIPP Development Phase 3 - How to Change
Once the PID is approved we can start to implement the planned changes
Implementation will follow the NHS NEW Devon CCG turnaround methodology and will seek to deliver benefits as fast as possible
Projects will be delivered and sustained under the Turnaround governance structure

12. Deep Dive Workshop Systematic QIPP Development
Questions?

13. Deep Dive Workshop
Deep Dive Pack
Review
50 minutes

14. Deep Dive Workshop Deep Dive Pack Review
Questions?

15. Deep Dive Workshop
QIPP Theme Selection
90 minutes overall

16. Deep Dive workshop QIPP Theme Selection
In your groups:
What:
Determine the themes suitable for improvement
Identify any further data or analysis needed
Determine “design principles” for that theme
Identify evidence of the opportunity
How:
Discuss the findings of the deep dive and identify 3 key themes and title a flip chart page for each theme
Produce a list in 2 columns of further data needed and the design principles for the project
Capture the benefit in a one line benefits statement
Nominate a spokesperson to brief the room at the end
60 minutes

17. Deep Dive workshop Plan and Approach to QIPP Theme
All Together
What:
Select the themes to progress
Identify how each Theme will be approached:
Commissioner delivered
Commissioner led
Determine timings to get each theme to optimal pathway redesign
How:
Produce summary post it for each theme
Rank theme by benefit (or time to deliver)
Identify cut-off point to select themes
Determine if theme is commissioner delivered or led
Outline key dates:
Plan (analysis, redesign, commissioner delivery)
Stakeholder engagement (provider , patient etc)
Ranked
Themes
Delivered
or Led
Outline
plan
Theme: physio referrals to outpatients
Benefit : £1.2M, 12,300 referrals
Time to deliver: immediate
Theme Cut off
30 minutes

18. Deep Dive Workshop QIPP theme selection
Questions?

19. Deep Dive Workshop
Workshop feedback
10 minutes

20. Deep Dive Workshop
Next Steps
5 minutes

21. Deep Dive Workshop
Thank You