1. Copyright 2011 Right Care Why act? If population healthcare is the solution – what is the problem? Sir Muir Gray Joint National Director, Right Care August 2013 Online Learning Series Right Care for Populations

2. 2 Great innovations of the first and second healthcare revolutions MRI and CT scanning Statins Antibiotics Coronary artery bypass graft surgery & stents Hip and knee replacement Chemotherapy Radiotherapy Randomised controlled trials Systematic reviews The First The Second

3. 3 - But…..all health services, world wide, still face 5 major problems failure to prevent preventable disease inequity patient harm, even when quality is high waste of resources unwarranted variation in: - activity - quality, safety - outcome & cost = value..and there is an iceberg ahead.

4. 4 Population Healthcare…5 questions 1.Is the service for people with seizures & epilepsy in Manchester better than the service in Liverpool? 2.Who is responsible for the headache service for people in Southampton? 3.How many liver disease service s are there in England and how many should there be? 4.Which service for frail elderly people in the London provides the best value? 5.Which service for children with mental health problems improved most in the last year ?

5. 5 The Healthcare Archipelago General Practice Mental Health Community Services Hospital Services

6. 6 The Commissioning Archipelago GPs / Pharmacists / Optometrists 152 Local Authorities Public Health 211 CCGs Specialist Commissioning

7. 7 Defining Population Healthcare “ The aim of Population healthcare is to maximise value for those populations and the individuals within them Population healthcare focuses primarily on populations defined by a common need which may be a symptom such as breathlessness, a condition such as arthritis or a common characteristic such as frailty in old age, not on institutions, or specialties or technologies ”

8. 8 Paradigm shift

9. 9 A new language A SYSTEM is a set of activities with a common set of objectives and an annual report. Systems can focus on symptoms, conditions or subgroups of the population (also known as a service) A NETWORK is a set of individuals and organisations that deliver the system’s objectives (a team is a set of individuals or departments within one organisation) A PATHWAY is the route patients usually follow through the network A PROGRAMME is a set of systems with ha common knowledge base and a common budget Primary Secondary Acute Community Outpatient X X X XX

10. 10 Work like an ant colony; Neither markets nor bureaucracies can solve the challenges of complexity

11. 11 Online Learning Series Right Care for Populations Follow Right Care online Subscribe to get a weekly digest of our blog alerts in your inbox, Receive occasional eBulletins Follow us on Twitter @qipprightcare Find the full series at: www.rightcare.nhs.uk/resourcecentre