2. Making every contact count Knowing your service

3. Policy context – background to reforms 1989 – Working for patients creates internal market in NHS 1997 – Labour comes to power with pledge to abolish internal market 2000 - Focus more on targets than competition 2004 – Targets achieved. Attention back on competition. ‘Commissioning’ born. 2010 (May ) – Coalition government formed. Promise of “no top down reorganisation of NHS” 2010 (July) – Equity and Excellence: Liberating the NHS published

4. NHS Reforms

5. Changing Population Source: Office for National Statistics 2013Source: Warrington CCG 2013

7. What does all this mean for you? Think about the context just presented and reflect on how this is impacting on you locally

8. 3 critical hooks On a post it note write down in bullet point style the top 3 things about your service, or if you are not in a service the top 3 things you would say about physiotherapy

9. Knowing your service Quality Effectiveness Patient experience Patient safety + COST Quality + cost = Value

10. Cost of falls tool

11. Knowing your population Population is made up of Current users of your service Future users of your service

12. Health profile

15. Knowing the evidence Published research National guidance Local data - audit - patient experience/satisfaction/outcome - KPIs Other...

16. Reflect on your offer My service is... Delivers to this population... Based on this evidence... For this price!

17. Next steps... Why do you need to change? What will you do differently? When... How can you improve? Who will you influence