1. City & Hackney ELIC Society Ltd. ELIC PAUL HAIGH - EXECUTIVE DIRECTOR

2. City & Hackney ELIC Society Ltd. WHAT? E ast L ondon I ntegrated C are City & Hackney ELIC Society Ltd BENCOM Registered in July 2006 Industrial & Provident Societies Act 247 members; represent 232,000 patients/34 practices 2 roles PBC support service Direct service provision

3. City & Hackney ELIC Society Ltd. WHY? Size matters Work together; strengthen provision; equity Opportunity of PBC to develop primary care Unified commissioning plan Harness the enthusiasm of the front line Organisational clout Bid for and provide services; compete

4. City & Hackney ELIC Society Ltd. ORGANISATION Membership - 247 GPs; Practice Managers; Practice Nurses; Practice staff; employees?; Public Organised into constituencies (for GPs based on Consortia)  Elect representatives onto quarterly Council Overall policy and direction Includes PEC Chair  Day to day management by monthly Clinical Executive Council Chair + 2 GPs + Exec Director (paid roles) Leadership, implementation, thinking

5. City & Hackney ELIC Society Ltd. PBC SUPPORT SERVICE 89% Hackney practices - 7 Consortia 95p per patient from practices Covers 100% of infrastructure (small!) Business support - plans; data; ideas Uniform approach Commissioning “clout” Pooling of 50% PBC savings

6. City & Hackney ELIC Society Ltd. ELIC ROLE Bureaucracy relating to PBC Business cases Data analysis What’s best done at individual practice and what done “corporately” Practice – new opd referrals, patient education/A&E, follow pathways, interpractice referrals, ?community matrons/emergencies

7. City & Hackney ELIC Society Ltd. PHILOSOPHY Support practices through education and training Care pathways with Homerton- 12 to date Education, audit, education Sharing best practice and ideas - Consortia Maximise primary care services Consultant advice/support and outreach

8. City & Hackney ELIC Society Ltd. ACHIEVEMENTS Savings £2.5m over 2 years Pathways and education Specifications for services – with all PBCers Community nursing Urgent Medical Clinic Heart failure, diabetes, COPD, Cardiology New practice/Consortia services planned this year Practice physio; Obesity support; Investigations Advocacy; Active patient monitoring Support practices to provide primary care/new lists

9. City & Hackney ELIC Society Ltd. DIRECT SERVICES Contract from PCT for ENT Delivered via 4 subcontracts Pooled savings - 2007/8 (900k) under development At risk COPD Obesity Antenatal services Drug monitoring “Willing provider” Surgery Heart failure team COPD team

10. City & Hackney ELIC Society Ltd. RELATIONSHIPS PCT Represented on monthly PBCE Commissioning framework input Renegotiate PBC Framework Commissioning plans/performance indicators Homerton Bimonthly Liaison Group Individual clinical and managerial meetings

11. City & Hackney ELIC Society Ltd. HACKNEY POLYCLINIC Primary Care Resource Centre Networked practices Intermediate services Chronic disease management to back up primary care Antenatal Surgery Consultant advice and outreach Pathways

12. City & Hackney ELIC Society Ltd. QUESTIONS FOR FUTURE Commissioning PCT services GPSI, specialist nursing Define service standards Specify where fit into pathways ?More direct provision NHS Pensions - ELIC “trading arm”? Primary care services – support vs provide Organisational capacity/growth VFM