This document discusses QIPP (Quality, Innovation, Productivity and Prevention), the NHS strategy to improve quality and efficiency. It describes:
1) QIPP's focus on mobilizing Allied Health Professionals and liberating the NHS.
2) Yorkshire and Humber's two phase approach - initial mobilization through meetings and briefings, followed by mainstreaming QIPP into core business through regional workstreams like telehealth.
3) Examples of potential areas for improvement like falls prevention, dementia, and diabetes telehealth programs.
5. The approach in Yorkshire and Humber
Phase one: Mobilisation
• Numerous network meetings
• QIPP Resource Packs
• Better for Less briefings
• Leadership events
Phase two: Implementation
• Mainstreaming QIPP into core business
• Regional workstreams
• Grip and pace
6. 6
Our approach – regional workstreams
T-health
Regional Telehealth Hub
Regional Telemedicine Stroke resource
Comprehensive Regional Telehealth Strategy
12 Clinically owned thresholdsClinical Thresholds
Dementia
Evidence Based Commissioning
System Wide Incentive
Staff Productivity
Future Commissioner Landscape
Future Provider Landscape
Urgent Care
Best practice and analysis of key success factors
Advice on the key system changes
Local implementation plans
Regional policy gateway
Set of regionally owned workforce and human
resources metrics and trajectories
New contract framework for non-elective services
and long-term conditions
Think Tank pieces and briefings
Doncaster as a test bed
Model for new commissioning landscape
Models for the provider landscape
8. Some specific areas of potential
• Falls
• Dementia
• COPD
• Diabetes: t-health
9. Falls Prevention
• Pathway for Paramedics
• North Yorks County Council Pathway
• Falls Co-ordinator
• Fracture Liaison Service
10. ROTHERHAM COMMUNITY HEALTH
SERVICES
Intermediate Care ServicesTE CARE SERVICES INTERMEDIATE CARE SERVICES
• Evidencing Quality, Innovation, Productivity and
Prevention (QIPP)
• Promoting a model of care that develops alternatives
to admission, reduced length of stay and care closer
to home
• Delivering an interdisciplinary approach to care
• Demonstrating best practice and improved health and
wellbeing
11. Description of Rotherham’s
Service
• A joint commissioned service by NHS Rotherham and
Rotherham Metropolitan Borough Council (RMBC)
• Delivered by RCHS and RMBC Providers
Providing:
• Residential rehabilitation services
• Day rehabilitation services
• Community rehabilitation services
Delivering:
• 6 x week rehabilitation programmes
Team:
• Joint Clinical Lead – OT and PT
• PTs, OTs, Social Care Officers, Support Workers, Home Care
Enablers, Therapy support workers
12. Community Rehabilitation Service
Team:
• PTs, OTs and Home Care Enablers
Delivering:
• Rehabilitation to clients in their homes
• Improving/maintaining independence and function
• Supporting carers and decreasing dependence
• Maximising abilities, reducing care packages
• Improving health and wellbeing
• Client centred treatment plans
13. Intermediate Care Services
Productivity Assumptions
2008/9 - following teams intervention impact on social
care packages:
• Reduction of = 578 hours
• Cost of care = £11.50 per hour
• Saving in care = £345,644
2009/10 prediction based on 9 months data:
• Reduction of = 827 hours
• Cost of care = £11.90 per hour
• Saving in care = £507,244
• Deliverability = 3 (achievable 2 - 3 years)
• Level of evidence = 4 (research evidence NICE L2)
14. Intermediate Care Services
Key Performance Indicators
NI 125 at 91 days post discharge from IC services and
NHS Rotherham Vital sign 04
• % of people living at home = 84.26% (target 81%
top quartile)
• % of people where health/condition has
improved/stable = 97%
• % of people reported that the service was good or
excellent = 98%
15. ROTHERHAM COMMUNITY HEALTH
SERVICES
Description of Care Homes Liaison Service
• Commissioned by NHS Rotherham
• Delivered by RCHS Adult Therapy and Adult Nursing Services
Providing:
• Planned, targeted support to residential and nursing homes
By:
• Working in partnership with Care Homes Managers and Care
Home Staff
• Developing a culture of person centred care
• Maintaining health and wellbeing
• Promoting independence and where ill health is avoided or
acted on appropriately
16. Care Homes Service
Delivering:
•Advice and support in the management of residents with
complex needs
•Screening and identification of physical and mental health
needs
•Assessments, training and rehabilitation
•Multi-factorial falls assessments and falls prevention strategies
Team:
•Joint Clinical Lead – Clinical Specialist OT-Older people and
Community Matron
•PTs, OTs, SALTs, Dietician, Generic Support Workers,
Reviewing Officer, Community Psychiatric Nurse
17. Care Homes Liaison Service
Productivity Assumptions
2008/9 - 440 admissions to hospital from 6 x Care Homes
(449 beds)
(Cost of admission = £1,389,520)
From April 2009 - December 2009 - following teams
intervention:
Admissions = 261
(Cost of admission) = £824,238
18. Care Homes Liaison Service
Productivity Assumptions
2009/2010 prediction:
• Admissions = 330
• Cost of admissions = £1,042,140
• Cash releasable = £347,380
• Deliverability = 3 (achievable 2-3 years)
• Level of evidence = 4 (NICE L2)
19. Care Homes Liaison Service
Key findings from review of 2 Care Homes by NHSR
Commissioning team following teams interventions:
• 90% reported that the service was either good/excellent
• “training around falls was brilliant - made us think more
about why people fall and preventing hospital admissions
• “Safe feeding and position training was excellent - now
have dedicated meal times and this has minimised weight
loss for some residents”
• “Care plans have now been adapted which are much more
personalised to meet residents needs”
• The training on tissue viability was excellent - this has
empowered staff to identify problems with skin tissue and
refer onto services quicker”
20. The White Paper
• NHS Vision
• GP Consortia
• NHS Commissioning Board
• Local Authorities
• Foundation trusts
We have become used to growth and to the NHS doing well in comprehensive spending reviews:
in the period between 1997 and 2009 NHS Spend grew by 5.7% in real terms each year. This translates to around £60bn extra resources per year.
Even now until 2011 we will continue to have NHS funding fixed at relatively high levels
However two unavoidable forces are now coming together to give us unprecedented challenges.
Firstly, public expectations of the safety and quality of care are rocketing.
And secondly, the economic recession is leaving the Government in such heavy debt that public spending will have to be radically reined back for years to come.
We have become used to growth and to the NHS doing well in comprehensive spending reviews:
in the period between 1997 and 2009 NHS Spend grew by 5.7% in real terms each year. This translates to around £60bn extra resources per year.
Even now until 2011 we will continue to have NHS funding fixed at relatively high levels
However two unavoidable forces are now coming together to give us unprecedented challenges.
Firstly, public expectations of the safety and quality of care are rocketing.
And secondly, the economic recession is leaving the Government in such heavy debt that public spending will have to be radically reined back for years to come.
We have become used to growth and to the NHS doing well in comprehensive spending reviews:
in the period between 1997 and 2009 NHS Spend grew by 5.7% in real terms each year. This translates to around £60bn extra resources per year.
Even now until 2011 we will continue to have NHS funding fixed at relatively high levels
However two unavoidable forces are now coming together to give us unprecedented challenges.
Firstly, public expectations of the safety and quality of care are rocketing.
And secondly, the economic recession is leaving the Government in such heavy debt that public spending will have to be radically reined back for years to come.