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Right Care Overview and National Roll Out
- 1. Copyright 2011 Right Care What is the Right Care Approach? June 2015 Right Care for patients Right Care for populations
- 2. 2 1948-1972 Free 1980’s Effectiveness 1990’s Cost-effectiveness 2000’s Quality and Safety 2010 and for the rest of the century VALUE The Value Century
- 3. 3 “Value” can mean different things in different contexts...
- 4. 4 The Right Care Manifesto For Patients For Populations Better Value Healthcare Accountable Integrated Systems Mobilise the patient No patient should make decisions in avoidable ignorance – the informed and empowered patient leads to more appropriate and sustainable care – embrace the Shared Decision Making paradigm Understand spend and outcome To deliver high value healthcare, commissioners need to manage the services they contract at programme budget levels – how much is spent on diabetes and for what outcome for the population served? Understand variation commissioners and providers need to identify unwarranted variation and benchmark against other populations in order to remove waste and shift spend to higher value interventions Manage the whole pathway In order to deliver integrated care providers need to work together and accept clinical and financial responsibility for entire programme budgets Devolve Pathway Design and Management Commissioners should focus on outcomes - devolving performance management (clinical outcomes delivered within budget) and responsibility to develop integrated pathways to a provider in the programme budget pathway Address whole populations to maximise value, not just those patients who appear in clinic – and provide clinical leadership to develop the network which delivers the service to the population and to lead innovation
- 5. Five Key Ingredients: 1. Clinical Leadership 2. Indicative Data 3. Clinical Engagement 4. Evidential Data 5. Effective processes 1 key objective + 3 key phases + 5 key ingredients = Commissioning for Value 5 OBJECTIVE - Maximise Value (individual and population) Key ingredients and phases
- 6. 6 In summary, right Care 1. Helps health economies find where they are wasting money on sub-optimal healthcare. 2. Helps them replace that with optimal healthcare and save money. An improvement methodology that meets needs of all perspectives and delivers efficiency and a sustainable health economy Overview
- 7. www.england.nhs.uk NHS Right Care Mobilisation plan 2015 - 2018
- 8. 8 Future - enabling the system to deliver by industrialising Right Care and expanding at pace • Making CCGs capable via CCG Development programme, including Governing Body development, Improvement and Clinical Lead training and coaching, practitioner network, advice and trouble-shooting • LPF/ CSU Development programme and accreditation • National Programme partnerships, e.g. Specialist Commissioning, Parity of Esteem, Urgent Care, Elective Care, Shared Decision Making, Future Focussed Finance • Spreading across whole system via collaboration with PHE, Monitor, TDA and DH • Helping the system to design and deliver optimal across system, driving efficiency via healthcare improvement
- 9. 9 Headline next steps • 2015/16 Summer/ Autumn - Recruit and train Delivery Partners Autumn - Recruit first cohort of CCGs Winter - Embed in first cohort • 2016/17 First annual cycle for first cohort Recruit and embed in second cohort Launch Practitioners Network for ‘Right Care health economies’ • 2017/18 Second cycle for first cohort First cycle for second cohort Recruit and embed third cohort, and so on Key question: how to get core leadership on board in advance of ‘arrival’?
- 10. 10 Find out more about Right Care online 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 The Atlas of Variation in Healthcare Series Commissioning for Value Programme and CfV insights packs for CCGs Value Tools Casebooks – who is doing it now Online learning video series Resource Centre www.rightcare.nhs.uk
- 11. 11 A post-card from Right Care Dear All We know that we have to use the resources available for health care differently and focus on population health care, thinking about the whole system, not just organisations. We have made a good start in identifying unwarranted variation and will roll-out our Right Care philosophy, which started with the production of the Atlas of Variation in healthcare, across the NHS. New models of care are now being designed around populations and patients, and that feels right. We would like your Ideas on a post card please. Right Care Colleagues NHS England Right care @nhs.net Posted JUNE 2015
Hinweis der Redaktion
- The dominant paradigm of the NHS can be summed up in one word, a word that changes from time to time. From 1948 to 1972 the word was “free” the fact that the NHS was free from the point of need was its most important feature. In 1971 Archie Cochrane published his revolutionary book “Effectiveness and Efficiency” and for the next 20 years the dominant word became effective. In 1992 as cost consideration became more pressing the term became cost-effectiveness and for the last 10 years the most important term has been quality, including safety as one dimension. From the next 20 years, perhaps forever, the most important word will be value and value is measured by the relationship between outcome and expenditure.
- The primary objective for the NHS Right Care programme is to maximise value, which we define as: the value that the patient derives from their own care and treatment, the personalisation of difficult decisions is optimised by patient decision aids http://sdm.rightcare.nhs.uk/pda/ and shared decision making the value the whole population derives from the investment in their healthcare and there are two aspects to this Allocative value, determined by how the assets are distributed to different sub groups in the population, for example to people with cancer or to people with mental health problems, Technical value, determined by how well resources are used for, this is measured by relating outcomes to the resources used, where the resources are not solely financial but include the time of patients and clinicians. Neither is it measured only with respect to the patients treated but to all the people in need in the population because there is under provision to some groups and the population based approach to technical value or efficiency is essential for increasing equity as well as value The inverse of value is waste which is any activity that does not add value
- NHS Right Care offers a standard means of prioritised and transformational commissioning. It teaches CCGs and CSUs to fish. It brings clinicians from across the system together on the same agenda. It gets Local Health Economies to design optimal in the systems they most need to fix and then challenge themselves to deliver the optimal they have just designed.