1. The future of market access – the local
picture
David Thorne, chief executive, Newcastle
West CCG

2. NEWCASTLE WEST CCG
The future of market access:
the local picture
David Thorne 29th November 2012

3. Where I come from
NEWCASTLE WEST
Me and my background
18 practices and 132,000 patients
Typical inner city ethnically diverse patch
£240m spend and medicines spend is........
All CCGs are different as you know!

4. One step ahead – NHS and market access

5. 1. Identify our population’s health needs
2. Note national priorities from the DH
3. Commission service provision to meet 1 and 2
4. Manage provision via contracts
5. Performance manage to ensure “bangs per buck”
6. Keep within budget
7. Maintain public confidence in the NHS

6. 1. Identify our population’s health needs
2. Note national priorities from the DH
3. Commission service provision to meet 1 and 2
4. Manage provision via contracts
5. Performance manage to ensure “bangs per buck”
6. Keep within budget
7. Maintain public confidence in the NHS
Clinical commissioning –
those closest to the patients are those
best placed to design
the way care is provided

7. Our QIPP challenge - the number plate
1894 1720 34
1856 1784 33

8. 32 43 12

11. Transition Authorisation
Circles of influence
and control

12. Transition: Authorisation:
the process through the process through
which the NHS needs which the ability to
to move to new have statutory
structures status is confirmed

13. Strategic Clinical
DH Networks
Clinical
Senates
NHS CB Academic
Strategic
Health
Region Networks
LAT
FTs
CSUs
CCGs

14. • 14.8 million population
• 1 NHSCB regional office
• 9 Local Area Teams
• 68 Clinical Commissioning Groups
• 8 Commissioning Support Services
• 50 Health and Well Being Boards
• 4 Clinical Senates
• 4 Strategic Clinical Networks

15. • Competition vs integration
• Long term irresistible trends:
• workforce
• consolidation and franchising
• redesign drivers and consequences
• provider-commissioner linear relationships
• Community services
• Primary care

16. Where we are as a CCG
NEWCASTLE WEST CCG
• Ageing population, highly dependant on benefits
• Life expectancy that of a developing country
• Increasing birth rate consequent of BME community
• Big drivers – local lifestyles, early chronic ill health, economics
• The three Cs – cancers, CHD and COPD
• Can’t under estimate local authority and economic position
• Over 40 live projects led by clinicians

17. Executive
GP Board Member - Domain 1 GP Board Member - Domain 2 GP Board Member - Domain 3 GP Board Member - Domain 4 Nurse Board Member - Domain 5
Contracting Clinical Development of LTC GP Chair Quality & Safety Patient Safety & Safeguarding
Commissioning Manager C Commissioning Manager B Head of Commissioning Commissioning Manager A PCPE Lead
Clinical Engagement Grouping Clinical Engagement Grouping Clinical Engagement Grouping Clinical Engagement Grouping Clinical Engagement Grouping
Prevention LA/Public Health Westgate LTC LTC users North Urgent / Secondary Care Armstrong Mental Health / Mental Health Mid west MGMP Primary Care Outer west
Unplanned Care Planned Care
Clinical Areas Member Clinical Areas Member Clinical Areas Member Clinical Areas Member Clinical Areas Member
Practices Practices Practices Practices Practices
Adult Mental Emergency
Cancers Dilston Broadway Scotswood Urgent Care Denton Turret Safeguarding Newburn
Health admissions
Prescribing Prospect Diabetes Ponteland Rd Care Homes Grainger A&E Betts Ave HCAIs Throckley
Ambulance Cruddas Park CVD Roseworth Public Health Holmside Access Westerhope PCPI Parkway
West Rd Respiratory Fenham Hall Maternity Denton Park
Primary Care
Quality

21. Yes! Look
how
important it is in
their data!
• Quality and Productivity
• Practice reviews activity data Would they
look at
• A&E, OPs and NELs our portfolio?
• External peer review
• Design pathways
• Typical practice gets £13k

22. The commissioning recipe
Shine a torch!
1. What do the numbers say?
2. What do patients say?
What have
3. What are our daily experiences of the system? we got and
what do we
4. What do our friends say? lack?
5. What works elsewhere?
6. Pragmatism and simple systems
Have we got a
torch and a set
of spanners?

23. • Transition capacity and capability
• Organisational development and networking
• Business intelligence
• Management support, management systems and project management
• Education and training
• Facilitating integrated care
• Messages:
– QIPP and cost efficacy are fundamental
– transferable positive practice
– collaboration across sectors of health care
– speak our language and know our whiteboard
– respond! Nb Ramadan and diabetes
• “See the person and you’ve seen the company” – it is all about you

24. NEWCASTLE WEST
Thanks for
listening
david.thorne@nhs.net