Patient Choice of Qualified Provider: Wheelchair Services Engagement
"Explore the perspective of a commissioner on extending patient choice of any qualified provider in national wheelchair services. Discover the policy framework, governing principles, and the national pick list for healthcare services. Empowering patients, improving outcomes, and promoting service innovation are key drivers of this approach."
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Presentation Transcript
Extending Patient Choice of Any Qualified Provider National Wheelchair Services Provider Engagement Event The Commissioner Perspective Sohaib Khalid Associate Director of Commissioning Birmingham & Solihull PCT Cluster
Context Extending patient Choice of Provider policy published in July 2011 Published at a time of significant period of change and reform: Move to PCT Clusters Formation of Clinical Commissioning Groups Commissioning Support Services concept emerging Much confusion?????
Context (2) Yet show must go on! The policy: Has good alignment to commissioning strategies Supports the Care Closer to Home approach Responding to feedback (patients / public/ stakeholders) Enabling scrutiny in key service areas A tool for procurement Supporting Market Development
The policy The key rationale underpinning this policy centres on: Empowering patients and carers Improving patient outcomes and experience Enabling service innovation Free-up clinicians to drive change and improve practice No income guarantees
The policy(2) Governing principles Key principles to govern AQP approach to contracting for services include: Providers qualify and register to provide services via an assurance process that tests providers fitness to offer NHS- funded services Commissioners set local pathways and referral protocols which providers must accept Referring clinicians offer patients a choice of qualified providers for the service being referred to. Competition is based on quality, not price. Providers are paid a fixed price determined by a national or local tariff.
The policy (3) National pick list for 2012/13: Musculo-skeletal services for back and neck pain Adult hearing aid services in the community Continence services (for adults and children) Diagnostic tests closer to home such as some types of imaging, cardiac and respiratory investigations to support primary assessment of presenting symptoms Wheelchair services Podiatry Services Venous leg ulcer and wound healing Primary care psychological (adults)
Early Actions Each PCT / Cluster has chosen 3 services for progression. In doing so they: Engaged with patients, CCGs and Stakeholders (where possible) Established (and progressed) a criteria for selection Confirmed their selections to the SHA by Oct 11 National Implementation packs published from November 2011 Commencement of service (spec) reviews
Some Selection Criteria Pragmatic (not an exhaustive list!) Clinical & Patient Safety Clinical (dis)-agreement on definition Commissioning priority (health need / patient feedback / experience) Perceived degree of complexity (in isolating a service for progression) Minimal disruption (system, service continuity) Best use of the public purse Existing strategic work underway
The West Midlands Approach In West Midlands pursuit of collaborative working Collective selection of 2 service priorities, with a majority pursuing the same third Sharing of capacity & capability recognising the short timeframes Establishment of the WM AQP Steering Group, supported by Task & Finish groups
The West Midlands Approach (2) Summary of NHS Cluster selections: PCT Cluster Population** Service 1 Service 2 Service 3 907,000 Adult Hearing Podiatry Wheelchair services Arden 1,460,000 Adult Hearing Podiatry Wheelchair services Black Country 1,130,000 Adult Hearing Podiatry Wheelchair services Birmingham & Solihull Staffordshire & Stoke (North) 480,000 Adult Hearing Podiatry Continence services Diagnostic tests closer to home Staffordshire & Stoke (South) 612,000 Adult Hearing Podiatry West Mercia (Worcestershire) 552,000 Adult Hearing Podiatry Wheelchair services MSK for back and neck pain 181,000 Adult Hearing Podiatry West Mercia (Herefordshire) West Mercia (Shropshire & Telford)* 460,000 Adult Hearing Podiatry Wheelchair services
The West Midlands Approach (4) Task & Finish groups have: Reviewed the published National Service Specification ensuring it was fit for purpose for the local health systems. Reviewed, analysed and are establishing supporting price currencies for the delivery of the specified service. Where appropriate and possible to do so, engage widely with clinicians and current providers to obtain a wider service understanding.
Wheelchairs - Coverage All PCTs from the former West Midlands SHA Area (Excluding Herefordshire and Staffordshire in Phase 1) Population size = c.4.5m NHS Birmingham East and North NHS South Birmingham NHS Coventry NHS Stoke on Trent NHS Dudley NHS Telford and Wrekin Heart of Birmingham Teaching PCT NHS Walsall Sandwell PCT NHS Warwickshire Shropshire County PCT Wolverhampton City PCT Solihull PCT NHS Worcestershire
Local review Three specifications Spec 1 (Assessment) Spec 2 (Provision Delivery & Maintenance) Spec 3 (Specialist) Phased roll-out Strong likelihood for a focus on Children Reviewing data to determine Eligibility / Exclusion Criteria to be reviewed Seeking a LEAN service that is patient focused
Local review (2) Market Overview (Currently) Ten Providers Overall Value = circa 13m per annum c. 900k per PCT area Pricing Assessment based upon staff time Equipment = Cost of equipment plus maintenance Currently undertaking exercise across area
Next Steps Advert date: Window 1 - 27th April 2012 Window 2 - July 2012 (TBC) Contract Award: August /September 2012 Mobilisation: September, no later than December 2012 Contact Details: www.supply2health.nhs.uk Today is an important stage for us (all)! Key opportunity to engage with Providers, for meaningful two way dialogue
Thank you. And we hope you enjoy the day.
