Primary Care Premises_ Creating sustainable development by pptfiles

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									   The financial challenge to
Hertfordshire health services
                                 Alan Pond
     Director of Finance NHS Hertfordshire
   Interim Chief Executive Herts Valley CCG
Commissioning for Patients –
future funding flows
        • Groups of GP practices will commission most
          local NHS services
           • Two Shadow Clinical Commissioning Groups (CCGs)
             in Hertfordshire
               • Herts Valleys CCG
               • East & North Herts CCG

        • The new national NHS Commissioning Board
          will commission GP, dentistry, pharmacy and
          ophthalmic services, specialised services and
          prison health services
Commissioning for Patients
        Clinical Commissioning Groups

        •Will be statutory bodies with own senior staff
        •All practices must be part of a CCG
        •NHS Commissioning Board will support by developing
        commissioning guidelines, model contracts and tariffs
        •CCGs will be able to employ staff directly or buy in
        services from external organisations
        •CCGs can decide which aspects of commissioning
        activity they undertake themselves and which aspects
        they share
        •Hertfordshire Integrated Commissioning Support
        Service being developed to support CCGs
Commissioning for Patients
        Finance
        •The NHS Commissioning Board will initially calculate
        practice-level budgets from the current PCT budgets and
        allocate these resources directly to CCGs
        •New weighted capitation formula will provide target
        allocations for each CCG
            • Pace of change policy will drive how quickly funding is moved
              to get CCGs to their target
        •Commissioning budget will be separate from surgery
        income
        •CCGs will receive a maximum management allowance
        to directly employ staff or buy in services. Indicative
        amount is £25 per head
        •Details on how any over/underspends will be managed
        is yet to be agreed with the DH and the Treasury
Commissioning for Patients
        Proposed implementation timetable

        In 2012/13
        •CCGs formal committees of NHS Hertfordshire Board
        •Formal establishment of CCGs and NHS
        Commissioning Board
        •Approvals process for CCGs in phased approach
        •CCGs receive indicative budgets and must prepare
        commissioning plans

        In 2013/14
        •CCG statutory bodies and where authorised will
        receive funding allocation and hold contracts
Transparency in outcomes
      • NHS targets focus on measuring outcomes
      • New outcomes framework for 2012/13 created
      • Framework to be structured around five areas:
                 •      Preventing people from dying prematurely
                 •      Enhancing the quality of life for people with long-term
                        conditions
                 •      Helping people to recover from episodes of ill health or
                        following injury
                 •      Ensuring people have a positive experience of care
                 •      Treating and caring for people in a safe environment and
                        protecting them from avoidable harm



        There are over 500 performance indicators which the PCT is
        responsible for reporting on (by provider and by CCG/PCT)
Transparency in outcomes 2

       • NHS Operating Framework – Key Priorities
              •   Dementia and care of older people
              •   Carers
              •   Military and Veterans Health
              •   Health visitors and family nurse partnerships


       • SHA Ambitions
          •   Eliminate pressure ulcers
          •   Every patient contact counts
          •   Quality/Safety in Primary Care
          •   Strengthened NHS/Local Government partnerships
          •   Improve patient experience
QIPP – Financial Context

• White Paper
  sets out £20bn
  efficiencies
                                                           Size of QIPP
  over next 4                                               Challenge
  years                                                        £276m
• Links to
  Operating
  Plan,
  Framework &
  Outcome
  Framework
                   Projected Expenditure   Projected Funding
                       Without QIPP
Financial Picture – 2012/13
 – Hertfordshire system in balance at 31st March 2012

 – Managed to deliver circa £100m efficiencies in
    2011/12 across Hertfordshire

 – Funding used non-recurrently to drive change and
    deliver efficiencies

 – PCT funding for 2012/13 £1.76bn

 – Significant challenge across the system in 2012/13 to
    2014/15 and beyond…
Financial Picture – 2012/13
 Illustration of how the PCT income is spent (2010/11)
Maintaining Performance
 Managing Change
 • Set out the vision – DQHH puts Hertfordshire
   ahead of other areas
 • Created early momentum, delivered first year
   of QIPP
 • Minimise fear to avoid distraction
 • Prioritise performance areas to concentrate
   on
 • Dedicated resource for transition
 • Talent management

								
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