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					Release 5.0 Preview
Changes affecting Commissioning users




                                 20.09.2010 – Version 1.0
Overview of Changes

   Support for Alternative Care Pathways


   Commissioning Rule Changes


   Enquiries Total
Release 5.0 Functionality
Commissioner Role
                                      Support for Alternative Care Pathways



Background

Prior to Release 5.0 the only way to restrict access to a service was for the
Commissioner to commission the service as not available for initial referral.

This function was only available for primary care menu services.

The service was then only visible as an onward referral.
 Release 5.0 Functionality
 Commissioner Role
                                         Support for Alternative Care Pathways



Release 5.0 Functionality:-

Providers of Primary or Secondary Care Menu services will be able to restrict
access to their services for clinical reasons or to support Practice Based
Commissioning.

Providers will be able to set up pathways to the restricted services.

These pathways need to be created so that the provider of a restricted service will
be able to specify which services, organisations and/or individual clinicians may
directly refer to, refer-on to and redirect to their restricted service.

Primary Care Menu services will still need to be commissioned.
  Release 5.0 Functionality
  Commissioner Role
                                          Support for Alternative Care Pathways



The reasons for the change are:

 To encourage service providers to put more specialist (tertiary) services onto
  Choose and Book, because restricted services are protected by identified care
  pathways.

 To enable multiple practices, within the same practice based commissioning
  consortia, to refer into a specific service which is not available to other referrers.

 To identify clear pathways of care for referrers.
 Release 5.0 Functionality
 Commissioner Role
                                           Support for Alternative Care Pathways


If a service is restricted then a clear pathway in will have to be identified. This
service will be via one or more of three routes: authorised service, authorised
referrer or authorised organisation.


Term                         Description
Authorised Service           might be an assessment service, that can refer onto the
                             restricted service, or a service that might redirect to the
                             Restricted Service.
Authorised Referrer          a referring clinician or service provider clinician, who can
                             refer/refer-on/redirect directly to a Restricted Service and
                             would not need to go through the agreed pathway.

Authorised Organisation      is a referring organisation, eg GP practice, that can refer
                             direct to the Restricted Service, which might be a Practice
                             Based Commissioned service.
  Release 5.0 Functionality
  Commissioner Role
                                      Support for Alternative Care Pathways




The following slides give examples of how this functionality might be used:

 Prior assessment services

 Tertiary or specialist secondary care services

 Initial Referral (authorised referrers)

 Practice Based Commissioning model (authorised organisations)
Prior Assessment Model                              Key
                                                          Restricted   Authorised   Authorised

Release 5.0 Functionality                                  Service       Service     Referrer



Commissioner Role
                                              Under local commissioning
                                              The pathway is Newtown
                                              arrangements, via the
                                              Newtown MSK Assessment
                                              Hospital provide an Orthotic
                          Newtown Hospital
                                              Service.and Village Hospital a
                                              Service This service is an
                              Orthotic        specialised Podiatric Referrals
                                              authorised service. Service
                              Service         received into this service are
                                              with Surgical Input.
                                              triaged and/or treated. Those
                                              referrals that are clinically
                                              Newtown PCT provide a
                                              community can be referred on
                                              appropriate Physiotherapy
                                              to the relevant restricted
                                              service.
                                              service.
      Newtown
                           Village Hospital   These services are restricted
    Musculoskeletal
     Assessment
                          Podiatric Surgeon   and wishing to send referrals
                                              GPs do not accept referrals to
                                Service       the restricted services will be
       Service                                direct from GPs.
                                              directed to refer via the
                                              authorised service.



                         Newtown Community
                           Physiotherapy
                              Service
Tertiary/Restricted Secondary Care Service
 Release 5.0 Functionality                     Key
                                                     Restricted
                                                      Service
                                                                  Authorised
                                                                    Service
                                                                               Authorised
                                                                                Referrer


   Model
 Commissioner Role
Newtown Optical
  Assessment
    Service
                                             The National Eye
                                             Infirmary offers
Village General                              specialised tertiary
    Eye Clinic                               services. These services
                             National        are published on the
                              Eye            national DOS as
                          Removal Service
Liverpool General                            restricted services. The
   Optical Clinic
                                             DOS entry lists all
                                             available authorised
                             National        services that referrers
 London Optical               Optic
  Assessment               Nerve Laser
                                             can initially refer into.
     Centre
                          Surgery Service
                                             Clinicians within the
                                             authorised service are
  Birmingham                                 able to refer on to the
General Eye Clinic
                                             restricted services
                                             where clinically
                                             appropriate
Bristol Eye Clinic
Initial Referral (authorised referrers)                                               Key
                                                                                            Restricted
                                                                                             Service
                                                                                                         Authorised
                                                                                                           Service
                                                                                                                      Authorised
                                                                                                                       Referrer




                                                  Newtown PCT Optical
                                                     Assessment
                                                        Service




 Dr Smith from Newtown Surgery                      Newtown Hospital                   National
 wants his patient to go to the                         General                          Eye
 National Eye Removal Service.                         Eye Clinic                   Removal Service
 He is not an authorised referrer so
 he cannot make a direct referral to
 the National Eye Removal Service.
 The Authorised Services presented as
 his pathways are Newtown PCT                           Village Hospital
 Optical Assessment Service or                              General
 Newtown Hospital General Eye Clinic                     Optical Clinic
 and Village Hospital General Optical
 Clinic


                                                                      Dr Jones          Dr Browne               Mr Green
                                                                       Village          Newtown                  Garden
                                                                     Community         Community               War Memorial
                                                                    Health Centre     Health Centre              Hospital
                Dr Jones from Village Community
                Health Centre wants his patient to go
                to the National Eye Removal Service.
                Dr Jones is a GPwSI and is an
                authorised referrer so he can make
                a direct referral to the National Eye
                Removal Service.
  Release 5.0 Functionality
  Commissioner Role
                                          Support for Alternative Care Pathways


How does this facilitate Practice Based Commissioning (PBC)?

 A service can be set up on the Primary Care Menu and commissioned by a
  Primary Care Trust (PCT).

 This service would be restricted, with the practices from the PBC consortia set
  up as Authorised Organisations. This would allow only these practices to refer
  into the restricted service.

 The restricted service will be visible to unauthorised referring organisations (i.e.
  other practices) within the PCT but these practices will not be able to refer
  directly to the service (which will be marked as „restricted‟), nor will there be any
  authorised service pathways for them to select towards such a service.
Practice Based Commissioning Model                         Key
                                                                   Restricted     Authorised   Authorised

 Release 5.0 Functionality
(Authorised Organisations)
                                                                    Service        Service     Organisation



 Service Definer Role
                                                      Newtown is defined as a
                                                    The servicePractice Based
 Newtown PBC                                        restricted service. This provide
                                                      Commissioning Group
                                                    particular service has no
                                                      a non-scalpel Vasectomy
  Newtown
                                                      Service authorised referrers,
                                                    individual for all practices within
   Group                                            and itPBC Group. referral
  Practice                                            the is an initial The service is
                                                    service so there are no practices
                                                      not available to other
                                                    authorised services. Instead it
                                                      within the PCT
                                                    is restricted to authorised
  Newtown                                           organisations. In this case all
   Surgery                                          of the practices within the PBC
                                                    Group (Newtown) are
                    Newtown PBC
                     Non-scalpel                    authorised organisations. Both
                  Vasectomy Service                 PBC Groups could be in the
 Dr Sweeting                                        same PCT.
 & Partners




  Fourways
   Surgery
                       X
                                            Oldtown PBC


                                                                                Two Towns
 Beech Grove        Village Health    New Lane      Village Road                  Group
   Practice             Centre         Surgery        Surgery                    Practice
Release 5.0 Functionality
Commissioner Role                            COPY MIKE’S ONE




                         New Restricted Services Enquiry
    The Restricted Services Enquiry will show which services are restricted and the
                                      reason why.
   The Restriction Date/Time column shows the last time the service was restricted
   (which is updated each time this action is carried out) and the Restricted Count
     column shows how many times this has been done. There are also columns
  showing numbers of authorised services, organisations and referrers associated to
                    each restricted service within the organisation.

                                                                  Fig 16. Restricted Services Enquiry
  Release 5.0 Functionality
  Commissioner Role
                                                  Commissioning Rules Change




 Since the introduction of “Free Choice” commissioners have not needed to
  commission services on the Secondary Care Menu.

      New functionality will no longer display ALL secondary care organisations
       and their services. These organisations will only be visible if they have a
       service on the Primary Care Menu.
      This will enhance response times, as the Secondary Care Menu services
       are no longer being loaded for the commissioner to see.

 The commissioner will now have access to the Directory of Services via a new
  tab, where they will be able to search and review service details of any service,
  Primary or Secondary Care Menu.
  Release 5.0 Functionality
  Commissioner Role
                                               Commissioning Rules Change




 If a service moves from the Primary Care Menu to the Secondary Care Menu
  and then back to the Primary Care Menu, any prior commissioning rules will re-
  appear.

     They will also appear on the Commissioning shrub within Service Definer
      Maintain Services tab.
     As part of the move to the Secondary Care Menu the service will
      automatically be end-dated with the date of the move.
     This service would therefore need to be re-commissioned if moved back to
      the Primary Care Menu
  Release 5.0 Functionality
  Commissioner Role
                                                           Minor Change




Enquiry Total

 Whenever an enquiry is made, the results returned will be displayed
  with a total - „Results Returned – X‟

				
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