Health Reform in England

1
Health Reform in England
2
The healthcare challenge

• A nation getting older
• 15 million people with long term needs
• Rising trend in lifestyle related diseases
• Increasing numbers of children with special
  needs
• The poorest areas often with the poorest
  healthcare

3
People wanting change

• Largest ever public consultation for Our Health,
• Our Care, Our Say revealed that people would
  like
• Greater control of their own health
• Support to remain independent
• Real choice
• More local care
• Care that is better integrated around their
  personal needs

4
The elements of reform
Money following the patients, rewarding the best
and most efficient providers, giving others the
incentive to improve (transactional reforms)
Better care Better patient experience Better
value for money
More diverse providers, with more freedom to
innovate and improve services (supply-side
reforms)
More choice and a much stronger voice for
patients (demand-side reforms)
A framework of system management, regulation and
decision making which guarantees safety and
quality, fairness, equity and value for money
(system management reforms)
5
The elements of reform

• Reforms are most advanced in the area of planned
  elective care
• This is a long term programme of development
  which will take
• time to implement
• There is much work to be done especially re.
  the payment
• system regulation strengthening
  commissioning and, tailoring
• provision
• A key objective is to give more power to local
  communities to
• tackle their specific health issues
• What works for Herefordshire wont necessarily
  work for inner
• city Manchester
• We need to free up local clinicians and local
  commissioners to
• work out the best solutions for and with
  their local population

6
The provider side, key features for the future

• Greater innovation
• More flexibility
• Better able to respond to individual needs
• Higher quality
• Increased productivity
• Firmer governance and financial base

7
Provider reform, the story so far

• Foundation Trust status
• Plurality in planned elective care
• Third Sector and Social Enterprise
• Primary Care

8
Provider Reform Community Services

• PCTs likely to review these services in 2007/08
• PCT directly managed provision remains an option
• What matters is the service offer quality,
  fit with
• patients needs and value for money
• New organisational forms are on the agenda only
• to the extent that they can help achieve
  better services

9
Community services the future provider landscape

• No single blueprint for provision

Continuing PCT provision
PBC providers
Social enterprises
Private companies
Commissioners
Third sector / voluntary organisations
Community Foundation Trusts
Acute FTs
10
Opportunities for Speech and Language Therapy
Services

• Increasingly diverse provider base
• Greater focus on personalised services
• Local leaders with commissioners to decide on
  service model, and if necessary provider form
• Strengths and weaknesses of different types of
  provider must be honestly understood and
  evaluated
• Form must follow function
• But real opportunity for greater innovation and
  service improvement