Polyclinics Learning and Development Programme Moving Ahead with Implementation Thursday 23rd Octobe

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Polyclinics Learning and Development
ProgrammeMoving Ahead with ImplementationThursda
y 23rd October 2008
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Welcome and Introductions Christina Craig,
Polyclinics Project Manager
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GPS FACE THE AXE IN SUPERCLINIC SHAKE-UP
Million protest as surgeries make way for the
polyclinics
Revolt over Hounslow polyclinic plans
Government to push doctors to compete for
patients
Centralised, unstoppable, NHS bureaucracy
GPs stage revolt over polyclinic
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Polyclinics Planning Framework
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Clinical Leadership in Commissioning Polyclinics
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Polyclinics Commissioning Specification
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Commissioning and Finance model
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• The Service Specification
• Pharmacy
• Urgent Care
• Diagnostics
• Met with Early Implementers
• Knowledge Exchange
• Common Challenges
• Clinical Engagement

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Healthcare for London Polyclinics Team

• Christina Craig Polyclinics Project Manager
• Penny Emerit Head of Implementation
• Juliet Mellish Head of Leadership and Engagement
• Ian Chislett Finance Lead
• Jennie Bostock Senior Project Officer
• Katharine Dell Project Officer
• Verity Soons Project Administrator

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Polyclinics Learning and Development
ProgrammeMoving Ahead with ImplementationThursda
y 23rd October 2008
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PCT polyclinic proposals The London wide
picturePenny Emerit
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Summary of Progress over the summer

• Met with all 31 PCTs to understand plans for
  improving primary and community care through
  polyclinics
• Demonstration of an understanding of the vision
  and a shared ambition for improved patient
  experience
• Recognition that this is a major change programme
  that brings unique challenges
• Local solutions are being developed for common
  problems that could be shared across all PCTs
• Identification of a number of common tricky
  issues that could be solved once and implemented
  locally
• Development of a number of items for a toolkit
  including project planning framework and GP
  communications

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Early Implementer Polyclinics
Harrow
Brent
Hillingdon
Brent
Ealing
South- wark
Greenwich
Lam- beth
Bexley
Lewisham
Bromley
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Progress with polyclinic implementation by April
2010
Harrow
Brent
Hillingdon
Brent
Ealing
South- wark
Greenwich
Lam- beth
Bexley
Lewisham
Bromley
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Local implementation of a shared vision
Harrow
Brent
Hillingdon
Brent
Ealing
South- wark
Greenwich
Lam- beth
Bexley
Lewisham
Bromley
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Polyclinics Learning and Development
ProgrammeMoving Ahead with ImplementationThursda
y 23rd October 2008
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Progress on implementation issues Penny Emerit
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Focus groups identified in July

• Pathways and Specifications
• Procurement and Tendering
• ICT
• Legal Advice
• Information Sharing
• Financial Modelling
• Clinical Leadership
• Consultation and Engagement

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Progress since July

• Pathways and Specifications
• Draft commissioning spec
• Procurement and Tendering
• GPLHC workshops
• Procurement Guide
• Advice available via polyclinics team from DH
  Commercial Directorate
• ICT
• Initial scoping of focused workshop
• Legal Advice
• Completed generic advice on Lift contracts
• Information Sharing
• Identified key learnings and documents from 31
  meetings
• Update on further work to follow from Richard
• Financial Modelling
• Training complete
• Clinical Leadership
• Initial proposals
• Consultation and Engagement
• Formal NHS London gateway role

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Further issues identified from PCT meetings

• Pathways and Specifications
• Procurement and Tendering
• ICT
• Legal Advice
• Information Sharing
• Financial Modelling
• Clinical Leadership
• Consultation and Engagement

Integration
Contracting
Governance
IT
Service models incl. Urgent Care and diagnostics
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How Best to Make Progress?

• Operationalising clinical integration
• IT as an enabler for integration
• Contracting including incentives
• Governance
• Clinical Leadership
• Consultation and engagement
• Affordability and mobilisation costs of
  polyclinics

• Pathways and Specifications
• Procurement and Tendering
• ICT
• Legal Advice
• Information Sharing
• Financial Modelling
• Clinical Leadership
• Consultation and Engagement
• Integration
• IT
• Governance
• Contracting
• Service Models

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Working Group Sessions

• Operationalising clinical integration
• IT as an enabler for integration
• Contracting, incentives and governance
• Consultation and engagement
• Affordability and mobilisation costs of
  polyclinics
• Which group would you like to help shape?

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Working Group Sessions Purpose

• Complex issues to which there are no simple
  answers
• London-wide issues that can be solved once and
  implemented locally
• Value engagement and ideas from everyone to shape
  the work today is an opportunity to scope the
  work
• We will take forward some work on your behalf,
  using PCT engagement and expert advice as
  appropriate
• We are committed to keeping you informed of
  progress
• If you want to take an active part in any group
  please contact us at any time

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Discussion areas for each focus group

• In relation to your topic, define the critical
  issues that you believe need to be resolved to
  enable the implementation of polyclinics
• Identify what should be achieved, that is, the
  outcomes or products that would most support PCTs
  in their implementation
• Consider what you think might be the most
  effective way of working to resolve these issues.

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Polyclinics Learning and Development
ProgrammeMoving Ahead with ImplementationThursda
y 23rd October 2008
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Clinical Engagement Juliet Mellish
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Clinical Engagement

• Whats been achieved to date?
• Clinical Leadership Tool
• Clinical Engagement Workshop
• Whats still to be done and how?

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Clinical Leadership Tool

• To ensure maximum output, the implementation of
  the Commissioning and Financial Model needs
  clinical input
• The Clinical Leadership Tool has been developed
  to help PCTs engage clinicians in the
  commissioning of polyclinics
• Tool describes 5 critical steps in commissioning
  local and clinically driven polyclinic services
• Tool provides illustrative examples of how PCTs
  can engage clinicians in these 5 steps   

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Clinical Leadership Tool
Inputs required
GP contribution

• Local services offered

• Definition of sub-service lines

• PCT population size growth, Demographics (age,
  ethnicity, deprivation), Drivers of each
  activity, Prevalence of driver, Local variation
  in risk factors (e.g., smoking, obesity, etc.)

• Local needs knowledge
• Health behaviours
• Local priorities

• National best practice
• Local best practice

• Number of visits, Time per visit, Clinical staff
  mix, Non-clinical staff mix, Space needed,
  Diagnostics needed, Other costs (Disposables,
  Instruments, Leaflets)

• Unit cost of all resources, Utilisation, Capex
  depreciations, Indirect cost drivers, Existing
  revenue streams, Existing contracts

• Understanding of utilisation, unit costs and
  other inputs

• Costs of existing provision, Number of sites and
  service mix across sites

• Sense checking outputs

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Clinical Leadership Tool GPs should expect to be
involved in challenging assumptions and can go
beyond this to become local leaders

• Support on modelling is important but GPs can go
  further
• Clinical leadership is key to improved patient
  care
• GPs are among the most respected members of their
  communities
• With the enthusiasm and knowledge of GPs, we can
  achieve ambitious goals
• Easy access
• Quality safety
• Staying healthy

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Clinical Leadership Tool - Exercise

• At a local level how are you going to use the
  Clinical Leadership Tool to ensure that GPs are
  engaged in the commissioning of polyclinics?

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Polyclinics Learning and Development
ProgrammeMoving Ahead with ImplementationThursda
y 23rd October 2008