INVESTING IN HEALTH Delivering World Class Commissioning Programme Budgeting and Marginal Analysis

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INVESTING IN HEALTH Delivering World Class
CommissioningProgramme Budgeting and Marginal
Analysis
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Speakers

• Shola Ajayi
• Head of Commissioner Developments and
  Planning, Northamptonshire teaching Primary Care
  TrustShola.Ajayi_at_northants.nhs.uk
• 01536 480436
• Wendy PearsonPolicy Development Associate,
  Northamptonshire teaching Primary Care
  TrustWendy.Pearson_at_northants.nhs.uk
• 01536 480320

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World Class Commissioning

• Vision
• Better health and well being for all
• Better care for all
• Better value for all

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World Class Commissioning

• Investment decisions are made in an informed and
  considered way
• Improvements are delivered within available
  resources
• Collaborate with Clinicians
• Manage knowledge and assess needs
• Prioritise investment
• Stimulate the market
• Make sound financial outcome focused investments.

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World Class Commissioning

• Organisational development
• Understanding throughout the organisation
• Clarity of purpose
• Development of staff
• Improving skills
• Enhancing Delivery
• Programme management organisational
  structure
• Engaging stakeholders

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Programme Budgeting Marginal Analysis

• PURPOSE
• To develop and deliver a commissioning tool for
  
• effective and evidence based decision
  making
• To inform the decisions of the Darzi next
  stage
• review work streams and provide evidence
  for moving
• resources around the system
• To inform the PCTs 3 5 year strategic plan

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Key Objectives

• Acceptability
• Engagement across organisation and its
  partners
• Data Availability
• Inputs, outputs and outcomes, current
  services, service investment and disinvestment
• Practical value
• Does this approach make a difference to
  patterns of service?
• Transferable
• Is it possible to make PBMA a regular
  feature of local
• commissioning decisions?

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Benefits

• Engagement
• Clinicians and Management
• Evidence Based Commissioning
• Outcome focused
• Deliver real change
• Offers real comparison to peers

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Progress to date.

• Workshops Commissioners
• Proposals

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Quadrant Analysis
High
High Spend/Good Outcome
High Spend/Poor Outcome
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10
2
13
5
16
Spend
1
4
19
18
21
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Low
Low Spend/Good Outcome
Low Spend/Poor Outcome
Outcome
Good
Poor
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Progress to date.

• Workshops Commissioners
• Proposals
• Action Plan

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INVESTING FOR HEALTH (PBMA)ACTION PLAN
 
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INVESTING FOR HEALTH (PBMA)ACTION PLAN
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 INVESTING FOR HEALTH (PBMA)ACTION PLAN
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Progress to date.

• Workshops Commissioners
• Proposals
• Action Plan
• Resources

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Resources

• Identified lead
• Team Commissioning, Public Heath, Finance,
  Policy and Best practice
• Capacity
• Knowledge and skills
• Organisational understanding
• Support within and outside organisation including
  PHO and SHA.

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Progress to date.

• Workshops Commissioners
• Proposals
• Action Plan
• Resources
• Structure

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PBMA delivery structure
DARZI Work streams
Clinical Cabinet
Cancer and Tumours Disease group
Commissioning Executive
Mental Health Disease group
PROGRAMME BOARD
Project Team
EMT
Partnership board
Circulatory problems Disease group
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PBMA delivery structure
Clinical Cabinet
DARZI Work streams
Cancer and Tumours Disease group
Commissioning Executive
Project Team
PROGRAMME BOARD
Mental Health Disease group
EMT
Circulatory problems Disease group
Partnership board
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Progress to date.

• Workshops Commissioners
• Proposals
• Action Plan
• Resources
• Structure
• Alignment with various work streams

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Investing in HealthClinical engagement structure
DARZI Work streams

• End of Life
• Children
• Long Term Conditions
• Acute
• Planned Care
• Staying Healthy

Cancer and Tumours Disease group

• End of Life
• Children
• Maternity and Newborn
• Long Term Conditions
• Acute
• Learning Disabilities
• Planned Care
• Staying Healthy

Mental Health Disease group
Circulatory problems Disease group

• End of Life
• Children
• Long Term Conditions
• Acute
• Planned Care
• Staying Healthy

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Recommendations

• Programme board
• Commitment and real engagement
• Active involvement of Practice Based
  Commissioners
• Clarify use resources and process

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Next steps

• Mental Health Aligned with the current Mental
  Health review
• Two identified disease groups to commence at
  earliest opportunity.
• Plans to use FESC partners to deliver

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Challenges

• Co-ordination coherence
• Flexibility and clarity of organisational
  structure
• Effective flows of patient pathways