UNDERSTANDING THE BIGGER PICTURE OF CHANGE: WHAT DOES IT MEAN FOR AHPs AND THERAPY SERVICES

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UNDERSTANDING THE BIGGER PICTURE OF CHANGE
WHAT DOES IT MEAN FOR AHPsAND THERAPY SERVICES?
Kamini Gadhok, Chief Executive Royal College of
Speech and Language Therapists
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OVERVIEW

• Understanding the direction of change
• Putting into context the changes for AHPs and
  therapy services
• Where will AHPs sit in the new environment?

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CONTEXT OF THE CHANGES

• The NHS Plan- 2000- 10 year plan
• Set a new direction
• Devolved and decentralised NHS
• Power in hands of the patient

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COMMISSIONING A PATIENT LED NHS

• Commissioning a patient led NHS July 2005
• Step change to how services are commissioned
• Aim to reflect patient choice
• Complement other policy developments

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WHERE ARE WE NOW?

• The process of transition to support
  commissioning a patient led NHS
• Four key areas which are inter- related
• Practice- based commissioning
• Payment by results
• Patient choice
• Independent providers and Foundation Trusts

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HOW DO THE CHANGES INTER- RELATE?

• Practice based commissioning
• Secondary care commissioned by GPs
• Incentivise GPs to only transfer to hospital
  cases which cannot be catered for in the
  community
• Links to the aspirations in Our Health, Our Care,
  Our Say

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PAYMENT BY RESULTS

• Single tariff for a hospital episode
• Aims to facilitate patient choice through
  practice based commissioning
• Facilitates plurality of provider- best value for
  money
• AHPF raised problems about the tariff
• Review of PbR- suspended 2006
• Financial pressures- GPs and practice based
  commissioning

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NEW PROVIDERS

• Plurality of providers
• Aims to facilitate patient choice money
  following the patient
• Problems in the system as care has not been
  affectively costed- issues re unbundling the
  tariff
• Not clear how patients can exercise their choice

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FOUNDATION TRUSTS- SOCIAL ENTERPRISE MODEL?

• Purpose of Foundation Trusts
• Devolve more power and responsibility to the
  local level- incentivise innovation and
  entrepreneurialism
• Devolve accountability to local stakeholders,
  including NHS patients and staff
• Support patient choice- increase plurality

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FOUNDATION TRUSTS

• Achievements
• Opened new treatment facilities
• Devised new services in the community
• Developed new partnerships
• The Financial position
• 1 in deficit
• 31 generated 20 million surplus

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FOUNDATION TRUSTS

• The Future
• FTs believe that the FT model should be at the
  heart of the reform agenda- all trusts should
  work within a more robust financial regime
• Government commitment that all NHS trusts can
  apply for FT status by 2008
• Issue re tariffs under PbR

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OUR HEALTH, OUR CARE, OUR SAY

• Three key themes
• Putting people more in control of their own
  health and care
• Enabling and supporting health, independence and
  well being
• Ensuring rapid and convenient access to high
  quality, cost effective care closer to home

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OUR HEALTH, OUR CARE, OUR SAY

• Three key challenges
• To meet the expectations of the public
• To do this with value for taxpayers money
• To shift services out into the community

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Priorities for 2006-07

• Achieving financial balance
• Reducing health inequalities - focus on smoking
  cessation
• Cancer waits - 31 and 62 day targets
• 18-week maximum wait by 2008

• MRSA reductions
• Patient choice and booking
• Sexual health and access to GUM clinics GUM
  appointments available within 48 hours by 2008

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WHAT DO ALL THESE CHANGES MEAN FOR AHPS?

• Commissioning
• Issues
• Knowledge of commissioners
• AHPF Action
• Joint leading edge briefing with the NHS
  Confederation
• Influencing the national commissioning work being
  led by the DH
• Influence work on tariffs

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WHAT DO ALL THESE CHANGES MEAN FOR AHPS?

• Commissioning
• Action by you
• Local commissioning cycle- make sure you are
  engaged
• Identify how you add value
• 6 priority areas
• Other commissioners?
• Value for money PBC and PbR incentives
• Our Health, Our care, Our say

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WHAT DO ALL THESE CHANGES MEAN FOR AHPS?

• Commissioning
• Development programme for Practice based
  commissioning ask your CEO/ PCT if your
  organisation is involved if not ask if it can be
• Get involved with the work of the professional
  bodies

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WHAT DO ALL THESE CHANGES MEAN FOR AHPS?

• Provider functions
• Issue
• What is the best solution for where your services
  sit within the different provider models?- No
  national framework
• AHPF Action
• checklist

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WHAT DO ALL THESE CHANGES MEAN FOR AHPS?

• Provider functions
• Action by you
• Who is taking the lead locally?
• What is the best solution for your patients?
• Foundation Trusts are social enterprises

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CONCLUSION

• This is the start of the journey
• Challenges and opportunities
• HOW to move forward