Collaborative Operating Model

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South Central PCTs new way of working The
Collaborative Operating Model (COM)
Collaborative Operating Model (COM) Overview
South Central Priorities Conference 18th May
2009 Janet Fitzgerald WCC Programme Director

• Our Collaborative Operating Model will deliver
• Improved quality and outcomes for people in our
  communities
• Improved cost effectiveness

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Why do we need a Collaborative Operating Model
(COM)?

• South Central PCTs spend 6 billion on health and
  wellbeing for the 4.2m people in our communities
• As the health leaders of our local communities,
  we are responsible for making the best use of
  these resources to ensure
• better health
• better quality
• improved productivity
• As Commissioners we are challenged with doing
  more for less, and never more so than now
• We have learned through the World Class
  Commissioning assurance process where we need to
  further improve as a matter of urgency
• Our leading edge approach to strengthening
  commissioning is through our Collaborative
  Operating Model
• Our Chief Executives are committed to
  collaboration, and believe it will help ensure
  each PCT operates strongly and to deliver the
  right outcomes for our communities
• It means a whole system change

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The Collaborative Operating Model (COM) is our
new vision for strategic commissioning in South
Central
South Central PCTs new way of working The
Collaborative Operating Model (COM)

• Our Collaborative Operating Model will deliver
• Improved quality and outcomes for people in our
  communities
• Improved cost effectiveness

A transformation management programme will
support South Central to undertake the change
journey towards our COM way of working
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Working together within the Collaborative
Operating Model (COM), we will deliver improved
World Class Commissioning (WCC) Competency
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COM addresses through Category Management
COM addresses through PRM
COM addresses through Clinical Leadership
COM addresses through CES
COM addresses through PCTs Local Activities
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Notes The competency scores are derived by
averaging individual PCT scores
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What is Strategic Commissioning ?
Analysis and Prioritisation
Implementation
Strategy and Planning
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Market Profiling
Intervention Strategy
Stakeholder Testing
Implementation Planning
Market Intervention
Implement Change
Measure and Manage
Segmentation
Initial Assessment
Prioritisation

• It is a detailed, robust and practical
  methodology
• The Strategic Commissioning approach details the
  specific activities and tasks required to
  implement world-class commissioning.
• It builds on existing commissioning capabilities
• Commissioners existing skills remain key.
  Strategic Commissioning builds on these,
  identifying where existing skills should be
  applied more consistently, and where additional
  support and tools are required to build new
  capabilities supporting new activities
• It puts an emphasis on end-to-end commissioning
  of clinical areas Category Management
• Category Management is core to Strategic
  Commissioning. Development of deep expertise and
  market knowledge by our Category Managers and
  Clinical Leads is critical, whether working at a
  local, cluster or regional level

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There are five interrelated functional areas in
the end-state COM
Reflecting collaborative categories/providers
OVERVIEW
Refreshed annually
Project based each category reviewed
periodically Ongoing market monitoring and
shaping
Ongoing Provider Relationship System
Management
Recurrence
Workload
First iteration substantial work Subsequent
years limited work
Substantial project-based work by category Some
ongoing work for all categories
Substantial ongoing work
KEY A function has overall accountability R
function is responsible for delivering specific
activities
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How will we work in the Collaborative Operating
Model (COM)?

• Our Collaborative Operating Model (COM) describes
  how we will work through clearly defined
  functions and geographies
• Our four key functional elements are
• Category Management
• Clinical Leadership
• Provider Relationship Management (PRM), and
• Commissioning Enablement Service (CES).
• We will work geographically at a
• Local PCT level
• Cluster level
• Northern - Oxfordshire, Buckinghamshire, Milton
  Keynes
• Central - Berkshire West and Berkshire East
• Southern - Southampton, Hampshire, Isle of Wight,
  Portsmouth (SHIP), and
• Regional Level.

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To Note With inputs from the clusters the
working list of categories has been generated and
confirmed by the ComOps Steering Group
UPDATED 16 April 2009
Clinical Pathway Groups
Staying healthy
Maternity and Newborn care
Children and Young People
Long-term conditions
Acute care
Planned Care
Mental Health
End of life care
Categories

• Obesity
• Alcohol misuse
• Smoking prevention and cessation services
• Screening1
• Sexual health2
• Drug misuse
• Falls3
• Prison health

• Maternity services
• Neonatal care4
• Termination of Pregnancy

• Depression/ anxiety in children /ADHD5
• Children with complex needs6
• Looked after children
• Safeguarding children
• Asthma
• Teenage conception
• Well Children
• Short-stay paediatric emergency admissions

• COPD7
• Diabetes
• Coronary heart disease8
• Chronic kidney disease
• Epilepsy
• Neurological conditions9

• Stroke
• Critical care10
• Intensive care 11
• Acute major trauma
• Urgent care
• Acquired brain injuries
• Cardiology

• Continuing care
• Orthotics 12
• General dentistry
• Low volume specialties 13
• Cancer
• Pain management
• Orthopaedics
• ISTC 14
• Oxygen 14

• Dementia 15
• Adult mental illness 16
• Adult psychological services
• Specialist mental health
• Learning disabilities

• End of life

The list will continue to be developed over time
the initial requirement is for a useful set of
categories that cover all major areas. Note that
some categories can fit in a number of Clinical
Pathway Groups
Notes 1. Includes Hepatitis B/C 2. Includes
STIs, HIV/AIDS 3. Includes older peoples
services, frail elderly care, osteoporosis 4.
Includes neonatal screening 5. Includes
CAMHS 6. Includes autism spectrum disorders and
Aspergers 7. Includes respiratory, adult asthma
8. Includes vascular prevention, heart failure 9.
Includes MS 10. Includes acute illness in
children 11. Includes Paediatric Intensive
Care 12. Includes prosthetics and wheelchairs 13.
Includes ENT, audiology, oral surgery,
rheumatology
14. Provider segments, not categories category
management approach to be applied to these
areas 15. Includes Alzheimers 16. Includes
mother/baby mental illness, eating
disorders .
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Source ComOps Steering Committee 15 April 2009
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To Note Collaboration and prioritisation -
agreed by Clusters
Collaborative categories Long List
2009/10 Priorities
Northern cluster

• Dentistry
• Termination of Pregnancy
• End of Life

• Cardiology
• Cancer
• Dentistry
• End of Life
• Maternity
• Termination of Pregnancy
• ISTC
• Oxygen

Central cluster

• End Of Life Care
• Continuing Care
• Planned Care
• Cardiology
• Orthopaedics (possibly with Trauma as part of
  that by default) ISTC
• ENT

• Obesity
• LTC (COPD/ diabetes/ CHD)
• Dementia
• Dentistry
• Physiotherapy/pain

• Acute major trauma
• Alcohol misuse
• Children with complex needs
• Continuing care 1
• Critical care
• Diabetes
• General dentistry
• Intensive care
• Orthotics

• DoCs to lead
• Cancer
• Dementia
• Stroke
• ENT (part of Low Volume Specialities category
  under Planned Care)
• DPHs to lead
• Obesity
• Screening
• Sexual health communicable diseases
• Smoking prevention and cessation

Southern cluster1
Lists are initial categories for collaboration
and may be expanded further at a later date
Notes 1. Focusing on continuing care for people
with learning disabilities
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Priorities Setting in support of the COM way of
working

• How can we align with
• Emerging Priorities?
• Clusters?
• What is our contribution to Category Management?
• How can we facilitate/play an active part in
  Clinical Leadership?
• What role can we play in supporting Provider
  Relationship Management?

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The governance and programme management of the
Collaborative Operating Model (COM)
Assurance
Board of Commissioners
PCT Alliance
Decision making
Delivery management recommendations
Collaborative Operating Model Programme
Each Steering Group has design and delivery
responsibilities
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To learn more please contact the team
Notes (1) Category Management, Provider
Relationship Management, Clinical Leadership (2)
Milton Keynes PCT, Oxfordshire PCT, Bucks
PCT (3) Berkshire West PCT, Berkshire East
PCT (4) Southampton PCT, Hampshire PCT, Isle of
Wight PCT, Portsmouth PCT (5) PCT Alliance
includes the Chief Executives of all South
Central PCTs and is the senior governance board
for the World Class Commissioning team