Judith Newman

1
Flexible HealthcareBreaking Down Barriers

• Judith Newman
• Director of Secondary Care Development
• NHS Somerset
• Peter Lewis
• Deputy Chief Executive / Finance Director
• Taunton and Somerset

May 2009
2
Potential Barriers to Success

• Payment by Results
• Organisational Boundaries
• Blockers

• Existing processes flexibility / complexity
• Targets / standards
• Payment rules / Contracts
• Complexity of need / service provision
• Organisational interfaces
• Alignment of organisational objectives

3
Drivers for Change

• Patient Experience
• Waiting Times
• Changing Economic Context

4
NHS Growth
5
Approach

• Based on needs of patients
• What do pathways look like?
• Responsiveness and Flexibility

6
Payment by Results

• Mechanism to support and drive change
• Potential to drive wrong behaviour
• Necessary framework to support complexity
• What is the need
• How can the need be met
• What are the implications and risks

7
Targets and Standards

• Best practice / quality / safety
• Targets as drivers for change (i.e. waiting
  times)
• New levers for change - validation

8
Care Pathways
Referrer
Outpatient Attendance
Pre Op Assessment
Elective Spell
Discharge
Diagnostics
Referrer
Outpatient Attendance
Pre Op Assessment
Elective Spell
Discharge
Diagnostics
9
Care Pathways
Referrer
Outpatient Attendance
Pre Op Assessment
Elective Spell
Discharge
Diagnostics
Referrer
Outpatient Attendance
Pre Op Assessment
Elective Spell
Discharge
Diagnostics
10
Care Pathways
Referrer
Outpatient Attendance
Pre Op Assessment
Elective Spell
Discharge
Diagnostics
Referrer
Outpatient Attendance
Pre Op Assessment
Elective Spell
Discharge
Diagnostics
11
What is Important?

• Leadership
• Doing the right thing for the right reasons
• Commitment Ability to Overcome Barriers