National Collaborative on Integrated Childrens Healthcare

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National Collaborative on Integrated Childrens
Healthcare Gary Belfield Director of
Commissioning Department of Health
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NHS Next Stage Review and Primary and Community
Care Strategy

• We will test and evaluate new ways in which PCTs
  can commission more integrated services from
  innovative groups of clinicians.
• We will invite proposals for pilots that involve
  clinicians working on a more collaborative basis
  across primary, community and secondary care
  and with local authorities and other sectors to
  achieve more personal, responsive care and better
  health outcomes for a local population (based on
  the registered patient lists for groups of GP
  practices).

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What is integrated care?
Patientcentred

• More personal and responsive care

Betterhealthoutcomes

• Delivers improved health outcomes including
  quality and patient experience

Joint provision

• Partnership of providers

• Primary, community, secondary, mental health,
  social care, local government, NHS, third and
  private sectors

Acrossboundaries
Systems not structures

• Partnerships, systems and models, not only
  organisations

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What does integrated care look like?

• Expertise and intervention previously separated
  in the system come together
• Resources and responsibility previously separated
  come together at a single point of accountability
• Clinicians and social care professionals work
  closely together in the service of the patient
• Patient satisfaction and reported outcomes are
  used to improve care and systems of care

(e.g. groups of primary and secondary care
clinicians practice as a team)
(e.g. a capitation budget for the whole of a
care year for an individual)
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What does integrated care look like?

• Clinicians and managers work from common goals
  and design and use incentives, systems and
  processes to achieve them
• Accountability for the use of resources and
  quality of care is explicit
• Information systems readily support co-ordinated
  delivery of care and enable measurement,
  evaluation and sharing
• Transparent systems enable peers to share results
  and learn from each other

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Our principles

• Freedom for local systems to experiment very
  few national givens
• Co-production process designed with your input
• Transparency of performance during pilots through
  publication of data
• Learning and evaluation through the piloting
  process
• National and local management of clinical and
  corporate risks

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What are givens for the pilots?
Led by primary and community clinicians
Based on GP registered lists
Diversity of models
Open reporting of results and shared learning
Partnership across health social care providers
Supported by PCT
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What will we evaluate?
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Organisational effectiveness

• Softer factors influencing success including
  local relationships, culture

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Management

• How PCTs commission integrated care
• Accountability and governance

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Impact on health outcomes

• Improvements in health outcomes
• Reductions in health inequalities
• Improved quality
• Better patient experience

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The plan for the next few months
Select pilots (Oct, Nov)
Final prospectus published, applications
developed and submitted, and pilots selected
against criteria
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Pilots begin (Dec)
Pilots begin alongside ongoing business focused
evaluation and shared learning
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Direction of travel for Child Health

• More integrated services through strengthened
  Childrens Trusts
• Stronger support for commissioners and deliverers
  of child health services
• Create a commissioning guide
• Develop minimum child health datasets

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Direction of travel for Child Health

• A range of improved services across the age
  ranges
• Development of the Family Nurse Partnership model
• A strengthened Healthy Schools Programme
• Individual Care Plans for all children with
  complex health needs