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How to win friends and influence the critics! - National Practice Based Commissioning Development Programme Jacquie White Programme Director : 

How to win friends and influence the critics! - National Practice Based Commissioning Development Programme Jacquie White Programme Director

Aim of the Programme: 

Aim of the Programme In close partnership with SHAs and PCTs, maximise the number of practices operating PBC: in order to develop and improve services for patients to embed a residual local skill base in commissioning for future development continue the NHS reform

Opportunities: 

Opportunities Structured approach – quick pace of change within a framework of quality improvement Clinical engagement & management support Share experiences and learning Linked into other “experts” and like minded peers Access to a range of resources that can be tailored for each site More rapid implementation of PBC to improve services for patients – by not doing it alone!

Timeline for PBC Support Programme: 

Timeline for PBC Support Programme Wave 1 Wave 2 Wave 3 Jan 06 Sep 06 May 06 Nov 06 Dec 06 LW1 LW3 LW2 LW1 LWs commence March 07

Programme Stages: 

Programme Stages Preparatory Phase - Baseline assessment framework - PBC training event 1 - PBC training event 2 Assessment Point Workshop Phase - Learning Workshop 1 - Learning Workshop 2 - Learning Workshop 3 Action Periods

Overview of the Assessment Framework: 

Overview of the Assessment Framework 2 main areas: PBC Commissioning cycles Building capacity

Baseline Results (Maximum score is 5): 

Baseline Results (Maximum score is 5)

Slide8: 

37 % improvement overall

PBC Training Events: 

PBC Training Events 96% found the events good – excellent Dr David Peignton, PEC Chair, Southampton City PCT was delighted as it offered his team “a real opportunity to get a head start on PBC and in particular get to grips with the tools needed and understand some of the challenges ahead”.

What services are being tackled by the teams?: 

What services are being tackled by the teams? Scheduled Care Dermatology Rheumatology Musculoskeletal Gynaecology ENT Diabetes Minor Surgery Urology Cardiology Diagnostics Unscheduled Care Case Management/Care Co-ordination Minor Injuries COPD/Pulmonary Rehab Heart Failure

Global Measures: 

Global Measures Scheduled Care – PCT & Practice level Number of Referrals to hospital care per 1000 patients in each chosen service area Number of Referrals to hospital care per 1000 patients in all specialities Follow-up ratios for hospital care in each chosen service area Patient Surveys – a ‘before and after’ survey recording patient views of service pre and post service re-design (voluntary) Unscheduled Care – PCT & Practice level Emergency admissions per 1000 patients at the acute hospital 0-length of stay per 1000 patients at the acute hospital

Parallel Learning Routes: 

Parallel Learning Routes

Parallel Learning Routes: 

Parallel Learning Routes Assessment Framework PBC tools Website & web forum Support for local learning exchanges Internet based training – web cast presentations Simulation event

Web casts: 

Web casts Series of 3 presentations run in April Some comments: “Enjoyed the experience and felt secretly thrilled to have logged on without any hitch!” “Very professional set up, easy to use” “Good presentation.  Would definitely recommend to others” “Will be able to expand the group in future now that contact has been made”

Parallel learning cont…..: 

Parallel learning cont….. What the Improvement Foundation is doing is highly innovative and effective. Not least their efforts to improve the communications system needed to support any radical change in service delivery. Uppermost among these initiatives are their simulation away days and their webcasts. The latter allow all and sundry to grill national experts and share their questions and answers across the profession. All this is free which is even more remarkable. GP, Nottingham

Feedback from Simulation Events : 

Feedback from Simulation Events What did teams take away? “A broader understanding of how PBC fits with other drivers” “have got a feeling for commissioning now” “Greater understanding of wider implications of PBC and long term consequences of decisions” “Confidence that our PCT is on track to deliver PBC” “The event has really broadened my thoughts about PBC and the future” One of the best days I’ve attended in years. Enjoyed it more that I expected

Where have we come from?: 

Where have we come from? 24 weeks ago the Improvement Foundation was commissioned by DH to run the programme 18 weeks ago applications were submitted by sites 16 weeks ago the preparatory phase of the programme started In those 16 weeks teams have: - completed the assessment framework: baseline & assessment point - developed their action plan and progressed in AF - participated in the orientation meeting, 2 training events and follow up site visits developing service areas and local measures, and mapping the system and chosen service area and identifying methods of sharing the learning across the PCT(s) What next: Workshop phase focussing on service re-design

Where are we going?: 

Where are we going? Testing out and implementing changes to the commissioning and provision of patient services Improve commissioning and the use of PBC Improve services for patients

From critics to converts?: 

From critics to converts? “Really useful timeout of everyday work to start planning how we can actually deliver PBC” “BRILLIANT! I learnt much more than I could have hoped” “Feel more confident about our plans for future re-design. Great opportunity to work with PCT staff”

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For more information: www.improvementfoundation.org Contact your local Improvement Foundation centre or SHA Contact the National Team: 0161 236 1566

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