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Armed Forces Health Commissioning Arrangements

Armed Forces Health Commissioning Arrangements. Melanie Iredale Head of Armed Forces Commissioning Tuesday 11 th November 2014. Armed Forces Commissioning. Cement the “No disadvantage” requirement as specified in Armed Forces Covenant and Government’s Mandate to the NHS

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Armed Forces Health Commissioning Arrangements

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  1. Armed Forces Health Commissioning Arrangements Melanie Iredale Head of Armed Forces Commissioning Tuesday 11th November 2014

  2. Armed Forces Commissioning • Cement the “No disadvantage” requirement as specified in Armed Forces Covenant and Government’s Mandate to the NHS • A single, national body commissioning for the serving armed forces with one set of commissioning policies • Build commissioning capability in the new system so as to credibly build networks and relationships • Standard operating procedures for Armed Forces personnel in development

  3. NHS England - Armed Forces Health NHS England Board NHS England Operations Directorate CCGs Reservists, Veterans’ & Families Commissioning Armed Forces Commissioning Design Principles : Retain: Knowledge, expertise, capability, continuity, skillsets, credibility Ensure: Momentum, partnerships, linkages, AFNs, practical configuration and delivery Area Teams – x 3 CCGs - Veterans, Families, Reservists, Armed Forces Networks lead Health and Wellbeing Boards, AFNs, Community Covenant and partnerships Armed Forces Commissioning Interface between MOD and Providers (Securing Excellence – Military Health) Veterans’ and families commissioning Transition management Veterans, reservists and families

  4. Armed Forces commissioning responsibilities

  5. Armed Forces commissioning responsibilities: Structures post-April 2013 NHS England COO DoC (Corporate) Ann Sutton NHS North NHS Mildands NHS South NHS London Hd PH, Armed Forces and Offender Kate Davies DoC Simon Weldon DoC Julie Higgins DoC Sue Davies DoC Catherine O’Connell Notts & Derbs AT N Yorks &Humber AT Bath, Swindon & Wilts AT Head of Public Health, Armed Forces and Offender Health Commissioning Alison Frater Kenny Gibson AF Network Lead/Transition Richard Swarbrick Asst Hd Military Andy Bacon Armed Forces Networks DoC Debra Elliott DoC Julie Warren DoC Vicky Taylor Wayne KirkhamNational Lead National Veteran Mental Health Network Hd of Spec AF Jenny Kirby Hd of Spec AF Alison Treadgold Hd of Spec AF Melanie Iredale CommMgr-SouthSharon Greaves/Karen Beckett Comm Mgr – James Carter CommMgr -MidsAnn Berry CommMgr –NorthJim Khambatta CCGs - Link to JSNA and H&WbBds

  6. Armed Forces Governance Structure ExternalPartnership Groups External Assurance Groups NHS England Board Armed Forces Partnership Board DMS/NHS England Joint Commissioning Group Directly Commissioned Services Committee Clinical Priorities Advisory Group ETM Health Partnership Working Group Armed Forces Oversight Group Operations SMT AF CRG Internal Delivery Groups (Armed Forces) Armed Forces Networks Screening & Immunisations Delivery Group Patient & Public Voice Forum Defence Recovery Steering Group Veterans Mental Health Network AF Joint Commissioning Task & Finish Groups CRG sub-groups as required

  7. Policy • Governmental and inter departmental business • 2 Murrison Reports • Mental Health Provision: • Veterans MH Network • Big White Wall • Prosthetics: • National Funding of Veterans Prosthetics • Improved Disablement Support Centres • Veterans Information Service DH Future Roles

  8. Joint Medical Command • MoD (Chief of Defence Personnel) deliver (support): • Tri-service welfare and recovery • Chain of Command looks after/owns service personnel under their command (Single Service or Tri Service) • Transition • Recovery • MoD (Joint Medical Command) still commission/provide (supporting) healthcare: • Operational Care • Primary Care • Rehabilitation • Community Mental Health • Inpatient Mental Health (NHS Provided) n.b. note supporting/supported tension that we understand MoD/Joint Medical Command

  9. Obligations • “The NHS and its public sector partners need to work together to help one another to achieve their objectives. …. This includes, in particular, demonstrating progress against the Government’s priorities of: upholding the Government’s obligations under the Armed Forces Covenant; • The Covenant says: • The Armed Forces Community should enjoy the same standard of, and access to, healthcare as that received by any other UK citizen in the area they live. • Personnel injured on operations should be treated in conditions which recognise service needs • For family members, primary healthcare may be provided by the MOD in some cases (eg when accompanying Service personnel posted overseas). And … should retain their relative position on any NHS waiting list, if moved around the UK due to the Service person being posted. • Veterans … should receive priority treatment where it relates to a condition which relates to .. their service, subject to clinical need • Those injured in service should be cared for in a way which reflects the Nation’s moral obligation …with professionals who have an understanding of Armed Forces culture

  10. NHS England • England (not whilst Overseas), or Devolved Administrations • Direct Commissioning: • Post Operational Health Care (non-recovery) • Community Care • Hospital Care (also for MH not in main contract) • Specialist IVF • IVF on Moves • Indirect Commissioning: • CCG Assurance • DMS – NHS IM&T Connectivity • NHS England Other: Dental, “Specialised”, Offenders, Immunization, Vaccination and Screening

  11. NHS Armed Forces Networks Charities Armed Forces Local Authorities • All Local Stakeholders: • Regional Armed Forces Structures • PRUs • Local NHS – Commissioners and providers • Local Authorities • Charities • Veterans Organisations • Currently 9 in England mapped closely to Brigade structure

  12. Planned Improvements Continuity of Care Pathway redesign (especially roles of 1ry/2ry) Improved Choice Recording and Performance monitoring of quality Referrer Involvement Patient and Carer involvement

  13. Issues • Very poor data: • £15M or £170M? • Philosophical Differences: • “The Armed Forces Community is entitled to appropriate recognition for the unique Service which it has given, and continues to give, to the Nation, and the unlimited liability which the Service person assumes” AF Covenant • “Only clinical features taken into account: The NHS CB must make decisions fairly about funding treatments and not on the basis of age, sex, sexuality, race, religion, lifestyle, occupation, family status (including responsibility for caring for others) social position, financial status etc. unless these directly affect the expected clinical benefit that an individual will derive from a treatment” NHS England Interim Standard Operating Procedures

  14. So what does this mean for CCG’s • Involvement in Armed Forces Networks • New North East, Yorkshire & Humber AFN • CCG stewardship • Rotating chair • Multi-agency representation • Veteran’s Awareness • Identification at practice level • RCGP e-learning tool • Staff training

  15. Continued ….. • Veteran Mental Health Services • Outreach services • Big White Wall • Combat Stress residential

  16. Thank you! http://www.england.nhs.uk/resources/resources-armed/

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