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Practice-based commissioning

Practice-based commissioning. Courage, conviction and culture. What’s PBC about. PCTs have paid bills - not commissioned PBC ‘handed’ GPs 50%+ of PCT spend – in Sheffield over £500 million! PBC gives GPs and PCTs finance/activity data so can see where patients and money going

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Practice-based commissioning

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  1. Practice-based commissioning Courage, conviction and culture

  2. What’s PBC about • PCTs have paid bills - not commissioned • PBC ‘handed’ GPs 50%+ of PCT spend – in Sheffield over £500 million! • PBC gives GPs and PCTs finance/activity data so can see where patients and money going • Spend not matched to need - Wanless says focus on long-term care of elderly/ LTCs • GP-led redesign to help realign spend

  3. Courage

  4. From a PBC Manager view… • Barriers • How do I engage busy GPs? • What I found works • Ask GPs to help you improve quality of patient care – not save money. But show them where the spend is now. • Find your lead GPs. Back them to the hilt practically. Get business cases for redesign approved – its why GPs do PBC.

  5. From a GP Point of View-Barriers -Time -Relationships -Organisational culture -Organisational boundaries -Lack of support -Poor data

  6. From a GP point of view -Enablers • PBC Lis • PBC Support • Patient support • Knowing your stakeholders • Organisational relationships • Clinical Leadership

  7. Conviction

  8. “You don’t need an engine when you have wind in your sails” Paul Bate, 2004

  9. Over 75yrs 7.4% population £106 million on Emergency admissions 43% of which was on over 75yrs age group Falls = £6million 1/10 over 85yrs

  10. Crisis

  11. How you might persuade and influence PBC clinicians Creating a clear vision for your patients journey and the pathway they take Ensure congruency between the people and the delivery mechanism • Knowing and being passionate about the patient journey • Understanding the context in which PBC takes place

  12. Culture

  13. Framing Infection Control

  14. Send the message 10 times in 10 different ways

  15. What have we done to date in Sheffield • Lis Unscheduled Care • Les Care Homes • Women's Continence Pathway • Falls • Dementia pathway • Community Nursing for the over 75years

  16. Direction • Prevention • Early identification • Working with Community and Hospital Geriatricians

  17. A Citywide Strategy • High Level buy in • Across the Health Economy • Project management support

  18. How PBC can help you • Back in your constituency find out who your consortia leads are and talk to them • If you don’t know who they are email your PEC Chair • Tell them what can be fixed. If you have data even better! • Get consortia leads to champion reform and put business case/pathways into PCT

  19. Contact details • Agnes.mcAuley@sheffieldpct.co.uk • Eithne.cummins@gp-c88034.nhs.uk

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