1 / 20

Practice Based Commissioning – East Devon PCT Devolved Budgets Project

Practice Based Commissioning – East Devon PCT Devolved Budgets Project. Beverly Stretton-Brown, Devolved Budgets Project Manager 22 September 2004. East Devon Profile. 13 Practices 7 Community Hospitals Population of c120,000 Wide Geographical Rural Area

ovidio
Télécharger la présentation

Practice Based Commissioning – East Devon PCT Devolved Budgets Project

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Practice Based Commissioning – East Devon PCT Devolved Budgets Project Beverly Stretton-Brown, Devolved Budgets Project Manager 22 September 2004

  2. East Devon Profile • 13 Practices • 7 Community Hospitals • Population of c120,000 • Wide Geographical Rural Area • High Elderly Population – 37% over 65’s

  3. Why Devolved Budgets? • Unsustainable Historical Growth trend in Secondary Care Activity • To enable appropriate use of future growth in PCT resources • Payment by Results Environment • Acute Hospital services are at national tariff, • Orthopaedic OP Appointment cost £312 • DVT Non-Elective Admission cost £989/£1691

  4. Why Devolved Budgets? ….Cont • Not about reducing referrals, but ensuring patient is seen in right place by right person at right time • New Local Services/Avoiding Admissions • Practices are best placed to make decisions on referrals • The scheme incentivises the GPs to • Look at their referrals/activity • Identify Local Service Opportunities • Ensure ‘we only pay for what we get’

  5. What is included in the budget? Day Case Elective Activity Non-Elective Activity Inpatient Elective Activity Out Patient Activity Exclusions – Intensive Care High Cost Procedures A&E, etc Activity in Acute Trusts Charged at National Tariff (RDE 92%) Activity in Community Hospitals Charged at 80% of National Tariff

  6. Divided Between 13 East Devon Practices Based on Historical Activity PCT Hospital Services Budget For 2004/05 Elective Inpatient & Day Case Non- Electives Out Patients

  7. Basic Principles…… • Optional Sign-up • Participation at Various Levels & Pace • No Sanctions for Budgetary over-spend • Budgets set on historical activity, with move to fair equity model • Flexibility - Practices can opt out of Emergency Admissions not referred from Practice section of Budget • New Services can be pump-primed in-year

  8. Basic Principles ….. • New Services can be introduced at various levels • In-house • Practice offering service to other practices • Practice groups • Localities • PCT Wide • New Services should eventually become self-funding – under Payment by Results • Currency ‘SPELLS’

  9. The Incentives ….. • If a practice is in an overall budgetary under-spend position at year end, they can retain 50% of their savings. • 50% retained by PCT to cover potential overspends or reinvestment in the locality. • Cost of staffing, training, equipment, and full set up costs can be included in cost of new service • Savings to be used on improving patient care

  10. Where are we now? • Preparation Year - 2003/04 • Launch Event May 2004 – Priorities Identified • 5 Practices signed up – 2 imminent • 2004/05 Practice Based Budgets set on Historical data • Monthly monitoring reports provided to practices • Showing budgetary status • Activity by HRG at Patient Level • Validation of Activity at HRG Level

  11. Current Budget Status (as at June 04)

  12. Support for Practices • Management Resource Funding • Supplying Referral Data • Clinical Review of Referrals • Management Time • Validation • Dedicated Central Management Support • Project Manager and Project Facilitator • GP Service Development ‘Can Do’ Group • Validation Workshops for Data Collectors • Learning Workshops for GPs/Practices • Database of Services within East Devon

  13. Support for Practices, cont • Effective Referral Programme • Introduced across N&E Devon • Practice Based Referral Collection (Electronically) • Central Information Service • Initially – • Handling Choice at 6 Months • Collect referral information from practices • Provide Robust information/Feedback • Longer Term – Information on Choice At Referral and Waiting Times

  14. Service Developments • Specialist Orthopaedic Physiotherapist • Dermatology GPSIs • Vasectomy GPSI • ENT GPSI • Gynaecology GPSI • Mixed Fracture/Minor Surgery Clinic • Community DVT Clinic • Community Access to Echos

  15. Lessons Learned • Quality and reconciliation of secondary care & primary care data • Local links important at practice and at DGH • Investment required at practice and PCT • Support required for developing local services at locality/practice level • Constant positive reinforcement from CEO essential

  16. Lessons Learned (cont’d) • Framework (Rules of Engagement) developed with visible GP Input • Documented detail essential, but can soon be out of date - Framework needs to remain flexible as scheme develops. • Structure in place to address Commissioning Issues • Savings made from Community Hospitals – not true savings –Block Contract Arrangement introduced

  17. Lessons Learned (cont’d) • Scheme took longer than expected to implement – Benefits reaped next year? • Dedicated Project Management time essential • Scheme has required trust/Leap of Faith on both PCT and Practices • Building good working relations essential – Key factor for success …….

  18. And we are still learning …..

  19. Thank You Beverly Stretton-Brown 01392 207492 beverly.stretton-brown@eastdevon-pct.nhs.uk

More Related