Paul Smeeton Chief Operating Executive Health Partnerships

2 Value Based Healthcare  The aim for any health system should be to maximise patient outcomes whilst minimising costs  A health system should aim to do this over the whole cycle of the care pathway – not a particular intervention or aspect of care

3 Value Based Healthcare  Better outcomes at reduced cost are achieved by: ○Early intervention ○Reducing mistakes ○Minimising complications ○Forestalling disease reoccurrence  These are delivered through:

4 Integrated Practice Units (IPU)  These combine specialties and services necessary for the full cycle of care for the medical condition with;  Clinicians dedicated to develop the expertise and experience in treating the condition – e.g. in a diabetes IPU they would have a Consultant Nephrologist who specialised in the kidney issues caused by complications from diabetes

5 Integrated Practice Units (IPU)  A common management unit with a conveniently located service  Single administration  Specialisation in primary care to more condition based care  Healthcare co-produced with patients

6 Outcome Defines Value This needs outcomes to be measured at:  Either the level of the medical condition  Or in primary and preventative care – the unit of care is a defined patient population  The outcomes aim for need to be defined from a patient’s perspective and include the most common co-occurring conditions

7 5 Examples  Forensic Mental Health  Schizophrenia  COPD  Children with Physical Disabilities  Children’s Universal Services

8 Implications  Who we work with and how we contract / ally / partner with them  How we would develop this with commissioners  How we would get the information and know what our outcomes should be and how we can get better

9 Implications  What this means for how we cost  Understanding : ○What we do not do well ○Could never do well – or ○ Where there is minimal chance for a value based approach to work and so leave