Developing PBC / Clinical Commissioning in the East Midlands Andy Gregory Assistant Director of Performance and Operations

Challenges/Opportunities Assessing impact £ Risk – PCTs and clinicians Information and analysis Pressure on primary care contracts Clinical behaviour – look inwards and outwards 30% management reductions Rewards and consequences Real Budgets? 30% marginal rate – non elective Scale TCS and integration agenda

Where are we now? Survey findings 24/34 questions above average 9/34 top regional scores Relationships and influence with PCT PBC influence on PCT strategy and commissioning Quality of managerial support and available budgets Proportion of business cases approved Care is: closer to home, more cost effective, improved safety and improved access

Where are we now? Survey findings Below national average scores Influence with secondary care managers and clinicians Involvement with contract negotiation and monitoring Addressing variation in primary care Involvement in equalities strategies Links with Local Authority Speed of PBC decision making Involvement in TCS

SHA support for PBC SHA Chief Executive commitment – dinner invite Clinical Network and website Benchmarking approaches Clinical Leadership programmes Assurance PCT Quarterly Reviews WCC Survey responses Clinical commissioner development Regional vision and strategy for PBC Regional Innovation Fund What else?

Regional vision and strategy 1st session 22nd February 2nd session 11th March Contribution from secondary care and Local Authorities Vision and strategy May 2010 Regional and PCT work programmes e.g piloting real budgets