Better health, better value How the NHS is changing Anne Swan Chief Executive NHS Bournemouth and Poole

Health and Social Care Bill GP commissioning through consortia, national commissioning through NHS Commissioning Board Extension of patient choice to community services, mental health, diagnostics and GP practice Level playing field - any willing provider More foundation trusts Health and well being boards Promote integration with social care Public health white paper Duty to reduce health inequalities

Priorities Transition and reform –Shadow consortia –PCT clusters Transparency and local accountability –Outcomes –Collection of patient experience –Information strategy –Translation of expenditure to local achievement

Priorities Quality and efficiency –Emphasis on quality –£20bn efficiencies –Increase in health visitors –Extension of cancer drugs fund –Improved services for veterans, carers, people with autism and dementia –Working across boundaries

Priorities Joint working –Health and well being boards - JSNA, health and wellbeing strategy, links to commissioning strategies –Post discharge support –Health and social care integration - reablement

Managing financial pressures Demographic trends Changes in the patterns of disease, Patient and national expectations Service developments and the introduction of new technologies. Reductions in social services budget Other public sector budgets.

Changing the focus

Pan Dorset approach Three year programme across Dorset –better health, better value –£200m efficiencies Improving quality, encouraging innovation, increasing productivity and delivering prevention

Key considerations Unavoidable cost pressures Increased demand Demand avoidance New priorities GP consortia leadership Partnership approach

Transformation Re-profiling of spend towards maximising population health outcomes reversing the growth in non-elective activity, mainly by optimising long-term condition management keeping a tight control on elective costs prioritisation and re-allocation of any re- profiled spending.

Outcomes locally More patients treated closer to home Fewer staff, particularly in management More efficient hospitals and shorter stays Not paying for procedures with little clinical benefit Changing expectations More personal responsibility