progress update: BEST POSSIBLE VALUE Project outline Context: Will give greater consensus and shared narrative around improvement Use Porter as framework: (Outcome + Safety + Experience) / Cost = Value Not perfect – e.g. numerator elements are non-standard BUT useful, applicable framework to allow development and some comparison Will help people better frame decisions

Improvement and development  “ The most powerful way to drive costs down is to improve outcomes (early and correct diagnosis and treatment, fewer complications, faster and sustained recovery”).  “It is nice to compare yourself with others; the really important thing is to show how you are doing year on year” Michael Porter Harvard

progress update: BEST POSSIBLE VALUE Project outline Scope: To develop a suite of evidence-based products – tools, exemplars of best practice, case studies, training, etc. – to support and develop finance professionals in both framing questions & making decisions as well as they possibly can. Decisions fall into four broad categories…

progress update: BEST POSSIBLE VALUE Project outline Types of Decision Allocation Public Health vs Social Care & Housing vs NHS Population allocation segmentation / geographical split Programme based allocation Prevention vs treatment Funding incentives Investment / Disinvestment Infrastructure and equipment (ROI) Service line Workforce investments Service Delivery Strategic change Pathways/Models of care System change and reconfiguration Productivity and costing Innovation & Risk Initiatives with unknown outcomes

progress update: BEST POSSIBLE VALUE Stakeholders / Sources Two Sides of the Same Coin / Decisions of Value – HFMA, NHS Confed, AMRC, Faculty of Medical Leadership & Management Better Value HealthCare - Prof. Muir Gray, Prof. Matthew Cripps Optimising Health Service Investment – NIESR (via Peter Spilsbury) NICE Approach – Stephen Brookfield, Keith Dickinson AnyTown – NHS England, Victoria Corbishley Symphony (Yeovil) & Southend Project – Whole system commissioning Four Habits of High-Value HealthCare Organisations – Richard Bohmer Nuffield Trust, King’s Fund, CIPFA, CIMA, external firms

progress update: BEST POSSIBLE VALUE Timescales Engage with stakeholders about whether priorities / decision types are right: End of July – external firm in place to support End of Sept – field work complete By end of calendar year, develop initial products to support decision making in at least two of: Allocations Joint Commissioning / BCF Capital investment Investment in innovation

progress update: BEST POSSIBLE VALUE Risks / Barriers Definition of ‘value’; patient, population, taxpayer, clinician Evidence & Information Capacity – time Capacity – skills Mandated policies and guidance o Treasury Green Book o Short term vs long term o Political must-do’s e.g. Walk-in Centres, Health Visitors o Tariff and funds flow o Competition rules and guidance Organisational interests Vested interests

progress update: BEST POSSIBLE VALUE Issues to consider with other action area leads Approach to costing? Does process improvement costing sit in Efficient Systems & Processes action area? Links to Close Partnering on outcomes?