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

2. 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

3. 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

4. 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

5. 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?

6. 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