1. Nene Commissioning Community Interest Company
Local Doctors Leading Local Healthcare

2. Growth through engagement
April 2007: established by 62 practices across majority of Northamptonshire
February 2008: PBC Survey – no confidence in commissioning plans, little support for PBC, no services commissioned
April 2009: 13 new practices ask to join, PBC survey results transformed, national recognition

3. How do we know we’re succeeding?
Attendance and engagement
Growth of organisation
Board elections
PBC survey results
23 schemes underway
Lead organisation for ICO pilot
National awards

4. PBC Survey Results

5. Believing in the right things
Local doctors leading local healthcare
Core objectives
Clinically led redesign
Clinical effectiveness
Strengthening general practice
Values –
Doctors make decisions
Delivering product
Whatever it takes

6. Doing the right things Board with majority clinical directors (9)
Engine of NC is our four locality structure
Monthly meetings, clinically led and locally set
Projects clinically led with management support
Regular “Update” with detailed web presence
Annual Conference

7. Saying the right things

8. Structure of Nene Commissioning
Board of Directors
Elected Chair
9 Clinical Directors
2 Non-Clinical Directors
Chief Executive
2 Clinical Directors
2 Clinical Directors
3 Clinical Directors
2 Clinical Directors
Daventry & South Northants
11 Practices
Kettering and Corby
14 Practices
Northampton Town
31 Practices
Wellingborough & East Northants
19 Practices
Executive Team in Support
Chief Executive
4 x Service Development Managers
Communications & OD Specialist
Information Analyst
Business Manager
Admin Support

9. Musculoskeletal, Spinal Community Service
Practical Example

10. The Problem
High number of referrals into secondary care for patients with back pain
Low conversion rate to surgery following first outpatient attendance
Service not delivery quality of care to patient

11. What would a community service look like?
Freed up resource
Lead GPs
Challenges
Current CAS in operation
What can we agree on?
GP Accreditation
Service Mapping
Communicate service model, Board, Localities, GPs, Secondary Care
Approval

13. Implementation From approval to implementation 4 months
Service delivered 20% below tariff
Build in time to review process
MDT monthly review meetings
Nov – March attendances (inc physio)
Evaluation – diversion rate away from secondary care increased from 25% to 30%
Further development
Clinical Psychology and Pain management

14. MSK county wide review Spinal Service in South GP led
Physiotherapy and Heartland Orthopaedic Triage service review - North
MSK service, Daventry
GP and ESP led
(1 Yr tender)