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The new health system and new ways of working Shelagh Morris Deputy Chief Allied Health Professions Officer CSP English Regional Networks 17 September 2013
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http://healthandcare.dh.gov.uk/system/ The Health and Care System from April 2013 http://media.dh.gov.uk/network/18/files/2012/09/final-system-overview.pdf 2
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3 Patients CCGs NHS England H&WB Board PHE Monitor HEE NTDA CQC DH Networks AHSN Senates Others (and important!) The New System…. NHSIQ
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4 http://www.nhsemployers.org/Aboutus/latest-news/Pages/The-new-NHS-in-2013-infographic.aspx
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Department of Health 5
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Meet the Ministerial Team! 6 Jeremy Hunt - (SofS) The Rt Hon Jeremy Hunt MP is the Secretary of State for Health Norman Lamb - MS(CS) Norman Lamb MP is the Minister of State for Care and Support MS(CS). Anna Soubry - PS(PH) Anna Soubry MP is the Parliamentary Under Secretary of State for Public Health PS(PH). Daniel Poulter - PS(H) Dr Daniel Poulter MP is Parliamentary Under Secretary of State for Health PS(H). Earl Howe – PS(Q) Earl Howe is the Parliamentary Under Secretary of State for Quality (Lords). 6
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NHS England 7
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Purpose of NHS England 9 Improve health outcomes Promote the NHS Constitution Promote equality and reduce health inequalities Operate within resource limits High quality care for all, now and for future generations
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Aims of NHS England Improved health outcomes as defined by the NHS Outcomes Framework People’s rights under the NHS Constitution are met NHS bodies operate within resource limits These will enable: patients and the public to have more choice and control over their care and services; clinicians to have greater freedom to innovate to shape services around the needs and choices of patients; and the promotion of equality and the reduction of inequality in access to healthcare. 10 NHS ENGLAND
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Commissioning Assembly 11 What is it? It is the community of leaders for NHS commissioning; the ‘one team’ which will deliver better outcomes for patients. Why have we got it? Because we have a greater chance of maximising the impact of commissioning on outcomes working together than apart. What is its purpose? Create shared leadership nationally and locally. Co-produce national strategy and direction. Embed principles for working together and create a common voice. Connect leaders, both within the NHS commissioning system and beyond. What will it do in practice? Facilitate networking and communication. Sponsor and oversee key pieces of work, and policy development on priority areas. Be a repository of expertise and views. Come together once a year to review progress, share best practice and explore challenges together. Organisational development of the commissioning system
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The Mandate First Mandate published on 13 th November 2012 Sets out what the Government expects in return for handing over £95bn of tax payers money to NHS England The NHS Outcomes Framework sits at the heart of this Mandate and the Board is expected to demonstrate progress across the entire framework In turn, the NHS Outcomes Framework sits at the heart of NHS England’s planning guidance ‘Everyone Counts’, published in December 2013 12
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NHS Mandate https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/127193/mandate.pdf.pdf 13
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14 Tools and levers of the Quality Framework
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15 How we align these tools and levers will be key to success
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Our focus – delivering improved outcomes The NHS Outcomes Framework NHS ENGLAND 16
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NHS Outcomes Framework; 5.4 Reducing harm from error NHS Outcomes Framework
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The role of National Clinical Directors Our shared purpose 1. Analyse the prob & opp’ty 2. Understand the evidence 3. Enable and drive change 4. Sustain improvement End of life care Major trauma Mental health Chronic disability and neurological conditions Learning disability Cardiovascular disease Cancer Musculoskeletal disorders Spinal disorders GI and liver Respiratory Obesity and diabetes Pathology services Health and Justice (offenders) Children and young people, and transition to adulthood Maternity and women’s health Diagnostics, including imaging Urgent care Rural and Remote Care and Services Dementia Integration and frail elderly Enhanced recovery and acute surgery Rehabilitation and recovering in the community Emergency preparedness and critical care NHS England 18
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Commissioning structures 19 NHS ENGLAND
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20 Regions North of England Midlands and East of England London South of England
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21 North of England – 9 LATs Midlands and East – 8 LATs London – 3 LATs South of England – 7 LATs http://www.networks.nhs.uk/nhs-networks/respiratory- leads/documents/NHSCB%20LATs%20-%20Specialised%20Commissioning.pdf
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Specialised Commissioning 22
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Specialised Commissioning 23
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Clinical Reference Groups 24
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Programmes of Care 25
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Clinical Senates 26
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12 Clinical Senates 27
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Strategic Clinical Networks (SCNs) 28
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Geographical Alignment 29
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Innovation 30 ‘An idea, service or product, new to the NHS or applied in a way that is new to the NHS, which significantly improves the quality of health and care wherever it is applied.’ http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_131299
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Academic Health Science Networks 15 – designated and licensed 5 year contracts Systematic delivery mechanism for diffusion of innovation and best practice and collaboration between partners including industry Align education, clinical research, informatics, training and healthcare delivery Improving patient and population health by translating research into practice and developing and implementing integrated health care systems 31
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Oxford Eastern Wessex UCL Partners South London East Midlands West Midlands West of England North West Coast Greater Manchester Yorkshire and Humber South West Peninsula Kent, Surrey and Sussex North East and North Cumbria Imperial College Health Partners AHSNs Academia Industry NHS
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CHPO team work Rehabilitation Non-medical prescribing NAHPIST 6 programmes of work: Prevention, early diagnosis and intelligence Community services Acute services Integrated care and support Patients in control Parity of esteem 33
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Questions to consider How best to exert influence and where? How to inform clinical commissioning? National versus local? Together and/or separately? Others……………….? 34
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Thank you shelagh.morris@nhs.net 0113 825 1168 0777 182 5939 shelagh.morris@nhs.net 35
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