1. Copyright 2011 Right Care Systems of Care Sir Muir Gray Joint National Director, Right Care August 2013 Online Learning Series Right Care for Populations

2. 2 How the NHS looks from space

3. 3 The Healthcare Archipelago General Practice Mental Health Community Services Hospital Services

4. 4 Population Healthcare Is the service for people with seizures & epilepsy in Manchester better than the service in Liverpool? Who is responsible for the headache service for people in Southampton? How many liver disease services are there in England and how many should there be? Which service for frail elderly people in the London provides the best value? Which service for children with mental health problems improved most in the last year ?

5. 5 What does a system look like? SELF CARE INFORMAL CARE GENERALIST SPECIALIST SUPER SPECIALIST

6. 6 The balance is different SELF CARE INFORMAL CARE GENERALIST Specialist Super Specialist

7. 7 A new language A SYSTEM is a set of activities with a common set of objectives and an annual report. Systems can focus on symptoms, conditions or subgroups of the population (also known as a service) A NETWORK is a set of individuals and organisations that deliver the system’s objectives (a team is a set of individuals or departments within one organisation) A PATHWAY is the route patients usually follow through the network A PROGRAMME is a set of systems with ha common knowledge base and a common budget Primary Secondary Acute Community Outpatient X X X XX

8. 8 An example of a national service setup as a system

9. 9 Objectives for an asthma system To prevent asthma To diagnose asthma quickly and accurately To slow the process of the disease by effective and safe treatment To help the individual afflicted adapt to the challenges To involve patients, both individually and collectively, in their care

10. 10 ….beyond clinical practice criteria To prevent asthma To diagnose asthma quickly and accurately To slow the process of the disease by effective and safe treatment To help the individual afflicted adapt to the challenges To involve patients, both individually and collectively, in their care To make the best use of resources To mitigate inequity To promote and support research To support the development of staff To report annually to the population served

11. 11 Hierarchy versus Network

12. 12 Pathways

13. 13 Matrix Management

14. 14 Defining Population Healthcare “ The aim of Population healthcare is to maximise value for those populations and the individuals within them Population healthcare focuses primarily on populations defined by a common need which may be a symptom such as breathlessness, a condition such as arthritis or a common characteristic such as frailty in old age, not on institutions, or specialties or technologies ”

15. 15 Online Learning Series Right Care for Populations Follow Right Care online Subscribe to get a weekly digest of our blog alerts in your inbox, Receive occasional eBulletins Follow us on Twitter @qipprightcare Find the full series at: www.rightcare.nhs.uk/resourcecentre Join our network: www.rightcare.nhs.uk/network