2. Plan for the day MorningLunchtimeAfternoon Making every contact count Market place and networking Moving forwards, innovations and solutions

3. Making every contact count Knowing your service

4. The context for change Know your service Know your population Know the evidence

5. Policy context – background to reforms 1989 – Working for patients creates internal market in NHS 1997 – Labour comes to power with pledge to abolish internal market 2000 - Focus more on targets than competition 2004 – Targets achieved. Attention back on competition. ‘Commissioning’ born. 2010 (May ) – Coalition government formed. Promise of “no top down reorganisation of NHS” 2010 (July) – Equity and Excellence: Liberating the NHS published

6. Department of Health NHS England Specialist Services Primary care Services HSCIC Patients NICE Social Care Public Health England Health Watch England H&W Boards Local Health Watch Competing providers CCGs CSUs LAs HEE NIHR

7. Changing Population Source: Office for National Statistics 2013Source: Warrington CCG 2013

9. What does all this mean for you? Think about the context just presented and reflect on how this is impacting on you locally

10. 3 critical hooks On a post it note write down in bullet point style the top 3 things about your service, or if you are not in a service the top 3 things you would say about physiotherapy

11. Knowing your service Quality Effectiveness Patient experience Patient safety + COST Quality + cost = Value

12. Cost of falls tool

13. Knowing your population Population is made up of Current users of your service Future users of your service

14. Health profile

16. Knowing the evidence Published research National guidance Local data - audit - patient experience/satisfaction/outcome - KPIs Other...

17. Reflect on your offer My service is... Delivers to this population... Based on this evidence... For this price!

18. Next steps... Why do you need to change? What will you do differently? When... How can you improve? Who will you influence