1. World Class Commissioning and World Class Informatics, the quest for quality information Jan Sobieraj - Chief Executive, NHS Sheffield

2. Outline NHS Sheffield National context Challenges What does world class commissioning and information look like? Commissioning for quality Summary Questions!

3. NHS Sheffield £850 million 520,000 population Complex health and social care system Achieving Balanced Health to reduce health inequalities Partnerships to deliver - the “Sheffield Way” Information is seen as high priority for commissioner and providers

4. Context Investment in NHS - £120 Billion + From ‘waiting’ to ‘quality’ Independence of providers (FT’s) Commissioning and regulation Integration of services (LA & vertical) Medical technology improvements Choice NHS Constitution NPfIT Expectations of public are rightly increasing

5. Context Quality at the heart of the NHS High quality care for patients and the public Freedom to focus on quality High quality care for all Raising standards Stronger involvement of clinicians in decision making at every level of the NHS Fostering a pioneering NHS Empowering frontline staff to lead change that improves quality for patients Valuing the work of NHS staff Help to stay healthy Empowering patients Most effective treatments for all Keeping patients as safe as possible

6. Challenges World Class Commissioning - are we competent? Likely restriction of £ growth (credit crunch) 18 weeks delivered, still expectation of improvements in access Technology and cost pressures Integration challenges - what will the delivery landscape look like? Contracting for Quality not volume Demand for Information and delivery of solutions

7. 1. Locally lead the NHS 2. Work with community partners 3. Engage with public and patients 4. Collaborate with clinicians Reputation and the local leader of the NHS Reputation as a change leader for local organisations Position as employer of choice Creation of Local Area Agreements based on joint needs Ability to conduct constructive partnerships Reputation as an active and effective partner Influence on local health opinions and aspirations Public and patient engagement Improvement of patient experience Clinical Engagement Dissemination of information to support clinical decision making Reputation as leader of clinical engagement World Class Competencies

8. 5. Manage knowledge and assess needs 6. Prioritise investment 7. Stimulate the market 8. Promote improvement and innovation Analytical skills and Insights Understanding health needs trends Use of health needs benchmarks Predictive modelling skills and insights Prioritisation of investment to improve population’s health Incorporation of priorities into strategic investment plan Knowledge of current and future provider capacity Alignment of provider capacity with health needs projections Creation of effective choices for patients Identification of improvement opportunities Implementation of improvement initiatives Collection of quality and outcome information World Class Competencies

9. 9. Secure procurement skills 10. Manage the local health system Understanding of providers economics Negotiation of contracts around defined variables Creation of robust contracts based on outcomes Use of performance information Implementation of regular provider performance discussions Resolution of on going contractual issues ‘Assessed under ‘Governance’ World Class Competencies 11.Make sound financial investments

10. What does World Class Commissioning mean for Informatics? “To become world class, commissioners will take an evidence based approach to commissioning. They will need advanced knowledge management, analytical and forecasting skills, as well as an ability to listen to and communicate with the local community” (DOH WCC Vision 2008) PCT’s that can commission quality services and measure it Great Knowledge Management - Joint Needs Assessments, benchmarking and patient reported outcomes Sound Use of information that describes need, quality and improvement

11. What does World Class Commissioning mean for Informatics? (cont’d) “To become world class, commissioners will take an evidence based approach to commissioning. They will need advanced knowledge management, analytical and forecasting skills, as well as an ability to listen to and communicate with the local community” (DOH WCC Vision 2008) Provider systems that integrate for detailed records and can aggregate to summary views across communities and pathways Information and IT intrinsic part of service specifications Increasing pressure for “real time” information

12. 1 Bring clarity to quality Expanding NICE so it selects the best available, or fills the gaps, and runs a new NHS Evidence service 2 Measure quality Quality Metrics across service lines (Patient experience and patient related outcomes) Clinical dashboards for teams 3 Publish quality performance All providers of NHS services will publish ‘Quality Accounts’ from April 2010 Comparative information on NHS choice 4 Recognise and reward quality improvement New Commissioning for Quality and Innovation scheme Multi-year tariff projections, tariff for mental health The Quest for Quality

13. Commissioning for Quality – some issues Traditional activity and transactions Defining quality - harder to measure Patient views on outcomes A Quality Framework approach - work across SHA - testing the Information core! Programme budgeting - optimum investment across pathways Driving for Effectiveness - will force service changes Partnership “rules” - will allow maximum leverage for change

14. Summary Challenges are immense and will not lessen In a rules based system – assurance is key Partnerships can provide quality improvements leverage Quality is central to commissioning Informatics is part of the solution and so we should invest for our future benefit Use what we have now wisely - don’t wait for perfection