UKMi Conference 2011 Structural Changes in the NHS Vic Standing Pharmaceutical Adviser NHS NW. Healthier Horizons

Transcription

1 UKMi Conference 2011 Structural Changes in the NHS Vic Standing Pharmaceutical Adviser NHS NW Healthier Horizons

2 1988 Secretary of State For Health Department of Health Special Health Authorities (8) NHS Management Executive Regional Health Authorities (14) Executive Outposts (7) NHS Trust Hospitals (292) General Practitioner Fundholders (6,098) District Health Authorities (145) Directly Managed Hospitals (175) Family Health Services Authorities (90) Non-Fundholders General Practitioners (20,018)

3 1994 Secretary of State For Health Department of Health Integrated District Health Authorities (87) NHS Management Executive NHS Trust Hospitals (450) Directly Managed Hospitals Regional Offices (7) General Practitioners Fundholders Non-Fundholders General Practitioners

4 1994 Trajectory Secretary of State For Health Department of Health NHS Management Executive Regional Offices (7) NHS Trust Hospitals (450) General Practitioners Fundholders

5 2002 Secretary of State For Health Permanent Secretary NHS Chief Executive Departmental Management Board Health & Social Care Directorates (4) National Clinical Directors Board Monitor The Independent Regulator Regional Governmental Offices (GOR) (9) Primary Care Groups (618) NHS Trust Hospitals (271) Strategic Health Authorities (28) Primary Care Trusts (PCTs) (350) Strategic Health Authorities 10 Primary Care Trusts 152

6 On July 5 there is no reason why the whole of the doctor-patient relationship should not be freed from what most of us feel should be irrelevant to it, the money factor, the collection of fees or thinking how to pay fees an aspect of practice already distasteful to many practitioners. The cost of ill-health is a burden on the community and a burden on the family, and the startling advances made by Medicine in the past 25 years have steeply increased this cost. There is, therefore, a logical case for spreading it over the whole of the community so that those who are fortunate enough to remain in good health may help those who temporarily fall out of the ranks. The price Britain will have to pay for this new service is high, but the fact that the country is prepared to pay this high price shows that it is well aware that on the crude economic level an efficient and complete medical service will pay a good dividend in health, happiness, and efficiency in work Aneurin Bevan, BMJ 3rd July 1948

7 2010 Parliament Funding Accountability Department of Health NHS Commissioning Board Monitor (economic regulator) Care Quality Commission local partnership licensing Local Authorities GP Commissioning Consortia contract Providers Local Health Watch accountability for results Patients and Public

8 2011 Parliament Funding Accountability Department of Health Regional Offices NHS Commissioning Board Monitor (economic regulator) Care Quality Commission local partnership licensing Local Authorities GP Commissioning Consortia contract Providers Local Health Watch accountability for results Patients and Public

9 2011 Vision Funding Accountability Parliament Public Health England Department of Health Regional Offices NHS Commissioning Board Monitor (economic regulator) Care Quality Commission Field Force Local Professional Networks Local Authorities local partnership PCT Clusters GP Commissioning Pathfinders contract licensing Providers Health and Wellbeing Board accountability for results Patients and Public

10 GP Clusters Commissioning Support Merseyside Constituent Primary Care Trusts Halton and St. Helens Liverpool Sefton Approximate number of GP practices Consortia Knowsley Central and Eastern Cheshire Cheshire Warrington Western Cheshire 189 Wirral Tameside and Glossop Stockport Trafford Ashton, Leigh and Wigan 13 Consortia Greater Manchester Bolton Bury 547 Manchester Oldham 10 Consortia 19 Consortia Heywood, Middleton and Rochdale Salford Central Lancashire 8 Consortia East Lancashire Pan Lancashire North Lancashire 251 Blackburn with Darwen Blackpool Cumbria Cumbria 95

11 2012 Vision Funding Accountability Parliament Public Health England Department of Health National Commissioning Board Field Force NHS Commissioning Board Monitor (economic regulator) Care Quality Commission SHA Quadrants licensing Clinical Networks and Senates PCT Clusters Local Authorities local partnership Clinical Commissioning Groups (CCGs) contract Providers Health and Wellbeing Board Shadow CCGs accountability for results Patients and Public

12 The NHS Outcomes Framework Domain 1 Preventing people from dying prematurely Domain 2 Enhancing quality of life for people with long-term conditions Effectiveness Domain 3 Domain 4 Helping people to recover from episodes of ill health or following injury Ensuring people have a positive experience of care Patient experience Domain 5 Treating and caring for people in a safe environment and protecting them from avoidable harm Safety

13 Breathing life into the NHS Outcomes Framework? Domain 1 Preventing people from dying prematurely NHS OUTCOMES FRAMEWORK Domain 2 Enhancing the quality of life for people with LTCs Domain 3 Recovery from episodes of ill health / injury Domain 4 Ensuring a positive patient experience Domain 5 Safe environment free from avoidable harm Duty of quality Commissioning Outcomes Framework NICE Quality Standards (Building a library of approx 150 over 5 years) Provider payment mechanisms Commissioning Guidance standard tariff CQUIN QOF contract Duty of quality Commissioning NHS Commissioning Board Specialised services, primary care and prison healthcare Commissioning / Contracting NHS Commissioning Board certain specialist services and primary care Clinical commissioning GP Consortia groups all all other services healthcare services Duty of quality

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17 Quality and Productivity Indicators

18 Summary of QIPP Prescribing Comparators:

19 QIPP Prescribing Q1 2011/12 - SHA North West PCTs

20 QIPP Prescribing Q1 2011/12 - SHA North West PCTs

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24 Government Network International Access to Medicines Inward Investment Enterprise & Regulatory Reform DFID FCO UKTI BERR Animal Rights Legislation HO DH MPI Division HMT Tax Incentives & Science Strategy NI(H)CE UKCRC MHRA New Technology Appraisals Translational Clinical Research EU Medicines Legislation

25 UK Pharmaceutical Industry Key Facts Employs 72,000 people direct and generates 250,000 jobs in related industries Invested 3.9 billion in UK research and development in 2010; more than 10 million a day Exported 15.2 billion of pharmaceuticals in 2010 Last year s trade surplus for the UK was 5.3 billion There is a need to shift the emphasis from conflict of interest to commonality of purpose

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