Dudley Multi-specialty Community Provider Delivering a whole population budget via a single provider Mr Paul Maubach Chief Executive Officer Dudley Clinical Commissioning Group
Timeline for MCP procurement July 16 Nov 16 Mar 17 Public Consultation GP development Contract development PIN Market engagement Gateway one Assurance PQQ Bidder submission(s) followed by Competitive dialogue process Development of GP leadership capability to engage with potential partners and MoU with GP membership CCG / NHSE continued development of contract, outcomes, scope. Secure external governance partner PIN signals opportunity for market to engage with GP leadership in forming potential partnership(s); and for GP leadership to negotiate options with GP membership CCG enters combined NHSE/NHSI/CQC gateway one ISAP Bidder submission(s) in response to PQQ requires GP participation Competitive dialogue affords the best mechanism for negotiating VFM and developing a new and complex contract
Timeline for MCP procurement Nov 17 Jan 18 Apr 18 Preferred bid determined Complete risk assessment Gateway two assurance Contract award MCP infrastructure mobilised Gateway three Assurance MCP Mobilisation Phased mobilisation of MCP begins New partnership & commissioning arrangements Risk assessment and assurance of MCP based on constituent parts (CCG, GP, partners)rather than MCP track record Opportunity for Gateway two ISAP measures to be built into CCG competitive dialogue MCP legal entity, governance and leadership needs to be put in place (transition). Gateway three includes CQC registration and NHSI regulatory requirements MCP delivery phased in accordance with outcome of dialogue process (starts with Primary Care & community) Some CCG functions contracted to MCP; new commissioning & system partnership arrangements commence
Possible Organisational Form (Other organisational forms are available) CCG Single Contract GP FT(s) &/or Private partner MCP Joint Venture Integration Agreement GP GP GP GP Subcontractor Subcontractor Subcontractor
Potential Future Dudley System Dudley MCP New extended primary/community model Capitation funded to a set of outcomes Partnership Agreement Risk / Gain share Dudley Group FT Best practice pathways Incentives to repatriate population activity Part of a Black Country acute alliance MCP Commissioning Acute / Specialised Commissioning Dudley CCG
MCP care model Specialist and OOH population care Extended practice multi-disciplinary teams Extended Primary Care Shared Outcomes Person Social Network Community
MCP outcome measures Access and population health 100% Reduce all waits Reduce inequality in life expectancy Continuity 30% Improve prevention & risk reduction Improve calls, visits, diagnostics, & treatment response Same day (<5 yrs) Appropriate Diagnosis and Long Term Condition Management Evidence-based outcomes framework Coordination Care plan constructed with all relevant parties, co-produced with the individual 5% Reduced avoidable admissions, DTOCs, and social isolation. Improved independent living and employment Lifestyle factors Quality & Safety Patient Benefits Staff Benefits Minimise harm (reduce number of incident per person / per practitioner); safer prescribing; reduced ACSC admissions Improve patient experience / patient outcomes as reported by them Improve staff efficiency, morale, patient contact time
Dudley MCP Outcomes Framework 6
Asset approach to the MCP Culture Values based Employer of choice New partnerships with public & private Workforce Empowerment model Teams without walls Integrated planning & development Technology Single IT system Disruptive technology Standardisation of work flow processes and communication Social Public participation Voluntary Sector Social networks, health & wellbeing Information Self-Improving system Patient reporting Outcome driven and evidence based Leadership Creates vision / belief Creates environment Focus on unblocking barriers to change Estate Community asset Local ownership Enabler to more efficient delivery Governance Financial responsibility Public accountability Confidence in capability of system Population Connects to public Aligns to public health Central to the design of the model of care
Creating an empowerment culture Leaders Empower delivery and improvement Unblock barriers and encourage learning Provide clarity of purpose Staff Locus for improvement and learning Identify faults and highlight barriers Deliver care
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