Lansley and Nicholson lead speaker programme SEE PAGE 2
Up-to-date exhibition floorplan SEE PAGES 4 & 5
SEE PAGE 6
www.commissioningshow.co.uk
Issue 1
MARSHALL:
Commissioners should learn from each other GP vigour for commissioning has finally recovered from its low point in 2009 and now needs an injection of support from PCT clusters to meet authorisation aspirations, according to a national commissioning spokesman.
“It’s about genuine engagement of clinicians” Dr Johnny Marshall, Executive member of the National Association of Primary Care
‘We also had 150 clinical commissioning groups (CCGs) represented at the joint event we held with the NHS Alliance in September and I would say the vast majority of them are aiming for authorisation by April 1, 2013, so there you have 50 per cent of CCGs [nationally] already who have that in their minds.’
After the political ‘pause’ earlier this year to deal with opposition to the health and social care bill, Dr Marshall said CCG pathfinders reported a curtailing of their local flexibility and uncertainty over the future. ‘There was definitely a downer.’ The low point for GP commissioning had come in 2009, he added, when practice-based commissioning had been described as a ‘corpse not for resuscitation’, by the then national director for primary care, GP Dr David Colin-Thome. Dr Marshall, who is a GP and CCG chair in Buckinghamshire, added that PBC had realised its true potential only in a ‘handful of areas’, where they were supported by PCTs who ‘genuinely recognised
The call comes from Intellect, the trade body for the UK technology sector, which has more than 260 of its members working in healthcare. Intellect is delivering the ‘Productivity through Technology’ stream of the 2012 Commissioning Show. Andrew Hartshorn, vice chair of Intellect’s healthcare council, said: ‘Too often, informatics solutions are perceived as complex, expensive and take a long time to deploy.’
member of all, Executive sh ar M ny hn Jo Dr imary Care sociation of Pr the National As that this just wasn’t about practice-based conversations, it’s about genuine engagement of clinicians and a delegation of responsibility and accountability to them’. He called on the Department of Health to direct PCT clusters to explicitly support emerging CCGs. ‘There are some PCTs who are keeping a handle on business as usual so they don’t hand over a £25m deficit as well as creating a new commissioning infrastructure. But there are others who are more restrictive in terms of support. In the NHS operating framework [due out at the end of November for the next 12 months], there needs to be a clear understanding that PCT clusters’ whole purpose now is to create successful CCGs.’ The NAPC had asked the DH to allow CCGs to shop around PCT clusters for the best support, in order to drive up the standard of help being offered. Dr Marshall urged GPs to attend the 2012 Commissioning Show. ‘ I think the opportunity to network with other people facing exactly the same challenges, both technically and emotionally, is a great reason why they ought to go.’
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Clinical commissioning groups (CCGs) have been urged to cast away any preconceptions that new technology is a complex and costly way to transform care.
Dr Johnny Marshall, Executive member of the National Association of Primary Care, and a confirmed speaker for the 2012 Commissioning Show, said: ‘There’s definitely been a shift. People are feeling much more upbeat about it and want to know, not whether to do clinical commissioning, but, how to do it. He added: ‘At our NAPC conference [at the beginning of November], we sensed a feeling much more akin to what we had under fundholding, where people were coming along to hear from others how to do it.
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However there was an incredibly diverse range of products and services available. ‘Do not assume you cannot afford solutions from the outset. There will be a range of solutions applicable and affordable to all types of commissioners.’ He said the NHS was already reaping the benefits of advances, such as the picture archiving and communication system (PACS) which replaces x-ray films with digital images that can be shared instantly between clinicians. Mr Hartshorn added there was eager anticipation for the results of the Department of Health-funded Whole Systems Demonstrator randomised controlled trial of 6,000 patients using telehealth and telecare. Results are due out at the end of November. ‘The evidence so far points towards improved quality care and cost effectiveness, but the success of telehealth on scale is more about the willingness to change the way care is delivered and embracing technology as an enabler to make that happen.’ CCGs can find out more about Intellect’s healthcare work by visiting www.intellectuk.org
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Lansley and Nicholson lead speaker line-up Commissioning is organised by CloserStill Media
Health secretary Andrew Lansley and NHS chief executive Sir David Nicholson have been confirmed as speakers for the 2012 Commissioning show. Also due to speak is Dr Johnny Marshall, outgoing chair of the National Association of Primary Care and the GP chair of United Commissioning in Buckinghamshire. Nearly 100 experts, including CCG leaders across the country, will address delegates on:
Unit 17, Exhibition House Addison Bridge Place London W14 8XP www.commissioningshow.co.uk Tel: 0207 348 5250 Ralph Collett Show director Ralph.collett@closerstillmedia.com James Hall Sales manager j.hall@closerstillmedia.com Dan Harding Event executive d.harding@closerstillmedia.com
• the future challenges of CCGs in the run up to authorisation • managing long-term conditions • integrated care • productivity through technology • health and wellbeing boards.
Some 3,000 delegates are expected to attend Commissioning 2012 on 27-28 June, building on the success of the inaugural show this year. Next year’s event has moved to the larger national hall a Olympia.
Facilitated workshop sessions will also be held to allow small groups to explore issues in more detail.
See www.commissioningshow.co.uk to register for your delegate place or exhibition stand.
GPs double-billed Authorisation for care workshops for commissioners Free facilitated workshops are on offer to clinical commissioning groups (CCGs) to help them meet authorisation criteria set by the Department of Health.
Alice Andrews Delegate manager a.andrews@closerstillmedia.com
Called ‘VIA’, the programme is funded fully by pharmaceutical company MSD and has the backing of the National Association of Primary Care (NAPC) and the NHS Alliance. The facilitated workshops are delivered by the company Healthskills.
Sophie Holt Marketing and PR manager s.holt@closerstillmedia.com Julia Danmeri Head of operations j.danmeri@closerstillmedia.com
GPs have been double-billed for a single episode of care and charged a non-elective – and far more costly – tariff, according to cases uncovered in the past month.
Vanda Vokes Conference and speaker manager v.vokes@closerstillmedia.com
The examples serve as a stark warning of the need for clinical commissioning groups (CCGs) to have excellent ‘business intelligence’, said Graham Poulter, managing director of iQ Medical.
Rebecca Royal Event administrator r.royal@closerstillmedia.com Jo Farrimond Accounts j.farrimond@closerstillmedia.com
Andy Center Chief Executive a.center@closerstillmedia.com Michael Westcott Business Development Director m.westcott@closerstillmedia.com Phil Nelson Commercial Director p.nelson@closerstillmedia.com Jonathan Wood Director of Finance j.wood@closerstillmedia.com Phil Soar Chairman
His company’s data tools, which are increasingly being installed in practices across the country, revealed the mistakes made by trusts. In Rochdale, a GP practice received a bill for £15,000 because the same episode had been counted twice. Another practice, in Leicester, was charged £21,000 for a leg amputation of a diabetes patient, because the trust mistakenly applied the non-elective tariff. The patient had in fact been referred as an elective case, which should have cost £8,600. Mr Poulter said: ‘We reference back to the clinical information that’s held in the GP’s system. If you don’t do that you will never pick up those things.’ Mr Poulter said the main challenge for GP commissioners who wanted to mine data was addressing inconsistencies between individual practices over how they entered information into clinical computer systems. ‘The key tool we provide is our iQ Budget and Data manager to help produce a common standard. Once we’ve got consistent data into the clinical system, we can extract it into a tool set and cut and slice it in a myriad of ways: referral patterns for each GP or practice, whether the QuIPP standards are being achieved, do they get discharge letters in time, or at all.’ He added the product had been developed over five years and was the only one available that could extract information overnight from all eight of the GP clinical computer systems used nationwide. Mr Poulter said latest Department of Health guidance made it clear that business intelligence was a key criteria for authorisation of CCGs. ‘If you can’t get accurate facts to make clinical and business decisions, you will be fumbling. It is absolutely fundamental that [data] tools must be deployed, otherwise authorisation is just a wish.’
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‘As CCGs evolve we recognise the need for additional support to help deliver the challenges to improve patient care within the financial constraints of today’s NHS,’ write NAPC chief executive Mike Ramsden and his counterpart at the NHS Alliance, Michael Sobanja, in their joint forward to the VIA information booklet. ‘We envisage the MSD service - VIA - helping CCGs develop towards authorisation as outlined in the six domains, contained within [the DH guidance] Developing clinical commissioning groups: Towards authorisation. The timing is just right for a service that supports addressing these challenges.’ MSD – which is one of the sponsors of the 2012 Commissioning Show – said CCGs could select some or all of the VIA modules, depending on what stage they had reached. The nine modules are: • Review the landscape • Influencing externally • Engaging primary care • Mission and vision sense check • Stakeholder analysis • Influencing skills • Working with local authorities • Engaging GP practices • Understanding the commissioning cycle. The workshops are 2.5 hours long and are aimed at groups of around 15 people. Rebecca Wild, commissioning manager at MSD, said: ‘We developed this sponsored programme as a result of dialogue with our NHS customers, and we believe it responds to key issues for CCGs such as building scale, developing leadership and engaging stakeholders.’ Commissioners interested in the VIA programme should contact their local MSD NHS development manager; the MSD commissioning manager on 01992 467 272; or email partnershipdevelopments@merck.com
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Health and Wellbeing Boards, your critical friends
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Westmorland named “Most Advanced CCG” A group of GPs in Cumbria has been named ‘Most Advanced Clinical Commissioning Group’ for their work in redesigning community services for the elderly. The Westmorland Primary Care Collaborative has developed GP-run wards, which allows elderly patients discharged from acute care to rehabilitate in a setting closer to their home. The South Lakeland GPs have also developed a minor injury and assessment service at Westmorland General Hospital. The GPs were recognised at the National Association of Primary Care’s annual Vision Awards on 1 November in Birmingham.
Health and wellbeing boards say they are determined not to be seen as ineffective, bureaucratic council committees. Dr Peter Brambleby, joint director of public health at Croydon PCT and NHS Croydon, said his area’s HWB ‘was certainly not going to be a talking shop’. ‘We already talk to each other in various forums but what’s different this time is the degree to which the GPs are on board, and want to learn more about the wider population they serve.’ Dr Brambleby is due to speak at the 2012 Commissioning Show in the health and wellbeing stream. His comments follow the publication of a study of nine HWBs across England, showing that boards want to be seen as ‘dynamic’ opportunities for change. The boards had adopted various strategies to overcome fears they would be ‘yet another council committee’. These included: • assigning council leaders or senior cabinet members as board chairs, to bring authority, resources and proof of intent to make HWBs work; • investing in informal ice-breaking sessions between GPs and councillors and council officers to shatter myths about each other’s work and views; • agreeing to run board meetings differently and consistently. Dr Brambleby said in his area it had been very useful to discuss a different topic – such as diabetes, dementia and childhood obesity at each meeting to help share different knowledge and viewpoints. ‘It’s not just about a shared understanding, but developing a shared response,’ said Dr Brambleby. ‘So with diabetes, instead of a social
worker going in to a patient, then a diabetes nurse, a stoma nurse, and the stroke nurse, we thought of a generic worker who could do the insulin injection, check mobility, and make them cups of tea and put them in a bath.’
“It’s not just about a shared understanding, but developing a shared response” Dr Peter Brambleby, Joint director of public health at Croydon PCT and NHS Croydon
He added: ‘This first year or two needs dedicated time to board development, familiarity of roles, customs, language, cultures and a few key ground rules.’ The study of HWBs, carried out for the Local Government Association, called for councils to act as ‘critical friends’ to CCGs to help avoid conflicts about the role of boards in advising whether groups were ready to be authorised.
The boards held mixed views about whether they should primarily provide strategic oversight of commissioning subgroups or whether they should directly control budgets. Board membership numbers ranged from 10 to more than 20.
New partnerships, new opportunities is available at www.idea.gov.uk
Have your say Leading trade on Commissioning association 2012 partners with Commissioning
The 2012 programme is growing with two new streams announced for next summer, taking the total to six. Based on feedback from delegates, streams focussing on technology, and the emerging relationships with Health and Wellbeing Boards, have joined Managing long term conditions, Integrated care, Clinical Commissioning Groups of the future and Facilitating healthcare solutions. Uniting all the streams is the recurring theme of “improving patient care”.
But now is the time for the primary care community to air their views about what they want to hear and talk about. The seminar longlist can be accessed at www.commisioningshow.co.uk with a short feedback survey allowing GPs and managers to propose their own speakers and topics. Delegates can also share their views via twitter (@CommShow) or the Commissioning Show group on LinkedIn.
Intellect, the leading trade association for the UK technology industry has partnered with the Commissioning Show to deliver the Productivity Through Technology stream. “Primary care has more challenges now than ever, with the expectation that CCGs will deliver high quality services and cost savings. When we asked GPs what were their top priorities for 2012, over a quarter believed the innovative use of technology would be one of the most effective solutions to improving productivity and patient care.” Advises James Hall, stream manager. Inspired by this swell of interest, this stream looks at different uses and solutions that technology can offer primary care and social services. The stream offers case studies and expert advice, with a particular focus on mobile and tele-health solutions. Hall continues: “Intellect represents more than 800 companies ranging from SMEs to multinationals. Their involvement ensures the content of this stream will reflect the very best the technology community has to offer and will provide valuable insights for the Commissioning delegates.”
Dr Hugh Reeve, lead commissioning GP for the Westmorland Primary Care Collaborative, said: ‘As a commissioning group our aim has been to develop services that are delivered in a more joined up way, both in the community and in hospital. We are also committed to keeping services local wherever this is appropriate. We still have some way to go but I think this award is a sign that we are going in the right direction and we are determined to continue with this.’ The NAPC is a major partner of the 2012 Commissioning Show. A range of winners from the Vision awards are expected to show case their work at the event. Other category winners announced were: • Principia, Partners in Health: Best Patient/Public Involvement/Engagement • NHS Cumbria: Best Care Closer to Home Initiative • H3 Plus Commissioning Group: Best Use of Data • Nene Commissioning Community Interest Company: Best Outcomes Focused Redesign • Whitstable Medical Practice Best GP Provider • Redbridge CCG: Best Efficiency Innovation • Healthworks, Black Country GP Commissioning and Sandwell GP Commissioning Consortia: Best Integrated Care Model • Dudley Respiratory Group: Best Respiratory Initiative • United Commissioning: CCG Manager of the Year.
Free “early bird” places for Commissioning 2012 • Programme featuring the who’s who of primary care • Network with peer, experts and leading partners • Six streams covering topics including leadership, strategic skills, technology and best practice case studies • Plan your own programme to mix education, inspiration and practical training Book online at www.commissioningshow.co.uk/book or call 02476 719686
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2012 National Hall - Floorplan Space: £399+VAT (per m2) / Shell: £409+VAT (per m2) C81
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Enhance delegate traffic to your stand, become an expert surgery sponsor and benefit from pre-bookable 1-2-1 meetings.
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Productivity through technology
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GPteamnet 4
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First Data 6 Bank
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THEATRE 3 Health and Wellbeing Boards: productive relationship
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Mednet Consult 3
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The Practice 6
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Roche Products
IE Design
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Bayer
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Idis
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Shire
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Browne Jacobson
AA22 3 Ochre Recruitment
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Prolan
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Diabetes & Kidney Care (DAKC)
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Hemp D30
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Leo Laboratories
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TEVA
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Weightwatchers
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Personal 3 Diagnostics
Become a session sponsor to deliver key messages to commissioners through insightful case studies
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AA23
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United Health UK
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Call the team on 0207 348 5254 or email sales@commissioningshow.co.uk
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Wesleyan Medical Sickness
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Holt NHS Solutions Doctors for Public Health B64
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NHS Technology Brickwall adoption Health 4 centre
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IQ Medical
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Telehealth Codegate Healthcare 3 Solutions at Home
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Marie Curie
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Attain
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LIFTS TO THEATRES 2&5
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STAIRS TO:
Mediracer UK 2.5
PIZZA EXPRESS Integrated care and Managing long term conditions streams
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Holt Doctors has the right openings
Patient Access, simply transformed GPs: Can you imagine the health benefit and job satisfaction from offering a same day service to all your patients, every day? And knowing you will go home on time, workload under control? Commissioners: evidence shows the link between our method of access and a 20% reduction in A&E attendance. Have you seen that anywhere else?
Holt Doctors - GP Division provides GPs with work across the range of employment types. As a preferred supplier to numerous practice groups together with individual practices, we have a fabulous range of vacancies across the UK and sometimes abroad, often exclusive to us. No matter what type of work: • • • • • • •
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We have vacancies for you. We provide a high level of support to our GPs, pay excellent rates, offer a fabulous Red Letter Days rewards scheme where you can earn points towards exciting and attainable experiences, weekends away, luxury gifts and much more. Come to see us on our stand for more information about our service and what we can offer our doctors. GP Division Contact: Hollie Thomas Address: 4th floor, 1 Belle Vue Square, Broughton Road, Skipton, North Yorkshire BD23 1FJ Telephone: 01756 704776 Email: gp@holtdoctors.co.uk Website: www.holtdoctors.co.uk/gp-division
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PSUK has the solution PSUK is the largest supplier of pharmaceutical and consumable products to GP practices in the UK. Our extensive product portfolio covers pharmaceuticals, consumables, disposable instruments and medical equipment at the most competitive nett pricing available. We are continually expanding our product range and are delighted to quote for refurbishments and new builds. Additionally, to enhance the purchasing experience PSUK offers innovative management solutions to over 7000 GP practices. We work closely with GP Consortia to streamline purchasing and facilitate relationships with suppliers to ensure a win/ win outcome for the NHS and the practice. Our management services encompass medicine optimisation and contract negotiation and implementation. Furthermore, we hold over 40 study days that are CPD accredited to increase profitability, efficiency, patient care and staff contentment. For further information on PSUK please contact Heidi Barrett on 01904 732274/07501 683574 or visit www.psuk.co.uk
Over 200 GPs from 42 diverse practices have discovered the means to make all the above a practical reality. Already covering some 350,000 patients, our service is modified in a simple way which goes with the grain of professional practice, putting doctors more easily in touch with their patients. Together we have created a social enterprise, with the objective “to transform access to medical care for the benefit of patients, doctors and the NHS.” Dr Kam Singh, Leicester, changed August 2011: “It’s given me a new lease of life.” www.patient-access.org.uk
Rila develops stroke programme “The key to a successful and cost effective NHS: Deliver more care in the community by ensuring ALL GPs and Nurses have a Special Clinical Interest”. The austerity measures and the restructuring as part of Andrew Lansley’s vision for the NHS will push more healthcare into primary care. Whatever the critics say the reality is that it is less expense to deliver care in the community. The trick is to ensure that the clinical standards are maintained, the difficult bit. Rila Institute of Health Sciences has been providing educational courses for GPs and Nurses to develop Special Interests for the last 16 years and have numerous evaluations of their cost effectiveness. Rila have programmes that cover the usual high priority pressure areas such as Diabetes, Cardiology, Musculoskeletal Medicine, ENT, Dermatology, Urology and Ophthalmology. More recently it has developed a programme in “Stroke Management”. Visit us on STAND: AA34
Your route to transformational change PRO-CURE supports commissioners to drive improvements in patient care through procurement and commercial expertise. We work with Primary Care Trusts (PCTs) and Clinical Commissioning Groups (CCGs) to meet a range of quality and outcome objectives with the overriding aim of achieving tangible benefits to healthcare. Our specialist team will guide you step-by-step through the most effective competitive procurement or any qualified provider
(AQP) process, supporting you to shape service specifications and maximise value for money. As experienced NHS procurement professionals, we can provide any level of support you require although our preferred model is for our staff to be embedded within PCT or CCG teams. This results in the most effective working arrangements and achieves the best results. As well as healthcare contracting, we offer advice, project and performance management. For more information, contact Caroline Thomsett, Assistant Director of Corporate Services, on 0118 916 7945 or caroline. thomsett@pro-cure.nhs.uk
First Databank identifies £4.2 million a week in savings across medicines budgets First Databank, the UK’s leading provider of drug databases and active clinical decision support in ePrescribing systems has identified tangible ways to deliver huge savings across medicines budgets. First Databank, as part of its latest product development phase, reviewed McKinsey’s report on the potential for £880 million additional savings per year from existing medicines budgets and has designed a new suite of products, due to be released onto the market in early 2012 that will tackle medicines budgets head on and help to meet the National QOF measures. Through its partnership with leading suppliers of electronic healthcare systems First Databank’s drug database Multilex, and referential clinical decision support product FIRSTlight, already influence a large proportion of prescribing and dispensing practice across GP clinical and community pharmacy systems in the UK. The company has the benefit of over 30 years’ experience and expertise as the trusted source of medicines
information at the point of care and has used this to great effect in this latest product development. The combination of First Databank’s well-regarded medicines information and knowledge of the industry gives the company a unique perspective into medicines optimisation opportunities. Neill Jones, clinical director at First Databank explains; “We have worked extensively across both the primary and secondary care sectors with end users and system vendors alike over the past 30 years. “We have recognised the impact that budgetary cuts and ambitious top-down targets have had on clinicians who are often working with reduced manpower, and experiencing frustration created by the proliferation of partial or inadequate solutions. Clinicians cannot reduce cost and improve quality, through prescribing interventions, while the level of granularity
of information about the interaction between the patient and their medicines is not fully available. That is why we are investing in patient-level medicines optimisation support within the primary care sector. “ With more than 670 million prescriptions generated each year in primary care, there is a huge potential for medication error and variability of prescribing. Currently £9.3 billion is spent on medications in the primary care sector; more than 80% of the total UK medications spend. Two key areas of spend that First Databank have identified potential savings within this complex budget area for GPS and CCGs are, firstly, improved prescribing practice to reduce variability of prescribing, and secondly, the increase in prescribing of generics. The potential savings identified as possible by First Databank are up to £850,000 per working day (£4.2 million a week) across the NHS medicines budget. First Databank is currently in active talks with healthcare partners in an early adopter programme and the product suite will be launched into the UK market in early 2012. The products will help reduce prescribing variation and provide decision-support based upon NICE and NPC guidance – helping GPs use their over-stretched budgets more effectively in addition to helping meet the QOF measures set.
For further information visit www.firstdatabank.co.uk
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PKF support cost-efficient protocols PKF, Chartered Accountants and Business Advisors, are at the forefront of providing specialist financial services to clients in the medical profession. Winners of the 2011 General Practice Awards “Accountancy Firm of the Year”, a preferred provider of accountancy services to Londonwide Enterprises Ltd, and tax advisors to BMA members, PKF have specialist healthcare teams at their offices throughout the country. PKF’s healthcare partners and management consultants are working with CCGs to establish cost-efficient and effective protocols and governance. PKF advise on all the financial issue facing GPs from setting up Community Interest Companies to advising on surgery developments, partner changes, refinancing and budget negotiations. PKF prides itself in a personal, friendly and efficient delivery of specialist accounts and taxation services and assisting clients with commercial decision-making to maximise the opportunities from the reformed NHS and minimise the impact of increasing tax rates and pension constraints. Valerie Martin-Long, national director of healthcare services at PKF, is speaking on “Identifying the opportunities for CCGs to make savings and efficiencies” and will be pleased to answer individual questions at the PKF stand I28 at the Commissioning Show.
Valerie can be contacted on Valerie.martin-long@uk.pkf.com
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Clinical Leaders Network confirmed as partners for Commissioning Show 2012 CloserStill, the organisers of the Commissioning Show, are delighted to announce that the Clinical Leaders Network will be chairing a stream at the 2012 show. Representing thousands of GPs, senior nurses and healthcare managers, the Clinical Leaders Network (CLN) is a national clinical leadership and engagement network, bringing together a broad range of local clinical champions to initiate positive, transformational change and spreading good practice across the NHS. CLN will be chairing the stream: Clinical Commissioning Groups of the Future, helping to develop content supporting effective leadership, financial management and strategy development. The show will offer members the opportunity to network with their peers both formally and informally, sharing best practice and practical solutions with commissioning groups from across England. The CLN join partners including the NAPC, Family Doctors Association and NHS Institute for Innovation and Improvement in supporting the development of the Commissioning Show as an invaluable resource for GPs and managers leading the changes to primary care commissioning.
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www.commissioningshow.co.uk
Omitted data could derail CCG 60 seconds efficiency plans, survey reveals with: CCG data quality in the GP clinical systems is the single biggest problem chief executive Poor facing Clinical Commissioning Groups (CCGs) and could derail any plans as they try to work collectively to monitor and improve Ben Gowland efficiency financial and clinical performance. Ben Gowland is chief executive of Nene Commissioning, a social enterprise bringing together 71 GP practices in Northamptonshire into a pathfinder clinical commissioning group. Named after the local River Nene, the organisation serves more than 625,000 out of 696,000 patents in Northants. The group has gained national attention – and a ministerial visit – for its innovative work, which has been recognised with a series of awards including ‘most advanced BC consortium’ and ‘best clinical leadership in primary care’.
I became a CCG chief executive because... My organisation turned into a CCG. The most challenging thing about being a CCG chief executive is... Designing and creating a new future whilst old mindsets prevail. The best thing about being a CCG chief exec is... Designing and creating a new future and changing old mindsets. The Nene CCG initiative I’m most proud of is... Our Community Elderly Care Service, which is reducing emergency admissions and improving outcomes for frail elderly people by providing high quality community alternatives to hospital admission. This year’s opposition to the health bill has been...
One of the key benefits of allowing family doctors to commission health services was that, being closer to the patients themselves, they would be in a better position to drive up quality and push down costs, improving the care pathway for the patient. But in order for GP’s in CCG groups to do this, they must be able to access and understand good quality and consistent information that resides in all their colleagues’ clinical systems.
In order to successfully manage a CCG, practices need to record and access accurate information which then permits analysis by: • Referrals by GP, date and Read Code • Admission and discharge dates • Episode types • Referral sources
But even when all GP practices within a CCG are working with the same clinical systems, the variation in the data they input into their clinical systems is huge and makes it incredibly difficult for that information to be used beyond the four walls of each individual practice.
• Contract monitoring
Our survey of CCGs across the country has found that when entering data into their clinical systems, practices are routinely missing out details in areas such as in-patient activity, particularly procedures, and failing to summarise out-patient activity.
These can only be monitored effectively if all the practices within a CCG agree on a common methodology that supports their internal processes, but also allows for this data to be inputted in a structured way which can then be accessed and analysed automatically via a range of reports which are produced in minutes.
When it comes to referrals, the study revealed that some practices within a CCG routinely scan and attach letters to patients’ records with a note of partial read codes, while others failed to record referrals at all. When GP practices worked in isolation, this level of data quality may have been acceptable as third parties would not need or be able to access those records. Now the rules have changed, CCGs need to be able to access that information in order to coordinate and monitor group performance.
• Excess bed days • QIPP targets • National and local tariffs, etc
iQ Budget and Data Manager does this and is currently being installed into a number of CCG pathfinders which have identified the importance of this information, and of good data quality, to their future success. Example of Data Input from 5 Practices within the same CCG
The problem of poor quality data isn’t restricted to GP practices. Historically PCTs have not validated SUS data against the original GP’s instructions. CCGs now have a unique opportunity to do this, through negotiating new contracts, to enable them to challenge inaccurate invoices and drive up the quality of patient care. Before any of that can happen, CCGs must first tackle the problem of poor data – whether it’s information they are responsible for, or information that has come from elsewhere. The iQ Data Template which works with all clinical systems within a CCG are a big step forward as they allow CCGs to create common formatted data which can then be automatically transferred to a secondary system for monitoring performance and analysis, in line with planned commissioning objectives. Doing this, then linking referrals and discharges to SUS data, would create one of most valuable sources of information in the NHS, allowing both operational and strategic decisions to be made on the basis of strong evidence. Failure to do so, or attempting to do it without standardising data entry first, would be to miss one of the greatest opportunities created by the current NHS reforms.
Unfair on GPs. I think tweeting is.... For tweenagers! My management guru is... Tim Ferriss, [American] author of ‘The 4-Hour Workweek’ (I am not there yet…). The most inspiring person working in or for the NHS today is.... The patient, because there is not a single process to which they don’t add value.
The iQ Data Template works by automatically reviewing the information already entered into the clinical system by the data clerk through the scanned document, and automatically presents a template which identifies the additional information required to create the vital commissioning information upon which numerous CCG management decisions will be made.
Patient awareness of CCGs is... Still to come. In five years’ time, CCGs will....
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