Penny Emerit Acting Director of London Programmes May 2010 Polysystems: how do they support tackling health inequalities in Sectors and PCTs?
Jan 13, 2016
Penny EmeritActing Director of London ProgrammesMay 2010
Polysystems: how do they support tackling health inequalities in Sectors and PCTs?
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Brief history of Commissioning Support for London
Established in April 2009 from a merger of seven organisations
Made up of five directorates:
London Programmes
Customer & Business Strategy
Clinical and Health Intelligence
Finance and Commercial Services
Informatics
CSL was designed as a collective investment by London’s PCTs to achieve critical tasks
that, individually, PCTs would find too difficult or costly to do alone.
Its purpose is to support PCTs to deliver quality and cost improvements through
implementation of the Healthcare for London strategy.
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Key principles for improved care from cradle to grave…
Equity is the founding principle of the NHS
However, there are big inequalities in health outcomes…
• life expectancy
• infant mortality
• incidence of disease
… and an inverse relationship between health needs and service provision
A Framework for ActionOne city…. but BIG inequalities in health and healthcare
1. Services focused on individual needs and choices
2. Localise where possible, centralise where necessary
3. Truly integrated care & partnership working
4. Prevention is better than cure
5. A focus on health inequalities and diversity
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Context – Healthcare for London Strategy
New models and pathways Care settings
QUALITY, OUTCOMES, HEALTH IMPROVEMENT, PATIENT EXPERIENCE, USE OF RESOURCES.
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Polysystem Vision
The programme must be built on strong clinical leadership with broad clinical engagement and string user involvement
with broad public understanding
The programme must enable increasing autonomy for clinically led commissioning over time
The programme must be built on a platform of transparent information that drives improvements in quality and
productivity and enables patients to make informed choices
BOROUGH
POLYSYSTEM
SECTOR
TOTAL PLACE
ORGANISE PRIMARY CARE
SERVICE AND SYSTEM REDESIGN
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Polysystems commitment 2010/11
Full Specification:
Ensuring that the PCTs have a polyclinic hub delivering the core services, structured around local need.
Ensuring that the hub is part of a polysystem where the networked clinicians care manage the local population
Ensuring that the polysystem delivers on the four key outcomes:
The focus in 2010/11 will be on ensuring there are 30 polysystems meeting the full specification in terms of provision of services and also delivering the full cost savings as set out in the affordability study.
We will also use 2010/11 to understand how to deliver polysystems to their full specification, commissioners will plan for a rapid intensification of the roll-out of polysystems in 2011/12. [NHS London ISP, 2010]
50% reduction in use of A&E through provision of urgent care in the
community
Reduction in admissions to hospitals through improved management of long
term conditions
Improvements in quality and access to primary care, contributing to the 35% productivity improvements required
through primary and community care
Shift and redesign of 55% of outpatient appointments from hospital
into the community
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Polysystems and inequalities
All frontline staff directly support the 5 Priority Actions… for instance, by immunising patients, providing cancer screening and contraception advice
For example, GPs should proactively review records to identify immunisation gaps for patients who present for other reasons
And preventative measures should be employed to minimise reoccurrence or relapse, for instance prescribing aspirin for some stroke patients
However, they also have a key role to promote good health, reinforce healthy messages and take timely preventative action…. making health improvement an integral part of ALL healthcare
Interventions could occur at any stage of a patient’s treatment… before or after diagnosis, pre-operation, post-discharge
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Working together to tackle inequalities
Health Improvement
Board
Wider NHS
Mayor’s London Health
Inequality Strategy
Multi-agency leadership to implement Healthcare for London Staying Healthy Pathway
A focus on partnership working to improve health & wellbeing
A key role to help deliver the Mayor’s Health Inequalities Strategy
Mayor’s commitment to improve health and reduce health inequalities
A call to arms for partner organisations to embed these principles in their work
Working at all levels to improve health outcomes and reduce inequalities
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Staying Healthy Pathway: A Case for Change
Population Health
Inequalities
Health systems
utilisation
National priorities
Case for Change
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ISP Priority Actions
Vascular HealthSmoking
ImmunisationScreening
Sexual Health
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Health Inequalities Intervention Toolkit
Designed to assist evidence-based service planning and
commissioning.
Contains tools to support planning
to meet both objectives in the national target to
reduce inequalities in life expectancy and infant mortality
Can also be used for Joint Strategic
Needs Assessments, Local Area Agreements,
other national priorities, including National Indicator Set indicator for
reducing All Age All Cause Mortality