Self management-support-roi

WELCOME

Wednesday 7 January 2015Webinar

Self-Management Support Return on Investment

Self-Management Support

Return on Investment

Wednesday 7 January 2015

1pm – 1.45pm

Renata DrinkwaterCEO & Trustee Self-Management UK

&

Beverley MatthewsLTC Programme Lead, NHS Improving Quality

Bev MatthewsA nurse by background, Beverley has worked extensively throughout the NHS in a variety of clinical, managerial and strategic roles. Beverley’s current role as Programme Delivery Lead for Long Term Conditions Improvement Programmes: LTC Year of Care Commissioning Model and LTC Framework. Prior to joining NHS Improving Quality in April 2013, Beverley was Director of NHS Kidney Care and NHS Liver Care.

Passionate about service transformation through developing networks and leading complex programmes. Providing strategic leadership to partners within health communities, managing stakeholders and working across agencies.

Renata Drinkwater

Chief Executive of self management uk (formerly the Expert Patients Programme

Community Interest Company), a position that she has held since December 2010. Prior to

this, Renata was a Non Executive Director of the organisation from July 2008.

In common with over 70% of self management uk staff and volunteers, she lives with

several long-term health conditions herself, and therefore has both a personal and

professional interest in health sector issues, with a strong focus on the improvement of

outcomes for those living with long-term health conditions, for which she is a passionate

advocate.

Meet the Speakers

Self-Management Support Return on Investment

• Better understanding of return on investment for self-management training and support.

• Impact on self-management on NHS resources.

• How to make a business case for self-management.

Learning Outcomes

Beverley Matthews

LTC Programme LeadNHS Improving Quality

[email protected]

www.england.nhs.uk

LTC Framework

6

Organisational &

Clinical

Processes

Informed and

engaged patients

and carers

Health & Care

Professionals

committed to

partnership

working

Commissioning

• Information and

technology

• Case finding & risk

stratification

• Care Planning

• Safety and

Experience

• Guidelines,

evidence and

national audits

• Care Delivery

• Self Management

• Information and

Technology

• Group and Peer

Support

• Care Planning

• Policies for carers

• Voluntary sector

patient & carer

support

• HSC Integration

• Multi Disciplinary

Teams

• Culture

• Workforce

• Technology

• Care Co-

ordination

• Care Planning

• Needs

Assessment and

Planning

• Joint

Commissioning

• Metrics and

Evaluation

• Service User and

Public Involvement

• Contracting and

Procurement

• Care Planning

• Tools and Levers

The table below sets out some of the key components needed to deliver the central

aim for LTC Framework - Person Centred Coordinated Care

Bespoke Support

Tools and Resources

LinksLong Term Conditions Dashboardhttp://ccgtools.england.nhs.uk/ltcdashboard/flash/atlas.html

Long Term Conditions House of Care Toolkitwww.nhsiq.nhs.uk/improvement-programmes/long-term-conditions-and-integrated-care/house-of-care.aspx

SIMUL8: Simulation Modelhttp://www.simul8.com/viewer/download.htm

#LTCyearofcare #LTCimprovement @NHSIQ

LTC Learning Forum

“Lunch & Learn” Webinar Series

&

Bite Size Master-classes

Virtual Learning Network

“Lunch & Learn”

• 45 minute “real time” Webinar sessions

• Topics agreed and learning outcomes identified

• Faculty of Speakers identified and booked

Open invitation

Bite Size Learning Master-Classes

• Pre-recorded 20 minute Master-classes

• Master-class either as stand alone sessions or pre-requisites for “Lunch & Learn” Webinars

• Faculty of Speakers identified and booked

Open invitation

To register email [email protected]

LTC Lunch & Learn Series ….coming soon…

Date Webinar Hosted by Bev Matthews &

21 January 2015 Commissioning for Outcomes Bob Ricketts CBEDirector of Commissioning SupportServices & Market Development, NHS England

4 February 2015 The Organisation of Integrated Care: encouraging collaboration through contractual mechanisms

Dr Rachael AddicottSenior Research FellowThe Kings Fund

The business case for self-management

NHSIQ webinar – 7th January 2015

Renata DrinkwaterChief Executive

Agenda

What is self management uk?

What are the evidence based benefits of self-

management to patients?

How does self-management deliver savings to the

NHS?

Return on investment

Making the business case for self-management

Discussion

self management uk

Formerly the Expert Patients Programme Community

Interest Company, now a registered Charity

Over 12 years’ experience working within/for the NHS

At the forefront of self-management education and training

Facilitated delivery of programmes to 100,000+ patients with

long-term conditions

Also programmes for clinicians/healthcare professionals

Delivered face-to-face or online

Benefits of self-management to patients

Increased self-confidence and reassurance

Increased control over own health and wellbeing

Better involvement in shared-decision making about own health

and wellbeing

Reduced time off work

Better symptom management, such as reduction in pain,

anxiety, depression and tiredness

Improved physical symptoms and clinical outcomes in people

with arthritis, asthma, diabetes, hypertension, heart disease,

heart failure, stroke, cancer and other conditions

Benefits to clinicians, healthcare professionals and the wider system

Percentage savings delivered by self-management

programmes [1]

GP visits 2.3% Inpatient visits 50%

Nurse visits 13.8%Outpatients

visits6.2%

A&E visits 12%Medication

saved5.4%

[1] Figures were extrapolated from The National Evaluation of the Pilot Phase of the Expert Patient Programme – Rogers et.al. December 2006

ROI model for commissioners

New self management uk tool developed for Commissioners to

demonstrate benefits

Based on model originally co-developed with the Department of

Health, now significantly enhanced

Shows financial benefits of delivering our programmes patients

(e.g. Self Management for Life/Expert Patients Programme)

Uses Department of Health/Office for National Statistics figures

and evidence from other key studies

Calculates impact for any Clinical Commissioning Group

Calculating the savings

[1] DH figures

Percentage savings

GP visits 2.3% Inpatient 50%

Nurse visits 13.8% Outpatients 6.2%

A&E visits 12% Medication 5.4%

Unit costs NHS services [1]

GP visits £52 Inpatient £2,195

Nurse visits £11 Outpatients £126

A&E visits £100

CCG Case Study - Typical system usage and medication spend

Statistics for CCG Value

People with a Long-Term Condition 61,539

People Newly Diagnosed (Per year) 4,308

Total GP Visits 300,347

Total Nurse Visits 165,191

Total A&E visits 67,941

Total Emergency Admissions 17,015

Total Hospital Admissions 40,004

Total Outpatients Visits 203,576

Total Medication Spend £27,968,172

Typical return on investment

For every £1 spent: £2.24 is saved!

Yes, £2.24 saving per £1.00 spent

Cost Benefit Default Costs

Total Cost of Programme £93,750

Total Practice and Commissioner Savings £210,073

Total Saving over Contract Length £116,323

Saving per Year £116,323

Return on Investment: For every £1 spent: £2.24 is saved

Typical Return on Investment

Reduced A&E admissions - KingstonStudy from Kingston CCG - 4 courses for 74 participants

Hospital attendance: 180 visits for the 12 months prior to attending a course to 70 for the 12 months post attending a course = 62% reduction

Making the business case for self-management

Key Elements

Issues

Evidence

Provider

OutcomesChallenges

Potential savings

Options

Key issues & policy

House of Care

Promoting independence & helping older and vulnerable people with LTCs and their carers better manage their own health

Identifying people’s health and social care needs at an early stage

Delivering care in, or close to, home where possible

Developing actions that reduce urgent interventions and improve value for money

Evidence-based approach

There is strong evidence that the most effective way to support self-management is through a range of approaches that empower and activate people

Action planning and goal setting, combined with regular and proactive follow-up

Strategies co-created by service users and care professionals or co-led by service users

Interventions that support care professionals in working with service users to improve their motivation to change

Access to advice, information and support and self-management programmes

Choose an experienced provider

self management uk – the ‘preferred provider’:

From the evidence available, this is the only credible provider - informed by web searches and the review of available evidence of the impact of patient education programmes

A former NHS and now a not-for-profit organisation

Strongly endorsed by the NHS

A strong, prolonged and independently evidenced track record of successful delivery of generic long-term condition patients and care professional education programmes within the NHS

Define your outcomes

Reductions in crisis and associated unplanned activity (primary outcome)

Improved clinical outcomes

Reduced demand on other health services

Improved physical activity

Better medicines adherence

Continued impact over the long-term

What are your challenges?Bromley CCG: the challenges are an ageing population and an increase in long-term conditions

QOF Registers Prevalence Data 2012-13 Total % of population

Coronary Heart Disease 10,165 3.2%

Stroke or Transient Ischaemic Attacks 5,122 1.6%

Hypertension Register 46,028 14.4%

Diabetes Mellitus (Diabetes) (ages 17+) 13,681 4.3%

Chronic Obstructive Pulmonary Disease 4,371 1.4%

Mental Health 2,616 0.8%

Asthma 17,348 5.4%

Heart Failure 2,252 0.7%

Dementia 1,794 0.6%

Chronic Kidney Disease (ages 18+) 10,183 3.2%

Atrial Fibrillation 5,252 1.6%

Obesity (ages 16+) 25,585 8.0%

Smoking Indicators 74,111 23.2%

Cardiovascular Disease Primary Prevention 7,927 2.5%

Calculate your savings

Cost of commissioning self-management interventions

Potential savings gained from reduced use of NHS resources

Include social value

Self-management courses are delivered by local volunteers, who have either first-hand experience of living with a long-term condition or care for someone who has

They gain valuable transferable skills

Local peer support network for people with long-term conditions

Weigh your options

For example:

Option 1: Do nothing – this is not an option. There is strong evidence of the value of supported self-management programmes

Option 2: commission Self-Management for Life Health and Social care Professionals – designed to build upon existing skills to help ensure that self-management is actively supported. This option alone does not fully support patients and their carers; clinical support is necessary but is not sufficient to change health behaviours

Options 3: commission self-management programmes for patients, carers and healthcare professionals

Thank you

Questions?

Renata DrinkwaterChief Executive

T: 03333 445 840

M: 07500 039 736

[email protected]

[email protected]

To register email [email protected]

LTC Lunch & Learn Series ….coming soon…

Date Webinar Hosted by Bev Matthews &

21 January 2015 Commissioning for Outcomes Bob Ricketts CBEDirector of Commissioning SupportServices & Market Development, NHS England

4 February 2015 The Organisation of Integrated Care: encouraging collaboration through contractual mechanisms

Dr Rachael AddicottSenior Research FellowThe Kings Fund