Cancer provider network workshop2nd March 2011

Agenda

Time Session

2.00pm Welcome and objectives

2.05pm The model of care

2.15pm Provider network development

2.25pm Workshop session 1Provider network scope and governance

2.55pm Feedback and discussion

3.10pm Coffee

3.30pm Workshop session 2Provider network incentives and culture

4.00pm Feedback and discussion

4.15pm Closing remarks and next steps

4.30pm End of session

Objectives

• To inform providers of the implementation programme

• To engage providers in the development of the provider network model and specification

• To outline to providers the timeframe for specification development and provider network bids

• To prompt providers to begin provider network discussions and bid development

The model of care Chris Harrison

Developing the proposals

• 45 clinicians working over 12 months

• Three work areas: early diagnosis; common cancers and general care; rarer cancers and specialist care

• Case for change: December 2009

• Model of care: August 2010

• Extensive 3-month engagement on proposals – over 85 per cent of survey respondents supportive

The case for change

• Later diagnosis has been a major factor in causing poorer relative survival rates

• There are areas of excellence in London but inequalities in access and outcomes exist

• Treatment and care should be standardised

• Specialist surgery should be centralised: common treatments should be localised where possible

• Comprehensive pathways should be commissioned; organisational boundaries should not be a barrier

The model of care

• Improve early diagnosis by addressing public awareness, GP access to diagnostics, screening uptake rates and health inequalities

• Extended local provision of common cancer services, such as chemotherapy and non-complex surgery

• Further consolidation of surgical services for rarer cancers into specialist centres

• A small number of networks of providers delivering standardised pathways

Workstream Phase oneDec 10–Mar 11

Phase two Apr 11–Mar 12

Phase three Apr 12–Mar 13

1. Public health and primary care

2. Best practice

3. Radiotherapy commissioning

4. Provider network designation

5. Provider network development

Implementation workstreams

Workstream Phase oneDec 10–Mar 11

Phase two Apr 11–Mar 12

Phase three Apr 12–Mar 13

1. Public health and primary care

2. Best practice

3. Radiotherapy commissioning

4. Provider network designation

5. Provider network development

Provider network developmentRachel Tyndall

Provider network designation

• Providers will be asked to respond collaboratively to a provider network specification

• Which network they are in will be the provider’s choice

• The model of care states that there will be fewer than five in London

• Only providers in a network will provide cancer services

• Legal status required for contracting

Services

• Provider networks will be required to demonstrate how they will contribute to the delivery of the model of care:

– Early diagnosis

– General care

– Common cancer

– Rarer cancers and specialist care

Specification

• In addition to services, the provider network specification will cover 5 areas:

– Scope

– Governance

– Information

– Incentives

– Culture

Standards

• Commissioners will set measures and thresholds to assure quality and drive excellence

Patient experience

Patient safety Effectiveness

Structure

Process

Outcome

Timeline

Event/task By

London Delivery Group 31st January 2011

Announcement of specification development process 8th February 2011

Individual meetings with providers Feb/Mar 2011

Specification development events Early March 2011

Publication of specifications April 2011

Support for bid development Apr/May/Jun 2011

Individual or group meetings with providers Apr/May/Jun 2011

Deadline for bid submission 30th June 2011

Workshop 1Scope and governance

Rachel Tyndall

The givens

• Only those part of a provider network will provide cancer services

• Will contain as a minimum all secondary and tertiary care providers

• Will demonstrate commitment to implementing model of care for common and rarer cancer services

• An overarching governance board will manage network as single entity

• Clinical leadership and management support

Some questions

• Should all providers in the pathway be part of the provider network?

• Should the network governance board include representation from all organisations?

• Where will ultimate clinical and contracting accountabilities will sit?

Group session (30 minutes on tables)

• How tight or loose should the overall specification be?

• Do certain areas require a tighter spec than others?

Workshop 2Culture and incentives

Chris Harrison

The givens

• Provider networks will be clear about how they will incentivise constituent parts of the network

• Incentives should be linked with achieving the best patient outcomes and experience

• Competition and co-operation rules should be adhered to and patient choice should be maintained

• Research, education and innovation should be fostered

Some questions

• What can be done to incentivise providers to work differently?

• How will the network share information across organisations to manage patients along the pathway?

• Where might competition be used to incentivise improved patient outcomes and experience?

Group session (30 minutes on tables)

• What commissioning incentives would drive the model?

• What incentives could be used within networks?

Next steps

• Three further workshops with your teams

• Ongoing work in March on commissioning a provider network

• Outline specification published in April

• Ongoing development of the model beyond April

• Bidding stage from April to June

• Tailored support available during bid development

• For further information on the case for change and model of care visit www.csl.nhs.uk/publications