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Earls Court Health Centre. Bold Commissioning Presented by: Frankie Lynch Borough Director Kensington and Chelsea 15 th June 2012. Vision. NHS Kensington and Chelsea - PowerPoint PPT Presentation

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  • Bold Commissioning

    Presented by: Frankie LynchBorough Director Kensington and Chelsea15th June 2012

    Earls Court Health CentreEarls Court Bold Commissioning_15/06/2012

  • VisionNHS Kensington and Chelsea

    Commitment to be a Health Advocate - enabling and empowering people to take responsibility for their own health by making healthy lifestyle choicesRecognition of Wider Determinants of HealthBenefits of Integrated Services

  • Shaping procurement

    PROCUREMENT PROCESS4. Community views and soft market testing 2. Local demographics and health needs1. PCT Vision, priorities, and constraints3. Existing service structure and provision5. Shared Vision-Social Values

  • Overview: Procurement TimelineDECISION May 2011PCT Health Needs Assessment & Service ReviewBuilding the Business Case for investment in a new provisionNHS K&C PCT Board ApprovalCommunity Engagement Activity Social Values & Commissioning National PilotSoft Market TestingIntegrated CareProvisionAssembling Project TeamDialogueOngoing EngagementSubmitted BidsSpecification- July 2010Evaluation20092009 - 20102010 - 2011OPENED DEC 2011

  • How we gathered the informationDEMOGRAPHIC & HEALTH NEED

    EXISTING SERVICE PROVISION

    COMMUNITY VIEWS

    PCT/ NHS SERVICE VISION

    Analysis of existing datasets Needs assessment Patient flows into services Performance indicators and complaints information- Premises info, strategic plans etc

    Consulting with local resident groups Range of meetings with established groups Opinion gathering event in Earls Court, plus range of other approaches Setting up and involving a new reference group throughout processQualitative market research interviews 45 residents systematically selected, based on quota sample Half hour in-depth interviews Explored insights into health and healthcare Created patient typologies

  • 10,000 population size and second most densely populated ward in all London

    Very high numbers of younger adults, mostly affluent (with more than half born abroad). Transient, like K&C generally

    Fewer older people, but more stable population. Many of the older population living alone with poor access to the street

    Small number of children, but higher proportion of these in overcrowded conditions and in social housing

    What the socio-demographic datasets told us about Earls Court

  • General practiceHigh number of small list size GPs offering variety of different service models, with some premises having poor physical access

    Very limited dental provision

    No existing flexible space for a range of health (and other) services. Therefore, big scope for a hub practice

    Access and conveniencePatients travelling to hospital sites for issues that could be dealt with locally

    A&E more likely to be used after hours by younger residents born abroadWhat the services datasets told us about Earls Court

  • What community engagement told usCore Service (Retain Focus)Balancing priorities/ evolving needsPeople not ProblemsEmpathyPartnershipsEfficient, EffectiveWellnessCommunity Activities

  • Shaping Procurement: Shared Vision-Social Values Social value is the additional benefit to the community from a commissioning/procurement process over and above the direct purchasing of goods, services and outcomes

  • Shaping Procurement: Shared Vision-Social ValuesThe aim is to move the delivery of social value from a happy accident to a proactively managed activity

    HOUSING

    UNEMPLOYMENTEmploys Restaurant Staff and Facilitators

    EDUCATION

    SOCIAL ISOLATIONProvides a regular meeting place for EC residents

    POVERTYIncludes Way Finding to Social Services and other community facilities

    ENVIRONMENTLow Carbon Footprint

    CRIME

    HEALTH

    EARLS COURT HEALTH CENTRE

  • Shaping Procurement: Shared Vision-Social Values Commissioners understanding of social values in relation to the ECHC scheme:

    A collective vision of social well-being

    A service model which builds an integrated package of services

    Improved participation in decision making

    Desired outcomes-health and social outcomes

  • Shaping Procurement: Service Specification Earth Regeneration were commissioned to soft market test a new kind of health centre - one which would address the needs of the whole person and result in a different kind of provision

    Several organisations interviewed: local GPs and Dentistsvoluntary sectorsocial enterpriseslooking for those with experience in managing an integrated package of services

    Concluded that, whilst there were relatively few organisations with substantial experience, there was sufficient interest from a range of organisations across the sectors to move to the next stage

  • Earls Court Performance Report- sampleKEY MESSAGES

    Services has assessed over 10 patients. 2 patients are currently in the service.Wellbeing Coaches have been developing the work programme and peer mentoring programme.Wellbeing coaching session has taken place at ADKC.NESTA: Focus on peer mentoring and look for 15 people accredited dual. All registered patients linked to changing behaviourCentre Manager & Wellbeing Coach presented at the worklessness Forum. The Centre will host the nest Worklessness Forum in May.Meetings have been held with both Maximus and Reed to discuss potential ways of working together. A meeting will Ingenus is planned.A co-production session was undertaken to develop an action plan to establish a Job Club at the CentreWellbeing ServicesEmploymentAdvancementProgramme

  • Earls Court Performance Report March 2012Key Messages Connected careSexual HealthThe outcomes of the community Researchers questionnaire survey has been presented to the Centres Executive Management Board, social Value Steering group and a meeting of the Centres staff.Further analysis of the key issues and outcomes and an action plan is being developed so that some of the key elements can be implemented within the centreA second nurse, Asma Ashraf, has started working within the Centre with the THT serviceContinued registration and walk-ins consistent with previous months. Percentage of walk-in patients registering a little lower in March.Patient population shows significantly higher number of 20-40 years olds than nationally and locally and has a high proportion of ethnic minorities.GP Patients

  • Earls Court Performance Report March 2012WELLBEING SERVICES

    IndicatorFreqTime PeriodThresholdPrevious PerformanceCurrent PerformanceComments & Improvement PlanNumber of accepted cases completing programme ie. guided self help, motivational coaching etcMonthly75%N/AAll clients of the wellbeing service to receive an individualised plan of care with achievable goals setQuarterlyQ4100%100%Wellbeing service clients are representative of defined target groups according to read codesQuarterlyQ4Y1: 50%95%Number of clients reporting increased confidence, wellbeing, locus of control, better management of condition, improved quality of life at the end of the interventionQuarterlyQ4>50% N/A

  • Earls Court Performance Report March 2012EMPLOYMENT ADVANCEMENT PROGRAMME

    IndicatorFreqTime PeriodThresholdPrevious PerformanceCurrent PerformanceComments &Improvement PlanNumber of participants reporting increased knowledge skills of subject area of which they receive coachingQuarterlyQ1Y2 threshold to be confirmedYear 2Number of participants reporting increased confidence & motivation to career progressQuarterlyQ1Y2 threshold to be confirmedYear 2Increased income levels/reduced benefit claimsQuarterlyQ1Y2 threshold to be confirmedYear 2Work placement/volunteering opportunities offered within the CentreAnnual2012/13Y2 threshold to be confirmedYear 2

  • Earls Court Performance Report March 2012CONNECTED CARE

    IndicatorFreqTime PeriodThresholdPrevious PerformanceCurrent PerformanceComments & Improvement PlanConnected Care audits completed by Community ResearchersQuarterlyQ4336100%Evidence of community researcher audit informing service development/integrationAnnual2012/13336 completed questionnaires analysed and to be discussed at Social Value Steering Group on 2nd April 2012% of community researchers reporting increased confidence and wellbeingAnnual2012/13>80%N/ANumber of community researchers selected from identified local population target groupsAnnual2012/13100%100%Increased uptake of services by target groupsTBCN/AIncrease in self-reported health status of community championsTBCN/ANumber of participants in focus groups/interviews/ surveys undertaken by community researchersAnnual2012/13 300336

  • Outcome We made the right decision!

    Integrating across a range of services and really understanding human need is complicated, difficult stuff.. but really worth while

    During the process it became apparent that how bidders thought about integration was the key i.e.: it needed to be lead and managed by the organisation that understood how to approach the whole person

    Winning bidder had planned for health researchers; health navigators; planned the use of the building; thought about how GPs could work with a range of existing voluntary groups; whole systems approach

  • LearningBeliefs and Values Managing resistance & doubtersTenacity LanguageExpectations Managing public expectations Balancing differing priorities & conflicts of interestCompetitive dialogue will not deliver it does!Flexibility National/local policy shifts; financial change Adapting the modelResources Time and people

    1. Local demographics & health needs: Characteristics of local population? Underlying level of health? What makes this population