Upload File

primary health care financing lessons from the uk beverly sibthorpe deputy director australian...

  • Home
  • Documents
  • Primary Health Care Financing Lessons from the UK Beverly Sibthorpe Deputy Director Australian Primary Health Care Research Institute
14
Primary Health Care Financing Lessons from the UK Beverly Sibthorpe Deputy Director Australian Primary Health Care Research Institute

Upload: lynn-richard

Post on 04-Jan-2016

215 views

Category:

Documents


0 download

Report

TRANSCRIPT

Page 1: Primary Health Care Financing Lessons from the UK Beverly Sibthorpe Deputy Director Australian Primary Health Care Research Institute

Primary Health Care Financing Lessons from the UK

Beverly Sibthorpe

Deputy Director

Australian Primary Health Care Research Institute

Page 2: Primary Health Care Financing Lessons from the UK Beverly Sibthorpe Deputy Director Australian Primary Health Care Research Institute

Problems Facing NHS in 2000

Under-invested system Lack of national standards Demarcations between staff Lack of clear incentives Barriers between services Lack of support Over centralisation Dis-empowered patients

Page 3: Primary Health Care Financing Lessons from the UK Beverly Sibthorpe Deputy Director Australian Primary Health Care Research Institute

PCTs and Fund-holding

Primary Care Trusts (PCTs)

Regional fund-holder for all NHS services

Negotiate and purchase services for registered population• expanding range of public and private providers

Carry financial risk

Page 4: Primary Health Care Financing Lessons from the UK Beverly Sibthorpe Deputy Director Australian Primary Health Care Research Institute

nGMS Contract

new General Medical Services contract

Practice not GP

Basic package of services

Minimum Practice Income Guarantee

Quality and Outcomes Framework (QoF)

• 146 indicators / targets

Additional money for reaching targets

Page 5: Primary Health Care Financing Lessons from the UK Beverly Sibthorpe Deputy Director Australian Primary Health Care Research Institute

Information and Review

Information

- Single unique identifier

- Massive investment in IT

- Collation of information from general practices

Review

- Healthcare Commission

Page 6: Primary Health Care Financing Lessons from the UK Beverly Sibthorpe Deputy Director Australian Primary Health Care Research Institute

Forecast Changes – System

Hospital ~ primary health care interface Participation of private providers, including US

HMOs Greater emphasis on promotion and prevention Nurse-based immediate care clinics Prescribing rights for non-medical clinicians Better links with social services Specialist ambulatory services and clinics

Page 7: Primary Health Care Financing Lessons from the UK Beverly Sibthorpe Deputy Director Australian Primary Health Care Research Institute

Forecast changes – general practices

Practice cooperatives pooling management, financial and IT resources

Practices working jointly Practice nurses, physicians assistants, health care

assistants Practice nurse management of people with chronic

diseases Allied health professionals

Page 8: Primary Health Care Financing Lessons from the UK Beverly Sibthorpe Deputy Director Australian Primary Health Care Research Institute

Forecast changes - GPs

GP focus on diagnosis and management of complexity

GP specialisation

Alternative career pathways in management, policy, strategic planning and public health

Growth in salaried general practice

Page 9: Primary Health Care Financing Lessons from the UK Beverly Sibthorpe Deputy Director Australian Primary Health Care Research Institute

Forecast changes - IT

Internet-based decision support

Email consulting

NHS Direct for telephone and internet access to home-based care and advice

TV-based access to health advice

Page 10: Primary Health Care Financing Lessons from the UK Beverly Sibthorpe Deputy Director Australian Primary Health Care Research Institute

Sweeteners for general practices & GPs?

Additional practice income New money for premises and workforce New career opportunities Improved working conditions: • after hours• locum support• retirement pensions• education and training

Page 11: Primary Health Care Financing Lessons from the UK Beverly Sibthorpe Deputy Director Australian Primary Health Care Research Institute

Threats?

Focus on what’s measured; neglect of what’s not measured

Increased fragmentation Erosion of doctor-patient relationship Erosion of continuity of care Erosion of comprehensive care Gaming and rhorting

Page 12: Primary Health Care Financing Lessons from the UK Beverly Sibthorpe Deputy Director Australian Primary Health Care Research Institute

Immediate challenges

PCT restructure

Diversion of care/costs from hospital sector

Practice-based commissioning

Clinician re-engagement

PCTs as service providers?

Page 13: Primary Health Care Financing Lessons from the UK Beverly Sibthorpe Deputy Director Australian Primary Health Care Research Institute

Bold Plan !

Need for system change Care and resources out of hospitals Focused on performance Underpinned by information Consumer focused Concerned with equity General practice support

Page 14: Primary Health Care Financing Lessons from the UK Beverly Sibthorpe Deputy Director Australian Primary Health Care Research Institute

Lessons for Australia

Health resources finite

Regional approach to resource management

Re-orientation to primary health care

Sophisticated and flexible commissioning

General practice as entity

Rich information driving change


Integrating Primary Care & Behavioral Health: … Primary... · Certificate Program in Primary Care Behavioral Health© The Center for Integrated Primary Care Integrating Primary

Primary Care - Mental Health Integration: Improving Mental ......Primary Care - Mental Health Integration: Improving Mental Health Care Access for VA Primary Care Patients Lucinda

2017 Primary Care Symposium Doctor Registration Materials WOA Primary Care... · FROM: Christine Renner, O.D. - WOA Primary Care Symposium Chair RE: 2017 WOA Primary Care Symposium

Improving Primary Care Providers’ Knowledge … Slide Set_revised for...Improving Primary Care Providers’ Knowledge ... Filipino American Physicians of ... Improving Primary Care

Primary Maternal Care: Antenatal and postnatal care in the ...bezak.umms.med.umich.edu/CIRHT/Content/Gynaecology and Obst… · Primary Maternal Care Primary Maternal Care Antenatal

Primary Care Spending 2020 - Primary Care Collaborative

Managing Migraine: Primary Care for Primary Headaches · 10/28/2019 1 Managing Migraine: Primary Care for Primary Headaches Jeff Unger, MD, FAAFP, FACE Director, Unger Primary Care

Strengthening Primary Health Care through Primary …neltoolkit.rnao.ca/sites/default/files/Strengthening Primary Health... · Strengthening Primary Health Care through Primary Care

Strengthening primary care in weak primary care systems

Health Systems Development Primary Health Care Primary Health Care Resources

Primary Care Home - Home | The Nuffield Trust · Primary Care Home: Evaluating a new model of primary care 6 6 Executive summary Introduction to the primary care home (PCH

Primary Care Office Manual - Welcome to ASTHO Primary Care... · PRIMARY CARE OFFICE MANUAL 4 PCOs need to know about many facets of primary and preventive care in their state’s

Palliative Care for Primary Care Providers · Palliative Care for Primary Care Providers QUYNH BUI, MD MPH DECEMBER 2015 . Objectives Define palliative care and primary palliative

CPC Primary Care Practice Solicitation · Primary Care Practice Solicitation . Contents. ... Eligibility Criteria for Primary Care Practices .....8 VIII. Primary Care Practice Selection

Transforming primary care (integrated care)

Primary Health Care PCN - Mosaic Primary Care Network · Alberta Health Primary Care Network (PCN) Profiles Mosaic Primary Care Network 2nd edition, March 2018

A Defence of the truth by W.M. Sibthorpe 1903

Primary Foot Care Primary Foot Care. Common Nail Problems

MANAGING CHANGE IN PRIMARY CARE: THE CONTRIBUTION OF … · emphasis towards primary care, primary health care organisations, comprehensive primary health care clinics and improved

STEM: 2015 - Hartford HealthCare Library/Publications...New Primary Care Patients: 32,652 Primary Care Visits: 319,799 Provider of primary care, surgical care, urgent care and specialty

Missouri Primary Care Association March 2011 Missouri Primary Care Association1

Strengthening primary health care through primary care ... Medicine and... · Family Medicine and Primary Care ... MCQ writing ... Strengthening primary health care through primary

Primary Maternal Care: Antenatal Care

Primary Care Commissioning Committee , Part 1 … Care...South East London Primary Care Team Nora Simon (NS) NHS England Assistant Head of Primary Care, South East London Primary Care

Primary Care Physicians-Distribution and Population to ......Wisconsin’AHEC’Health’Workforce’Data’Brief! primary!care! physicians! primary!care ! ! ! ! ! ! !!!!! Primary!care!physicians!!

Primary Solutions for Primary Care

DISCOVERY PRIMARY CARE › assets › discoverycoza › ...4 DISCOVERY PRIMARY CARE You can choose between Discovery Primary Care Advanced or Discovery Primary Care Activate. The cover

Primary Care Spending in Oregon...February 1, 2016 Primary Care Spending in Oregon Page 3 Primary care is the front line of Oregon’s health care system. Primary care providers deliver

Primary Care Spending in Oregon SB231... · February 1, 2017 Primary Care Spending in Oregon Page 4 Primary care is the front line of Oregon’s health care system. Primary care providers

Webinar: Comprehensive Primary Care Initiative - For Primary Care Physicians

primary care

Primary Palliative Care in Ireland · PRIMARY PALLIATIVE CARE IN IRELAND Primary Palliative Care in Ireland Identifying improvements in primary care to support the care of those in

Primary Care Challenges: Data, Teams and Primary … Care Challenges: Data, Teams and Primary Care. ... JAP. $0 $500 $1,000 $1,500 ... Primary Care Challenges: Data, Teams and Primary

Primary Care: The Opportunities and You (Primary Care Progress)

SFHN Primary Care Update...Primary Care Director of Population Health and Quality SFHN Primary Care Update July 12, 2017. Vision for SFHN Primary Care 1st Choice for Health Care