1. Learning from an integrated care organisation
Where next for commissioning and integrated care:
Can the NHS rise to the challenge?, The Kings Fund
Dr Lucy Moore CEO Whipps Cross University Hospital Trust
Conor Burke, Borough Managing Director
March 2010

2. Decommissioning - Prevent -
• 20% of OP • 35% LTC Adms
• 6% Electives
Shift Acute Activity - Acute Quality -
• 40% A&E • Weak & Weak AHC
• 12% Electives • ↑Mortality
• 42% OP
• ↓Patient Experience

3. Real improvement comes from
changing systems, not changing
within systems.
Donald Berwick
President & CEO
Institute for Healthcare Improvement
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5. As an integrated local healthcare delivery
network ‘PolySystems’ will:
Promote the health & Maximise Independence & Improve service for people
wellbeing of all people in quality of life for people with with non-critical acute care
the local community long-term needs needs
Achieving improved health • Reduce emergency admissions • Reduced waiting RTT
outcomes overall and for • Care Navigation & Coaching • Improved patient satisfaction
specific communities e.g.
• Improved care coordination & • Better value for money
• Childhood obesity dmanagement
• Better quality of life measures • Increased Access
• Teenage conception
• Reduced cost per head
• Physical activity
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6. Everybody in Redbridge is already a member of a polysystem
5 established - the engines driving change at a local level – delivering local services that are
clinically and cost effective.
Loxford Polysystem
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7. Delivering Change…
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8. Focusing on CHD
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12. And so what?
•Whipps Cross fax discharge summaries to practices within
24 hours of discharge
•GP Practices are required to contact the patient within 3
days of discharge
•Patients have a face to face appointment within 10 days at
which time the clinician will use a standardised checklist to
review patients.
•Clinicians have access to data on a patients treatment,
diagnostic results and medication changes via email.
….currently getting it right 50% of the time after 2 months
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13. Underpinned by Aligned Data
 Aligned and patient focused data GP
Systems
for primary and secondary care
data across the PCT Stratify Data
Warehouse Journal entries
 Risk Stratification
 Computes patient risks PCT
SUS records
Databases
 Provides “risk aware” analysis tools
for GP and PCT staff
 Pathway focus and financial Community
Services Records
tracking Users Community
Records
• Practice Managers
• Polysystem Managers www.health-analytics.co.uk
• PCT Staff
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14. Information Driving Change at all Levels
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15. Delivering Improvement…
...through People, Processes and Technology
Consultants
One inclusive
Polysystem Collaborative and
Budget with Competitive incentives
pathway at cost
Comm Nursing, AHPs GPs Pharmacists, Social Care
Estate Underpinned by data
Specialist Care
development – - Combined
transformational productivity and
change quality measures
……Clinical Integration
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16. The Acute Provider perspective
Key incentives
• Better patient experience.
• Better supports the management of capacity.
• Reduces waste and duplication.
• Integrated delivery without changing structures.
Risks
• Financial ….but we have a burning platform for change together.
• Governance…addresses issues rather than creates issues.
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17. Thank You for Listening