Preparing for 2019/20 Operational Planning and Contracting
NHS RightCare features in the preparatory guidance which covers system planning, the financial settlement, operational plan requirements (for primary care, workforce, data and technology) and the process and timescales around the submission of plans.
All systems will work with the NHS RightCare programme to implement national priority initiatives for cardiovascular and respiratory conditions in 2019/20. They will also be expected to address variation and improve care in at least one additional pathway outside of the national priority initiatives. CCGs yet to implement a High Intensity User support offer for demand management in urgent and emergency care will be required to establish a service in 2019/20. CCGs have made great progress working with GPs to reduce unnecessary referrals into hospital. They will continue this work using NHS RightCare data to identify opportunities and outliers and increase the focus on the development of primary care service to further reduce referrals and follow-ups.
The NHS RightCare teams work locally with systems to present a diagnosis of data and evidence across that population. NHS RightCare Delivery Partners and their teams work collaboratively with systems to look at the evidence to identify opportunities and potential threats. The Delivery Partners are senior roles whom are effective change leaders which influence systems to deliver effective and efficient returns for their population.
Using nationally collected robust data, this collaborative working arrangement helps systems to make improvements in both spend and patient outcomes. Together they complete delivery plans on a continuous basis, to evaluate the system and establish a base plan to maximise opportunities and turnaround issues. Throughout this process they ensure patient care is at the top of agenda by promoting the strong clinical interventions developed with the Senior Clinical Advisors and key stakeholders. Delivery Partners and their teams will highlight good practice, in particular at STP population, to accelerate delivery, standardise reporting and embed practices to ensure systems use optimal care pathways.
The NHS RightCare delivery methodology is based around three simple principles of working with local systems;
NHS RightCare Methodology
NHS RightCare’s offer is aimed at systems and starts with a review of indicative data to identify opportunities to reduce unwarranted variation and improve population healthcare.
NHS RightCare data packs (produced across a range of programme areas e.g. CVD, Respiratory, MSK) allow local health systems to consider information from across patient pathways to identify the greatest potential improvements in spend and outcomes.
As most health conditions are linked to demographic factors such as deprivation and age, NHS RightCare compares systems to their closest demographically similar geographies. This is to provide realistic comparisons, taking into account the need for healthcare of different populations. Deprived populations will have much higher rates of admissions and worse health outcomes for conditions such as Respiratory, CVD, Cancer, Diabetes, etc. By comparing 10 demographically similar CCGs, ensures that comparisons are fair and meaningful.
NHS RightCare has developed the ‘Similar 10 CCG Explorer tool’ which allows users to investigate all the different demographic variables that comprise the similar ten calculations and see how similar their CCG is to the similar 10 CCGs on each these factors. The tool also allows users to create their own bespoke similar ten grouping by changing the weightings of any of the different variables.
The three main data sources which make up a significant number of NHS RightCare indicators combine Secondary Uses Service (SUS+) inpatient data, Quality and Outcomes Framework (QOF) and ePACT prescribing data supplied by the NHS Business Services Authority.
NHS RightCare also provides STPs opportunity data by presenting the sum of all the equivalent opportunities of the CCGs in that area in one pack. They do not include negative opportunities or those which are statistically insignificant.
NHS RightCare Pathways and scenarios are designed from a patient point of view starting with prevalence right through to end of life. They are developed in close collaboration with NHS England’s National Clinical Directors, patient groups, Public Health England, Royal Colleges, and other key stakeholders.
The data and evidence provides a set of resources to support systems to concentrate their improvement efforts where there is greatest opportunity to address variation and improve population health.
Develop and Deliver
To support the implementation of NHS RightCare, every local health system in England has an NHS RightCare team working with them, led by a Delivery Partner, providing the data and intelligence and focussing support for transformation. NHS RightCare supplies the Delivery Partners with tools and products to structure and shape their conversations with health systems and Delivery Partners are then able to share evidence-based best practice, developed with our national partners, at the moment that local clinicians are considering what good looks like in that area of their system.