Bayer Womens Health Collaborative commissioning womens reproductive health
Bayer Women’s Health Collaborative commissioning women’s reproductive health services Incorporating a sustainable integrated IUS/D service ////// Donna Dadge KAM Womens Health May 3 rd 2019. This meeting has been co-ordinated by Bayer RP-PF-WHC-GB-0044 January 2019 1
Objectives Understand the importance of IUS/IUD provision to women’s reproductive health in Suffolk Share a framework model for delivering collaborative women’s health services in primary care Agree actions and next steps to move collaboration forward 2
Challenges and needs Women’s health services in IPSWICH, SUFFOLK 3
These are the challenges you’re facing Fragmented commissioning environment Squeezed budgets Reduced access to LARC Growing demand on primary care Skills at risk of being lost Women’s basic right to access care disrupted 4
Intrauterine system (IUS) and device (IUD) fitting are at particular risk IUS/IUD span multiple indications across commissioning boundaries Heavy Menstrual Bleeding (IUS) Long acting method of contraception (IUS/IUD) IUS/IUD fitting Menopause management (IUS) 5 Emergency Contraception (IUD)
What is the impact in Suffolk For your CCG: 1883 abortions in 20171 For your local authority: 454 unplanned pregnancies resulting in live births in 20163 6 391 admissions for HMB in 2015162 £ 855, 164 estimated costs of all admissions for HMB 2 A 5% reduction in unplanned pregnancies could save £ 70, 6464 1 Abortion Statistics, England Wales: 2017 2 Bayer, Heavy Menstrual Bleeding Cost Model. September 2016 3 Calculated using NATSAL data (Wellings, K et al. Lancet. 2013. ; 382: 1807 -16) that 5. 7% of pregnancies are unplanned 4 Bayer Budget Impact Tool 2018 – derived from ONS birth summary tables England Wales 2016 and based on reduction in unplanned pregnancies that result in live birth
Taking a closer look at what this means in your area What are the local trends? What do these trends mean for women accessing care in Ipswich? Does this reflect what you’re seeing in reality? What does this mean for the future? 7
A framework for collaborating for women’s health The vision 8
The journey to date May 2017: Bayer convened expert group to develop a new vision and framework for collaborative services in women’s health 9 November 2017: new vision road-tested at roundtable with key national stakeholders and local experts October 2018: implementation explored at workshop with PHE for commissioners and clinicians from four local areas
The vision: The ‘women’s health hub’ framework Tier 1 service Every GP surgery offers general contraception and counselling towards IUS/IUD for all indications and referring to Tier 2 as required Tier 2 ‘Women’s health hub’ A ‘service’ with lead provider contract for IUS/IUD across all four indications, networked into the Tier 1 services Conditions for referral / signposting 10 Secondary care Hospital offering secondary and tertiary care for women requiring specialist and hospital care, based on conditions for referrals
Services should build on existing fitting resources 11
Flexible to local health system Whilst bringing together four core services – contraception, emergency contraception, menopause management and HMB treatment – the hub model is flexible to the local system Fully networked service, including Ca. SH and secondary care Service based on maximising existing resource 12 Include other services to strengthen the offer Convenient access for women Other possible services include: Mould the model to suit your area and its population Ensure sustainability of IUS/IUD fitting in your locality • Cytology - cervical smears • Community gynaecology - HMB • Specialised menopause service • Removal of polyps • Fitting ring pessaries
Footprint New models of care Service Where does it fit in the bigger picture? 13 ‘Women’s health hub’ Networks ie GP Federation or Alliance Multispecialty Community Provider (MCP) Primary Care Home (PCH) Integrated Care System (ICS) Sustainability and Transformation Partnership (STP)
System-wide benefits of hubs Women Healthcare professionals Wider system 14 ü A single point of access to an IUS or IUD, regardless of indication ü Improved patient experience ü Lower risk of complications ü Development of portfolio careers and specialist skills retained ü Building confidence in treating in primary care or referring women ü Efficiencies of scale delivered for both NHS and public health budgets ü Reduced demand on other services ü Vision of the NHS long term plan and integrated care achieved Improving population health Improving patient satisfaction Decreasing cost Institute of Healthcare Improvement’s Triple Aim Framework
What would success look like Aligned to NHS strategic priorities Increase opportunity for specialism and skills retention Increase patient choice, satisfaction and access Increase provision of intrauterine methods Reduce unplanned pregnancies and terminations Reduce expensive inappropriate referrals to secondary care for HMB Reduce outcomes variation 15
Making the model a reality How can we drive collaboration in Suffolk 16
What we’ve learnt about implementation Understanding your local population Making every contact count Empowering your workforce 17 Building local networks Setting realistic objectives
Moving forward with the model Is this model an achievable ambition for Suffolk? What improvements for patients, providers and commissioners would be generated? Who needs to be involved to make this a reality? What are the enablers and barriers to progress? How can they be overcome? 18
Kick starting collaboration Establish an action group with CCG, local authority and local healthcare professionals with an ambition to streamline service delivery Undertake an assessment of existing services and skills, including IUS/ IUD services for all indications Identify the gaps between what currently exists and what is required 19
How Bayer can help Bayer is committed to help you on this journey and share our work with you 20 Policy paper with framework model Interpractice referral templates Cost calculators Mapping local services Implementation guide and toolkit Case studies
Thank you! ////// 21
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