ELIC PAUL HAIGH EXECUTIVE DIRECTOR City Hackney ELIC

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ELIC PAUL HAIGH - EXECUTIVE DIRECTOR City & Hackney ELIC Society Ltd.

ELIC PAUL HAIGH - EXECUTIVE DIRECTOR City & Hackney ELIC Society Ltd.

WHAT? l East London Integrated Care l l l City & Hackney ELIC Society

WHAT? l East London Integrated Care l l l City & Hackney ELIC Society Ltd BENCOM Registered in July 2006 Industrial & Provident Societies Act 247 members; represent 232, 000 patients/34 practices 2 roles l l PBC support service Direct service provision City & Hackney ELIC Society Ltd.

WHY? l Size matters l l l Work together; strengthen provision; equity Opportunity of

WHY? l Size matters l l l Work together; strengthen provision; equity Opportunity of PBC to develop primary care Unified commissioning plan Harness the enthusiasm of the front line Organisational clout l Bid for and provide services; compete City & Hackney ELIC Society Ltd.

ORGANISATION l l l Membership - 247 l GPs; Practice Managers; Practice Nurses; Practice

ORGANISATION l l l Membership - 247 l GPs; Practice Managers; Practice Nurses; Practice staff; employees? ; Public l Organised into constituencies (for GPs based on Consortia) Elect representatives onto quarterly Council l Overall policy and direction l Includes PEC Chair Day to day management by monthly Clinical Executive l Council Chair + 2 GPs + Exec Director (paid roles) l Leadership, implementation, thinking City & Hackney ELIC Society Ltd.

PBC SUPPORT SERVICE l l 89% Hackney practices - 7 Consortia 95 p per

PBC SUPPORT SERVICE l l 89% Hackney practices - 7 Consortia 95 p per patient from practices l l Business support - plans; data; ideas l l l Covers 100% of infrastructure (small!) Uniform approach Commissioning “clout” Pooling of 50% PBC savings City & Hackney ELIC Society Ltd.

ELIC ROLE l Bureaucracy relating to PBC l l l Business cases Data analysis

ELIC ROLE l Bureaucracy relating to PBC l l l Business cases Data analysis What’s best done at individual practice and what done “corporately” l Practice – new opd referrals, patient education/A&E, follow pathways, interpractice referrals, ? community matrons/emergencies City & Hackney ELIC Society Ltd.

PHILOSOPHY l Support practices through education and training l l l Care pathways with

PHILOSOPHY l Support practices through education and training l l l Care pathways with Homerton- 12 to date Education, audit, education Sharing best practice and ideas - Consortia Maximise primary care services Consultant advice/support and outreach City & Hackney ELIC Society Ltd.

ACHIEVEMENTS l l l Savings £ 2. 5 m over 2 years Pathways and

ACHIEVEMENTS l l l Savings £ 2. 5 m over 2 years Pathways and education Specifications for services – with all PBCers l l New practice/Consortia services planned this year l l l Community nursing Urgent Medical Clinic Heart failure, diabetes, COPD, Cardiology Practice physio; Obesity support; Investigations Advocacy; Active patient monitoring Support practices to provide primary care/new lists City & Hackney ELIC Society Ltd.

DIRECT SERVICES l Contract from PCT for ENT l l Pooled savings - 2007/8

DIRECT SERVICES l Contract from PCT for ENT l l Pooled savings - 2007/8 (900 k) under development l l l Delivered via 4 subcontracts At risk COPD Obesity Antenatal services Drug monitoring “Willing provider” l l l Surgery Heart failure team COPD team City & Hackney ELIC Society Ltd.

RELATIONSHIPS l PCT l l l Represented on monthly PBCE Commissioning framework input Renegotiate

RELATIONSHIPS l PCT l l l Represented on monthly PBCE Commissioning framework input Renegotiate PBC Framework Commissioning plans/performance indicators Homerton l l Bimonthly Liaison Group Individual clinical and managerial meetings City & Hackney ELIC Society Ltd.

HACKNEY POLYCLINIC l Primary Care Resource Centre l l Intermediate services l l l

HACKNEY POLYCLINIC l Primary Care Resource Centre l l Intermediate services l l l Networked practices Chronic disease management to back up primary care Antenatal Surgery Consultant advice and outreach Pathways City & Hackney ELIC Society Ltd.

QUESTIONS FOR FUTURE l Commissioning PCT services l GPSI, specialist nursing l l l

QUESTIONS FOR FUTURE l Commissioning PCT services l GPSI, specialist nursing l l l l Define service standards Specify where fit into pathways ? More direct provision NHS Pensions - ELIC “trading arm”? Primary care services – support vs provide Organisational capacity/growth VFM City & Hackney ELIC Society Ltd.