NHS 2010 - 2015: from Good to Great

Preventative, People-centred, Productive
DH December 2009

Some key quotes:

1.4 More productive services can and should also mean better services for the public - more preventative and people-centred.

1.18 There is still too much care organised in hospitals, which best practice shows could be organised around patients at home or in community settings.
Services are not as preventative, people-centred and productive as they could be.

1.23 Our vision will require significant transformation in the way in which care is delivered in the future.
Transforming the care and lives of those with long term conditions and delivering truly integrated, efficient and people-centred community services has the potential to improve the quality of millions of peoples lives.
It will also release annual savings of up to £2.7 billion by enabling people to better manage their own conditions, treating them closer to their own homes and avoiding unnecessary hospital visits.

1.28 More care will be provided closer to people’s homes and those services must be better integrated around people’s needs.
Hospital-based care will be re-structured to support this change and concentrate on providing care for the sickest patients.
Patients and the public will need to engage in a debate around the future shape of the NHS and the need for services to change, in order for the NHS to deliver increasingly preventative, people-centred and productive services.

1.13 We will make more use of information-based technologies to design new models of care as well as improving the performance of existing services.
We will integrate information around the patient, deliver relevant information at the right time to clinicians and use technology to drive efficiency for both patients and clinicians.

2.25 Preventing ill-health requires partnerships and our goal will only be met through the NHS working closely at a local level with its wider public, private and third sector partners.

2.59 We will link a significant proportion of provider income to patient experience and satisfaction.

2.70 We want to see care for these groups transformed, starting with care for those with diabetes, heart failure, respiratory disease (including chronic obstructive pulmonary disease COPD), cancer as a chronic disease and dementia.

HEART FAILIRE We will consider how we can build on the major improvements that have already been made, and transform care for patients with heart failure.

This includes patients having an accurate diagnosis and being put on the correct treatment pathway, through the use of diagnostic tools in primary and secondary care.

This will result in reduced referrals to outpatients and unplanned admissions.

2.79 Building on the progress already made by NHS organisations, we will create further programmes to ensure that people are cared for in the right place - both convenient for them and more efficient for the NHS.

4.4 A high-quality and productive NHS needs payment systems that offer the right incentives.
That means incentivising providers to maximise the efficiency of care; to provide the highest quality of care; and to shift care from hospitals to the community, reducing hospital admissions.

4.5 The tariff payment system must incentivise providers to maximise efficiency.

4.6 The tariff payment system must incentivise providers to offer the highest quality care.

4.7 The tariff payment system must incentivise the shift of care out of hospital settings.

4.9 The payment system for primary care must also deliver improvements in quality and productivity.

4.19 We will continue to work with the independent and third sectors, particularly where new services or new service models are required to meet future needs or to offer patients more choice.

4.37 We will encourage commissioners to work together to increase efficiency and effectiveness in procuring particular services.
PCTs should expand the use of joint commissioning arrangements between groups of PCTs and between PCTs and local authorities.
They should also devolve appropriate commissioning activities to practice-based commissioners.
These actions will increase productivity and allow us to reduce management costs without the need for changes to organisational boundaries.

4.43 Where groups of GP practices, working as part of practice-based commissioning consortia, can demonstrate significant improvements in quality and efficiency, with an increasing focus on prevention and health outcomes, they will also have growing opportunities to commission wider services on behalf of PCTs, for instance through devolved budgets.

4.57 Innovation in healthcare can transform the quality of care provided to patients and increase productivity, whether through high-end technologies or service-led system improvements.
Cost-effective innovation in the health and social care sector will not only help to provide quality services, but will also stimulate the private sector and invigorate the economy.