1. Nuffield Trust:
Removing the Policy Barriers
to Integrated care
Dr Lucy Moore, Whipps Cross University Hospital Trust
Conor Burke, NHS Redbridge
9th December 2009

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

4. 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

5. Everybody in Redbridge is already a member of
a polysystem
5 established and will become the engines driving change at the local level – delivering local
services that are clinically and cost effective.
Loxford Polysystem

6. Incentives and Performance

7. Information Driving Change at all Levels

8. Clinical Commissioning - Governance
Outer North East London
X
PEC PCT Board
CAC
Acute Commissioning Unit
Clinical Commissioning Unit (CCU)
Clinical Commissioning
Board
Wanstead Loxford Cranbrook Seven Kings Fairlop
PolySystem PolySystem PolySystem PolySystem PolySystem
 Boroughwide Clinical Commissioning Board
 Clinical leadership team and self-monitored
 Accountability for PolySystem effectiveness
 Responsible for Pathway Development
 Manage budget and incentive schemes
 PBC Partner relationship with PCT
 Establish Clinical Assurance Committee

9. Integrating Design & Delivery
• PolySystems are the ‘engine’ which drives local change to meet the
wider health and healthcare needs of its community.
• PolySystems are accountability for the delivery of high quality and
productive services.
• PolySystems are held accountable for delivery and in return will be
resourced and supported appropriately to enable change to happen.
“PolySystems will only achieve their full potential if
they bring together primary and secondary clinicians
to innovate by designing and delivering care models
that enable system change.”

21. Delivering Polysystems…
...through People, Processes and Technology
Consultants
One inclusive
Polysystem Collaborative not
Budget with Competitive incentives
pathway at cost
Comm Nursing, AHPs GPs Pharmacists, Social Care
Estate Performance and
Specialist Care
development – information –
transformational Combined
change productivity and
quality measures
Not vertical or horizontal ……Clinical Integration