The Dalton Review. New Options for Providers Emerging thinking. 11 July 2014 NHS Confed Hospital Forum Steering Group

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1 The Dalton Review New Options for Providers Emerging thinking 11 July 2014 NHS Confed Hospital Forum Steering Group 1

Context: Providers face a familiar set of challenges Patients and public expect high standards and access Drive to improve quality and safety Ageing population with increasing LTCs Financial

2 Context: Providers face a familiar set of challenges Patients and public expect high standards and access Drive to improve quality and safety Ageing population with increasing LTCs Financial constraints and forecast deficits In responding to these challenges Providers need the flexibility to work in new and innovative ways to improve quality and become more efficient No single solution is a panacea we need a range to apply to different situations Solutions must come from organisations themselves but can be enabled by the centre 2 Dalton Review #DaltonReview2014

3 1. Typology of models 2. What, Why, How 3. Emerging key themes 3 Dalton Review #DaltonReview2014

4 Typology of models What models are we looking at? Locality based single or multisite trust Site NHS Trust or FT Site Governance Operations Site Federations (e.g. UCL Partners) Provider Provider Provider Provider 4 Dalton Review #DaltonReview2014

5 Typology of models What models are we looking at? Service level chain Service Standalone organisation Standalone organisation Service (e.g. Moorfields) expert or specialist provider Service Standalone organisation Service Standalone organisation Joint venture (e.g. GSTS Pathology) Partner 1 Partner 2 Joint venture 5 Dalton Review #DaltonReview2014

6 Typology of models What models are we looking at? Management/ operational franchise (e.g. Circle H brooke) Operational franchise Board Organisation Management contract Board Organisation Geographically disperse multiservice chain (e.g. BMI) Group HQ Outlet Outlet Outlet 6 Dalton Review #DaltonReview2014

7 Typology of models What models are we looking at? Vertically integrated care organisation Secondary elective Secondary emergency Community Primary We are considering the social enterprise/ employee ownership/ mutual/ community interest company ownership models as an option across each of the archetypes 7 Dalton Review #DaltonReview2014

8 Agenda 1. Typology of models 2. What, Why, How 3. Emerging key themes 8 Dalton Review #DaltonReview2014

9 What, Why, How Why consider Organisational form? Unrealised potential in the health sector Struggling providers Learning from approaches internationally Learning from other sectors 9 Dalton Review #DaltonReview2014

10 What, Why, How How? The review will be open and consultative. Arm s Length Bodies NHS England Monitor TDA Sector Representatives Hospitals Forum NHS Confed FTN Sector Experts KPMG McKinsey Reform Think Tanks Health Foundation Nuffield Trust Kings Fund Dalton Review Public and Patients 10 Dalton Review #DaltonReview2014

11 1. What, Why, How 2. Typology of models 3. Emerging key themes 11 Dalton Review #DaltonReview2014

12 Emerging key themes We are making use of three types of evidence Desk based Research Engagement Qualitative Case Studies Literature review Commissioned research to inform the evidence base Sector stakeholder events throughout May to September Workshops and round tables to test emerging policy findings Public ideas and comments launched this week Call for evidence across the sector Interview with a range of system leaders who have experience of each model National and international visits to examine the detail of each model barriers/ incentives Case studies to inform the final report We will triangulate these evidence sources to provide robust findings and conclusions. 12 Dalton Review #DaltonReview2014

13 Emerging key themes What the sector has told us so far Some of these models exist already but could be done bigger, faster and better if some of the barriers were removed Processes are taking too long, having some way of speeding this up such as pre approved or credentialing would help Boards want to be able to self determine but need more options Faster solutions are required for chronically challenged organisations to help them move forward Needs to be incentives for successful providers of NHS care to do more Culture and leadership important factors 13 Dalton Review #DaltonReview2014

14 Can your experiences help us inform our thinking on these areas? What are your initial reactions to what you have heard? Are you currently trying to implement any of these models? What is your experience of doing so? What are your views on pre approval / credentialing? Is there an appetite for the more radial options such as management contracts or chains? 14 Dalton Review #DaltonReview2014

15 Questions Thank you for your contributions us at Contribute to the review at #DaltonReview Dalton Review #DaltonReview2014

Integrated Planning Checklist 2014/15: Sustainability

Integrated Planning Checklist 2014/15: Sustainability BACKGROUND INFORMATION: Enter Your Name: Enter Your Email Address: Mary Bytheway mary.bytheway@dwmh.nhs.uk Select Your Organisation: Dudley and Walsall