Surrey PCT is on track to launch the first Integrated Care Pilots

Surrey PCT is on track to launch the first of a series of Integrated Care Pilots in October. Further waves of the year-long pilots are planned by December as more practices bid to get involved. The PCT says it intends to control risks, resources and the complexity of the Integrated Care Pilot by putting a limit on the number of patients enrolled. No more than 200,000 patients are to be included.

 

A world class example of Integrated Care is Kaiser Permanente in the USA.  But Paul Bennett, Deputy Chief Executive, Surrey PCT, said that is not the model Surrey has in mind. “We are not intending to replicate the Kaiser model in Surrey, but to define a tailored and practical solution for the needs of our population.  As such, Integrated Care has to link into and support the strategic commissioning plans of Surrey PCT.  Also, while the Pilot is expected to be a catalyst for change, the entire local health economy cannot be unreasonably destabilised.”

 

“We want to test whether the integrated care models that we see elsewhere in the world would deliver the same benefits attributed to them in a UK model in terms of improving the patient pathway and the patient experience.  One question we have is for us to get the full benefits of ICT does policy need to change? It’s about how far we can take things in terms of existing guidance.”

 

The pilots take Surrey into transformational change, Mr Bennett said. “One of the key drivers for us is knowing that doing what we have always done in Surrey is not going to work for us in the future. We are in the top end of achievements for national health indicators but we are looking now at how do we continue to do that in a resource constrained health service into the future.”

 

 Aims of the Surrey PCT pilots are to:

• Deliver transformational improvements in patient care and health
• Stay within budget, and create efficiency gains and savings

·         Test and refine the specifications for an Integrated Care model beyond the Pilot

·         Extensively engage patients in the development of Integrated Care

·         Allow a robust evaluation through clear metrics and targets

·         Uphold and further choice and contestability

·         Enhance the integration of health and social care and clearly demonstrate patient benefits from improved collaboration of these services

 

Practices that have applied to take part in the first Integrated Care Pilots, but were not given the go-ahead, will be offered opportunities to participate in Integrated Care in 9-12 months time, when the reach of Integrated Care is extended to the whole of Surrey —assuming the initial Pilots are successful in achieving their aims.

 

Practices that want to engage in Integrated Care in the future will do so through a phased approach. To begin with they will enter a Phase 1 Demonstration Phase that will allow them to introduce and test new processes and ways of working with the support of Surrey PCT and without taking on budget risks.  In Phase 2, practices will move to ‘PBC+’ where practices will rely heavily on generating savings to cover their additional PBC+ related costs, and where practices start taking on some of the care budget overspend risk in return for the opportunity of retaining savings as profits. These principles would then be extended to a fully capitated provider Integrated Care contract.

 

One of the Keys to succeeding in Integrated Care will be for GP practices to take on greater responsibility for the entire health care budget of their population, Mr Bennett said. This could be achieved by providing GPs with the professional support of an Integrated Care Organisation, which would have to contribute management and analytical capabilities, scale for development of services, as well as capital.  The ICO and the GP practices together would form an Integrated Care Provider.

 

The PCT is going down the integrated care route in a bid to:

 

• Improve patient care, making it better and more cost effective. In producing these positive results the Pilots have to create efficiency gains that will compensate Surrey PCT for the cost of the Pilots. 

·         Test and refine the specifications of Integrated Care to enable Surrey PCT, after the successful conclusion of the Pilots, to commission ongoing Integrated Care services in an open and transparent procurement process.  The specifications need to:

·         Be fit for purpose in the context of the local health economy in Surrey

·         Result from extensive patient engagement and involvement in the development of Integrated Care

·         Demonstrate clear benefits for the population, patients and carers of Surrey and for Surrey PCT

·         Be attractive enough for Integrated Care Organisations to create a pluralistic local market for Integrated Care services in Surrey

·         Encourage more GP practices to take on greater responsibility for the entire health budget of their patient population, while improving health outcomes.  Integrated Care Pilots are expected to involve PBC and collaborate also closely with those practices not directly participating in the Pilot in order to avoid destabilising PBC efforts, said Mr Bennett.