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Proposed changes to how practices are funded to manage people living with Long Term Health Conditions A PRESENTATION FOR CPPEG Since Oct 2013 the CCG has funded practices to… Actively find people who are living with or at risk of any of the following conditions: • Hypertension (persistently high blood pressure) • Diabetes • Chronic Kidney Disease • Heart Failure • Chronic Obstructive Pulmonary Disease (lung condition) There is strong evidence that early identification leads to better care 3 And… Regularly review and monitor people who are most struggling to manage their condition • People living with Heart Failure and COPD – review every 6 months • People living with Diabetes – care plan every 12 months Embed treatment templates and protocols – ensuring high standards in all practices Working with the people of Camden to achieve the best health for all 4 We know that this is making a difference “It’s now a discussion between the two of you, which is how it should be.” “It’s a bit more thorough now. They talk about diabetes and all the aspects of my condition….”. Prevalence 6 Current Payment for GPs £ To achieve targets for register sizes both individually and as a locality (promoting federated approach) £ For each clinical review for defined groups of people £ For improvements in the number of people with high blood glucose levels 7 Proposal for the next Phase (from April 2016) 1. Practices to deliver at population level - 50,000 patients plus 2. Practices come together to develop plans for how to deliver service 3. Upfront payment to give practices capacity to make sustainable changes Also: Include other diagnoses eg cancer, epilepsy Bring in contracts for Complex Care, Serious Mental Illness Minimum quality standards 3 year agreement 3 8 What will this be like for Camden residents • More people who have a Long Term Condition will be proactively reviewed and have a Care Plan • Those living with a Long Term Condition will have better support to manage clinical indicators such as blood pressure, blood glucose and to quit smoking • People living with epilepsy who are struggling to manage will be proactively contacted by their GP to discuss their condition • GPs will be well equipped to identify the symptoms of cancer at an earlier stage 9 Timeline . Sept - Nov Approval by Nov - Apr Procurement Cttee Practice develop plans collaboratively and start to put capacity in place Commissioning Cttee Apr 16 New contract commences Governing Body 10