General CCG Projects – Consultancy

Ad Hoc projects borne of the period when NHS first introduced Clinical Commissioning Groups

Out of Hospital Care and Admission Avoidance

One of our Associates had previously designed and implemented a “one stop” option for GP’s to gain access on behalf of elderly or infirm patients. A service providing rapid assessment and access to community and social care support to maintain the patient at home and avoid unnecessary admittance vie A&E within the Acute.
While this service had been a success within the original localised environment, several iterations of expansion and major structural changes within the provider had diminished the effectiveness, ease of access and general understanding of the service.
The local consortia (and original user of the service), in anticipation of their progressive engagement with commissioning and particularly certain QIPP projects, wished to understand the key actions that would be necessary to reinstate the service at its original level of effectiveness.
We provided a document defining the key features that were at the core of the original service
Its mode of operation and service level expectation
Its communication and publicity needs
The key areas of engagement and relationships required
Learnings from the original model that would enhance any newly launched service

Budgeted Comparison v Fair Share Allocations – Community Provider

An emerging GP Consortia had received comparative statements showing a major adverse comparison of their indicative Budgets against the Fair Share.
The issue was of particular significance given the consortia were deciding upon their prioritisations and the picture painted would indicate that a major dis-investment would be required. We were asked to examine the statements and make enquiries with the PCT as to the assumptions and provide our conclusions.  Our historic knowledge of the relative history within the area allowed us to focus our enquiries and to provide some educated estimates for an anticipated outcome.
Our report to the Consortia Exec detailed the conclusions of our enquiries and modelling and provided/concluded:

Assumption used were based upon pre PCT consolidation block contracts.
Original contracts included pan county services hosted and costed within specific areas.
Detailed specific question for on-going discussion with the PCT.
Detailed recommended Caveats for a “Budget” sharing agreement requested by the PCT.
Recommendations regarding a proposed programme of Cost and Volume definition and shadowing.
Our Estimates for the likely total Budget/Spend Value highlighting a saving to the original spend of some £4m.
After a more detailed review by the PCT and Consortia our estimates were within 1% of reissued numbers.

Challenges arising from NHS Reforms (including operating plan synopsis)

Following the initial white paper introducing the expectations of emerging GP consortia we were asked to produce a discussion document for an emerging GP consortia.
The report identified:
The critical milestones laid out within the proposed legislation.
The expectation of actions and milestones being proposed by the PCT.
Using our experience of World Class Commissioning and CFT processes our best guess of the areas, process and headlines that would be included within any authority process.
Major challenges that would face the consortia and our views upon these.
Key risks and possible mitigations.
Typical process that should be implemented to design, implement and deliver an overarching Organisational Development programme.
A separate digestible synopsis of the 2011/12 Operating Framework.