Copyright 2011 Right Care

Systems of Care

Sir Muir GrayJoint National Director, Right Care

August 2013

Online Learning Series

Right Care for Populations

2

How the NHS looks from space

3

The Healthcare Archipelago

General Practice

Mental Health

Community Services

Hospital Services

4

Population Healthcare

Is the service for people with seizures & epilepsy in Manchester better than the service in Liverpool?

Who is responsible for the headache service for people in Southampton?

How many liver disease services are there in

England and how many should there be?

Which service for frail elderly people in the London provides the best value?

Which service for children with mental health problems improved most in the last year ?

5

What does a system look like?

SELF CARE

INFORMAL CARE

GENERALIST

SPECIALIST

SUPER SPECIALIST

6

The balance is different

SELF CARE

INFORMAL CARE

GENERALIST

Specialist Super Specialist

7

A new language

A SYSTEM is a set of activities with a common set of objectives and an annual report. Systems can focus on symptoms, conditions or subgroups of the population(also known as a service)

A NETWORK is a set of individuals and organisations that deliver the system’s objectives(a team is a set of individuals or departments within one organisation)

A PATHWAY is the route patients usually follow through the network

A PROGRAMME is a set of systems with ha common knowledge base and a common budget

Primary Secondary Acute Community OutpatientX X X X X

8

An example of a national service setup as a system

9

Objectives for an asthma system

• To prevent asthma• To diagnose asthma quickly and

accurately• To slow the process of the disease by

effective and safe treatment• To help the individual afflicted adapt to

the challenges• To involve patients, both individually

and collectively, in their care

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….beyond clinical practice criteria

• To prevent asthma• To diagnose asthma quickly and accurately• To slow the process of the disease by effective and

safe treatment• To help the individual afflicted adapt to the challenges• To involve patients, both individually and collectively,

in their care• To make the best use of resources• To mitigate inequity• To promote and support research• To support the development of staff• To report annually to the population served

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Hierarchy versus Network

12

Pathways

13

Matrix Management

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Defining Population Healthcare

“The aim of Population healthcare is to maximise value for those populations and the individuals within them Population healthcare focuses primarily on populations defined by a common need which may be a symptom such as breathlessness, a condition such as arthritis or a common characteristic such as frailty in old age, not on institutions, or specialties or

technologies”

15

Online Learning Series

Right Care for Populations

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