Sarah Morgan: The Dalton Review

1

New Options for Providers Emerging thinking

Nuffield Trust – 9 June 2014

The Dalton Review

2 Dalton Review #DaltonReview2014

Agenda

1. What, Why, How

2. Typology of models

3. Emerging key themes


What? The purpose of the review

To provide new options and opportunities for providers of NHS care to support their future clinical and economic sustainability.

The review will seek to develop a new range of options for new organisational forms, that present real benefits and opportunities for Boards, not create a national blueprint for the provider sector or promote any one model.

What, Why, How


Context: Providers face a familiar set of 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

In responding to these 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

What, Why, How


What, Why, How

Why consider Organisational form?

• Unrealised potential in the health sector

• Struggling providers

• Learning from approaches internationally

• Learning from other sectors


How? The review will be open and consultative.

Dalton Review

Think Tanks

• Health Foundation

• Nuffield Trust

• Kings Fund

Arm’s Length Bodies

• NHS England

• Monitor

• TDA

Sector Representatives

• Hospitals Forum

• NHS Confed

• FTN

Sector Experts

• KPMG

• McKinsey

• Reform

Public and Patients

What, Why, How


1. What, Why, How




Typology of models

Locality based single or multi-site trust

Federations (e.g. UCL Partners)

What models are we looking at?

Governance

Operations

Site Site

Site

NHS Trust or FT

Provider Provider Provider Provider


Typology of models

Service level chain (e.g. Moorfields)

Joint venture (e.g. GSTS Pathology)


Standalone organisation




expert or specialist provider

Service

Service

Service

Service

Partner 1

Partner 2

Joint venture


Typology of models

Management/ operational franchise (e.g. Circle – H’brooke)

Geographically disperse multi-service chain (e.g. BMI)


Operational franchise Management contract

Board

Organisation

Board

Organisation

Group HQ

Outlet Outlet Outlet


Typology of models

Vertically integrated care organisation

Do you have a good

example of one of these

models? Get in touch

with us at [email protected]


Secondary - elective

Secondary - emergency

Community

Primary


1. What, Why, How




Emerging key themes

We are making use of three types of evidence

• Literature review

• Commissioned research to inform the evidence base

Desk-based Research Engagement Qualitative Case Studies

• Sector stakeholder events throughout May to September

• Workshops and round tables to test emerging policy findings

• Public – ideas and comments

• 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.


Emerging key themes

Why consider Organisational form?

• Unrealised potential in the health sector

• Struggling providers

• Learning from approaches internationally

• Learning from other sectors


Emerging key themes

Emerging themes

• Leadership and management

• Ownership and governance

• Policy, legal and regulatory barriers

• Culture and values

• Infrastructure and assets

• Efficiency, costs and savings


Questions

Questions or contributions?

Thank you for listening

Questions, contributions?


Contact details

Get involved

#DaltonReview2014

Sarah Morgan: The Dalton Review

Health & Medicine

Transcript of Sarah Morgan: The Dalton Review