As Surrey Heartlands reaches the half way point of its 22-week Population Health Management (PHM) Development Programme, the final series of workshops has got underway with the recent kick-off of the Finance and Funding Action Learning Set. Surrey Heartlands is one of four systems on Wave 2 which will benefit from an enhanced package, supported by the national team in NHSE/I and their partners in Optum. The first Action Learning Set was held in late September, with a series of further workshops planned between now and January 2021. Supported by the national pricing team, this will give Surrey Heartlands the opportunity to be at the forefront of reform in this critical area.

“The key to success will be building bespoke and flexible models together that support service redesign across multiple partners, working within a clear financial remit,” said Rachael Graham, Deputy Director of Contracts for Non Acute and Primary Care in Surrey Heartlands, after attending the first Action Learning Set. “For example, if activity needs to shift between providers to rebalance efforts towards prevention, then contracting and finance arrangements should enable that change.”

“There is no one size fits all approach,” she added. “All partners need to be involved, including GPs, NHS trusts and social care, to ensure we design effective, transparent and flexible arrangements based on shared understanding. Delegated budgets should allow Integrated Care Partnerships to cater for local priorities and variation, with appropriate accountability and decision-making retained at system level by Surrey Heartlands.”

Over the course of the remaining six workshops, Surrey Heartlands will build on insights from Population Health Management to explore innovative approaches to payment and contracting to maximise collective resources and reduce fragmentation of care.

“All too often care can be episodic, reactive and disjointed with multiple hand offs for complex patients between different teams and organisations working in silos,” said Dr James Adams, Clinical Director for Frailty Services at the Royal Surrey Foundation Trust who has been participating in the Place Action Learning Set, which is looking at designing interventions based around the Trust’s Proactive Care Service.

“We want to use PHM principles to identify this cohort and to use finance and payment models to enable a new way of integrated working. This is the paradigm shift required, from reactive to proactive and collaborative care, generating value for patients and the system.”

The service aims to test changes in integrated care for patients who are risk stratified using the PHM approach; integrating further with the district nursing teams, community matrons, GPs, social care, mental health professionals, the voluntary sector and acute hospitals. This multi-disciplinary group will design a new intervention, incorporating a comprehensive clinical assessment and ensuring individuals and their families or carers have the advice, support and information they need to regain or maintain their independence at home.

Understanding how finance and payment models can support this kind of collaborative work is a key outcome of the Population Health Management development programme. The next Finance Action Learning Set will take place on 13 October from 9am. Anybody interested in attending this or any of the other Population Health Management workshops should contact Surrey Heartlands Project Manager, James Palmer.