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Event / International Value Symposium 2021

10:00, 6 October 2021 Online

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About this event

The International Value Symposium attracted senior decision-makers from all parts of healthcare interested in making value-based healthcare a reality, and welcomed international delegates.

With the move to more integrated healthcare for populations, a key focus for the Symposium was value-based healthcare at system level. The day included speakers from overseas as well as the UK and encouraged interactive discussion to tackle the key challenges as well as sharing case studies and success stories.

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Oct 06

    In this opening session Tom sets the scene for the day and specifically discusses a new global report on Person-Centred Value-Based Health Care (PCVBHC), which was published on the 1st September 2021 (see:

    Tom speaks about one of the key challenges in healthcare – how do we enable a focus on the individual, while simultaneously equitably managing the needs and preferences of a population? Patients have their own goals and it follows, therefore, their own preferred outcomes, processes and structures of care. How do we understand these preferences? How do we ensure our systems of care are responsive to such preferences? How do we evolve our measurement systems to ensure our data reflects the extent to which we have achieved an individual’s goals? How do we then use this data to support consultations, quality improvement and resource allocation? Finally, how do we do all of this in the context of finite resources that we must use equitably? Tom explores these challenges with us and discusses the report in the context of the implications for the finance community and their role in this area.

    Dr Thomas Kelley   / CEO , Sprink Ltd

    Dorset started its population health management journey three years ago as part of the first NHS England and Improvement pilot waves. In this session we will touch on some of Dorset's PHM journey, including multi-disciplinary working to re-design patient pathways, the use of clinical champions to tackle data sharing and information governance challenges and using real time data on the population to understand where to redirect resources.

    This session will also share a more recent development for Dorset - using the population health management framework to look at elective care in a more holistic way. This year the team started looking at the waiting for elective care and whether it was evenly distributed across the population, to better understand elective and non-elective care in the context of health inequalities. The formal programme has launched recently at the beginning of September 2021, and the presenters will share their progress so far in terms of interrogating the data and aiming for proactive changes to interventions through intervention design workshops. They will also outline their next steps and ambitions for the future.

    Janine Ord   / Head of PHM , Dorset CCG
    Judith May   / Associate Director of Operational Performance , University Hospitals Dorset NHS Foundation Trust
    Ashleigh Boreham   / Deputy Director of Transformation , Dorset CCG

    This session will give an overview of the Canterbury Health System and how its principles are being applied by a number of NHS organisations in the UK. The Canterbury model is widely recognised around the world as a leading example in healthcare integration. One of the key successes has been the use of an alliance framework to share a joint vision for the health system and to ensure the data tells one version on the truth. New Zealand has faced a number of disasters in recent years, both natural and man-made. The response of the country's healthcare systems in these situations has shown the importance of culture and adaptability, but has also highlighted the crucial need for patient and healthcare data to be shared, usable and transparent.

    Carolyn will share with us some of the key elements of the Canterbury Health System, such as the Health Pathways programme, the use of time series analysis to link up data across a patient pathway and Canterbury's shared health record which shares all patient data across the whole system and therefore enables shared planning. Carolyn and Alun will also cover some of the work being done in Wales to adopt parts of the Canturbury approach, and will discuss how this model can be applicable and highly valuable to the NHS as it embarks on its own integration journey.

    Carolyn Gullery   / Specialist Healthcare System Advisor , Lightfoot Solutions Group Ltd
    Alun Tomkinson   / Clinical Board Director, Surgery Clinical Board , Cardiff and Vale University Health Board
    Sarah Day  / HFMA policy and research manager

    In 2015 five NHS Trusts were selected to work with the Virginia Mason Institute (VMI) based in the US, to develop localised versions of the Virginia Mason approach to continuous improvement and adoption of the Lean methodology. The goal was to develop a sustainable culture of continuous improvement capability in each of the five partner NHS hospital Trusts, and to share lessons from the partnership with NHS system leaders. In 2018 a research team at Warwick Business School commenced a three-year independent evaluation of the NHS-VMI partnership, commissioned by the Health Foundation and NHS England & Improvement.

    In this session Nicola and Bernard will give an overview of the NHS-VMI partnership and some of the findings so far, in terms of both Quality Improvement and financial return on investment. One of the key findings from the partnership evaluation has been the importance of cultural readiness in order to successfully adopt the VMI approach of continuous improvement. Nicola and Bernard will reflect on this and will also share how the partnership and the VMI tools shaped the five trusts' response to the Covid-19 pandemic.

    Dr Nicola Burgess   / Reader (Associate Professor) , University of Warwick - Warwick Business School
    Professor Bernard Crump   / Professor , University of Warwick - Warwick Business School

    Cancer Alliances were established by NHS England to bring together the key organisations in their area to coordinate cancer care and to improve cancer outcomes and experience for the local population. The session will look at the work undertaken by SE London Cancer Alliance to develop a value based healthcare approach to cancer pathways across the SEL system aligned to the work of King’s Health Partners. The ambition of the Alliance is to ensure cancer intelligence and outcome data drives our clinical programme to improve cancer pathways, outcomes and experience for the SE London population. We will discuss the challenges and successes in embedding this approach with specific examples including the impact of the covid pandemic on cancer outcomes and our work to address inequalities in cancer services and outcomes.

    Dr Kate Haire   / Clinical Director , South East London Cancer Alliance
    Catherine Mitchell  / HFMA head of costing and value

    In this session Valerie will introduce Heartbeat Medical, the leading solution in Germany for Patient Reported Outcomes collection. Heartbeat works across a wide range of disease areas with the largest hospital chains and major university hospitals in Germany, and we will hear about some of the providers' work in using the patient's perspective to transform care and influence decision making. Valerie will also outline some of Heartbeat's key ambitions and challenges, including encouraging a more standardised collection of PROMs across healthcare providers, linking outcomes data to finance data, creating data-based evidence that value-based healthcare is the best approach, and the need for a shift in culture and ways of thinking. This session encourages the audience to engage actively in the Q&A with Valerie, discussing how we can evidence the shorter-term financial impact of changes that have been made based on longer-term patient outcomes.

    Dr Valerie Kirchberger   / Chief Medical Officer , Hearbeat Medical
    Dr Aldemar Hegewald   / Chief Physician of the Department of Neurosurgery and Spinal Surgery , Vamed Baltic Sea Hospital Damp

    Machteld is the founder of the Positive Health philosophy. Originally a general practitioner, she had her own experience with illness early in her career and discovered that she could actively and positively influence her recovery by considering a broader perspective of health outside of interventions and treating symptoms. This lead to extensive research on health promotion and the eventual creation of Positive Health. Positive Health is a broader view of health where the emphasis is not on a person's illness or condition, but on their ability to deal with physical, emotional and social challenges in life, and on what makes their lives meaningful.

    In this session Machteld will give an overview of her research on the theme of ‘what health is’ among different stakeholders in healthcare and how she came to set up Positive Health, as well as outlining some of Positive Health's key aims. Machteld will also share some examples of the impact this approach has had for patients in terms of their health and happiness, and the consequential reduction in referrals and use of healthcare resources.

    Machteld Huber   / Founder , Institute for Positive Health

    Around the world, the Covid-19 pandemic has brought health inequalities into sharp focus. The unequal impact of the pandemic across different sectors of society has highlighted existing inequalities and potentially created new ones, as the pandemic interacts with and exacerbates existing inequalities in chronic diseases and the social determinants of health.

    In this panel session we will discuss the use of both cost and outcome data to highlight and address health inequalities, and the importance of a value-based healthcare approach in reducing inequalities. The panel will consider the role both finance and clinical staff can play in tackling inequalities, both within the NHS and in other healthcare systems abroad.

    There were no slides used for this session.

    Dr Bola Owolabi   / Director – Health Inequalities , NHS England and Improvement
    Nicci Briggs   / Executive Director of Finance, Contracting and Corporate Governance , LLR CCGs
    Dr Sally Lewis   / National Clinical Lead for Value-Based and Prudent Healthcare , NHS Wales
    Andi Orlowski   / Health Economist & Director , Health Economics Unit
    Dr Günther Jonitz   / President , Berlin Chamber of Physicians

    In a time of unprecedented turmoil, change and uncertainty in healthcare around the world, there are some universally desired ingredients that nearly all patients want from their care, and even more so now in the midst of this pandemic. Authenticity, empathy, reliability, compassion, laughter and human connection are just some of the elements that can make the difference between whether a patient trusts their healthcare system and care givers or not. However, these are also some examples of outcomes that are the most challenging to define, collect as data, measure and study.

    In today's keynote session Tom will discuss why trust is so important for value-based healthcare, for both patients and the people delivering care. We will discuss what matters to patients, how patient values have been affected by the pandemic and how developments in AI can now capture these kinds of values as data to be used in effecting change and decision-making.

    Thomas H. Lee   / MD, Chief Medical Officer, Press Ganey and Senior Physician , Brigham and Women’s Hospital, Boston, Massachusetts

    In this session Pedro will give an overview of the Joinvasc stroke care programme, implemented at Joinville in Southern Brazil to improve stroke prevention and outcomes for the whole city. The initiative started in 1995 and has recently won the 2021 Value Based Health Care Prize.

    The programme's cycle of care was developed over 25 years incrementally using real-world data that indicated gaps and opportunities to improve patients’ value in health, from prevention to rehabilitation. Pedro will highlight the importance of data collection in the programme's successes, with populationbased data being collected since 2009 including clinical and epidemiological data, patient-reported outcomes, radiological and genetic information. Direct, indirect, and social costs are also collected for the full cycles of care, creating one of the first real-world databases that allow the calculation of the economic burden of stroke in developing countries.

    Dr Pedro Magalhães   / Stroke Neurologist and Interventional Neuroradiologist, Neurologica; Coordinator , Joinvasc, Joinville Stroke Registry, Brazil