SPOT analysis: Improving healthcare outcomes
This is the SPOT (Strengths, Problems, Opportunities, Threats) analysis for Improving healthcare outcomes, as discussed at the Leading Clinical Commissioning event held by NHS Birmingham East and North on 20 and 21 July 2010.
Add your views at the foot of the page.
Strengths
- Patient improvement
- Better use of resources
- Primary care continuity
- Driving up quality of providers
- Clinical agreement that outcomes are important
- Encourages clinically relevant behaviour and remove perverse incentives
- G.P’s make decisions on their understanding of needs
- Current workforce/skills
- Local knowledge
- Expert Pts/PPI
- QOF/achievers
- Some experience in fund-holding commissioning
- Awareness health needs
- Managing change
- Better evidence
- Talking to clinicians
- Positive inclusive joint commissioning
Problems
- Fragmented currently – how will they come together?
- Breadth of commissioning agenda
- Variation in GP engagement
- Commissioning of G practise somewhere else
- Choosing the right priorities
- Don’t know what outcomes
- Don’t have systems to measure
- PBR visibility in unwanted activity
- Cancer drug fund looks unworkable
- Non-alignment of incentives between primary and secondary care
- Relationship with GP often determines your level and quality of care
- Who regulates locally?
- What’s the definition of a health outcome?
- Limited patient knowledge
- Inexperienced/single handed GP’s/practises
- Monitoring evaluation
- QOF – ticking boxes
- Communication – generally
- Patient education/responsibility
- Fragmentation of healthcare (primary/secondary care)
- GP lists/geography
- Need med-long term plan/vision
Opportunities
- Clinical engagement via GPs
- Interface with local authority
- Easier Total Place
- GP contract
- Population level public health
- To be systematic – no organisational barrier
- Tariff for mental health
- Opportunity for patient information to improve outcome
- To get joined up care pathways between clinicians
- Revivify relationship between primary care and consultants
- Genuine focus on efficiency
- booming health outcomes
- All round wellness
- More prevention – earlier intervention
- Social enterprise
- Tailor service provision to local need
- Radical thinking
- Closer working – specialist teams & GP’s
- Re-examination of current service provision
- Patient involvement
- Reducing bureaucracy
- Integrating care
- Innovation service redesign
- Cut waste duplication
- Change in culture
- Reduce re-admissions –working with secondary care more positive
- Outcomes focus welcome and LA/NHS
- Integrated services
- Private sector if market development done well
Threats
- IT
- Widen inequality
- One size of engagement doesn’t fit all
- Loss of expertise and knowledge
- Loss of organisational memory
- Level of commitment, compulsory commissioning
- Destabilisation of organisations
- Failure of concept
- Cherry picking by independent contractors of services
- Losing good staff
- Lack of meaningful buy in from social care
- CiP make decisions on their understanding of needs
- May come down to postcode lottery – good/not so good G.Ps
- Loss of knowledge – health improvement data etc…
- More “vulnerable “ people “forced” to take responsibility
- We might not be here in 12 months
- Postcode lottery
- Financial threat
- Private companies
- Cost V Quality
- Loss of knowledge
- Losing skills
- Restrictive budgets
- Patient expectations
- Increasing demand
- Skill dilution
- Funding structure
- Continuity of clinical commitments/care
- Citizens’ attitude/awareness
- GP capacity
- Consortia configuration
See also: LCC SPOT write-up (Word doc) – plus comments
