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North Cumbria and North East Integrated Care System approach to Population Health Management

Saturday 4th May 2019

North Cumbria and North East Integrated Care System approach to Population Health Management

The Clinical Commissioning Intelligence team have been instrumental in supporting the North Cumbria and North East Integrated Care System, to develop a robust approach to population health management.

NECS’ approach is to assess how well a health and care partnership utilises population health management data.  Using analytics, intelligence and techniques to underpin the best health and care delivery it can, ensures a partnership focuses on the health and wellbeing of the citizens it serves, delivers high quality, safe care and has a sustainable future in terms of its finances and efficiencies.

A diagnostic assessment in North Cumbria was completed, basing the approach around five categories, with the aim of answering five key questions:

  • Population Demographic – Are we different?
  • Population Health – What are my health and wellbeing needs?
  • Supply and Demand – How well do we meet my population needs?
  • Resourcing – What do we spend, on who, on what and where?
  • General Approach – how do we manage health and care?

The findings allowed NECS to develop a tailored approach for the North Cumbria Integrated Care Partnership, with key elements being the development of an Integrated Care System (ICS) Dashboard, to facilitate a single version of the truth across the system, incorporating new and existing datasets as appropriate.

The approach supports development of a ‘social connection index’; through identifying community variations in accessing outcomes from interventions / treatments and understanding system-wide demand and capacity.  This informs population health segmentation and risk stratification, whilst facilitating the introduction of patient activation measures to optimise amenability to treatments.

NECS are continuing to develop this approach in North Cumbria with a view to rolling out to other areas.

For further information please contact: Ian Nicholson, Head of Clinical Commissioning Intelligence