From January 2013, the Right Care team will work with receiving organisations and SROs to assist and advise on the development of  future programmes of work to commence from April 2013.

All existing products of Right Care (Atlases of Variation, Right Care Casebooks, Tools, Health Investment Packs and other publications) will remain accessible from the Right Care website until further notice and arrangements will be made to ensure that these outputs remain accessible to the NHS into the future.

The Right Care approach

The Right Care programme was initially sponsored by Jim Easton, as then National Director for Improvement and Efficiency and launched in January 2010.

The primary objective for Right Care is to maximise value

• the value that the patient derives from their own care and treatment
• the value the whole population derives from the investment in their healthcare

Value being defined as patient health outcomes relative to the total cost (inputs):

 “Value in any field must be defined around the customer, not the supplier. Value must also be measured by outputs, not inputs. Hence it is patient health results that matter, not the volume of services delivered. But results are achieved at some cost. Therefore, the proper objective is… patient health outcomes relative to the total cost (inputs). Efficiency, then, is subsumed in the concept of value. ”

Source: Porter ME. (2008). What is Value in Health Care? Harvard Business School.

The challenge for the NHS is to get more for less in an era of “no more money”. To do this, the NHS needs to shift from lower value interventions to higher value interventions.

The Right Care approach is based on adopting the following principles:

• Describe why variation is an issue for modern healthcare systems
• Illustrate that un-explained variation is an opportunity for commissioners to increase effective healthcare for populations
• Describe those variations in terms of spend and outcomes between populations to help local commissioners understand their opportunities to improve outcomes and increase value
• Provide tools, co-produced with clinicians and commissioners to help the local health care system understand the value of healthcare being provided to their populations
• Help commissioners and providers understand the importance of a “population perspective” whether based on geography or patient cohort (eg Frail elderly), to maximise value and benefit to their populations
• Help commissioners think about fresh ways of commissioning, eg; Programmes of Care based on Programme Budgets, and population based integrated care within each programme
• Describing new models of commissioning and contracting for value

Achievements to date

Key achievements include:

• Two compendium Atlases have been published (2010 & 2011) and this year (2012) there is a focus on Atlases themed by condition or patient group
  • Approaching 20,000 printed copies requested
  • 490,000 downloads
  • Widespread press coverage
  • The successful launch of Patient Decision Aids (PDAs), plus the successful completion of a major OJEU procurement to commission three contractors to take forward and accelerate the SDM programme, including the development of a further 36 PDAs.
  • Development of new tools such as the Procedures Explorer Tool, a CCG level SPOT tool, and Commissioning for Value pack for CCGs, developed in Derbyshire. 152 Health Investment Packs for PCTs in 2010.
  • Successful launch of a programme of Commissioning Guidance Development, in collaboration with the Royal College of Surgeon, FSSA and East Midlands Quality

The NHS Atlases have been widely used in local planning and Right Care continues to respond to approaches from local health economies to provide support and coaching to implement the Right Care approach locally.

A collaborative effort

A key feature of the work of Right Care has been the many organisations and individuals who have directly contributed to or championed the development of Atlases and other Right Care products and principles – From Department of Health Policy teams, NCDs, Quality and Public Health Observatories, local CCGs to national professional bodies, NHS membership organisation and think tanks and third sector organisations. Too many to mention individually, this broad church has ensured that Right Care has been first and last “by and for” the NHS family. Successful achievements of future programmes will depend on building on this level of “co-production” and engagement with stakeholders. A big thank you to all who have contributed; you know who you are.

The Future for Right Care

In recognition of the success and value of the Right Care programme, plans have been put in place to take forward the four key modules described above and ensure that they become embedded in the new commissioning and public health agendas for the NHS.

From January 2013, the Right Care team will work with receiving organisations and SROs to assist and advise on the development of future programmes of work to commence from April 2013.

In the meantime we will be completing the  themed Atlas series and developing a series of online learning tools to capture the knowledge and experience built up over the last three years.