So what is commissioning?
Commissioning is: • A cycle, an ongoing process. • Nothing new. • What IS new is the clinical input as well as involvement from patients and the public. • Securing the highest quality healthcare services to meet the identified needs of a population within available resources.
We DO commission…. • NHS elective, non elective, urgent and emergency services • Most community health services • Mental health • Learning disability services • All elements of the commissioning process
We DON’T commission… • Primary care services e.g. dental, optician, pharmacy services OR PRIMARY CARE. • National or regional specialized commissioning • Our own services. Conflict of interest
NAPC
Planning • How do we know what we need to commission? • Sources of information include JSNA, patient surveys, benchmarking, national directives, ONS.
What have we got, where are the gaps and what are the priorities? • PROM information, patient surveys, Links, benchmarking, capacity. • National directives • Risk registers, • Outcome frameworks, • Financial, QIPP
Procurement • Designing or redesigning the services, clinical challenge invaluable. • Contracts with service specification. May be AQP or competitive tendering but quality in contract vital (CQUIN) • Manage the demand – pathways.
Monitor the service • Activity and quality • Payments (challenge) • User , LA and H&WB will want information on the service and help to inform patients. • Feedback to practices to help us manage our commissioning budgets.
NAPC
Public Health has moved.. • Now part of PHE. • Aligned to LA, accountable to LA, ring fenced budget. • - Protect and improve H&W and reduce inequalities • -Health Protection • - Health Intelligence – JSNA.
Public Health • • • •
Think population v individual Get to grips with the drivers of demand Think upsteam Input into commissioning in LA and CCG • Support the H&WB to be effective in implementing the JHWS • ‘Rainbows’
Health and Wellbeing Board • New structure that links LA and CCG/NHSCB to deliver JHWS • 2 GHCCG board members sit on H&WB. • PH consultant – Dr Nicky Hoyle sits on governing body of GHCCG.
Healthwatch • Formerly LINks – consumer champion • Tasked with raising involvement in planning and checking services. • Ensure that decision makers know the community views-influence policy. • Provide information • Support complaints
How will we be measured? • • • • • • •
Outcomes > process Outcome frameworks Nice quality standards QOF Variation is benchmarked – Atlas. Financial, QIPP NHSCB.
Who commissions us?? • NHS CB. • Primary care contracts will move to NHSCB • Quality driven outcomes.
How we can all help our CCG and our practices. • • • • • •
Contribute Support Promote Represent Quality Lead
Useful resources • RCGP. Centre for Commissioning. Competencies for Clinically – led Commissioning. Pt 1. 2011
• NAPC The Essential Guide to GP Commissioning • JSNA – 2011 Kirklees • NHS outcome framework