The integration of primary and secondary care to address fragmentation of patient services and achieve greater efficiency and value for money means services will be designed to focus on disease prevention and reducing hospital admissions.

Dr Charles Alessi, chair of NHS Clinical Commissioners, says a current obstacle to integration is the payment by results system which rewards secondary care for increasing activity.

Continues on page 3

Commissioning Support Units (CSU) will be playing a major role in the transformational work that will enable clinical commissioners to turn their aspirations into reality, says Central South CSU managing director John Wilderspin.

CSUs will be providing CCGs with expertise in information analytics, ‘health intelligence’

and service redesign in addition to the everyday back office functions.

They will also contribute a depth of knowledge and expertise gained from working with other partners in the health service, public bodies such as local authorities and academic institutions and the commercial sector. Linking with organisations such as the new NHS Improvement body will ensure the support they

provide to CCGs is backed by evidence based practice.

‘We will be making sure that commissioning support is part of a wider network of people and organisations so that we really will be able to make a difference,’ says Mr Wilderspin.

Many CSUs have been recruiting former primary care trust (PCT) staff and particularly those with a track record of success. ‘We will be making sure that we incorporate the best of what PCTs have done historically but we will also have to learn and adapt quickly to ensure that the service we provide will meet the needs of CCGs. We will find out what is best in class by learning from other parts of the country, other parts of the world in terms of how other healthcare systems operate, or from other organisations outside healthcare where that is useful,’ he says.

CSUs are being set up primarily to support CCGs but will also support other customers, including the NHS Commissioning Board, specialist commissioners and even NHS providers.

www.commissioningshow.co.uk Issue 5

Integration of primary and secondary healthcare will trigger hospital reconfiguration

CSUs to play major role in transformation

GPs feel mix of anger and optimism as CCGs go live With less than two months to go before clinical commissioning groups (CCGs) take control of £65 billion of NHS spending, feelings on the ground range from excitement to disillusionment.

This is the personal view of Dr David Jenner, a Devon GP, senior policy adviser for the NHS Alliance and board member for Northern, Eastern and Western (NEW) Devon CCG.

In quite a few areas he said people were genuinely excited about taking up the challenge of clinical commissioning.

SEE PAGE 7 SEE PAGE 7SEE PAGE 6

Take a look at who’s exhibiting at Commissioning 2013

Technological innovation improving healthcare integration

2013 CSU Innovation Pavilion revealed!

Create your own bespoke conference programme and choose from a variety of dedicated streams, providing world-class speakers and expert advice.

Practical advice and case studies on first-year priorities for CCGs, including transformation, commissioning support, quality and outcomes, population health, integration and collaboration, and achieving financial balance.

Practices are facing tough times with changes to the GMS contract a restriction on finances. Get advice on combating key threats in 2013, protecting profits, identifying new income streams and seizing lucrative opportunities arising from NHS reforms.

Targeted at staff from CSUs and LATs, this stream gives an overview of the new £400 million commissioning support industry and expert advice on how CSUs should evolve to support CCGs, drive transformation and achieve commercial success.

Practical strategies and innovative case studies on how to reduce the burden of long-term conditions on the NHS, social care and patients through integration, collaboration and behavioural change.

Providing powerful examples of how new technologies are being used by the NHS and local authorities to share data and knowledge, to empower patients and to drive transformation and the QIPP agenda.

Delegates can also take part in the smaller facilitated learning sessions, which will cover key hot topics.

CCG Business:

Your Practice: Challenges & Opportunities:

Commissioning Support:

Long-Term Conditions:

Productivity through Technology:

Commissioning 2013 Stream Overview

Thank you to our partners and sponsors:

Continues on page 2

Dr Charles Alessi, chair of NHS Clinical Commissioners

Register you and your colleagues for

FREE* atwww.commissioningshow.co.uk

An increasing focus on integrating health services by clinical commissioning groups could destabilise acute trusts and drive hospital reconfigurations, says a leading GP.

John Wilderspin

Continues on page 7

Media partner:

Event sponsors:

In association with:

BOOK YOUR FREE* PLACE AT THE COMMISSIONING SHOW AT WWW.COMMISIONINGSHOW.CO.UK

*Qualifying NHS delegates can register for free. Please see website for terms and conditions.

www.commissioningshow.co.uk www.commissioningshow.co.uk2 3

Good relationships and a sense of responsibility for the population are the key factors which will enable local systems to work together to improve health outcomes.

The effectiveness of the Pathways2Wellbeing service has led to their successful entry into the NHS in Hertfordshire as well as the management information system meeting level 2 of information governance.

Research at the University of Hertfordshire helped to inform the knowledge transfer - the practice and embedment of The MUS Clinic: Symptoms Groups based on The BodyMInd Approach. Research outcomes included increased activity and wellbeing levels; decreased symptom distress, anxiety and depression and fewer GP visits/medication and secondary care referrals/investigations. Market research and cost effectiveness studies (showing NHS savings per head) were also undertaken.

Patients are encouraged to think, talk and move gently to become more aware of their body, its limitations and its possibilities. Exercises in mindfulness and relaxation as well as practices to explore negative feelings, lifestyle and personal relationships are integrated where appropriate. The patients are encouraged to understand symptoms and their function through various body-based and group methods. Increasing patient wellbeing is the ultimate goal.

Pathways2Wellbeing train practitioners from the health service in order for the NHS to licence the delivery of this innovative treatment. They provide a high quality service, evidence-based, proven effective to reduce NHS costs for this patient population in primary and secondary care.

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Pathways2Wellbeing (P2W) is a newly formed company with a health and social care focus. They provide an established approach for people with, persistent, physical symptoms which have no medical explanation and which fail to respond to treatment.

Shared responsibility will improve health outcomes

CCGs must build good relationships with everybody says Hakin

This is the view of Dr Stephen Kell, a N o t t i n g h a m s h i r e GP and chair of Bassetlaw Clinical C o m m i s s i o n i n g Group and vice chair of his local health and wellbeing board, who will be giving a talk on ‘integrated responsibility’ at the Commissioning Show.

Dr Kell, whose CCG has been planning services since it was

formed in April 2010 and was one of the first to be authorised with no conditions, says in the new NHS if one part of the system doesn’t operate effectively it will significantly affect every other part. For example, if public health stops providing smoking cessation services this will impact on cancer outcomes.

‘Increasingly over the next year or so we will see more local systems working together, whether it’s hospitals and GPs or

GPs and social care – I do think that will happen. So we need to make sure that outcomes are aligned and that we are aiming for the same thing. But we also need to consult each other about our plans. It’s about gaining a mutual understanding of the pressures that we are under as a system.’

Dr Kell says his message is that people need to assume responsibility. ‘We’ve said locally we would rather more people took responsibility for an issue than they didn’t. GPs for example will need to assume clinical responsibility for the outcomes of their patients and be strong patient advocates.

‘One of the strengths of clinical commissioning, which I feel very passionately about, is that as a GP I feel a huge sense of responsibility when I refer somebody to a service if I’m also responsible for the quality of that service. I don’t sit there and think somebody else is doing it.

‘Integrated responsibility is all about quality and safety being your first parameter, then working together and relationships, assuming responsibility and pushing the real advantages of clinical commissioning.’

The first thing clinical commissioning groups (CCG) should be doing is reaching out to the whole local community to understand what people want from their health services, says Dame Barbara Hakin, national director of commissioning development at the NHS Commissioning Board.

This was something the NHS had never got right before and CCGs now had the chance to do something differently, she said in an address to the NHS Alliance’s national conference.

‘I have got really high hopes and expectations of CCGs that they can do this and because of their basis and their foundation on general practices and because of their relationship with their local communities. That’s my number one thing,’ she said.

CCG leaders also needed to concentrate on keeping their member practices on board. ‘When I say practices, I don’t just mean GPs, I mean all those who work in the practices need to feel they belong and that the CCG is theirs,’ said Dame Barbara.

Another priority was building good relationships with local authorities and health and wellbeing boards. Local authorities, health and wellbeing boards and CCGs were all partners and needed to hold each other to account for creating the right

strategy and each playing their part in making things better for patients.

CCGS also had to focus on their interactions with their providers and bring everyone round the table who had the relevant interest or experience to help them design the best services. Dame Barbara said one of her worries with the reforms was that other clinicians and other organisations might feel left out. ‘It is CCGs’ responsibility to make sure that doesn’t happen because we won’t get integration, the right services, the best clinical and managerial brains together unless they come from providers as well as commissioners,’ she said.

Finally CCGs also needed to maintain a good partnership arrangement with the NHS Commissioning Board because its role in commissioning primary care and specialist services. If CCGs did not get that right then they could up end up with fragmented services.

‘So concentrating on that relationship will be absolutely vital and also concentrate on your relationship with your partner CCGs because no man, or no CCG is an island,’ she said.

Dame Barbara will be addressing the Commissioning Show.

Dr Stephen Kell

Commissioning is organised by:

Unit 17, Exhibition House, Addison Bridge Place, London W14 8XP. Tel: 0207 348 5250

www.commissioningshow.co.uk

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But at the same time he points to the anger expressed recently in a public demonstration over proposals to close the A&E unit and to downgrade the maternity service at Lewisham Hospital.

There was optimism that the clinical input into commissioning will increase quality and lead to service redesign but there was also frustration that progress could be limited by the payment by results schedule. Another irritation was that despite being told there would be no targets, they had reappeared as NHS constitution responsibilities in the commissioning framework.

Also GPs were feeling angry about the new GP contract the Government is trying to impose on them, which will mean them working harder for less money. ‘This is making a lot of GPs feel exasperated at a time when they most need to be engaged into the commissioning agenda to take up all the opportunities that it offers,’ said Dr Jenner.

Much of the structure needed for clinical commissioning is now in place and even the CCGs which have not yet been authorised have been getting on with negotiating contracts and planning services for next year.

‘There are plenty of commissioners out there who are optimistic that they can make a difference. We will just have to see how much change can be achieved when CCGs become statutory,’ he said.

A second wave of 67 CCGs were authorised in January bringing the total across the country to 101, almost halfway to the anticipated total of 211. Nineteen CCGs have been authorised with no conditions, 45 have received conditions against some of the criteria, which they should be able to discharge within a short period of time and three CCGs have been authorised with directions, which means that they have legally-binding instructions to take into account when moving forward with their development.

Dame Barbara Hakin, the NHS Commissioning Board’s National Director: Commissioning Development, said: ‘The vast majority of these 67 new organisations have demonstrated excellence and a very high level of achievement and are clearly ready for the challenge of leading their local health communities in partnership with the public and with local partner organisations. Many have been commissioning services for one or two years already and are making a significant difference to local health and care services.

‘CCGs have made fantastic progress in a very short time.‘

Continued from page 1

“Integrated responsibility is all about quality and safety being your first parameter”

Dr Stephen Kell

Continued from page 1

But commissioners will have to work with limited budgets and prioritise care which means that if one provider gets more money, another will get less.

‘We are very conscious of the fact that we have too many acute trusts and distribution of services is not ideal so integration of health services could be one of factors that drive reconfiguration.

‘The payment by results system that we currently have is a product of a different age when we were expanding the NHS. In future acute trusts will need to understand that they live within the local health economy. Integrated care is based on the premise that we need to use the resource that we have for health care as efficiently as possible. Let’s sit down and have a discussion about how we are going to do that clinically,’ said Dr Alessi.

There were likely to be heated discussions in CCG meetings which must be held in public because people need to understand the need for prioritising care.

‘Integration is going to have to be driven by all sides. It’s in everybody’s interest that we get commissioning input into the process from our colleagues in secondary care. We know there is going to be a whole series of reconfigurations over the next three to four years because of the financial situation we are in. Integrating services gives us the potential to think differently around the way we deliver services,’ said Dr Alessi.

Dr Alessi will be speaking at the Commissioning Show on the potential for integrating primary and secondary care health services.

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Integration of primary and secondary healthcare could trigger hospital reconfiguration

Tanita – Taking you beyond BMI

“It’s in everybody’s interest that we get commissioning input into the process from our colleagues in secondary care”

Dr Charles Alessi

Dr Charles Alessi

The Commissioning Show 2012 proved itself as the definitive event for GP commissioning with the biggest gathering of primary care professionals since the Health and Social Care Act received royal assent.

A reflection of the changing way care is delivered is central to Commissioning 2013 and is widening its remit by moving to a new location at London’s Excel.

Commissioning 2013 will be co-located in the wider setting of the Health+Care show, a macro event to meet the needs of both primary care and social care practitioners. With an aging population and resources becoming extremely restricted, the demand on health and social care is continuously challenging standards, the need for efficiency and integration is vital.

For the first time, health and social care commissioners and providers will come together at an event dedicated to taking a huge step forward in providing better care in the NHS.

Commissioning and Health+Care together will be a dynamic platform for the future of patient care.

Health+Care will include four key events in the calendar for health and social care workers. The four areas include:

Commissioning 2013:The central hub for healthcare innovation and integration

Commissioning: the definitive event for CCGs, CSUs, LATs, GPs and practice managers to acquire first hand expert advice and practical training in business and finance management, provision of care, commissioning support, long term conditions and productivity through technology.

Integrated Care: health and social care commissioners and providers are facing more responsibility with fewer resources, Integrated Care will be the first time these two groups will gather to develop solutions.

Home Care: An aging population has resulted in domiciliary care agencies supporting people with far more complex conditions in their own homes, Home Care 2013 will be a hub for discussion and evolution of domiciliary service provision.

Residential Care: showcasing the work between commissioners and leading organisations in transforming the roles within residential care.

The Commissioning Show 2013 is movingIf you work within delivering primary care, put the 12 & 13 June 2013 in your diary as an event not to be missed. Now in its third year and with a growing number of visitors and evolved conference programme, the Commissioning Show will take place in London’s Excel.

The new conference location ensures a better delegate experience for visitors to network and gain practical hands-on training in the heart of the Olympic regeneration area.

Visit www.commissioningshow.co.uk to register you and your colleagues for free.

FOLLOW US ON TWITTER@CommShow

FOLLOW US ON FACEBOOKCommissioning-Show

www.commissioningshow.co.uk4 www.commissioningshow.co.uk 5

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FIND OUT HOW THE COMMISSIONING SHOW CAN WORK FOR YOU. CALL JAMES: 0207 348 5254, EMAIL J.HALL@CLOSERSTILLMEDIA.COM OR LEE: 0207 348 5278, EMAIL LEE.DAVIES@CLOSERSTILLMEDIA.COM

Plan not to scale and subject to change. Correct at the time of print

The NHS landscape is changing. New healthcare decision-makers are emerging, old structures are set to disappear and all this is against a backdrop of financial constraints meaning the NHS needs to do more with less.

The quest for efficiencies is driving a greater need for partnership and, as such, the willingness to work together with Industry. This is reflected in the recent Innovation Health and Wealth report:

Where can Lundbeck help ?

Lundbeck are proud of the fact that we are the UK’s leading pharmaceutical company specialising in central nervous system (CNS) disorders.

Lundbeck are already successfully contributing to the redesign of care pathways and provision of education for HCPs to improve patient outcomes and help deliver the QIPP agenda. To see what we have to offer and discuss areas we can help you with, please come and see us at the event.

Crescendo isn’t just a digital dictation system, it is a Referral Management Solution.

The benefits of moving from analogue tapes to a digital dictation are clear, better sound, increased visibility and better control over your referrals. So

what else should you be looking for when upgrading your dictation system?

Referring patients is one of the biggest costs for a General Practice. Crescendo can help minimise these costs. Our extensive reporting module allows you to manage your referral trends enabling you to plan commissioning with your CCG to obtain best value. From this data you will also be able to easily identify high referrers and training requirements.

Crescendo’s solution is designed like your clinical system for N3 branch working, secure data access and true flexibility including desktop dictation, mobile recorders, iPhones and iPad’s.

Crescendo adds substantial value to an unavoidable investment.

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Integration [of health and social care] must establish a seamless delivery of high quality provision across all organizations; primary, secondary, local authorities, volunteer, independent and the 3rd sector.

Strata Health connects this entire network of providers, ensuring the patient’s journey is planned & monitored; creating a truly shared approach.

Sophisticated matching and e-Referrals based on patient need; and in accordance with agreed commissioning criteria, aids clinicians in identifying and mobilising the optimal transitional plan.

Capacity across Intermediate Care, Step-up/Step-down, Hospice, Nursing Homes, and Residential Homes; as well as throughput of Community-based teams; facilitates access to the right care, quickly.

Meaningful analytics on acceptance/rejection; response times; threshold breaches, unmatched service requests (service gaps) and even service costs provide a real-time operational MO.

Strata Health. Delivered paperlessly. Configured bespoke to local best practice. Built to reduce front-line clinicians non-clinical workload. Optimising patient outcomes.

Currently managing over 10.8m lives across the UK & Canada.

Working in Partnership with CNS and Mental Health

Simplifying referrals, cutting costs

Strata Health improving patient care

2013 Floorplan

www.commissioningshow.co.uk www.commissioningshow.co.uk6 7

CSU Pavilion

The show’s headline sponsors, will use the conference and exhibition being held at the Excel, London on 12th and 13th June 2013, to demonstrate how parts of the NHS are already beginning to see the value in using technology to join-up healthcare services across boundaries to improve outcomes, patient experience and value for money.

During a panel session at the show, Harris Healthcare will explore how technology can underpin coordinated, continuous and person centred care and the rewards that closer integrated working and care can bring for commissioners and providers, individual users of health and social care and government overall.

The panel will discuss how better health outcomes and experiences for people, especially those with long-term

conditions can be achieved through a more joined-up approach to health and social care. In addition, panel members will address how integration can provide better value for money, efficient use of resources and increased productivity, leading to delivery of QIPP and show how the NHS is already reaping the benefits of doing so.

Helen Parslow, director of marketing and business development EMEA, Harris Healthcare, said: “Quality data and information is not only needed to ensure that high quality care is delivered and shared across health and social care, but also to enable commissioning decisions and evaluation to ensure that performance and quality are prioritised in the commissioning process.

“The use of information and technology is therefore a critical enabler in the commissioning process and Harris Healthcare will use the Commissioning Show to explore a number of case studies and examples, calling in a range of experts to discuss their experiences and use of IT to enable transformation across the care continuum.”

Harris is a global Healthcare provider who was recently awarded

with the contract to make two of the world’s largest healthcare systems - the Veterans Association and the Department of Defence in the US - interoperable. Closer to home, amongst other projects, Harris has successfully deployed a clinical portal to join- up healthcare services across four health boards in Scotland.

The Commissioning Show aims to provide a platform for healthcare commissioners to network with the most senior professionals from all the disciplines, backgrounds and organisations involved in care.

James Hall, Commissioning Show manager, said: “Delivering integrated care and ultimately achieving the best possible outcomes for patients, while driving value across the spectrum of care, will be driven by the clinical commissioning process.

“Having Harris Healthcare provide unique content to the sessions on how this can be achieved will provide real value to our large number of delegates including Clinical Commissioning Groups, Clinical Support Units and Local Authorities, who are keen to find out more and learn from others.”

Given the changes foreshadowed in the government’s White Paper ‘Caring for our Future’ local authorities will need to shift from being procurers of care to being facilitators of the wider care market, Professor Andrew Kerslake, Associate Director of the Institute of Public Care, will say in a talk to the Health+Care event.

Call James Hall on 0207 348 5254 to join these prestigious exhibitors at Commissioning 2013

Headline sponsor, Harris Healthcare is getting behind the government’s commitment to actively support better joint working and integrated care across the NHS at this year’s Commissioning Show.

LAs must oversee innovation and choice in the care market as more self-funders emerge

How CCGs can mobilise patient data

Harris Healthcare to demonstrate how IT can drive value-based integrated health and social care at Commissioning 2013

In the past local councils were the main purchasers of care and in most parts of the country they dominated the market. That is changing. More people are now self-funders either because eligibility criteria have changed or people are better off because they have equity in their houses and occupational pensions.

The task for local authorities will be one of ensuring there is suitable care available at the right price for all regardless of whether they are self-funding or are using state funds. Consequently, they will need a wider understanding of the care

market and how they can stimulate innovation across the sector; a task that may prove difficult at a time of financial hardship.

‘This means local authorities will have less control of the market than they have had in the past and they will have to show that they can offer the market real help in terms of the role they will be performing in helping to facilitate care,’ says Professor Kerslake.

However, social care is not master of its own destiny. Demand is influenced by whether people have suitable accommodation which promotes their health and well-being (and given that nearly 80% of older people are home owners that means housing predominantly in the private sector) and on the performance of the NHS.

Professor Kerslake says reports from the Royal College of Physicians and other organisations show that the NHS has

a poor record in dealing with conditions that are prevalent amongst older people such as strokes, falls, continence and dementia. With the advent of health and well-being boards, local authorities and GPs need to seize the initiative to drive down demand for health and care in older age. If they fail to do so, the demographic growth of the older people’s population in some parts of the country could bring public care systems to their knees.

Local authorities and health commissioners also need to be clearer about the role and tasks that they think residential care should perform and for whom. ‘We have got to stop creating residential care that is a one foot in the grave hostel model. What we need is a slimmer, but better funded, residential care sector. I never understand how we think for the price of travel lodge bed we can deliver twenty four hour, good quality care for older people,’ says Professor Kerslake.

The Commissioning Show 2013 will see commissioning innovation taking a prominent place in the dedicated Commissioning Innovation Pavilion. This will be the first opportunity for the newly created Commissioning Support Units to showcase their products and services to representatives Clinical Commissioning Groups who will be attending the show.

Most CSUs have expressed an interest in participating and David Collingbourne of Healthcare Commissioning Services - co-ordinators of The Commissioning Innovation Pavilion - is expecting heavy involvement from CSUs presenting sessions and taking exhibition stands.

Mr Collingbourne says, ‘CCGs are looking for the best commissioning help – and we have identified that there are 300 services for CSUs to sell. CCGs will have a chance to see all that’s on offer from CSUs all in one place. We know that the pace of commissioning innovation is increasing almost exponentially so we can promise attendees that they will be able to review an extraordinary range of new opportunities which they can then use in their local settings.’

The pavilion will have an exclusive lecture theatre for CSUs to promote their services. Additionally, there will be a networking lounge and dedicated bookable meeting rooms where exhibitors and CCGs can meet to discuss commissioners’ needs and share ideas. CSUs will also be able to keep CCGs up-to-date with developments in innovative services through a series of weekly bulletins which will run all the way up to the show.

For more information, you can contact David at david.collingbourne@intelligentmedia.co.uk or on 07778667544.

EMIS – a leading provider of clinical healthcare systems – explains how CCGs can capture a complete picture of the patient’s health and care.

Accurate, timely patient information is a cornerstone of integrated healthcare – but it presents a significant technological challenge for CCGs.

How do you put in place the right IT infrastructure to deliver the NHS Commissioning Board’s vision of “joined-up and complete information about patients”? In the new-look NHS this is no mean feat. There will be a greater diversity of service providers than ever before, each potentially using different IT systems to record their interactions with the patient.

The rise in long-term conditions and an ageing population means that more professionals will be involved in the care of patients whose needs are becoming increasingly complex.

Interoperability – one solutionOne approach to joining up patient data is through interoperability between the different clinical systems, enabling them to ‘talk to’ each other.

EMIS has long advocated this approach as useful for an organisation of the size and complexity of the NHS. Healthcare Gateway Limited (HGL) – a joint venture company formed by EMIS and another leading supplier, INPS – is already making great strides to help healthcare professionals to share patient data from the two systems via the Medical Interoperability Gateway (MIG).

However, an approach based on interoperability alone is unlikely to deliver the “patient-centred service integration” that is seen as a key requirement for CCGs.

EMIS Web – cross-discipline integrated care Delivering truly integrated care requires an integrated clinical system – one that enables clinicians working across different services in the same locality to share the patient record via a common system, but with workflows tailored to their own specialty.

The award-winning EMIS Web system was designed to provide exactly this – and customers are demonstrating the striking benefits it can deliver.

These include:

• significant efficiencies through a common workflow across different clinical teams, and common ways of recording data

• benefits for patients through truly integrated care – with seamless pathways across different healthcare teams and supported by a common approach to referral management

• cross-organisational appointment-booking – reducing paperwork and administration for the CCG and hassle for patients

• improved clinical safety through a standard formulary, protocols and embedded decision support.

Proven resultsIn Tower Hamlets, 500 healthcare staff from different disciplines are using EMIS Web to record and share patient information in common ways.

Thanks to this integrated approach, the community respiratory team has been able to:

• respondmorequicklytourgentreferrals

• reduceonwardreferralstosecondarycareby73percent

• reduceduplicationofdatarecordingby88percent.

For more advice about how CCGs can more effectively use patient data, visit www.emis-online.com

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“Demand is influenced by whether people have suitable accommodation which promotes their health and well-being ”Professor Andrew Kerslake

Exhibitors at Commissioning 2013

140more patients a month

Direct access to patients’ medical records is

allowing acute medical unit pharmacists in

North Mersey to see 140 more patients a

month - an increase of 17.5%

Increased productivity

The challenges for CSUs are likely to come from competing for business with each other and also from commercial services. But Mr Wilderspin is confident they will have an inbuilt advantage from the respected NHS brand. At the same time he acknowledges that they will have to demonstrate to CCGS that they will get added value by buying their services from a CSU.

Mr Wilderspin, who has worked as chief executive in both the NHS

acute and primary care sectors and is former Department of Health national transition director for health and wellbeing board implementation, applied to run a CSU because he saw it as an opportunity to do some things on a scale that hasn’t previously been achieved in the NHS.

He explains: ‘The biggest example for me is using information to really to make sure that commissioning is evidence based, that

it’s very focused on clinical outcomes and patient experience. It is also about ensuring that with benchmarking against the ‘best in class’ or service redesign that commissioners will be able to see whether their providers are currently offering the best possible service or, frankly, whether it could be better.’

Mr Wilderspin will be giving a talk on the proactive role of CSUs at the Commissioning Show.

CSUs to play major role in transformation Continued from page 1

www.commissioningshow.co.uk8

The results show that this programme was associated with a reduction in mortality

of 1.3%, equating to a reduction of 890 deaths in this population of patients.

Clarity Informatics can confirm that the proven trend of quality improvements, cost savings, reduced bed days and lives saved continues from the end of their evaluation period to the current date. Clarity has supporting evidence and data proving significant financial savings from this programme.

QIS is an end to end solution for secondary care which reviews clinical topics and combines proven clinical best practice, data collection, software, analytics and workshops to improve quality of care and clinical outcomes. Introduced to the UK by Advancing Quality and developed further by Clarity from 2010,

the solution has been used for over four years in the North West and independent evaluation up to 2010 by the University of Manchester has demonstrated tangible benefits in terms of lives saved.

QIS was developed out of a pilot designed to improve outcomes in secondary care for specific disease areas in NW England, where mortality relating to myocardial infarction and heart failure was observed to be higher than the national average for England. Since the project started, the clinical focus has expanded from five to ten patient pathways and new developments have included using NHS SuS linked data sets.

Mike Farrar, Chief Executive of the NHS Confederation, who originally worked on the QIS project, said: “My only regret is that this programme did not become national.”

To view the report and for more information, please visit www.clarity.co.uk

Local clinicians have now been given the authority to take control of the NHS budget in almost half of England’s local health communities.

The latest 67 CCGs to be authorised follow a first wave of 34 groups authorised in December 2012. A total of 211 CCGs will, from 1 April 2013, be responsible for £65 billion of the £95 billion NHS commissioning budget. The remaining 110 CCGs are set for authorisation over the next two months.

Nineteen of the 67 CCGs in the second wave have been authorised with no conditions, meaning they fully met all 119 authorisation criteria. A further 45 CCGs have been authorised with conditions, and will continue to receive some formal support

to help them continue their development so that they also fully meet the criteria in all areas.

Three CCGs – NHS Nene CCG, NHS Herts Valleys CCG, and NHS Medway CCG - will be authorised to take control of their commissioning budgets, but with more intensive support. This will be provided by the NHS Commissioning Board or neighbouring CCGs and will be underpinned by legal directions.

Dame Barbara Hakin, the NHS Commissioning Board’s National Director: Commissioning Development, said: ‘Almost half of the CCGs are now authorised and we are moving at pace towards a clinically-led NHS that is focused on delivering improved health outcomes, quality, innovation and public participation.’

Quality Improvement Scheme reduces mortality rates

Second wave of CCGs given green light to take control of NHS budgets

Figures published in the New England Journal of Medicine by a team from the Universities of Manchester, Nottingham, Birmingham and Cambridge, show significant drops in mortality after using Clarity Informatics’ Quality Improvement Service (QIS) in the North West of England.

The NHS Commissioning Board has authorised a second wave of clinical commissioning groups, taking the total to 101, serving more than 28 million people.

£23million deficit spurs rapid transformation of urgent & emergency care in Croydon

TAG Medical Opus Business Systems

Escalating costs, variable quality of care and the unexpected £23 million PCT inherited deficit have led to rapid transformation of urgent and emergency care in Croydon over the last year.

‘Tinkering around the edges was not an option,’ says Dr Agnelo Fernandes, a GP and assistant clinical chair of Croydon Clinical Commissioning Group, who has led the changes.

Dr Fernandes will be giving a talk at the Commissioning Show outlining how clinical c o m m i s s i o n e r s tackled the reforms that were needed.

The first phase, completed in the space of a year, has involved redesigning the entire urgent and emergency care pathway. The aim was to direct patients with urgent care needs to the right professional, in the right place, at the right time at the right quality and cost.

First, a single point of access to the urgent and emergency care system using NHS 111 was introduced then an urgent care centre with a separate provider and an urgent care contract was set up at the front door of the emergency department that included the GP out of hours service. Quality measures were included in all contracts.

Currently, 60 per cent of patients walking in to A&E who are not acutely ill are streamed in to the urgent care centre and savings have been made as the A&E tariff is now paid only for the 40 per cent of patients seen in the emergency department.

The second phase, which is currently ongoing involves more closely integrating health and social care. Commissioners are working on reablement services provided by the local authority and developing alternative care pathways with the ambulance service so that patients who could be treated at home, are not automatically conveyed to A&E.

Urgent care networks are being developed to bring together voluntary organisations, local authorities, NHS trusts and mental health providers as well as integrated governance.

Primary care clinicians are being incentivised to identify patients with long term conditions at risk of hospital admissions and to improve prevention through care planning, case management and with telehealth. Commissioning for Quality and Innovation (CQUIN) payments are being developed for each hospital to improve the integration of community and hospital services.

‘There is no money so we are improving integration through the removal of duplication and waste,’ explains Dr Fernandes.

The third phase of improvement will involve reconfiguring local hospital services working with other CCG’s. Commissioners will be involved in making case for change based on arguments of cost, safety and quality.

Dr Fernandes says rapid improvements have been achieved in Croydon because clinicians have led the changes: ‘You can bring about huge system change as clinical commissioners and it doesn’t have to take a long time. It’s all about having a good management team that is focused on delivery. We used quality as a driver to improve the service.’

Calibration, Testing and Repairs

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Our friendly team of engineers cover the whole the UK, and will always go above and beyond to help you maintain the smooth running of your practice. And don’t forget, annual equipment calibration enables you to claim 3 QOF points as per the nGMS contract management point 7.

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Opus Business Systems is an established independent communications provider, serving London and the

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Our specialist Healthcare Communications team has been providing effective and reliable communications solutions for more than 20 years.

We are accredited as a Specialist Healthcare Partner with communication industry leading manufacturer Mitel and were named the ‘Communications Provider of the Year’ at the 2012 General Practice Awards.

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Dr Agnelo Fernandes

Book your place at the Commissioning Show by visiting www.commissioningshow.co.uk