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