The Commissioner: March 2007

Thursday, March 22, 2007

Intelligent Practice: understanding the information needs of GP commissioners

For the first time, the information requirements for commissioning GPs have been identified. The Intelligent Practice, the fourth report in the independent Intelligent Board series, proposes a basic set of criteria as the information necessary to the running of a successful practice. The report's steering group, all practising GPs, unanimously agreed that practice-based commissioning is the key to the modernisation of the NHS. Effective commissioning depends on effective information. GP commissioners are not receiving the information they need to ensure that their local populations receive the best quality health services. This report is a practical guide for GPs and PCTs. It sets out two frameworks of minimum information requirements: one for every GP and another more detailed one for lead commissioners.

(Published February 2007, 18 pages)

Commissioning framework for health and well-being

Commissioning for health and well-being means involving the local community to provide services that meet their needs, beyond just treating them when they are ill, but also keeping them healthy and independent. This framework builds on the White Paper Our health, our care, our say, which promised to help people stay healthy and independent, to give people choice in their care services, to deliver services closer to home and to tackle inequalities. This framework is about action, with a particular focus on partnership. It is for everyone who can contribute to promoting physical and mental health and well-being, including the business community, government regional offices and the third sector.

(Published March 2007, 100 pages)

CRC Commissioning services to reduce drug related deaths

Over the last ten years, there has been increasing concern at the rising numbers of preventable drug related deaths. Many drug-related deaths can be prevented by commissioning and providing a baseline of quality services that are evidence-based and responsive to local need. The aim is to provide treatment through integrated care pathways across all four treatment tiers that are as seamless as possible, as indicated in Models of care (NTA 2002). The establishment of effective interfaces between services across all tiers of service provision requires communication and collaboration between services. Central to this are joint commissioning of services, common assessment /referral protocols that are appropriate to each tier and the establishment of robust service level agreements.

(Published February 2007, 12 pages)

Operating framework 2007/8- King’s Fund Briefing

This King’s Fund Briefing discusses the Department of Health second ‘operating framework’, The NHS in England: The operating framework for 2007/08 (Department of Health 2006), which provides a set of rules and guidance for NHS organisations in England for the year ahead. Aimed primarily at managers and clinical staff, the operating framework for 2007/8 is the latest in a series of explanatory documents that aim to explain the purpose of NHS reforms and add detail on how those reforms should be carried out.

DH Operating Framework

Commissioning conscious sedation services in primary dental care

This guidance provides advice on strategic commissioning of sedation services, together with advice on some transitional issues where PCTs have sought clarification of existing guidance. Previous guidance on sedation services has focused on transitional issues associated with the new contractual arrangements from 1 April 2006. This guidance addresses strategic commissioning issues that have previously been covered only by more general guidance on specialist dental services.

(Published February 2007, 13 pages)

New model contract threatens survival, foundations warn

Commissioners will not have to pay for any type of hospital treatment they have not authorised, or for activity which exceeds agreed limits, under the new model contract. The final contract, published on Friday, makes no concessions to foundation trusts' fears that it threatens their survival. Primary care leaders have welcomed it as a 'necessary rebalancing' between commissioners and providers.

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So where are the alternative providers in primary care?

PCTs can now commission primary medical care services from a range of different providers. Yet a recent study by the Kings Fund reveals that the volume of alternative types of provider in primary care remains small and the use of APMS contracts limited.

British Journal of Health Care Management, 2007, vol. 13, no. 2 p. 43-46 (Available via your local NHS Library)

Developing service provision for patients in primary care.

This article outlines the government's changes to the way that primary and community health services will be commissioned and provided. It also discusses the opportunities that exist for nurses to lead and develop services for the benefit of patients in the implementation of changes.

Nursing Standard, 2007, vol. 21, no. 23, p. 43-48 (available via your local NHS Library)

PCT futures : faster, stronger, better.

In December HSJ ran the PCT Futures conference in London, bringing together a wide range of speakers from government, primary care, and the independent sector. In this special report we examine some of the main themes to emerge, from the complex arguments around splitting commissioning and provision, to the role of independent providers and writing a new chapter in the troubled history of public engagement.

HSJ, 2007, vol. 117, no. 6040, p. 29-33 (available via your local NHS Library)

Cost-effectiveness of a nurse-led case management

The objective of this study was to evaluate the cost-effectiveness of a nurse-led, home-based, case-management intervention (NHI) after hospital discharge in addition to usual care. In conclusion the authors do not recommend the implementation of this intervention in populations that do not consist of severely vulnerable and complex patients.

Journal of psychosomatic research, 2007, vol. 62, no. 3, p. 363-70 (available via your local NHS Library)

The Commissioning Friend for Mental Health Services

This Guide to Commissioning Mental Health Services is the second in a series of guides developed by the National Primary and Care Trust Development Programme (NatPaCT) to assist Primary Care Trusts (PCTs) and Local Authorities in the vital role leading ‘Whole System Commissioning’ of health and social care. The structure and content has also been informed by a wealth of input from the National Institute for Mental Health in England (NIMHE) whose aim is to improve the quality of life for people of all ages who experience mental distress. This Guide has been designed to support PCTs and Local Authorities in understanding how to use their commissioning activities as a key part of improving the mental health of the communities they serve.

(Published January 2005, 162 pages)

From segregation to inclusion: Commissioning guidance on day services for people with mental health problems

This guidance is designed to assist commissioners of mental health services in the refocusing of day services for working-age adults with mental health problems into community resources that promote social inclusion and promote the role of work and gaining skills in line with current policy and legislation. This is good practice guidance for commissioners and it progresses the implementation of the developmental standards as set out in 'National Standards: Local Action'; published by the Department of Health in 2004.

(Published February 2006, 28 pages)

Practice-based Commissioning in the NHS: The implications for mental health

This paper looks at the implications of GP practices commissioning mental health services, and the risks and benefits to the patients who use the services.

(Published November 2004, 8 pages)

Choosing health: supporting the physical health needs of people with severe mental illness (commissioning framework)

This document provides best practice guidance to help PCTs plan for, design, commission and monitor services that will deliver improved physical health and well-being for people with severe mental illness. It describes appropriate leadership for a physical healthcare programme, roles and responsibilities of those involved and provides case studies.

(Published August 2006, 38 pages)

Payment by results: opportunity or threat for mental health commissioners?

Parsonage argues that payment by results represents both an opportunity and a threat for mental health commissioners. On the positive side, it offers PCTs the chance to exert more leverage in the system, for example in the planning and design of services and, where supply conditions permit, in promoting choice and contestability. On the downside, it requires them to manage more risks, particularly financial risks.

Primary Care Mental Health, 2005, vol. 3, no. 4, p. 271-273 (available via your local NHS Library)

Improving user/carer involvement in commissioning and reviewing mental health services.

Increasingly there is greater emphasis on user/carer involvement in the delivery of mental health care. There are five levels of participation from none at all to partnership and optimal involvement. A two-year pilot steering group was established by a health authority in December 2000 and criteria for independent evaluation agreed. These included the context, data collection, analysis and report, and recommendations based on the findings to increase user/carer involvement in all aspects of mental health service delivery.

Mental Health Review, 2006, vol. 11, no. 1, p. 16-2 (available via your local NHS Library)

10 High Impact Changes for Mental Heath Services

The 10 high impact changes were first launched in 2004. Now, building on the success of the original work, this guide sets 10 High Impact Changes for use across mental health services. The scope is wider but our aim of improving quality and efficiency of care for each and every service user remains the same and will continue to guide our service improvement activity through 2006 and beyond. The 10 high impact changes aim to improve quality of care but they are also about improving the efficiency of services – making the best use of resources to benefit service users. In this sense the drive to increase efficiency provides a more streamlined and effective service tailored to individual service user needs.

(Published June 2006, 57 pages)

The Commissioner