The Commissioner: August 2009

Wednesday, August 19, 2009

The Commissioner Volume 4 Issue 8

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The Commissioner Volume 4 Issue 8

Health select Committee review of commissioning

The Health Select Committee has decided to undertake an inquiry into commissioning in the NHS.

The terms of reference for the inquiry are as follows:

"World-Class Commissioning": what does this initiative tell us about how effective commissioning by PCTs is?
The rationale behind commissioning: has the purchaser/ provider split been a success and is it needed?
Commissioning and "system reform": how does commissioning fit with Practice based Commissioning, "contestability" and the quasi-market, and Payment by Results?
Specialist commissioning;
Commissioning for the quality and safety of services.

Organisations and individuals are invited to submit written evidence to the inquiry.

The link between health spending and health outcomes for the new English primary care trusts

This report describes a model which takes into account population need in a way that has not previously been undertaken. The authors note that their work has a number of limitations including the use of a rather narrow outcome indicator (mortality) and the need to assume a relatively stable pattern of spending by PCTs across programmes over the recent past. Notwithstanding these limitations, the study offers clear confirmation that current expenditure by PCTs on some important programmes of care is highly cost-effective and illustrates how programme budgeting data can be used to generate information which might usefully inform PCTs' spending decisions.

Published June 2009, 64 pages

PBC 2 years on: moving forward and making a difference

In 2007, a straw poll of GPs and practice managers by The King’s Fund and NHS Alliance found that primary care trusts (PCTs) were struggling to put in place the basic building blocks of practice-based commissioning (PBC). Two years on, has PBC moved forward and is it making a difference to patient care? A new poll has found continuing commitment to PBC and optimism about its potential but progress is still hampered by a lack of local vision, a lack of clarity over roles and responsibilities and bureaucratic governance processes. Moving into an era of restricted financial resources, it will become increasingly important for PCTs and practices to work together. Real clinician engagement – underpinned by locally developed visions, structures, agreements and lines of accountability – is key to the development of effective partnership working.

Published July 2009, 16 pages

Commissioning for Stroke Prevention in Primary Care

The new NHS Improvement publication “Commissioning for Stroke Prevention in Primary Care: the role of Atrial Fibrillation” which has been developed following a national consensus meeting of opinion leaders in the field, to develop a concerted strategy towards the management of AF in primary care.

This document considers the evidence that a review of AF management in primary care is needed to develop more systematic strategies for the identification, diagnosis and optimal treatment of patients with AF to reduce the risk of stroke. It is aimed at cardiac and stroke networks, PCTs, commissioners, medical directors, cardiac and stroke leads, public health colleagues, and GP’s.

Published June 2009, 16 pages

Commissioning interventions to reduce alcohol-related harm

This DH guidance is designed to direct commissioners in areas where tackling alcohol harm is an identified priority, to the resources and guidance, which will assist them in commissioning interventions to reduce alcohol-related harm in their local community. It offers ways to improve commissioning, looking at each World Class Commissioning competency and all stages in the commissioning cycle.

Published July 2009, 90 pages

Prospects for NHS funding: 2011-2017

NHS spending in England may have more than doubled in real terms since 1999/2000, but the prospects for future funding now look bleak. Although there is consensus that the NHS faces a tough financial future, there is no agreement about just how cold the financial climate will be. Starting with a look at historical funding for the NHS, The King’s Fund and the Institute for Fiscal Studies set out three plausible future funding scenarios and their consequences. The paper concludes with an assessment of each scenario and the options for funding up to 2017.

Published July 2009, 28 pages

Shared vision for mental health - consultation

Good mental health is fundamental to the well-being and prosperity of England. In the last decade, greater investment and reforms have transformed mental health care, but now we need to go further.

We need to target the root causes of mental illness and support the local development of higher quality, more personalised services.

New Horizons sets out ideas for achieving this. It explores the prevention of mental illness and earlier intervention when things go wrong. It also looks at how services can become more innovative and work more effectively together.

The Commissioner