World class commissioning - an introduction

World class commissioning is about delivering better health and wellbeing for the population, improving health outcomes and reducing health inequalities. In partnership with local government, practice based commissioners and others, Primary Care Trusts (PCTs),supported by Strategic Health Authorities (SHAs), will lead the NHS in turning the world class commissioning vision into a reality, adding life to years and years to life.

Published October 2009, 10 pages

Practice based commissioning: GP practice survey wave 8

This is the eighth quarterly practice survey for 2009, covering a sample of practices from each primary care trust (PCT), conducted between June and August 2009. The aims of the survey are to get feedback from practices on their perception of the support offered by their PCT and on the clinical and financial engagement of practices with PBC. The survey is part of a group of indicators that will be assessed together to give a picture of PBC implementation.

Published September 2009, 28 pages

WCC summer update - July/August 2009

This letter from Gary Belfield gives a progress report on the world class commissioning (WCC) programme for July and August. It includes updates on the launch of assurance year two, the PBC National Clinical Network, a new film showcasing PBC in action, some new support and development resources and an update on the programme of Integrated Care Pilots (ICP).

Published August 2009, 4 pages

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:

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

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

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

Practice-based commissioning in action: a guide for GPs

Practice-based commissioning offers front-line clinicians the opportunity to play a major role in the development and delivery of strategies and activities that improve local health and well-being. However, many GPs don’t know how to get started, to make their ideas for change a reality.

This Department for Health Guide provides easy to follow advice, practical examples and details of where to find further support. Although primarily designed for those just starting out with PBC, it also contains information and useful tips of interest to those that have already made progress but are looking to expand their activity further.

Published June 2009, 28 pages

Practice based commissioning GP practice survey

This is the 1st quarterly practice survey for 2009, covering a sample of practices from each primary care trust (PCT). The aims of the survey are to get feedback from practices on their perception of the support offered by their PCT and on the clinical and financial engagement of practices with PBC. The survey is part of a group of indicators that will be assessed together to give a picture of PBC implementation.

Published March 2009

Other Documents and Conferences

1. Conference: World Class Mental Health Commissioning 2009; Making an impact?
2. PBC Connection: an initiative by NHS Networks to bring together stakeholders in practice-based commissioning.
3. Improving the patient experience: sharing success in mental health and learning disabilities
4. The Power of One the Power of Many
5. Comprehensive Area Assessment: Framework document
6. Health Action Planning and Health Facilitation for people with learning disabilities

NICE has published six new commissioning guides

The National Institute for Health and Clinical Excellence (NICE) has published six new commissioning guides to help the NHS in England effectively commission evidence-based care for patients. The guides cover services for:

• otitis media with effusion
• patient education for people with type 2 diabetes
• diagnosis and initial management of stroke
• diagnosis and initial management of transient ischaemic attack
• attention deficit hyperactivity disorder in adults and young people in transition
• insulin pump therapy.

Each commissioning guide signposts and provides topic-specific information on key clinical and service-related issues to consider during the commissioning process. They also offer an indicative benchmark of activity to help primary care trust and practice-based commissioners determine the level of service needed locally.

To access the guides go to: www.nice.org.uk/CommissioningGuides. Ideas for future topic specific guides can be emailed to commissioningguides@nice.org.uk
For more information call Kristin O’Leary on 0161 870 3138 or email kristin.oleary@nice.org.uk.

Clinical commissioning: our vision for practice-based commissioning

This document sets out a vision for clinical commissioning, the hallmarks of successful clinical commissioning, the support and entitlements that practice-based commissioners can expect, and the principles underpinning vibrant, productive partnerships between PCTs and their clinical communities.

Published March 2009, 20 pages

Practice based commissioning drive begins in Brent

The first project in a new government funded drive to improve practice based commissioning has been launched in Brent. Brent primary care trust will work with a partnership of NHS Alliance and Humana to develop the skills of clinicians and managers.

Published March 2009, 1 page

Practice-based commissioning budget guidance for 2009/10

PCTs are responsible for ensuring that practices receive an indicative budget that reflects the needs of their population as accurately as possible. This allows a practice to access a 'fair share' of the resources available to the whole of the PCT for its patients. The Department has updated the toolkit that can be used to determine weighted capitation indicative budgets at practice level. This is part of the DH ongoing commitment to refine the methodology and improve accuracy.
To accompany the toolkit the DH have also produced guidance which sets out:

• Changes to the recommended methodology for deriving practices fair shares for 2009/10
• Changes to the minimum pace of change to practices budgets for 2009/10
• Information on how to use a new toolkit that can help PCT set budgets

Published February 2009

Practice-based commissioning: reinvigorate, replace or abandon?

Practice-based commissioning (PBC) is one of the cornerstones of health policy reform, but has it delivered its intended benefits? Its objectives were to encourage clinical engagement in service redesign and development, improve services for patients and make better use of resources. Through in-depth interviews with GPs, hospital and primary care trust staff in four sites, this Kings Fund report assesses the progress of PBC and identifies the barriers that are limiting success. Using the evidence from the four case studies and from previous research, it suggests ways forward for policy-makers.

(Published November 2008, 80 pages)

Practice based commissioning GP practice survey

This is the fifth quarterly practice survey, covering a sample of practices from each primary care trust (PCT), conducted between September and November 2008. The aims of the survey are to get feedback from practices on their perception of the support offered by their PCT and on the clinical and financial engagement of practices with PBC. The survey is part of a group of indicators that will be assessed together to give a picture of PBC implementation.

(Published December 2008)

PBC Development Framework

The Department of Health has established a PBC Development Framework, which SHAs, PCTs and practice-based commissioners (PBCs) can now use to appoint appropriately skilled organisations to provide a range of PBC capability development support.

(December 2008)

Commissioning IAPT for the whole community: Improving Access to Psychological Therapies

This document is intended to assist commissioners (including practice-based commissioners), to deliver Improving Access to Psychological Therapies (IAPT) services that are effective and appropriate for the whole community, using innovative ways of meeting the needs of local people. It is drawn from the work of the IAPT special interest groups (SIGs).

(Published November 2008)

Improving outcomes in cardiovascular disease; a guide for practice-based commissioners

This timely guidance reviews the evidence base for promoting prevention and optimising treatment in CVD. It then outlines how PBC groups can use savings to fund a more systematic approach to the management of CVD in primary care.

(Published September 2008, 20 pages)

Practice based commissioning: case studies

These case studies, from the Department for Health, contain examples of areas in which practice based commissioning is already happening. Practices have been able to receive an indicative budget since April 2005. In some areas, forms of practice based commissioning precede this date.

The future of commissioning

This supplement contains five articles on various aspects of commissioning. The topics covered are: patient and public engagement; quality assurance; practice based commissioning and joint working.

Health Service Journal 2008; 118 (6110): 1-9

Ask your local health librarian to locate journal articles. Don't know who they are in the UK pop your postcode into HLISD and locate them today!

Other documents and conferences

Innovation workshops available to support world class commissioning

To register your interest in attending a workshop, please contact: gina.shakespeare@dh.gsi.gov.uk.

Development of new NHS contracts.

National Cancer Intelligence Network: Cancer e-Atlas

Will practice-based commissioning in the English NHS resolve the problems experienced by GP fundholding? Public Money and Management 2008; 28 (4): 231-238.

The role of specialist physicians in the commissioning of clinical services Clinical Medicine 2008; 8 (3): 248-249.

Ask your local health librarian to locate journal articles, don't know who they are in the UK pop your postcode into HLISD.