The document is a resource for commissioners and others interested in shifting care closer to home. It aims to share local emerging practice, how national enablers can support shifting care, and highlights new products developed to support local commissioners and providers.
Published July 2008, 57 pages
Developed by the Care Closer to Home Urology sub-group, this resource aims to provide guidance and information for commissioners to consider and use when commissioning services for people with urological conditions, in the community. It is also intended to provide information for clinicians and others who are exploring providing urology services in the community.
Published July 2008, 30 pages
Although all of the world class competencies have a strategic dimension, two are perhaps most directly focused on strategy: Competency 1: ‘Are recognised as the local leader of the NHS’ and Competency 6: ‘Prioritise investment according to local needs, service requirements and the values of the NHS’. This review of the published literature on strategy is intended to provide an overview of the main approaches to developing strategy, how these can be applied in practice, and how the resulting strategy can be best implemented.
Published July 2008
This is the fifth survey of peoples’ experiences of local health services to be carried out since 2003. More than 69,000 people took part in the 2008 survey, which is a response rate of 40%. The results of the survey offer a valuable insight into peoples’ experiences of local health services, such as GP practices and health centres and accessing dentistry. The results should be used by Primary Care Trusts (PCTs) to improve the services that they provide to their local population.
This case study is written for clinicians, service managers and commissioners to illustrate the complexities in commissioning and procuring a new service for people with long term conditions if existing services do not address patients’ needs. It is accompanied by a set of suggested “dos and don’ts” on the last page.
Published June, 2008, 13 pages
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.
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
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A guide designed to help you when you are tasked with the responsibility for leading a project team from project start-up through to successful project delivery. Project Delivery for Commissioners User Guide provides detailed end-to-end guidance for working through the process of setting up and delivering a service change project, as well as for using the extensive range of supporting tools and techniques available from the NHS Institute website. It also provides detail on who should be involved at various points in the process, explains the activities that will need to take place and highlights examples from the health communities who helped design the approach.
Published July 2008
The Secretary of State's speech to the NHS Confederation conference on 18 June 2008 and the Next Stage Review report published on 30 June 2008, signaled that PCTs have the freedom to re-name to NHS Local. This means that they can choose to adopt the NHS prefix before their place name, so for example, Blackpool PCT would become known as NHS Blackpool. This will allow PCTs to position themselves as the local leader of the NHS and front-line commissioners of patient care. It is integral to the objectives of World Class Commissioning and in particular, competency 1, that PCTs should be recognised as the local leader of the NHS.
This new resource published by NHS PCC and developed by the Dermatology Care Closer to Home Group is for commissioners to consider and use when commissioning services for people with skin conditions in the local health community.
Published July 2008, 34 pages
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.
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How do we know that what we plan to do will lead to a service innovation or … make a bigger difference? These guides illustrate methods and tools to help NHS teams answer this question. Using methods and tools that support a specific 5-step process framework, with a special focus on world-class commissioning, and a ‘Culture for Innovation’ section describing seven factors that organisational studies show are linked to innovative output.
(Published June 2008)
The pace of change and reform in the NHS has been relentless as government and those who work in the NHS seek ways to improve the service. The King’s Fund set up an expert working group to examine how effective the current incentives were in achieving this aim. The group focused on the role of PCTs as commissioners and on practice-based commissioning but discussed other issues, including patient choice. This paper includes specific proposals for government, the Department of Health, strategic health authorities and primary care trusts. These conclusions should feed into Lord Darzi’s review and help to clarify the next steps for the NHS.
(Published June 2008, 40 pages)
The delivery of the world class commissioning vision and competencies will take place within a commissioning assurance system. There will be one national system of commissioning assurance, locally managed by strategic health authorities (SHAs). There will be flexibility to set local priorities. Commissioning assurance will be designed to help primary care trusts (PCTs) identify areas of development and move towards filling gaps in their capabilities.
The Department for Health’s vision is for primary and community care to provide high quality, personal care and support, treating people when they're sick and helping them stay healthy, where and when they need it most.
Primary and community care services are regarded with pride at home and admiration abroad. Thanks to the dedication of family doctors, community nurses, health visitors, allied health professionals, social care professionals, pharmacists, dentists and opticians, most patients enjoy good quality care, close to home. There are high levels of satisfaction with services and trust in the staff who provide them.
We need to ensure that high-quality care is a consistent part of everyone's experience of primary and community care. Services need to evolve to reflect changes in healthcare and society. This document sets out a vision for how services will continue to grow and develop over the next ten years. It is a vision of a continuously improving service, where essential standards are guaranteed and excellence is rewarded.
(Published 2008)
Government health policy has been encouraging a shift in the balance of care from hospital to community settings. The Department of Health commissioned The King's Fund, in partnership with Loop2, to undertake a simulation-based project entitled SeeSaw to understand how this shift in care could be achieved. This report outlines the simulation process and describes the event itself. The majority of the report, however, focuses on the learning that emerged during the event and in all the subsequent discussions on the implications for policy-makers, managers and professionals working in the NHS, in social care, and in the independent sector.
(Published June 2008, 72 pages)
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 (12 June 2008 Suppl.)
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The point of minimum financial risk is reached by placing between 20 per cent and 40 per cent of the inpatient budget into the risk pool. Allocating only five per cent of the budget to a risk pool requires a population base equivalent to the whole of England to achieve a one per cent tolerance on the risk pool. Moving 35 per cent of the practice based commissioning [PBC] inpatient budget into a primary care trust [PCT] held budget leads to between three per cent and eight per cent risk associated with the PCT retained budget for the largest and smallest PCTs in England respectively, i.e. only risk pools consisting of groups of PCTs are sufficiently large to mitigate financial risk.
British Journal of Health Care Management 2008; 14 (6): 240-245
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The financial risk associated with healthcare budgets is high. To operate within a financial tolerance of less than three per cent a PBC [practice based commissioning] group will need a population of greater than 50,000 (budget £15 million). The point of minimum financial risk is reached by placing all admissions costing more than £3,000 into a larger risk pool. A core of 47 HRGs [health resource groups] accounting for 30 per cent of the budget, are the only HRGs with sufficient volume for a PBC group to discern whether a statistically significant reduction in costs has been made.
British Journal of Health Care Management 2008; 14 (5): 199-204
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The purpose of this document is to support commissioners in their work with local service providers and education providers as they develop workforce plans to ensure the development of children’s palliative care services. In commissioning for quality and choice, there are likely to be a diverse range of potential services and a mix of approaches to provide palliative care services for children and their families. This document aims to provide a framework in accordance with the Children's Workforce Development Strategy to ensure a workforce to provide children's palliative care that:
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The world class commissioning programme is designed to raise ambitions for a new form of commissioning that has not yet been developed or implemented in a comprehensive way anywhere in the world.
The assurance system for world class commissioning (“commissioning assurance”) is linked to the vision and competencies published in December 2007 and to resources for support and development available both nationally and locally. Together these provide a coherent programme aimed at supporting commissioners in delivering their health agenda.
This handbook provides a detailed explanation of the content of commissioning assurance, with a practical guide on how to follow the process.
(Published June 2008, 90 pages)
The NHS Institute for Innovation and Improvement commissions a number of programmes and activities that support Board development for world class commissioning. In addition to the opportunities listed on their site, other programmes are in development and will be launched in the coming months.
Lord Darzi was asked by the Prime Minister and Secretary of State for Health to lead the NHS Next Stage Review in July 2007. His interim report in October set out a vision for a world class NHS that is fair, personal, effective and safe.
The Review has been led locally by clinicians in each NHS region. Seventy-four local clinical working groups, made up of some 2000 clinicians, have been looking at the clinical evidence and engaging with their local communities. They have developed improved models of care for their regions to ensure that the NHS is up to date with the latest clinical developments and is able to meet changing needs and expectations.
‘Leading Local Change’ sets the context for these local visions and the principles which will guide their implementation.
Published May 2008, 19 pages
The PCT Procurement Guide for Health Services supports NHS commissioners in deciding whether and how to procure health services through formal tendering and market-testing exercises. The Guide sets out the policy and regulatory context for procurement, and issues to consider when developing a procurement strategy. The Guide should be read in conjunction with the ‘Principles and rules for Cooperation and Competition’, published as Annex D of the 2008/9 Operating Framework, and the ‘Framework for Managing Choice, Cooperation and Competition’
Published May 2008, 24 pages
This Framework supports SHAs and PCTs in understanding the roles, responsibilities, values and behaviours required for the effective management of choice and competition within the NHS. The Framework is the outcome of a series of workshops and seminars with senior SHA and PCT leaders. The Framework should be read in conjunction with the Principles and rules for Cooperation and Competition (Annex D of the 2008/9 Operating Framework) and the ‘Primary Care Trust Procurement Guide’ (published 16 May 2008). Additionally, the Framework signals a further series of tools and guidance for system managers to be released throughout the year.
Published May 2009, 7 page
Care Services Minister Ivan Lewis has announced the opening of the second round of the Department of Health (DH) Social Enterprise Investment Fund. He also announced that this year, it would include a new element, the 'Innovation for Life Challenge Fund', developed in collaboration with the Social Enterprise Coalition. The Innovation for Life Challenge Fund will encourage Strategic Health Authorities (SHAs) and their partners to find collaborative solutions to health and social care needs through social enterprise.
Two healthcare management experts lock horns over whether the drive to raise the standard of commissioning really can transform the quality of care.
Health Service Journal 2008; 118 (7006): 22-24
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With the World Class Commissioning agenda gathering momentum, many Trusts are making significant progress translating the vision into reality. Learning from best practice examples across the country is key if Trusts are to move towards World Class status.
This is an opportunity to catch up with HealthExecTV's World Class Commissioning programme designed to assist Trusts in their transition.
Keynote interviews from policy leaders provide advice on how to step up the current approach. In addition, best practice case studies showcase achievements from Trusts leading the way in delivering their world class commissioning strategies.
Simply click the links below to view the programme elements:
Gearing Up for World Class Commissioning - Interview with Gary Belfield, Director of Commissioning, DoH
World Class Commissioning - NHS Confed Support - Interview with David Stout, Director PCT Network
Evidence-Based Planning for World Class Commissioning Transition
West Kent PCT Makes Strides in Delivering World Class Commissioning Vision in Sexual Health and Dentistry
GPs Lead the Way in Practice-based Commissioning Transformation at Warrington
Government policy is driving a fundamental shift of care from hospitals to more community-based settings. There is a growing expectation that this shift will be supported by the development of a network of new facilities in which primary, community and secondary care services are co-located, often referred to as polyclinics. Will this model improve the quality and accessibility of health care and deliver cost savings? Drawing on published information and original research into facilities similar to the polyclinic model in the United Kingdom and abroad, this report identifies and explores both opportunities and risks in relation to: quality of care, accessibility of services and cost.
Published June 2008, 67 pages
The Improving Access to Psychological Therapies (IAPT) programme has one principal aim - to help PCTs implement NICE Guidelines for people suffering from depression and anxiety disorders. The Government is committed to improving access to psychological therapies and announced additional funding to increase services over the next three years. This Commissioning Toolkit is designed to help PCTs improve or establish stepped care psychological therapies following NICE guidelines. The toolkit is structured around the commissioning cycle and is specifically linked to the World Class Commissioning competencies. It brings together a wide range of existing tools and guides and includes positive practice examples throughout.
(Published April 2008, 48 pages)
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