Further to the publication of ‘Improving Access to Audiology Services in England’ in March 2007, this document provides good practice and evidence to help commissioners and service providers to make changes to the way that paediatric hearing services are delivered, and in particular to reduce waits for patients with the most common hearing difficulties.
Published September 2008, 47 pages
World Class Commissioning Programme - August update
Local 18 Week patient experience surveys Health and Care Services for Older People: Overview report on research to support the National Service Framework for Older People
Seven Ways to No Delays
Making a bigger difference; A guide for NHS front-line staff and leaders on assessing and stimulating service innovation
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Widespread variations in how much the NHS spends locally on different diseases – even after the different needs of local communities are taken into account – are revealed today in a new report from The King’s Fund. NHS spending: local variations in priorities: an update analyses Department of Health data covering the financial years 2004/5, 2005/6 and 2006/7. The report provides an update to a previous report from The King’s Fund in 2006, which for the first time analysed the varying amounts primary care trusts (PCTs) in England spend on diseases such as cancer, mental health and circulatory diseases (such as heart disease).
(Published August 2008, 8 pages)
This letter and annex set out the existing policy and legal framework for the transfer of learning disability social care funding and commissioning from the NHS to local authorities with effect from 1 April 2009. The annex provides guidance on what is covered, what PCTs and LAs need to do and the timescale for the transfer. The proposed transfer was set out in Valuing People Now.
(Published August 2008, 15 pages)
World-class commissioning in the NHS means that the provision of high-quality, up-to-date information has never been more important. Information on the use of healthcare resources is critical to the success of Practice Based Commissioning. The NHS Comparators service enables general practices to analyse variations in the use of services across practice populations and to identify areas that may benefit from the redesign of services. SUS will support by By undertaking standard processing such as the correct grouping of activity and application of national tariffs once, SUS provides the opportunity to minimise the transaction costs associated with the comprehensive implementation of Payment by Results. SUS will manage new data flows to enable the analysis necessary to support the achievement of the Government's target of a maximum waiting time from referral to treatment of 18 weeks.
This commissioning guide provides support for the local implementation of NICE clinical guidelines through commissioning, and is a resource to help health professionals in England to commission an effective service for the accurate diagnosis of the epilepsies in adults.
This report was prepared by the Royal College of Psychiatrists, working in partnership with representatives from the Royal College of Physicians of London, the Royal College of Nursing and the College of Emergency Medicine. The current provision of mental health services to people attending the Emergency Department of General hospitals or those admitted to medical and surgical wards are extremely variable across the country. There is an urgent need to develop national standards that inform the commissioning of services, thereby guaranteeing that people in need receive prompt assessment and management by appropriately trained professionals.
(Published August 2008, 24 pages)
The BMA is concerned that many polyclinics are being imposed across the country, regardless of local need. This could lead to some local GP surgeries having to reduce the services they offer, or being closed if funding is diverted towards new polyclinics. Patients are also likely to have to travel further in order to see their GP.
An Expert Group on Commissioning NHS Infertility Provision was established by the Department at the beginning of 2008, with the aim of identifying the barriers to the implementation of the NICE fertility guideline and helping PCTs move towards the implementation of the guideline. The group is due to report in 2009, and has issued an interim report with recommendations, including that consideration be given to a clear clinical pathway and a national tariff for regulated fertility services
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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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