Practice Based Commissioning & Patient & Public Involvement: The New Frontier

PBC offers an opportunity for GP practices, Primary Care Trusts and local people to work together developing more appropriate pathway-based care and more efficient services. The report 'Practice Based Commissioning & Patient & Public Involvement: The New Frontier' explores this area.

However despite a general feeling that users should be involved, views of local communities are rarely taken on board with PBC.

Surveys carried out by NHS Alliance and Developing Patient Pathways suggest that some practices a experiencing barriers to involving patients in the early phases of PBC, despite adequate mechanisms.

(Published July 2007, 26 pages)

Enhanced services

Enhanced services are services not provided through essential or additional services, or essential and additional services delivered to a higher specified standard. They were negotiated into the GMS contract as a key tool to help PCTs reduce demand on secondary care. Their main purposes are to expand the range of local services to meet local need, improve convenience and choice, and ensure value for money. They were designed to provide a major opportunity to expand and develop primary care, and give practices greater flexibility and the ability to control their workload.

(Updated August 2007)

The Primary Medical Services (Directed Enhanced Services) (England) Directions 2007

(Updated August 2007)

Payment by Results (PbR) for stroke and transient ischaemic attack (TIA) services

The aim of this fact sheet is to help those affected by Payment by Results (PbR) understand how it works and ensure that the system operates in the best possible way for people in need of stroke care. This fact sheet begins by explaining the PbR tariff and looks at the key issues for stroke and TIA services. PbR is a way of paying for services commissioned on behalf of NHS patients provided by NHS Trusts, NHS Foundation Trusts (FTs), Independent Sector Extended Choice Network providers and PCTs. There is a national price list for all activity within the scope of PbR – this is the “national tariff”. Providers are paid according to the amount of activity they do, multiplied by the relevant tariff price. Activity x Price = Income

(Published July 2007, 13 Pages)

Bidding for capital finding for the Campus Reprovision Programme 2007/08

Following the announcement of capital funds to assist the campus reprovision programme, a letter has now been sent to PCT Commissioners informing them of the bidding process to apply for this year’s capital funding for reproviding campus learning disability services in the community.

(Published August 2007)

NHS Comparators

NHS Comparators (NHSNet Site) is a national resource, initially focused on supporting Practice Based Commissioning. It supports comparisons at GP practice, Primary Care Trust, Strategic Health Authority and national levels, enabling users to investigate aspects of local commissioning activity, costs and outcomes. It is designed to supplement information available by local systems, not to replace local systems. The initial releases have limited functionality and a modest range of comparators but this will increase quite quickly over time.

In search of quality in practice-based commissioning

This article describes people-based commissioning, to be distinguished from the more technical and short-term approach characterised as pocket book commissioning, and argues that people-based commissioning should be the preferred approach, which needs to address public health and mental health needs of the community.

Quality in Primary Care 2007; 15 (4) p. 235-239

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Working with the independent sector and managing out of area treatments

Not for profit and for profit sectors are currently working both alongside and in competition with NHS provider organisations. How all parts of the service system interconnect will in future be crucial for service users and carers.

Mental Health Review Journal, 2007; 12 (2) p. 25-29

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From general practice to general provider: how to do it

As the primary care landscape changes following recent proposals for expansion and greater services, astute individuals and teams are taking the opportunity to expand their horizons. One such individual is Dr Peter Godbehere, who, together with several other local practices, formed a private business providing additional health services.

Management in Practice, 2007; 8 p. 26-27

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Cost effectiveness of … screening for Chlamydia

The objective was to investigate the cost effectiveness of screening for Chlamydia trachomatis compared with a policy of no organised screening in the United Kingdom.

BMJ , 2007; 335, (7614) p. 291-294

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A Problem Shared

This article describes the products and services of the Greater Manchester commissioning business service and other such agencies which support PCTs and practice-based commissioners. Providing such support as needs analysis, commissioning strategy, service and pathway redesign, market management and contracting, performance reporting and contract management.

HSJ, 2007: 117 (6072) p. 22-25

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Other documents and conferences

Conference: HSJ Commissioning for Health & Wellbeing

Strategic Health Asset Planning & Evaluation (SHAPE)

News: National Solutions to 21st Century Healthcare

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Patient and public involvement in PCT commissioning

A survey of Primary Care Trusts (PCTs) was carried out to determine their readiness to engage patients and the public in healthcare commissioning. One third (51 out of 152 PCTs) responded. By virtue of their interest in the survey, these are likely to be among the better end of the patient and public involvement spectrum. While some PCTs have embarked on ambitious programmes to engage patients and the public in commissioning, many are not ready for the new challenges that confront them.

It is crucial that PCTs effectively involve patients and the public in their commissioning processes. A commissioning strategy without the input of the community is not worth the paper it is written on. But if they are to prioritise this as they must, PCT staff need help: they need budgets, leadership, techniques and technology.

(Published June 2007, 25 pages)

Good practice in offender health

The report outlines examples of good practice in provision of health care services to offenders in prison and the community. The examples have been drawn from surveys, internet search and individual submissions. From all of the documents and sources reviewed, over 400 were selected as potential examples of good practice. The examples have been distilled from that selection and form the results of the survey.

(Published July 2007, 81 pages)

Social Enterprises and the NHS

Recent years have seen great changes in the accountability of different parts of the NHS as alternative providers have become an increasingly visible part of the healthcare landscape. This latest report from Durham University is therefore very timely in its analysis of the wide variety of organisations characterised as social enterprises and their approaches to involving staff, public and patients.

(Published July 2007, 63 pages)

Hearts and minds: commissioning from the voluntary sector

This report sets out our findings on: the extent and nature of the voluntary sector's delivery of public services; the locally perceived impact of government efforts to build capacity; the current state of commissioning; and procurement practice. The report is primarily for managers in local councils who are responsible for commissioning services, but it will also be of interest to voluntary organisations and national policymakers.

(Published July 2007, 76 pages)

Developing effective joint commissioning

This paper argues that effective joint commissioning between health and social care is a necessary component of the government's plans for adult services manifest in the policies of its 2006 white paper, 'Our health, our care, our say'.

Journal of Care Services Management 2007; 1 (3) p. 279-93

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Strategic Health Asset Planning and Evaluation

Strategic Health Asset Planning and Evaluation toolkit (SHAPE) has been developed by the Department of Health for SHAs and PCTs. SHAPE is a web enabled, evidence based tool designed to support and inform strategic planning. It brings together existing national data sets of clinical activity, human geography and healthcare estate assets supported by Geographical Information Systems (GIS) technology.

The impact of contracting-out on health system performance

This paper presents a conceptual framework that is expected to facilitate comprehensive, rigorous, and standardized evaluation of contracting-out at health system level.

Health Policy 2007; 82 (2) p. 200-11

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From general practice to general provider

As the primary care landscape changes following recent proposals for expansion and greater services, astute individuals and teams are taking the opportunity to expand their horizons.

Management in Practice 2007; 8 p. 26-27

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Primary Care Service Frameworks: New Management of Health for People with Learning Disabilities in Primary Care

The purpose of this Primary Care Service Framework is to equip commissioners, providers and practitioners with the necessary background knowledge, service and implementation details to safely commission and deliver a high quality, integrated service for the management of health for people with learning disabilities in primary care.

(Website)

Other documents and conferences

South West Primary Care Leads Network Event: PBC & Pharmacy

New university-accredited programme: Advanced Commissioning

Delivering the 18 week pathway; Update

Practice based commissioning and 18 weeks: How to create win-wins

Improving services and support for people with dementia

Dental Commissioning and Contract Monitoring

How can funding of long-term care adapt for an ageing population?

Debates and dilemmas; commissioning children and young people

This briefing bulletin will help directors of children’s services and senior managers with lead responsibility for strategic commissioning to improve outcome for children and young people by developing more robust commissioning arrangements. The briefing is informed by a study seminar sponsored by the Improvement and Development Agency (IDeA), the Department for Education and Skills (DfES) and Research in Practice (RiP). Discussion at the seminar was wide ranging; it provided a rich source of information and practical suggestions. The seminar confirmed that strategic commissioning is a complex process and that directors of children’s services need to play a lead role in championing new approaches. Commissioning must focus on outcomes – and this is a different and challenging way of designing and performance-managing services.

(Published July 2007, 20 pages)

Commissioning health care services for children and young people: increasing nurses’ influence

This guidance provides assistance in influencing the commissioning process for nurses who manage and lead children’s and young people’s services. As children’s nurses, it is our professional duty to monitor the quality of services provided to children and their families and influence processes for service enhancements. Commissioning processes are continually evolving, and this document will provide information and support to help you influence the development of effective, efficient and appropriate high quality services for your area.

(Published May 2004, 20 pages)

Commissioning children's services and the role of the voluntary and community sector

The Laming Inquiry, followed by the publication of Every Child Matters, heralded the start of a debate that would bring about the most significant changes to the provision of Children’s Services for a generation. This document seeks to bring together core principles and challenges, as well as evidence of good practice. We hope it will help professionals in all sectors to share a common understanding of commissioning and the role of voluntary sector plays at the moment and has the potential to play in the future, as we progress our shared goal of improving children’s outcomes.

(Published 2004, 35 pages)

Joint planning and commissioning framework for children, young people and maternity services

The framework aims to help local planners and commissioners to design a unified system in each local area which will create a clear picture of what children and young people need, will make the best use of resources, and will join up services so they provide better outcomes than they can on their own. The framework is designed for people working in all sectors of children, young people and maternity services including political leaders, senior management, planners, commissioners, providers, corporate procurement, finance, legal and other support staff, central and regional government officials.

(Published 2006, 36 pages)

Commissioning drug services for vulnerable young people

This self-assessment tool is designed to assist PCTs and their partners in assessing their knowledge and capability to commission children's and young people's services. It reflects the importance of effective partnerships in commissioning the integrated services, which are fundamental to the improved outcomes of services for children and young people.

(Published April 2007)

Commissioning drug services for vulnerable young people

This paper examines commissioning processes for drug services in the case of vulnerable young people. In the context of government's modernisation agenda it characterises drug service commissioning as an activity that should occur across professional boundaries in health, social care, local authority and crime agencies.

Drugs education prevention and policy, 2003, 10 (3) p. 251-262

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Fact file: joint commissioning of children's service

What will a shake-up of children's services mean for joint commissioning bodies? Amanda Reid provides an overview.

Care and Health Magazine, 2005 Suppl., (105) p. 17-18

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Children and Young People's Plan

The Children and Young People's Plan (CYPP) is an important element of the Every Child Matters reform programme. It has been a powerful force in driving forward better local integration of children's services and the development of local partnership arrangements.

A series of 12 papers that presents the findings from NFER’s analysis of Children and Young People’s Plans (CYPPs) were produced. Number 3 Commissioning and Resourcing in Children and Young People’s Plans sets out how aspects of commissioning and resources feature in CYPP and includes illustrative examples.

Other documents or websites of interest

Children Services: Department of Health

Commissioning Children’s and Young People’s Palliative Care Services

Children’s NSF Case Studies

Choice at Referral: Guidance Framework for 2007/8

This document provides best practice guidance for commissioners and providers on how the roll-out of free choice in elective care in 2007/8 will operate. It supplements existing guidance on choice at referral policy and implementation by setting out a framework to govern the further extension of choice in 2007/08.

(May 2007, 16 pages)

Getting the Basics Right: Final Report on the Care Closer to Home: Making the Shift

This document evaluates the NHS Institute’s Care Closer to Home Programme, which ran from November 2005 to March 2007. It identifies the factors that helped or hindered progress in shifting care outside hospital, and the lessons for the NHS from the experience of field test sites. The NHS Institute’s Care Closer to Home Programme
was established in 2005 to explore the scope for bringing about shifts in care within the NHS. Following an observation phase that ran from November 2005 to February 2006, the NHS Institute selected five healthcare communities to act as field test sites. In these five sites, 14 projects were identified to provide the focus for the programme.
This report summarises the main findings of the evaluation and the lessons for the NHS. It notes that almost all the 14 projects have started to test the scope for making shifts in care, with some getting underway more quickly than others.

(May 2007, 49 pages)

Delivering health services through Sure Start Children's Centres

The Government has set out its vision for a Sure Start Children's Centre in early community. Children's centres offer significant opportunities for improving children's health and ensuring that families are able to access the information, support and services they need to help their child to thrive and achieve their full potential. The purpose of this document is to increase PCTs awareness of the childrens’ centres agenda and the opportunities it provides.

(June 2007, 30 pages)

Practice Based Commissioning: A Practical Guide for LPCs

This document aims to help Local Pharmaceutical Committees think through the action they should be taking to assist community pharmacy contractors understand and engage with Practice Based Commissioning (PBC). As well as providing background information on the place of PBC in current policy, it provides practical suggestions.

Windmill 2007: The future of health care reforms in England

The NHS has undergone many reforms over the past decade. To test out where the reforms – and interactions between them – might lead the NHS, the King’s Fund formed a partnership with Loop2, Monitor and Nuffield Hospitals to produce Windmill 2007. This initiative included a two-day simulation of a fictional but realistic health economy from 2008 to 2011 and extensive discussions of the emerging findings from that event with clinicians, managers, policy-makers, regulators and analysts.

(June 2007, 80 pages)

A rational way forward for the NHS in England

This report sets out a rational way forward to secure the long-term future of the NHS in England. The main body is divided into two sections, on: a) where and why the reform programme is going wrong; b) the BMA’s rational way forward for health service reform in England.

(May 200, 82 pages)

New information source for commissioners

A Practice Based Commissioning (PBC) Comparators website is launched nationally this month. The benchmarking service uses existing data sources from The Information Centre and NHS Connecting for Health Secondary Uses Service, standardises it for population and breaks it down by GP practice to show activity and referral patterns and outcomes for a number of key conditions.

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. (June 2007, 14 pages)

Tuberculosis prevention and treatment

A toolkit to enable PCT commissioners plan and commission high-quality TB services for their local population. (June 2007, 60 pages)