CHIM

5 November 2008

Commissioning

Commissioning“is the prioritisation (rationing or resource allocation) of healthcare based on the expressed health needs of a defined population and framed by mandated care and local and national health priorities …. A process of differentially valuing various forms of healthcare; a set of moral judgments about the relative value (benefit) of different kinds of health services framed by politically and clinically defined requirements”

Tritter, 2008

World Class Commissioning

D.O.H. approach to strengthen Commissioning

Improving Wellbeing and Health

World Class Commissioning

• Vision

• 3 key components

- Outcomes

- Competencies

- Governance

• Assurance Review Process

World Class Commissioning: VisionWorld class commissioning is not an end in itself, so in order to prove themselves successful, commissioners will need to demonstrate better outcomes; adding life to years and years to life

Better health and well-being for all• People live healthier and longer lives• Health and inequalities are dramatically reducedBetter care for all• Services are evidence based, and of the best quality• People have choice and control over the services that they use, so they become more personalisedBetter value for all• Investment decisions are made in an informed and considered way, ensuring that improvements are delivered within available resources• PCTs work with others to optimise effective care

The vision for world class commissioning will be one that is developed, articulated and owned by the local NHS, with a strong mandate from local people and other partners (such as local authorities). PCTs should state what their vision for world class commissioning is locally, and what they will achieve through continually commissioning better services and delivering better outcomes based on local priorities.

World Class Commissioning

3 Key components: outcomes,competencies and governance

World Class Commissioning

Outcomes

Reflect the overall improvement in the health and well being of the population

Up to 10 outcomes for review

2 national - life expectancy and health inequalities

Up to 8 determined locally in line with strategic plan

World Class Commissioning

Improvement based on ‘relative’ outcomes

World Class Commissioning

Competencies

Competencies reflect improvements in the PCT’s skills and behaviours as commissioners

They describe the Commissioning Process

Competency 11 is assessed within the governance component of assurance

World Class Commissioning

11 world class competencies

• 3 indicators/competency

• Criteria/indicator

• Rating 1 to 4

• Self assessment

• Survey Feedback

World Class Commissioning

GovernanceGovernance reflects the underlying grip that the Board and the organisation have on their core business

Key components:Strategy Strategic PlanFinance Financial PlanBoard Self Certification + evidence

Organisational Development Plan

R

R

R

A

A

A

G

G

G

World Class Commissioning

April May June July August September October November December January February March

Calibration

PCT PLANS

COMMISSIONING ASSURANCE*

Publication of Next Stages Review(2008)

PCT preparation

Ongoing follow-up

Ratings published(2010 onwards)

Annual operating plan

Five-year financial plan

Strategic plan

Revised strategic plan

Organisation development plan

Panel day

Panel preparation

Strategic planscomplete

Timed around an annual cycle

World Class Commissioning

World Class Commissioning: Why?World Class Commissioning: Why?• Commissioning in a health context still very new• Key to achieving Govt’s aims and objectives

- put the emphasis on improving wellbeing and health

- end historic pattern of provider led service development

- investment based on needs assessment and involvement in public and patients

• Move from contracting to commissioning• Become Health Benefit organisations

System Reform – Made Easy

Group Work 2

What are a PCTs information requirements to successfully support the 3 components of World Class commissioning ?

- Outcomes- Competencies- Governance – particularly the Strategic

Plan and the Financial Plan

Are these information requests readily available to the PCT ?