Policy and PracticeThe changing face of

commissioning in primary care

Dr Anne Mackie

Why countenance change ?

• PCTs originally set up to commission on behalf of their populations and to take cognizance of the commissioning intentions of primary care

• Systems worked in some areas better than others – but expected improvements did not materialize fast enough

• Our populations deserve better – hence initiatives like practice based commissioning are some of the initiatives which will drive change

Is primary care up to the task ?

• Where are the commissioning skills ?• Where is the knowledge outside their

areas of experience ?• Is primary care homogenous enough to be

able to take on this task ? • Is primary care able to understand and

access the evidence base on which to base their initial commissioning assumptions

How can I contribute to the cycle of effective commissioning?

Assessing needReviewing provisionDeciding prioritiesDesigning servicesShaping the structure of supply/procurementContractingClinical decision makingContract management Seeking views of patients and the public

What can I do today?

• Get to know your area• Exploit your skills and share your

knowledge• Develop relationships with primary care• Assist with the evidence base • Help with the interpretation of data – as far

as you can• Encourage and support – you are a

potential user too – it is in your interest

What will the landscape look like ?

• Primary care will be made to be more consistent in terms of accountability, quality and depth

• Public health will be seen as an integral and essential part of the commissioning process – straddling primary care and the PCTs – with responsibilities in both areas

• Knowledge will be available and accessed regularly– not just masses of data only comprehensible to the few