Where next for commissioning?

David Evans chief executive of Northumbria Healthcare NHS Foundation Trust shares his view on where next for commissioning as part of Provider Voices | NHS Providers.

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My honest opinion is that the purchaser-provider split has outlived its usefulness. The NHS environment has changed hugely from the time when commissioning seemed like a good idea. Back then, there was plenty of money in the system, and options for getting better deals for your money by managing the market.

Now money is tight, the question must be whether money spent on commissioning wouldn’t be better used delivering services. Look at the situation nationally: some providers are in dire financial straits and their commissioners sit on surpluses. In other places, the reverse applies.

We have seen private providers hit this wall too, as well as some high-profile commissioning decisions (as in Cambridgeshire) that fall foul of the reality of providing services.

Read the full post here

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Dementia in older age: barriers to primary prevention and factors

Evidence review showing that changing some behaviours in midlife can reduce the chances of getting dementia in older age | PHE

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These documents help commissioners and researchers make decisions about prioritisation of primary prevention measures relevant to dementia.

This review, by the Personal Social Services Research Unit (PSSRU) at the London School of Economics and Political Science (2016), shows that there is evidence that the risk of dementia is increased by:

  • physical inactivity
  • current smoking
  • diabetes
  • hypertension in mid-life
  • obesity in mid-life and depression

It also shows that mental activity can reduce the risk of dementia.

To promote primary prevention of dementia, it is important to understand both the barriers to primary prevention and factors which facilitate primary prevention.

Read the full overview here

Cancer app developed by GPs being trialled by CCGs

A GP-developed app aiming to help GPs navigate the tests and urgent referrals necessary for patients presenting with cancer symptoms is being trialled by two CCGs | Pulse

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C the Signs was co-founded by newly qualified GP Dr Bhavagaya Bakshi and fellow doctor Miles Payling and quickly checks symptoms of more than 200 cancers against multiple diagnostic referral pathways.

Last week the app won the People’s award at the Tech4Good awards and is now set to be trialled with GPs in the East of England to test its real world cost and clinical effectiveness.

Read the full news story here

General Practice Nursing – Developing confidence, capability and capacity

This Ten Point Action Plan for General Practice Nursing, describes the nursing element of the General Practice Forward View (GPFV) | NHS England

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The GPN ten point action plan sets out the measures required to bring about the changes that are needed, which will be taken forward by NHS England, Health Education England, NHS Improvement, Public Health England, The Royal College of Nursing, The Royal College of General Practitioners, The Queens Nursing Institute and The British Medical Association. These organisations will support commissioners and providers to implement the actions at local level. Delivery of this Ten Point Action Plan at a local level will be supported by one of four Regional GPN Delivery Boards.

General practice at scale and new care models provide fresh opportunities for supporting general practice nurses to develop skills and advance their careers. This will assist recruitment and retention which will in turn ease GPs’ workload as well as improving the experience of care for individuals, the outcomes of care and treatment, the use of NHS resources and staff experience.

New draft recommendations for the care of acute medical emergencies

This draft guideline includes recommendations for the organisation and delivery of emergency and acute medical care | NHS Networks

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It includes recommendations for practice and for research. Recommendations are included on:

  • first points of contact with emergency and acute care services
  • alternatives to hospital care
  • opening hours and locations of acute care services
  • services within hospitals
  • ward rounds, transfers and discharges
  • monitoring and managing hospital bed capacity.

Who is it for?

  • Commissioners and providers of health and social care.
  • Health and social care practitioners.
  • People with or at risk of a medical emergency or acute illness, and their families and carers.

Read the full draft here

Sexual health at risk of becoming ‘Cinderella’ service, say GPs

Sexual and reproductive health is at risk of becoming a ‘Cinderella’ service thanks to red tape, and financial and training hurdles facing GPs and their practice teams, the Royal College of GPs (RCGP) has warned.

These issues risk undoing years of improvement in the quality of sexual and reproductive healthcare being delivered to patients – including a halving of teenage pregnancy rates over the past decade and steadily increasing uptake of long-acting reversible contraceptives (LARCs), it says.

The findings of a College consultation, published in a report, Time to Act, show that GPs fear rates of teenage pregnancy and transmission of sexually transmitted diseases will rise – reversing current trends – as vulnerable patients are being excluded from accessing the most appropriate forms of contraception, and widening  health inequalities as a result.

Full report: Sexual and Reproductive Health: Time to Act

Story via OnMedica

People with co-occurring conditions: commission and provide services

Better care for people with co-occurring mental health and alcohol/drug use conditions: A guide for commissioners and service providers | Public Health England

This Public Health England (PHE) guide, developed with the support of NHS England,  should be used by the commissioners and providers of mental health and alcohol and drug treatment services, to inform the commissioning and provision of effective care for people with co-occurring mental health and alcohol/drug use conditions. It also has relevance for all other services that have contact with people with co-occurring conditions, including people experiencing mental health crisis.

The guidance has been co-produced with members of the expert reference group for co-existing substance misuse with mental health issues, and in consultation with experts through experience, service providers, practitioners, commissioners and policy leads.

It aims to support local areas to commission timely and effective responses for people
with co-occurring conditions. It encourages commissioners and service providers to
work together to improve access to services which can reduce harm, improve health
and enhance recovery, enabling services to respond effectively and flexibly to
presenting needs and prevent exclusion.

Full document available via Public Health England