‘Trust and collaboration within vanguards is essential but not easy’ – new report

A new report launched today (15 June) at Confed17, looks to better understand how to build trust across systems to promote more effective collaborative working | NHS Employers

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Trustworthy Collaboration, written for NHS Employers by Prof Veronica Hope-Hailey of the University of Bath, explores the challenges of building trust across health systems, in the context of the 50 vanguard sites tasked with delivering transformational change through new care models.

The report looks into the challenges facing the leaders of the partner organisations within the vanguards, who are required to collaborate to deliver transformational change. Trust is essential to collaboration, the report states, but achieving this is easier said than done.

For the vanguards, trust was an important ingredient for ensuring success. It was vital for senior leaders to swiftly establish trust with other leaders across multiple and complex systems.

The report explores the meaning of trust in organisations and offers six key recommendations for how to successfully achieve it.

Strategic commissioning

NHS Clinical Commissioners, in partnership with Academic Health Science Networks (AHSNs), has published Supporting strategic commissioning: collaborative working between CCGs and AHSNs.

This briefing explores how CCGs can work with AHSNs to support local strategic commissioning and provides a series of tips through case studies which demonstrate the impact that collaboration between CCGs and AHSNs can have for local populations.

Case studies in Supporting strategic commissioning that demonstrate the impact that collaboration between CCGs and AHSNs can have include:

  • the reduction of anti-coagulation treatment costs by £1 million while at the same time improving patient outcomes in Newcastle;
  • a six day fall in referral admission times for patients with acquired brain injuries in London; and
  • the development of a platform able to predict when a patient would present at a hospital if no intervention took place in Somerset.

The future of commissioning

NHS Clinical Commissioners have published a paper setting out their vision for the future of clinical commissioning.

Informed by interviews with CCG leaders and other key players in the health and care sector, The future of Commissioning suggests that we will continue to see an evolution in the commissioning system but that it remains a vital part of the health system that is focused on delivering for patients and local populations.

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Enhanced Health in Care Homes model

One in seven people aged 85 or over is living permanently in a care home. The evidence suggests that many of these people are not having their needs properly assessed and addressed. As a result, they often experience unnecessary, unplanned and avoidable admissions to hospital, and sub-optimal medication.

The enhanced health care homes model  lays out a clear vision for providing joined up primary, community and secondary, social care to residents of care and nursing homes, via a range of services.

Seven key components and eighteen sub-components which define the care homes model are put forward, with practical guidance explaining how organisations and providers can make the transition and implement the whole model.

These plans can help transform the way care is delivered, with staff from across health and social care organisations working together as part of multidisciplinary teams  to deliver high quality and financially sustainable care.

The enhanced health in care homes (EHCH) care model is one of a number of new care models that are delivering whole population healthcare. It will become a core element of the multispecialty community provider (MCP) and primary and acute care system (PACS) models.

Primary and acute care system (PACS)

NHS England launches frameworks to increase integration of health and care services

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NHS England has published Integrated primary and acute care systems (PACS) – Describing the care model and the business model

A PACS can be defined as a population-based accountable care model, with general practice at its core. It is organised around patients’ needs and aims to improve the physical, mental and social health and wellbeing of its local population.

However, it will also include most hospital based care, as well as primary, community, mental health and social care services. By aligning the goals and incentives of hospitals with other health and care providers, it offers the potential for a radical new approach to population health.

The integrated (PACS) Framework outlines the next steps required to set up the model – including the need to develop new contractual, funding and organisational form. It sets out three contractual options that will help make a phased transition towards a fully-fledged PACS – a single provider with a single contract for all local health and care services.

This puts clinicians in the driving seat by pooling and allocating resources to areas that will have the greatest impact on the health of their local community and creates a shared responsibility towards the most vulnerable patients.

Commissioning through Competition and Cooperation

PRUComm. Published online: 17 June

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Following several versions of the NHS quasi market since 1990, a wide ranging set of reforms was introduced into the NHS under the recent Coalition government by the Health and Social Care Act 2012 (HSCA 2012). The idea behind these is the same as that behind previous versions of the NHS quasi market: that competition between a wider range of providers will produce the desired results of improved quality and greater efficiency. The HSCA 2012 made a direct correlation between competitive behaviour in the NHS and competition law. The Procurement, Choice and Competition Regulations No.2 2013 relate to sections 75-77 and 304 (9) and (10) of the HSCA 2012, and indicate that competitive procurement by commissioners is to be preferred, although not in all circumstances. Monitor (the former NHS Foundation Trust regulator) took on the role of economic regulator for the whole of the NHS. Along with the national competition authorities (being, since April 2014 the Competition and Markets Authority, and prior to that, The Office of Fair Trading and the Competition Commission), has powers to enforce competition law to prevent anti-competitive behaviour.

At the same time, it is still necessary for providers of care to cooperate with each other in order to deliver high quality care. There are many aspects of care quality where cooperation is needed, such as continuity of care as patients move between organisations, and sharing of knowledge between clinicians. Monitor is also responsible for promoting co-operation. It is the role of NHS commissioners (including Clinical Commissioning Groups ‘CCGs’), however, to ensure that the appropriate levels of competition and cooperation exist in their local health economies.

Read the full report here

What makes a top clinical commissioning leader?

NHS Clinical Commissioners has published What makes a top clinical commissioning leader?

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This report highlights how both clinical and managerial leaders are integral to the success of a CCG, bringing different strengths to the organisation and its ability to deliver more for patients. The report sets out how current leaders can be supported, and a future generation inspired and encouraged to take up a role in commissioning.

Read the report ‘What makes a top clinical commissioning leader?’ here.

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image source: http://www.nhscc.org/