Strategic commissioning

Steering towards strategic commissioning: transforming the system | NHS Clinical Commissioners

Clinical commissioners are playing a key role as architects of the changing health and care landscape, analysis shows. A new publication by NHS Clinical Commissioners sets out CCGs’ vision for the future and what they need to get there at pace so they can deliver more for patients.

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

Steering towards strategic commissioning shows there is a strong belief that healthcare commissioning must continue to be clinically led, operate at a scale larger than a CCG footprint, retain its purchasing function and remain accountable to the local population.

The analysis, which was informed by a survey and interviews with CCG leaders, shows that CCGs are embracing change, with 77 per cent of those surveyed intending to contract for a new care model in 2017/18, and 72 per cent planning on increasing their collaborative commissioning.

Related: The Changing Commissioning Landscape

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Elective care: model access policy

We’ve produced this policy in response to requests from providers and wider health systems for guidance and support in producing their own elective access policies | NHS Improvement

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The purpose of this policy is to ensure all patients requiring access to outpatient appointments, diagnostics and elective inpatient or day-case treatment are managed in line with national waiting time standards and the NHS Constitution.

The policy:

  • is designed to ensure the management of elective patient access to services is transparent, fair, equitable and managed according to clinical priorities
  • sets out the principles and rules for managing patients through their elective care pathway
  • applies to all clinical and administrative staff, and services relating to elective patient access at the trust

Access the full policy here

Networked care – a toolkit for practice

Moorfields Eye Hospital NHS Foundation Trust is one of the 13 acute care vanguards which aim to “link hospitals together to improve their clinical and financial viability, reducing variation in care and efficiency” | Institute of Healthcare Management

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The Moorfields vanguard team has spent the past year exploring whether the longer-term sustainability of single speciality services can be strengthened by entering into a networked care partnership, and the other benefits that the model might bring.

The team was keen to understand what makes the biggest difference for patients, staff and partner organisations in getting things right first time when establishing a networked care partnership; and to identify the best way to sustain services so that specialist care can continue to be offered locally.

The team’s findings are shared in the toolkit, an online resource with evidenced-based learning that other trusts can use to evaluate whether networked care could help their smaller clinical services.  It has practical advice on how organisations can establish their own network in the way for them.

The toolkit also includes recommendations on how to:

  • ensure consistent quality of care at multiple sites
  • ensure a sustainable workforce
  • maintain effective partnerships
  • develop sustainable specialist care
  • provide a standardised quality of care

Excellence In Diabetes Care Commissioning

NHSCC launch new report on excellence in diabetes care commissioning | NHSCC

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Image source: NHSCC

The document draws out lessons from those involved in the projects to share and embed for the future. Since 1996 the number of people living with diabetes in the UK has more than doubled. The NHS is now spending more than £9.8bn each year on treating the condition and its complications.

The new report Excellence in commissioning diabetes care features a range of programmes from CCGs across the country with case studies including:

  • Slough CCG’s approach involving both targeted support for communities and education in GP practices – the CCG is ranked second best in the country on delivering the eight care processes identified by the National Institute for Health and Care Excellence as representing good practice in diabetes care.
  • Surrey Downs CCG’s work to improve communication between GP practices and paramedics in relation to incidences of hypoglycaemia.
  • Aylesbury Vale and Chiltern CCGs’ joint approach to diabetes care, which focuses on what the patient wants to achieve rather than only their blood sugar levels.

The report is available to download here

The Impact of Walk-in Centres and GP Co-operatives on Emergency Department Presentations

Crawford, J. et al. International Emergency Nursing | Published online: 18 April 2017

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Image source: Kake – Flickr // CC BY-NC-SA 2.0

Highlights:

  • Workload and resource pressures on EDs require the development of applicable minor illness and injury pathways.
  • Walk-in-centres have the potential to reduce ED workloads but more work is required to substantiate this pathway.
  • GP cooperatives can reduce ED workloads but further evidence is required to be confident of the efficacy of this care pathway.

Read the full abstract here

NHS England Dementia: Good Care Planning

Care planning is crucial in delivering improved care for people living with dementia, and supporting their families and carers | NHS England

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Image source: NHS England

he importance of having a high quality care plan that is reviewed regularly is reiterated through its inclusion in the CCG IAF as one of the dementia indicators. It also forms a key part of the forthcoming evidence-based treatment pathway for dementia.

Simply having a care plan, whilst being a good start, is not enough. Any care plan needs to be personalised to the specific needs of each person with dementia and reflect changes in their care needs over time. To support the adoption of high-quality care plans NHS England has developed a guide Dementia: Good Care Planning, with input from people living with dementia, their carers and health and social care professionals.

View the full range of resources here

New care models: now available in GP-friendly packages

There are a number of reasons for general practice to change – it is often small and called inefficient, with wide variations in quality from one practice to the next | PCC

There are also things GPs and patients are desperate not to change – general practice is local, personal and often delivers exceptional care as well as excellent value for money for taxpayers.

The scaled up version of general practice imagined by policymakers makes complete sense: organisations big enough to cope with changes in demand, able to expand the range of services they provide, able to benefit from economies of scale, and able to make more creative use of the wider primary care clinical workforce to free GP time and add value for patients.

However logical or inevitable big general practice may appear, practices are left with a number of questions:

  • How do we grow big without losing the benefits of being small?
  • What are the longer term gains and what might we have to give up for them?
  • How do we retain a voice in the new bigger enterprise?
  • How practical is it to share patients and workforce?
  • How do we bring patients along with us?
  • What about governance – who is ultimately responsible for care when patient lists are shared?

And the biggest question of all: how do we find time to make the changes we need to make when we’ve never been busier?

Read the full article here