Driving forward system working

NHS Providers | December 2018 | Driving forward system working: a snapshot of  early progress in collaborative commissioning 

A report,  Driving Forward System Working, commissioned by both NHSCC (NHS Clinical Commissioners)  and NHS Providers, explores emerging practice in systems that are rethinking the way in which they plan and design services at a local level to support the delivery of joined-up and sustainable care. It revisits views from leaders in CCGs, providers, national bodies and think tanks about the concept of strategic commissioning, particularly as CCGs are increasingly working together to focus on outcomes across larger geographies and reduce management costs. It also explores views about the likelihood that providers will take on more of the activities that NHS England (as a direct commissioner) or CCGs currently undertake – be that to help develop service specifications or lead on pathway redesign.

The report considers:

  • Commissioning arrangements
  • Enabling collaboration
  • Areas of divided opinion


Contributors to the report identified the following areas key areas for systems to consider which can either enable or impede the evolution of local commissioning models.

  • Strong leadership
  • A ‘bottom-up’ approach
  • Involving all system partners
  • One version of the truth
  • Supporting the workforce
  • Governance and accountability
  • Regulatory behaviour
  • Contractual mechanisms
  • Previous system failures
  • Legislation

(Source: NHS Clinical Commissioners )


Investigating recent developments in the commissioning system

Policy Research Unit in Commissioning and Health Care System | September 2018 | Investigating recent developments in the commissioning system

The Policy Research Unit in Commissioning and Health Care System (Pru Comm) has produced a report: Investigating recent developments in the commissioning system. The report looks at the initial stages of CCG involvement in the planning of local services. 


The researchers had five research foci:

  1. How are CCG internal processes of decision making changing?
  2. What is the role of the individual CCG in the current commissioning landscape?
  3. How is accountability maintained by CCGs in the current commissioning landscape?
  4. How is competition and the current pricing regime relevant to CCGs’ commissioning decisions?
  5. How should commissioning develop?

The study utilised  three case study sites in three CCG areas, spread across England. Interviews held with senior commissioners in the CCGs and senior managers in a selection of local provider organisations and local authorities  formed the  main method of data collection. Additional data was also collected by examining locally produced documents, such as STP plans.

The results centre on:

Final report 

Related:  PRUComms [news release]

Be the change : ensuring an effective response to all in psychiatric emergency equal to medical care – recommendations from the first international summit on urgent and emergency behavioural healthcare

NHS Clinical Commissioners & RI International  | October 2018 | Be the change : ensuring an effective response to all in psychiatric emergency equal to medical care – recommendations from the first international summit on urgent and emergency behavioural healthcare
Be the change
Image source: nhscc.org

A major international report published by NHS Clinical Commissioners and RI International, a US- based healthcare organisation outlines ten recommendations that if fulfilled would make urgent and emergency psychiatric health care ‘minimally adequate’, and calls on governmental agencies, policy makers and health and social services to take radical action to address inequalities and improve mental health crisis care.

The recommendations were agreed by delegates at an international summit in May 2018, hosted by NHS Clinical Commissioners and RI International, which brought together commissioners, providers and clinicians including GPs, paramedics and psychiatrists; service users; civil servants; and first responders such as ambulance workers and police officers from both the UK and USA. The summit found that despite cultural, system and geographic differences, the challenges faced in both countries were remarkably similar (Source: NHS Clinical Commissioners & RI International)

The ten recommendations are:

  1. End the current fragmentation of care through an integrated, systematic approach to behavioural health crisis care at the national level.
  2. Actively develop crisis service alternatives to the usual emergency measures of formal assessment and psychiatric inpatient care.
  3. Include special consideration to cater for armed forces veterans.
  4. Implement an integrated health information exchange capable technology solution to enable seamless care across organisations.
  5. Develop balanced scorecard dashboards that display real-time, meaningful data and outcome measures that support continuous quality improvement.
  6. Embed users, peers and carers should be embedded in the design and leadership of crisis systems; peer support staff should be trained and integrated in crisis service delivery.
  7. The zero-suicide aspiration should be owned by governmental agencies, policy makers and those implementing health and social services.
  8. Family and friends should be fully engaged in crisis care and inappropriate barriers created by confidentiality or privacy need to be sensitively overcome.
  9. Implement a single national three-digit crisis hub number that drives easy access in which all callers are welcome, the crisis is defined by the caller, and which is promoted via intelligent social media to get the word out to those who need it.
  10. Significant system-wide investment is needed to deliver these recommendations.The full report is available from NHS Clinical Commissioners 

CCG Annual Assessment 2017/18

NHS England | July 2018 | CCG Annual Assessment 2017/18

NHS England have released CCG Annual Assessment 2017/18, the document lists the overall rating for each of the 207 CCGs as part of their annual assessment under the CCG Improvement and Assessment Framework (CCG IAF).

Image source: england.nhs.uk

CCG Annual Assessment 2017/18 


Making money work in the health and social care system

 HFMA & PwC | June 2018 | Making  money work in the health and social care system

PwC have  worked closely with the Healthcare Financial Management Association (HFMA),  to explore what those working in both policy and practice
across the health sector think about the current mechanisms.

making money work
Image source: hfma.org.uk

They have used their findings, and experience, to propose a number of
recommendations which they believe would facilitate the move towards place based care and support the ambitions of the Five Year Forward View.
These recommendations are particularly timely as indications are that an
announcement of a well needed, long term funding settlement for the NHS is imminent. The need for additional funds is widely recognised. The recommendations in their report would enable this funding to be put to best use for patients (Source: HFMA & PwC). 

Further details are available from HFMA here

RCGP strategic plan 2017-2020

Great doctors, great care sets out the College’s four main objectives for the next three years. It also defines 12 ‘values’, applicable to College members and employees, that will shape how we go about achieving these goals | RCGP

RCGP 2-17
Image source: RCGP

Four objectives

The College has identified four objectives that explain its purpose and what it is aiming to achieve over the next three years:

  • Shape the future of General Practice
  • Ensure GP education meets the changing needs of UK primary care
  • Grow and support a strong, engaged membership
  • Be the voice of the GP (influence)

Vision and values

The College has also identified 12 values, which can be summarised in four ‘core’ values:

  • Excellence
  • Teamwork
  • Leadership
  • Care

Read the full plan here

Faulty by design: The state of public-service commissioning

How public services are commissioned underpins their success in healthcare, criminal justice, employment services and beyond | Reform

Image source: Reform
Image source: Reform

This report reveals that commissioning bodies are not delivering value for money in three key areas.

  • Commissioners are failing to focus on outcomes that matter to service users.
  • Fragmented commissioning bodies stand in the way of integrated services that meet users’ needs most effectively.
  • Devolution of commissioning to local areas is not happening in practice, with a one-size-fits all approach creating a postcode lottery across in healthcare, welfare-to-work and probation services.

Watch the interview about the report below:

Read the full report overview here

Read the full report here