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Inside the Head of a PCT A Guide to Understanding Commissioners

Inside the Head of a PCT A Guide to Understanding Commissioners. Margaret Stockham Managing Director Partners in Practice Ltd. Money following the patients, rewarding the best and most efficient providers, giving others the incentive to improve (transactional reforms).

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Inside the Head of a PCT A Guide to Understanding Commissioners

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  1. Inside the Head of a PCTA Guide to Understanding Commissioners Margaret Stockham Managing Director Partners in Practice Ltd

  2. Money following the patients, rewarding the best and most efficient providers, giving others the incentive to improve (transactional reforms) More diverse providers, with more freedom to innovate and improve services (supply-side reforms) A framework of system management, regulation and decision making which guarantees safety and quality, fairness, equity and value for money (system management reforms) Commissioning – What is it all about? Better care Better patient experience Better value for money More choice and a much stronger voice for patients (demand-side reforms)

  3. needs activity money health provision Path-ways CDM referral Commissioning, so what is it …really? Commissioning is an all encompassing approach to identifying and understanding needs and ensuring the provision of services that deliver improving outcomes for all patient within the area. ... undertaken by the PCTs with Practice-based Consortia (PBC)

  4. Who are your commissioners? National Policy Guidance and x National Priorities x SHAs make the very sensitive decisions e.g. hospital closures x x Executive x √ PCTs decide the level and type of services needed in an area Hertsmere Commissioning Ltd PBC Groups – design services to meet local patients needs √ Provider Trusts agree how they wish to deliver the services commissioners want x

  5. Conflicting Pressures RADICAL CHANGE Contestability and Partnership New Skills & Work Arrangements Strengthened Commissioning The Context for PCTs Policy Imperatives

  6. Key Drivers • Cost – use of taxpyers money • Care Closer to Home • Patient Choice • Integrated Pathways • Quality & Safety • Demand and Capacity • Reducing inequalities Commissioners are looking for solutions

  7. Laws of economics applied to health DEMAND Fixed budget Lack of understanding of patterns of demand Defined suppliers with expectations for future Unreliable information to make decisions SUPPLY

  8. Laws of economics applied to health Fixed budget Lack of understanding of patterns of demand Defined suppliers with expectations for future Unreliable information to make decisions SUPPLY DEMAND PCT Understand demand Create picture of supplier requirements Supply chain management PBC Inform demand Identify change opportunities Reconfigure supply Enable effective contracting

  9. Making it happen: the hardest part! Must understand patterns of demand What patients want/need Must understand supply chain required to meet demand What NHS must do to deliver it DEMAND PCT Manage change SUPPLY Impact this Prevention strategies Self care Alternatives PBC Maximise speed of change Reshape this to create biggest ‘Bang for £££’

  10. Good commissioning This will change patterns of services through • Comprehensive Assessment and Planning • Thorough Contracting and Procurement • Detailed Performance Management and Review • Continual Patient and Public Engagement

  11. Assessment and Planning • Assessment of health needs • Reviewing current services and provision • Deciding on priorities for the future • Designing the new pathways or services • Shaping the structure of supply • Managing current and future demand This Consists of

  12. Contracting and Procurement • Commissioning of primary care services • Procurement for extended primary care services • Contracting and procurement for secondary care services

  13. Performance Management Review • Tracking overall performance against the contract – for quality and volume • Budget and activity management • Performance against national and local targets • Collection and analysis of patient and GP feedback

  14. What Next? Access is emerging as the number one priority - including Polyclinics Modernisation to continue - electronic prescriptions, extended role for optometrists and pharmacists A Mixed Economy - with the private sector as only supporting a sortage in NHS capacity

  15. So - what might success look like? • A relationship with the PCT which is a meeting of equals • Clarity about what you want to do and how it fits withthe important local goals ...an agreed Business Plan showing how to move forward on areas of mutual interest e.g. Eyecare Pathway

  16. Summary and conclusion By being an informed ‘customer’ of the commissioners you can influence the services available to your patients ... but not unless you understand the process and then choose to get involved.

  17. Patients have choice and so do you ... Over to you for questions ... ...

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