THE NPC HANDBOOK

1

• THE NPC HANDBOOK
• Major step forward
• NHS Confederation was first to attempt at
  developing a key area of commissioning practice
  in their priority setting publications in 2008
• NPC Handbook has produced a more detail practice
  guide
• Capacity for ongoing development and support
• The handbook may also help educate those outside
  commissioning organisations

2

• ITS NOT JUST ABOUT DRUGS AND TREATMENTS
• NHS Constitution focuses on drugs but this is
  not a legally sustainable position and so the
  right applies to any aspect of healthcare.
• A whole system approach is needed.
• All levels of priority setting are intimately
  linked.
• Strategic planning
• Annual commissioning round
• Managing new treatments drugs, medical devices
  and surgical procedure
• Individual funding
• Be very careful about the structures you set up.
  DONT be tempted to set up decision making
  structures which are dislocated from the budget

3

• CLINICAL NETWORKS
• PCTs will need to review the terms of reference
  of their sub-committees and associated groups and
  clarity the status of their advice.
• The limits and nature of the advice which is
  sought should also be defined. For example a
  professional group which has not budgetary
  responsibility might be asked to categorise a
  treatment into
• Do not fund
• High priority assess priority in year
• Refer to the annual commissioning round
• It is a good opportunity to review clinical
  networks and their role in priority setting.

4

• PCT COLLABORATION
• PCTs will need more extensive policy making
  capacity than currently they have.
• PCTs will need to cooperate on an unprecedented
  manner.
• Assessment of the evidence
• Policy making.

5

• THE NHS CONTRACT
• This is not currently used to optimum effect.
• Area which needs development and training.
• The direction requires trusts to co-operate with
  PCT decision making processes
• Engage
• Be clear
• Be consistent in your behaviour and responses

6

• THE RISKS
• These have increased as a result of
• NHS Constitution and supporting documents
• DH policy on private treatment
• Change in approach to end of life treatment
• Legal risks cannot be fully mitigated much more
  difficult as of 1st April.
• The hope has been to reduce the work and
  pressures related to individual funding requests
  but the reverse is likely to happen.
• Legal challenges will probably rise and
  collectively we need to take a view on how to
  deal with this more effectively.
• We need to get much better at not only
  documenting opportunity costs but also explaining
  them to public.