Commissioning High Quality Stroke Services

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Commissioning High Quality Stroke Services
EALING Primary Care Trust
North West London Cardiac Stroke
Network

• Peter Kottlar
• Joint Head of Older People Commissioning and
• Lead for Stroke Services
• Ealing PCT NW London Cardiac and Stroke Network
• 20th March 2009

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History of Commissioning in NHS

• 1991 introduction of purchasing
• Aim separating the interest of those receiving
  healthcare from those supplying them
• 1990s GP fund-holding move to Primary Care
  Groups (PCGs)
• 2001 Primary Care Trusts (PCTs) created

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What is Commissioning?

• Process of ensuring health and care services
  provided most effectively meet the needs of the
  population  
• Roles of PCTs
• the advocate for patients and
• the custodian of taxpayers money

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Objectives of Commissioning

• Improve health and wellbeing and reduce health
  inequalities
• Improve quality, effectiveness and efficiency
• Increase choice and responsiveness
• Develop comprehensive services
• Achieving best value within
• available resources

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Commissioning Cycle
Review Services
Decide Priorities
Needs Assessment
PATIENTS and PUBLIC
Design services
Seeking patient views
Capacity Planning
Managing performance
Shaping Structure of Supply
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COMMISSIONING Strategic Planning Stage
NEEDS ASSESSMENT

• Public Health data
• Other statistics/data
• identify unmet need?

REVIEW SERVICES

• Service Mapping
• Gap analysis
• Identify service improvements

DECIDE PRIORITIES

• Development of strategic plan
• Resources/Budgeting
• Involve users and carers

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COMMISSIONING Service Procurement Stage
DESIGN SERVICES

• Development of service model
• Involve service users and carers

CAPACITY PLANNING, DEMAND MANAGEMENT

• Development of strategies for care and resource
  utilisation

• PCT develop service specification, PIs
• Support encourage providers to develop services
• Invite NHS/private/3rd sector providers

SHAPING STRUCTURE OF SUPPLY
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COMMISSIONING Monitoring Evaluation Stage
MANAGING PERFORMANCE

• Ensure agreed targets are met
• Review patient set goals
• Develop improvement plans

SEEKING PATIENT/ PUBLIC VIEWS

• Patient outcomes experiences
• Informs commissioning actions

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Commissioning Cycle
Review Services
Decide Priorities
Needs Assessment
PATIENTS and PUBLIC
Design services
Seeking patient views
Capacity Planning
Managing performance
Shaping Structure of Supply
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World Class Commissioning

• WCC will deliver a more strategic and
  longer-term approach to commissioning services,
  with a focus on improving health
  outcomes Commissioning Assurance Handbook,
  2008

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World Class Commissioning
VISION
ASSURANCE SYSTEM
WORLD CLASS COMMISSIONING
DEVELOPMENT FRAMEWORK
COMPETENCIES
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World Class Commissioning
VISION
Adding life to years and years to life
Better health and well-being for all, better
care for all, and better value for all.
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World Class Commissioning
COMPETENCIES
Stimulate the market
6
Locally lead the NHS
Promote improvement and innovation
1
7
Engage with public/patients
Secure procurement skills
2
8
Collaborate with clinicians
Secure procurement skills
3
9
4
Manage knowledge /assess needs
Manage the local health system
10
Make sound financial investments
Prioritise investment
5
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World Class Commissioning
ASSURANCE SYSTEM
PURPOSE to understand whether PCTs are improving
as commissioners of better health outcomes
PCT are assessed by NHS London across three
elements
Rate of improvement
OUTCOMES
Level 1 - 4
COMPETENCIES
R
A
G
GOVERNANCE
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World Class Commissioning
DEVELOPMENT FRAMEWORK
BOARD DEVELOPMENT
FRAMEWORK FOR PROCURING EXTERNAL SUPPORT FOR
COMMISSIONERS
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World Class Commissioning
The aim of world class commissioning,and
therefore the ultimate test of its success,will
be an improvement in health outcomes and a
reduction in health inequalities
Commissioning Assurance Handbook, 2008
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References

• Health Reform in England Update on Commissioning
  Framework Department of Health, 2006
• World Class Commissioning, Department of Health,
  2007 http//www.dh.gov.uk/en/Managingyourorganisat
  ion/Commissioning/Worldclasscommissioning/index.ht
  m
• Commissioning Specialised Services, Department of
  Health, 2007, http//www.dh.gov.uk/en/Managingyour
  organisation/Commissioning/Commissioningspecialise
  dservices/index.htm

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WORLD CLASS COMMISSIONING
COMPETENCIES
Locally lead the NHS
1
SKILLS
PROCESS AND KNOWEDGE REQUIREMENTS
OUTPUTS
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WORLD CLASS COMMISSIONING
COMPETENCIES
Locally lead the NHS
1

• SKILLS (sub-components)
• Listens to partner NHS organisations and other
  providers
• Signals future priorities of the local NHS
• Has good presentation and influencing skills,
  e.g. in reputation management
• Has good organisational development skills

• PROCESS AND KNOWEDGE REQUIREMENTS
• Able to articulate vision of NHS, fair personal,
  effective and safe
• Is skilled in engagement involvement methods
• Understands own the strengths and weaknesses, and
  develops its competence

• OUTPUTS
• Clear Communication policy on reports, findings,
  commissioning plan
• Strong interaction with other organisations
• Good understanding of reputation management

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WORLD CLASS COMMISSIONING
COMPETENCIES
Locally lead the NHS
1
Level 4
Level 3

• Key stakeholders strongly agree that the
• PCT is the local leader
• of the NHS
• The PCT actively
• participates in and
• leads the local health
• agenda, effectively
• participating in
• multi-agency and NHS
• wide agendas
• The local population
• strongly agree that the
• local NHS is improving
• services

Level 2

• Key stakeholders agree that the PCT is the local
  leader of the NHS
• The PCT actively
• participates in and
• leads the local health agenda
• The local population
• agree that the local
• NHS is improving
• services

Level 1

• Key stakeholders
• somewhat agree that PCT is the local leader of
  NHS
• PCT has an
• understanding of its
• current and intended reputation, with
• strategies in place to address this

Does not meet Level 2 requirements