1. How knowledge services can support the new commissioners? Tim Jones NHS Commissioning specialist

2. Content 1. Why practice based commissioning? 2. Who are the practice based commissioners? 3. What is commissioning and who will do it? 4. What support is needed? 5. A final thought

3. Why practice based commissioning? Choice is at the heart of all Govt. policy Choice is at the heart of all Govt. policy Choice requires… Choice requires… 1. Funding mechanism 2. A range of providers 3. Information 4. Strengthened commissioning To make it happen needs ‘system reform’ To make it happen needs ‘system reform’

4. System reform 1. Funding mechanism – Payment by Results (PbR), National Tariff 2. A range of providers – NHS trusts, foundation trusts, ISTCs, APMS, SPMS 3. Information – GPs, Dr Foster, ratings system 4. Strengthened commissioning – practice based commissioning, specialised commissioning

5. Who are the practice based commissioners? Practice Practice Consortium/collaborative Consortium/collaborative Cluster/locality Cluster/locality PCT PCT

6. What is commissioning? A general definition … a set of activities related to describing, paying for and monitoring health care services A service re-design definition … a discrete, time-bounded process used to effect service change

7. A methodology for commissioning (service redesign) 1. Planning 2. Purchasing 3. Contracting

8. 1 Planning Analyse activity data Analyse activity data Validate activity data Validate activity data Map existing patient pathway Map existing patient pathway Quantify health need Quantify health need Analyse capacity Analyse capacity Model impact of new technology Model impact of new technology Map to performance targets Map to performance targets Identify constraints Identify constraints PCT, PBC Practice ? PCT (PH), PBC PCT PCT (Rx advisors) PCT, PBC PCT

9. 2 Purchasing Draw up a service specification Draw up a service specification Cost the service change Cost the service change Submit a business case Submit a business case Agree procurement method Agree procurement method Run procurement Run procurement PBC, PCT PBC,PCTPBCPCTPCT

10. 3 Contracting Negotiate the price Negotiate the price Draw up a contract Draw up a contract Agree a quality programme Agree a quality programme Agree performance monitoring arrangements Agree performance monitoring arrangements PCT, PBC PCTPCT,PBCPCT

11. What support is needed? Thinking and learning Thinking and learning The skills deficit The skills deficit Developing organisations Developing organisations

12. 1 Thinking and learning Case studies – best practice and skills Case studies – best practice and skills Opportunities for safe learning – action learning sets, workshops Opportunities for safe learning – action learning sets, workshops Rapid access to source material – guidance, best practice Rapid access to source material – guidance, best practice Critical appraisal of sources Critical appraisal of sources

13. 2a The skills deficit Patient pathway mapping Patient pathway mapping Engaging patients in pathway mapping and development Engaging patients in pathway mapping and development Data skills Data skills Validation – how to do it, tools Validation – how to do it, tools Understanding data – variance, significance, critical analysis Understanding data – variance, significance, critical analysis

14. 2b The skills deficit Finance skills – costing and budget monitoring Finance skills – costing and budget monitoring Marketing skills – marketing services from practice to practice or PCT Marketing skills – marketing services from practice to practice or PCT Writing skills - business cases, service specifications, persuasive text Writing skills - business cases, service specifications, persuasive text Presentation skills – ideas, pathways, etc Presentation skills – ideas, pathways, etc

15. 3 Developing organisations Organisational development tools Organisational development tools Training needs assessment Training needs assessment Skills audit – management and clinical Skills audit – management and clinical

16. A final thought! Why is practice based commissioning so difficult?

17. Thank you Tim Jones m. 07811 255171 e. tim.jones@nhs.net