Commissioning Masterclass 25 th January 2016 Tony Mercer (Health Improvement Manager) Public Health England – West Midlands Centre

Outline of the Commissioning Masterclass Morning Context, Definitions and Models (Tony Mercer PHE) Needs Assessment (Tony Mercer PHE) Service User Involvement (Sunny Dhadley SUIT) Afternoon Contracting (Jennifer Finch BCC) Introduction to asset based approaches (Tony Mercer PHE) Asset based commissioning (Tony Bullock SCC) 2

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Place-based approach to public health 4Presentation title - edit in Header and Footer Public health advice Health and wellbeing boards Local government CCGs PHE centre NHSE area team EPPR Screening and immunisation Offender public health programmes Specialised commissioning Primary care public health programmes and population healthcare NHS providers Non- statutory providers* People and communities *Including voluntary and community sector 4

What is commissioning ?... basically shopping! 5Presentation title - edit in Header and Footer You assess need Service mapping Specify requirements Test the market Award contract (transact) Service monitoring Contract management 5

Some definitions… The strategic activity of assessing needs, resources and current services, and developing a strategy to make best use of available resources to meet identified needs (NTA 2003) The set of linked activities to assess the health needs of a population, specify the services required to meet those needs within a strategic framework, secure those services, monitor and evaluate the outcomes (Woodin 2006) Commissioning is the process by which primary care trusts (PCTs) secure best value and deliver improvements in health and care services, to meet the needs of the populations they serve (WCC 2008) Commissioning is not one action but many, ranging from the health-needs assessment for a population, through the clinically based design of patient pathways, to service specification and contract negotiation or procurement, with continuous quality assessment (NHSE 2013) 6

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World Class Commissioning competencies locally lead the NHS work collaboratively with community partners engagement with the public and patients engagement with a broad range of clinicians manage knowledge and assess needs prioritise investment of all spend stimulate the market promote and specify continuous improvements in quality and outcomes secure procurement skills manage systems and work in partnership with providers ensure efficiency and effectiveness of spend 9

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In groups of 2, 3 or 4…. formulate a definition of “commissioning” 15

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Health Care Needs Assessment or Health Needs Assessment What’s the difference? 17

Here’s a clue… 18

Health Needs Assessment = a systematic method for reviewing the health issues facing a population, leading to agreed priorities and resource allocation that will improve health and reduce inequalities Health Care Needs Assessment = a systematic method of identifying the unmet healthcare needs of a population 19

NEED DEMAND SUPPLY 20

Need what people might benefit from Demand what people might wish to use in a system of free health care Supply what is actually provided 21

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Comparative HCNA - compares service provision between different populations but variations may be influenced by a number of factors not just differing needs Corporate HCNA - based on eliciting the views of stakeholders but blurs the difference between need and demand and also between science and vested interest Epidemiological HCNA - considers the epidemiology of the condition, current service provision, the effectiveness and cost-effectiveness of services/interventions 23

Epidemiological HCNA How many people need the services/interventions? Do the services/interventions confer any benefit and if so at what cost? Which services/interventions need to change and what opportunities are there to release resources to enable this to happen? 24

Joint Strategic Needs Assessment (JSNA) A statutory document that was introduced by the Local Government Health and Public Involvement in Health Act (2007) “A process that identifies current and future health and wellbeing needs in light of existing services, and informs future service planning taking into account evidence of effectiveness. JSNA identifies “the big picture” in terms of the health and wellbeing needs and inequalities of a local population” 25

Asset based approaches 26 Clients and consumers have deficiencies & needs Citizens have capacities and gifts

Asset based approaches 27

Asset based approaches 28