RCSLT Policy & Public Affairs Team Navigating the new commissioning environment

Aims of the session To update you on the new commissioning environment. To facilitate a discussion about how you can influence decisions in that environment.

Giving Voice – firm foundations

SLTs interested in the bigger picture and ready to play their part SLTs interested in the bigger picture and ready to play their part SLT brought to the attention of (and better understood by) more politicians and commissioners than ever before SLT brought to the attention of (and better understood by) more politicians and commissioners than ever before SLT on the map through the media SLT on the map through the media Where did 2011 get us?

Where does SLT want to be in 2012? Making best use of the relationships established and messages conveyed Systematically covering areas with champions and local Giving Voice activity Seizing opportunities to influence decisions in the new commissioning environment

Context The NHS is trying to achieve up to £20 billion of “efficiency savings”. The number of SLTs employed by the NHS in England dropped by 3% between December 2010 and December 2011 (in terms of full time equivalents).

NHS reforms The government’s NHS reforms are based on the following principles: giving patients more power focusing on outcomes giving front line professionals a strong leadership role

Future commissioning of SLT The responsibility for commissioning SLT will remain in the NHS. The government sees a role for SLT in supporting public health, particularly in relation to the health visiting service and the Healthy Child Programme. The Bill will allow the Secretary of State or local authorities to provide services to improve communication skills where the purpose is to improve health.

NHS accountability structure 2012/13 Clinical Commissioning Groups (CCGs) with delegated budgets PCT clusters SHA clustersDepartment of Health

NHS accountability structure 2013/14 CCGs NHS Commissioning Board Department of Health

The NHS Outcomes Framework The NHS Outcomes Framework aims to provide a national level overview of how well the NHS is performing provide an accountability mechanism for the NHS Commissioning Board drive quality improvement and outcome measurement with a stronger focus on tackling health inequalities.

CCGs The governing bodies of CCGs will include GPs, at least one registered nurse, a doctor who is a secondary care specialist and at least two lay members. Any decision that does not incorporate a genuine viewpoint from emerging CCGs will be open to challenge. PCT clusters must support all CCGs in making progress to full authorisation by the NHS Commissioning Board. PCT clusters will need to delegate 100% of their relevant commissioning budget to emerging CCGs by the end of March 2012.

2012/13 planning arrangements PCT clusters are required to have an integrated plan with explicit support from the emerging CCGs in place by March SHAs had to submit them to the Department of Health in draft format on 27 January 2012 and will submit them in final format on 5 April.

CCG authorisation Initial development phase Application Authorisation process Annual assessment

A strong clinical and multi- professio nal focus. Meaningful engagement with patients, carers and their communities. Clear and credible plans which continue to deliver the QIPP challenge. Proper constituti onal and governan ce arrangem ents. Collaborative arrangements for commissioning. Great leaders who can make a real difference. The ‘domains’ for CCG authorisation

“ A great CCG will have a clinical focus perspective threaded through everything it does, resulting in having quality at its heart, and a real focus on outcomes. It will have significant engagement from its constituent practices as well as widespread involvement of all other clinical colleagues; clinicians providing health services locally including secondary care, community and mental health, those providing services to people with learning disabilities, public health experts, as well as social care colleagues. It will communicate a clear vision of the improvements it is seeking to make in the health of the locality, including population health.” Domain 1

Health and wellbeing boards (HWBs) HWBs will achieve joint leadership by CCGs and local authorities of the local health and care system. HWBs will be responsible for developing joint strategic needs assessments (JSNAs) and joint health and wellbeing strategies (JHWSs).

Joint strategic needs assessments (JSNAs) JSNAs should describe needs and how services will meet them look ahead 3-5 years analyse data define where inequalities exist use local views and evidence about service effectiveness to shape investment define achievable improvements in health and wellbeing.

Joint health and wellbeing strategies (JHWSs) JHWSs will provide local partners with a locally determined set of priorities on which to base their commissioning plans. The government also believes that JSNAs and JHWSs will enable commissioners to plan and commission integrated services.

The membership of HWBs The proposed membership includes at least one councillor from the local authority; the director of adult social services; the director of children’s services; the director of public health; a representative of the local HealthWatch; a representative of each relevant CCG; other persons or representatives the local authority or HWB thinks appropriate.

Health and wellbeing boards will be a forum for addressing the determinants of health and reducing health inequalities. Inequalities

Questions for discussion – contacts What contacts do you have with your local CCGs? What contacts do you have with your local HWBs? Have you had input into your local JSNAs? What contacts do you have with local authority heads of service (e.g. for SEN, early years, older people or adult learning disabilities)? What contacts do you have with local head teachers? What plans do you have to develop your work with local health visitors (e.g. on training and referrals)?

Questions for discussion – ‘stories’ What story can you tell about how SLT can help to achieve local NHS objectives? What story can you tell about how SLT can help to meet the needs identified in your local JSNAs? What story can you tell about how SLT can help to implement your local children and young people’s plan? What story can you tell about how your service can reduce health inequalities?

RCSLT resources Manager’s Resource Pack Commissioning Resource ManualCommissioning Resource Manua Quality Self-Evaluation Tool (Q-SET) Giving Voice campaign delivery toolkit Briefing material on the Health and Social Care Bill and influencing the health reformsBriefing material on the Health and Social Care Bill and influencing the health reforms Policy statements and position papers List of outcome measurement tools