Health reform in England: commissioning policy update Anthony Kealy Head of Commissioning Policy

The commissioning framework – July 2006 Main Themes  Greater clinical engagement  More community engagement  Better information to support commissioning  New incentives and contracts  Securing the cash limit  Developing capacity and capability

PBC - Practical Implementation, November 2006 Scope: Budget-setting  Procurement / tendering  Pricing like-for-like services  Incentive schemes  PCT Support for PBC

New NHS Contract for Acute Care The contract aims to ensure:  Choice and 18 weeks are delivered  There are genuine agreements about the volume and flow of acute hospital activity required  Providers are paid at tariff for the work they do and manage their capacity flexibly to accommodate patients’ choice of provider  The risk of activity exceeding that agreed levels is mitigated  Commissioners and providers collaborate on the introduction of prior approval, utilisation management and capacity review schemes where reasonable

The Commissioning Framework for Health & Well-being  More personal services, sensitive to the needs of the individual, focused on maintaining independence.  Promoting health and wellbeing, and prevention of ill health.  Focus on commissioning for outcomes,  Health and local government together tackling health inequalities.

Eight Steps to more effective commissioning  Putting people at the centre of commissioning  Understanding the needs of populations and individuals  Sharing and using information more effectively  Assuring high quality providers for all services  Work, health and well-being  Developing incentives for commissioning for health and wellbeing  Making it happen: accountability  Making it happen: capacity and leadership

Key Dates and Next steps  Commissioning Framework for Health and Well-being launched, 27 Feb  Consultation, Mar - May  NHS Contracts Signed, Feb/Mar  FESC Launched, May  New contracts developed for out-of-hospital services, and acute contract for all providers, Mar - Oct