2.  Commissioners in Somerset wanted to test whether outcomes based commissioning would lead to better outcomes and greater financial sustainability  External advisors were engaged to assist in the production of an outline business case for an OBC model  An intensive 12 week programme was followed to deliver the business case and identify key working assumptions and principles  Provider and patient representative engaged in the process (formal consultation to follow)

3.  Approve in principle a move to a capitated outcomes-based and incentivised Commissioning approach for health and social care services in Somerset  Approve the use of ‘Capability’ as part of an assessment criteria to identify which providers might be ‘most capable’ for the purposes of OBC  Agree that the CCG via the Clinical Operations Group engages further with primary care providers and NHS England to develop detailed options for practices to participate in Outcome Based Commissioning  Agree that the CCG via the Managing Director and Senior Leadership team engages with Somerset County Council and NHS England on closer integration of health and social care commissioning  Agree in principle to future discussions to pool budgets for health and social care, subject to these proposals being reviewed and agreed at a future meeting  Support the development of a full business case for the re-commissioning of health and in scope social care services in Somerset to be brought to a future meeting  Agree that the CCG engages with the Council and NHS England in the process of re- commissioning health and social care services subject to the agreement of any full business case.

4.  Identify those providers who are ‘most capable’  Undertake further engagement with primary care providers and the County Council  Confirm with providers that they are content to enter and invest in the process  Undertake detailed scoping of the programme plan, timeline and costs  Wider public consultation to develop whole population outcomes  Formal Public Sector Equality Duty consultation  Develop co-commissioning structures and delivery team  Support to providers to: contribute to the design of the new health and care system create an infrastructure that works for Somerset

5. ActionTiming SCC Cabinet consider & approve outline paper29 June CCG Governing Body consider OBC business case16 July Full business case to SCC Cabinet and CCG Governing BodyOctober If approved, start of OBC selection routeNovember If successful, first OBC running in shadow formatApril 2016 If successful, OBC ContractsApril 2017

6. Calendar Year3Q20154Q20151Q20162Q20163Q20164Q20161Q20172Q2017 Community Services Review Test & Learn Most Capable Provider Go / No Go Primary Care Option to formally join MCP process Shepton Mallet procurement [Award] Key decisions Identify potential capable providers Have providers demonstrated capability? Key decision to contract with MCP Ongoing T&L and Evaluation New contract in place for ‘OBC’ Primary Care Strategy Alignment of Transformation Activity Contracting Identify CP Collaboration Evaluation & Dialogue Transition & Operations Develop proposals for community services Join with MCP process Novate to MCP Join with MCP process Option to join MCP