We work with commissioners across health and care to develop commissioning as a transformational process to meet the new demands of the health and care system.
Commissioning framework for health and well-being (Department of Health 2007) focuses on commissioning services to treat people when they are ill and to keep individuals and communities healthy and independent. It builds on the White Paper Our health, our care, our say, with its emphasis on prevention, choice, care closer to home and tackling inequalities. The Commissioning framework for health and well-being sets out eight steps for effective commissioning for health and well-being. These are:
- 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
- Recognising the interdependence between work, health and wellbeing
- Developing incentives for commissioning for health and wellbeing
- Making it happen - local accountability
- Making it happen - capability and leadership
World class commissioning aims to raise ambitions for a new form of commissioning to be implemented in a comprehensive way across the developed healthcare economies. The vision is to 'add life to years and years to life'. World class commissioning: Vision (Department of Health 2007) explains the WCC vision for commissioning that maximises potential to increase choice and innovation, led by the local NHS, with a strong mandate from its population and partners. It sets out 11 organisational competencies PCTs should develop to underpin effective commissioning. These are:
- Lead the NHS locally
- Work collaboratively with community partners
- Engage with public and patients
- Collaborate with clinicians
- Manage knowledge and assess needs
- Prioritise investment
- Stimulate the market
- Promote improvement and innovation
- Secure procurement skills
- Manage the local health system
- Make sound financial investments
World class commissioning: Competencies (Department of Health 2007) examines each competency, identifying component skills, processes and knowledge requirements, and examples of outputs. It looks at competencies in the context of training and development and personal goals.
Commissioning diagnostic tool (Department of Health 2007) describes all activities necessary for good commissioning at PCT level, expected standards and best practice at UK and international level. It helps identify gaps and provides the basis for operational and financial plans. There are four separate diagnostic tools and user guides, measuring:
- strategic planning
- care pathway management
- provider management
- monitoring and remediation
Achieving the competencies: Practical tips for NHS commissioners (Department of Health 2008) sets out success indicators and criteria for each WCC competency, with tips on reaching level 2 and progressing to world class, such as different research methods, suggestions for supporting evidence and links to further information.
Achieving many of the competencies will depend on PCTs developing effective working relationships with local authorities and other partners. Since April 2008 there has been a statutory duty on all upper tier local authorities and PCTs to produce a joint strategic needs assessment (JSNA), as set out in the Local Government and Public Involvement in Health Act 2007. The JSNA concept was first described in the Green Paper Independence, well-being and choice and the White Paper Our health, our care, our say.
The idea behind JSNA is that all key decision makers in a local area work together to produce a wide-ranging needs assessment that deals with the whole population and identifies the health and well-being needs and inequalities that exist within that population.
The Guidance on joint strategic needs assessment (Department of Health 2008) says outcomes can be expressed at four different levels, then discussed with providers to clarify the results commissioners want from investment in a service and open the door to innovative practice and ideas.
