Post on 05-Jun-2015
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Copyright 2011 Right Care
What do we mean by commissioning?
Dr Peter Brambleby MBBS, DCH, FRCP (Edin), FFPHMIndependent Public Health Consultant (Former DPH in Norwich; North Yorkshire & York; Croydon)August 2013
Online Learning Series
Right Care for Populations
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Definitions 1
“Commissioning is a collaborative exercise between interdependent parties who invest local resources of
money, talent and commitment to reshape local services and networks to meet local needs and
thereby improve patients’ and populations’ health and wellbeing.” *
* Brambleby P, Health Service Journal, 2005
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Definitions 2
“Good commissioning is about being a good GP, and the values that underpin success in
commissioning services in the future for our patients should be the very same values with which we approach our day-to-day bread-and-
butter practice. It’s about knowing the needs of our patients as individuals, and about knowing the
needs – ever evolving – of the populations and communities we serve.” *
* Gerada, C, South London GP and Chair of RCGP, 2012
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Definitions 3
Say it slowly….“Co-mission-ing!”
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Aims of commissioning:
• To invest resources to improve individual and population health and well-being,
• reduce inequalities in health, • raise standards of health care, • promote integrated working between all the
elements of a collaborative system, • and to support an innovative and evaluative culture
of continual learning and improvement.
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Finance
Specification Volume
Structure
Outcome
Process
Incidence and Prevalence
Demography
Marginal Costs and Benefits
Opportunity Costs
Three elements of a contract
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The Nolan Principles
• Selflessness• Integrity • Objectivity • Accountability • Openness• Honesty • Leadership
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People are a valuable resource!
A thrust of current government policy is to help people and their carers to play a more active role in protecting their health and managing their own illness, and supporting their loved ones closer to home and away from a hospital setting where possible.
“Needs assessments” should always include “capability assessments”.
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There is no more money!
The “golden rule” of commissioning should be:
“no new investment into any service without a matching disinvestment from areas of lower value”.
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Questions…
Is there a difference between “commissioning”, “procurement”, purchasing” and “payment”?
What bearing do these distinctions have in how you relate to your partners in the local economy for health and well-being?
Further reading
Increasing value: commissioning on the front line. DaSilva P. Kingsham Press. 2012
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