COMMISSIONING DEVELOPMENT PROGRAMME WORK IN PROGRESS – STRICTLY NOT FOR FURTHER CIRCULATION...

COMMISSIONING DEVELOPMENT PROGRAMME

WORK IN PROGRESS – STRICTLY NOT FOR FURTHER CIRCULATION

Principles previously agreed

Towards Authorisation (published 30/09/11) sets out thinking to date and some key parameters:

Evidence for authorisation

Minimising the evidence requirement for formal submission of evidence.Maximising the use of the pre-authorisation period for informal submission.

6 domains of authorisation

Describing a good clinical commissioning group through the domains is enjoying significant support as a simple framework easily understood

Authorisation as a journey

Recognising authorisation as a safe threshold on a journey of continuous improvement,

not an end point. A maturity model.

Authorisation: design for success

Assuming the majority of CCGs will be authorised by April 2013.Expecting that 100% are established with conditions where appropriate.

Potential after authorisation

Seeing authorisation as an assessment of confidence in CCGs’ potential to deliver, whilst also drawing on track record to date as delegated sub-committees of PCTs



2

Authorisation remains based on six domains as widely discussed

1 A strong clinical and multi-professional focus which brings real added value

2 Meaningful engagement with patients, carers and their communities

3Clear and credible plans which continue to deliver the QIPP challenge within financial resources, in line with national requirements (including outcomes) and local joint health and wellbeing strategies

4

Proper constitutional and governance arrangements, with the capacity and capability to deliver all their duties and responsibilities, including financial control, as well as effectively commission all the services for which they are responsible

5Collaborative arrangements for commissioning with other clinical commissioning groups, local authorities and the NHS Commissioning Board as well as the appropriate external commissioning support

6 Great leaders who individually and collectively can make a real difference



Authorisation content: a clear line of sight

Evidence for authorisationEvidence for authorisationThreshold for

authorisationThreshold for authorisationCriteriaCriteria

Potential beyond authorisation

Potential beyond authorisation



Draft application submission list Authorisation application form

CCG constitution and other documents detailing governance arrangements (please specify)

CCG Organogram

Case studies (please specify)

Draft Joint Strategic Needs Assessment

Financial management arrangements compliant with national requirements

Health and Wellbeing Board minutes and reports

Joint Health and Wellbeing Strategy

Letter of support for CCG Chair

List of collaborative and joint commissioning arrangements

Minutes of multi-professional meetings

Organisational Development Plan

SLA or MoU with assured commissioning support provider

2012-13 contracts

2012-13 Integrated Plan and draft commissioning intentions for 2013-14

360° stakeholder survey report and CCG comment



Phases of Authorisation

Covering:•Most aspects of governance•Organisational form•Commissioning support arrangements

Enabling the CCG to set out factual details relevant to its application, but also to demonstrate compliance / self-certify against a number of authorisation criteria

Covering all aspects of authorisation

•Desktop review•360 review•Site visit

Pre-application Application NHSCB assessment



CCG performance and population health profiles

Provided to all CCGs at least one month before the application date for their wave, profiles will provide the following data configured at CCG level:

• Geography - including the relationship between the CCG and their Local Authority, and the relationship between a CCG’s registered and resident population;

• Demographic and socioeconomic profile - e.g. age/ sex/ Index of Multiple Deprivation;

• Population level outcomes data - e.g. QOF;

• Activity and outcomes data (e.g. the latter from inpatient survey) split by main provider;

• Performance data;

• Finance - including baselines, fairshares and risk of overspend given the CCG populations.

CCG profiles will be used by the assessor team to understand the challenges facing applicant CCGs and will form part of the data triangulation on track record, planning, prioritisation and financial management.



360° Stakeholder Review

Objective The survey will assess whether CCGs have been developing strong foundations for successful relationships with all key stakeholders and examine the potential for these relationships to evolve.

Timing CCGs to provide participants’ contact details approx. 8 weeks prior to authorisation. Survey results will be returned to CCGs just prior to authorisation leaving enough time for their comment

Participants c40-45 stakeholders per CCG to include GP constituent practices, other CCGs, (shadow) Heath & Wellbeing boards, Local Authorities, LINks/(shadow) Healthwatch, NHS providers…

Format An online survey that will include generic questions to all participants plus small banks of stakeholder-specific questions. Total survey length will be approx. 15-20 mins

Content Will cover themes such as stakeholders’ experiences of working with emerging CCGs so far and their opinions of CCGs’ potential to deliver quality, clinically-led commissioning in the future

Role of CCGs To provide accurate stakeholder contact in a timely manner and to submit the survey results plus CCG comments as part of the authorisation documentation

Assistance provided Information materials and a website will help inform CCGs and their stakeholders as to the survey’s purpose and content. A dedicated email and enquiry line will also be made available

Non-response Non-respondents will be followed up with reminder emails and a phone call. Any stakeholders not wishing to participate in the full survey will be asked to complete a non-response survey

Objective The survey will assess whether CCGs have been developing strong foundations for successful relationships with all key stakeholders and examine the potential for these relationships to evolve

c40-45 stakeholders per CCG to include GP constituent practices, other CCGs, (shadow) Heath & Wellbeing boards, Local Authorities, LINks/(shadow) Healthwatch, NHS providers…



Case Studies CCGs are asked to submit case studies as part of their application, and they will also be used to

establish a national library of best practice emerging from clinical commissioning

They are an opportunity for CCGs to demonstrate their ability to deliver improvements (e.g. in access to services, health outcomes, service quality/productivity, reducing health inequalities) across all six domains. They also form part of the core evidence for authorisation in the following areas:• Member practice involvement in decision-making

• Taking devolved responsibility for specific commissioning budgets/areas/programmes from local PCT cluster

• Innovation - e.g. through use of intelligence/information, service redesign, through collaboration with other clinicians, engagement with the public and patients, use of technology

• Leadership and leadership development

• Enhanced clinical involvement in service redesign and improvement

• Involvement in 2012-13 contracting round

• Measurable improvements in productivity and quality delivered – e.g. improved holistic management of patients with chronic conditions and those at end of life

• Engaging different groups and communities through a range of communications channels in the development of vision, commissioning plan, or in broader CCG decision-making processes

• CCG collaboration with other CCGs and a multi-disciplinary range of clinicians



Application Timetable

COMMISSIONING DEVELOPMENT PROGRAMME WORK IN PROGRESS – STRICTLY NOT FOR FURTHER CIRCULATION...

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