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

2

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

3

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

4

Definitions 3

Say it slowly….“Co-mission-ing!”

5

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.

6

Finance

Specification Volume

Structure

Outcome

Process

Incidence and Prevalence

Demography

Marginal Costs and Benefits

Opportunity Costs

Three elements of a contract

7

The Nolan Principles

• Selflessness• Integrity • Objectivity • Accountability • Openness• Honesty • Leadership

8

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”.

9

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”.

10

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

11

Online Learning Series

Right Care for Populations

Follow Right Care online• Subscribe to get a weekly digest

of our blog alerts in your inbox, • Receive occasional eBulletins • Follow us on Twitter

@qipprightcare

Find the full series at:

www.rightcare.nhs.uk/resourcecentre

Join our network:

www.rightcare.nhs.uk/network