Clinical commissioning and the
voluntary and community sector
Louise Edwards
Commissioning Development team
A system focused on
improving outcomes
Robust economic regulation
and quality inspection
Clinically-led
commissioning &
payment for results
Enhanced
local voice
Empowered
professionals working
in autonomous providers
Informed patients
exercising choice
Summary of NHS reforms
Parliament
Funding
Accountability
Reformed NHS
has lots of new
structures that
are supposed to
look like this..
Department of
Health
NHS
Commissioning
Board
Monitor
(economic
regulator)
Care Quality
Commission
licensing
Local
Authorities
local
partnership
GP
Commissioning
Consortia
contract
Providers
accountability for results
Local Health
Watch
Patients and Public
But it might look and
feel more like this to
you for a while!
These reforms are all about putting clinicians
in the driving seat…
In essence, it’s about putting
accountability for decision
making in the hands of those
who commit resources.
And with that accountability comes high public
expectations
National IPSOS MORI/DH survey 2010
73% of respondents said they were satisfied with the NHS as a
national service
76% of respondents voiced pessimism in relation to the
challenges facing the NHS in future years.
47% believe that NHS is understaffed.
75% of respondents feel that NHS spending should be protected.
Where are the trade offs in here??
Do you know who your local clinical
commissioning group is?
• In the North West we currently have 48
Clinical Commissioning Groups (CCG) that
cover the geographical patch, all of whom
have been approved as Pathfinders.
• The majority of the consortia have broad
alignment with Local Authority boundaries
and have representation on local Health and
Wellbeing Boards alongside other key local
stakeholders.
‘Authorisation’ of clinical commissioning groups will
set the pace for their development between now
and 2013
Phase 3
‘Authorisation’
Summer 2012April 2013
The Pole represents the apparatus required to
support effective trajectory and scale the
challenge (i.e. the business support)
Phase 2
‘Development
path’
Now – Summer
2012
The CCG
Phase 1
‘Configuration’
October –
December 2011
The Pre-Authorisation Timeline (i.e. the track)
H1 H2 H3 = the standards required to demonstrate Domain Capability
H4 = the final authorisation stage following validated evidence of fitness for purpose
The Bar represents the aggregation of evidence
required from all domains (i.e. the size of the
challenge)
What does all this mean for the voluntary and
community sector?
We know that all this change makes planning very
difficult
A huge number of voluntary organisations are currently delivering
health related outcomes that are funded from within the health
system – mainly through PCTs.
Many of these organisations are looking to deliver more services
but are currently struggling to come to terms with what clinical
commissioning will mean for them.
Planning in the sector is proving incredibly difficult in the current
environment with so many uncertainties and organisations are
struggling to make sense of how clinical commissioning will
evolve.
VSNW/Regional Voices/NHSNW
workshops November 2010-now
Over the course of the last 8 months we’ve brought together a range
of voluntary and community sector organisations to consider how the
sector might respond to the commissioning reforms in the NHS.
Department of Health national workshop
July 2011
Brought together national voluntary organisations to explore
potential role of sector in commissioning support (i.e. support
to the new clinical commissioning groups) and to decide best
way for an informed dialogue between commissioners and
voluntary sector.
What are the themes emerging from
these workshops?
New landscape is confusing for voluntary sector and we
might lose really valuable assets if we’re not careful –
NHS and DH need to help vcs interpret new landscape
and make sense of it
GPs don’t necessarily understand distinct contribution
of vcs – hearts and minds awareness raising needed
based on GP reality, not moral high ground
How might vcs organisations work together and with
other sectors to make themselves easier to commission
– 3 ‘c’s for voluntary sector = collaboration, competition
and co-opetition
Questions for today’s workshop
• Do the three themes resonate with you?
• What might be the practical ways DH/NHS can
help vcs interpret new NHS commissioning
landscape and make sense of it?
• Do you have experience of working with clinical
commissioning groups, or GPs? How has that
been?
• How might we enable and encourage vcs
organisations to collaborate in order to grow
their share of the market?