Transcript Document
The New Landscape Transforming Commissioning Agenda • The likely impact of the White Paper on the commissioning landscape • The NHS London Commissioning Development programme You may have seen... NHS revamp to ‘push up standards’ NHS shake-up 'hands funding powers to GPs’ “Biggest reorganisation in the NHS since 1974” NHS 'reorganisation' is outlined “radical programme for a radical government” Andrew Lansley has a clear vision... • patients must be at the heart of everything we do • the NHS must be focused on achieving continuously improving outcomes for patients • we must empower clinicians • we must prioritise prevention and create a public health service • we must reform social care alongside healthcare Andrew Lansley: 'A shared ambition to improve outcomes' This includes some concrete changes Out with the old, in with the new • Funding from DH > SHAs > PCTs > GPs and Commissioned Providers • 80% of funding to be held by GPs, who will commission using an ‘Any Willing Provider’ model • Public Health responsibilities held by PCTs • Responsibility for Public Health to be held by Local Authorities • FT status for NHS Hospital Trusts optional • All hospital trusts must become an FT, or part of one • Occasional financial bailouts • Limited independent sector commissioning support of NHS funded services • No bailouts for commissioners and providers • Commissioning support will become a new ‘market place’ for the NHS, with considerable outsourcing The end state will look very different Parliament Funding Accountability DH NHS Commissioning Board Monitor (economic regulator) CQC licensing Local Authorities Local strategic partnership GP Commissioning Consortia contract Providers Accountability for results Local HealthWatch Patients and Public The NHS Commissioning Board will provide national leadership • establishing consortia (assigning them if necessary) Responsible for: • calculating practice-level budgets (based on weighted capitation) and allocating to consortia • ensuring the NHS in England is resilient and is mobilised in times of national emergency • primary care & ‘family health services’ – dental, optometry and pharmacy • national and regional specialised services It will commission: • maternity care • health services for those in prison or custody • equality in health outcomes • choice & personalisation, including personal health budgets It will promote: • research and use of evidence • productivity & competition It will promote: GP Consortia will commission the majority of services for their local populations • commissioning the majority of healthcare services • managing combined practices’ commissioning budgets Responsible for: • deciding commissioning priorities to reflect local needs, supported by an outcomes framework • commission services using the Any Willing Provider model • use a lead commissioner arrangement Will be empowered to: • procure support for commissioning activities • agree local priorities each year – carrying out patient and public involvement exercises • take part in risk-pooling arrangements & appoint staff for statutory governance role Will need to: Will need to: • ensure continuity of services and promote health equality Plus many players in the current structure will be given increased powers to support the new world • strengthen patient and public voice HealthWatch • advise the NHS Commissioning Board, Monitor and the Secretary of State “Nothing about me, without me” • local health improvement Local Authorities • local coordination of joint commissioning • fund and hold to account ‘local HealthWatch’ Plus many players in the current structure will be given increased powers to support the new world • license providers, alongside Monitor, against safety & quality standards “Greater autonomy will be matched by increased accountability ” Care Quality • targeted and risk-based inspections, Commission • enforcement if standards not met • economic regulator for providers to the NHS and social care Monitor • promote and enforce competition & choice • powers to set efficient or maximum prices Plus many players in the current structure will be given increased powers to support the new world “Improvement in quality and healthcare outcomes is the new governing principle” National • independent, non-departmental public Institute body for Health • develop quality standards for key care and pathways Clinical Excellence • social care as well as health Public Health Service • will take over functions of existing improvement & protection bodies • set LAs national objectives for improving population health outcomes • research and evaluation The scope of NHS London’s contribution to supporting the transition to GP-led commissioning is currently being defined Support development of GP consortia Support development of commissioning support market Establish NHS Commissioning Board Realign clinical networks Define and implement transition structures Joint working and communications Thank You Rachel Bartlett Assistant Director, Commissioning Development E: [email protected]