Transcript Presentation heading - West Midlands Strategic Clinical

Commissioning Explained
Presentation heading
Sarah
Freeman by / Sub-heading
Presented
Local Service Specialist – West Midlands Team
NHS Values
• Working together for patients
• Compassion
• Commitment to Quality of Care
• Respect and dignity
• Improving lives
• Everyone counts
2 NHS | Presentation to MS EAG | 10th October 2014
Health and Social Care Act 2013
• Move to clinically led commissioning
• Increase in patient involvement
• Renewed focus on the importance of public health
• Streamlining of “arms–length” bodies
• Allowing healthcare market competition in the
best interest of patients
NHS | Presentation to MS EAG | 10th October 2014
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Finances
• Money for the NHS comes from the Treasury, mostly via taxation.
• Every 2-3 years the Treasury holds a Spending Review setting budgets for all
major public services. Health receives around £107 billion a year.
• Nearly half the NHS budget is spent on acute and emergency care.
• 10% goes on each of General Practice, Community Care, Mental Health and
Prescribing
• 10% remaining health commitments – Public Health, Offender Health, running
costs etc.
• CCG budgets are set on population size, adjusted for age, health and location
• Money is paid to providers by a combination of Payment by Results (PbR), block
contracts and local variations. This is working towards a payment system based
on quality of care and health outcomes.
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Money Flows from the Treasury to Patient Services
• Money flows from the Treasury to the Department of Health which retains
a proportion for its running costs and funding bodies such as Public
Health England.
• Department of Health allocates approx. £96 billion p.a. to NHS England.
Approx. £30 billion is retained to pay for running costs and directly
commissioned services - primary care, specialised services, offender
and military health care.
• The remaining £64 billion is passed onto clinical commissioning group
(CCGs) to enable them to commission services for their populations
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Commissioning: NHS England
• NHS England was formally established as the NHS Commissioning
Board in October 2012.
• It’s main aim is to improve health outcomes and deliver high quality care
by:
• Providing national leadership for improving outcomes and driving up
the quality of care
• Overseeing the operation of CCGs
• Allocating resources to CCGs
• Commissioning primary care and directly commissioned services
• 4 Regional Teams, 27 Local Area Teams (ATs), 10 with responsibility for
specialised services
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Setting the Agenda: CRG’s
Specialised Services Clinical Reference Groups (CRGs) have been
established to cover the full range of specialised services defined
within the Specialised Services National Definition Set (SSNDS)
portfolio.
CRGs aim to ensure clinical and patient led development and
delivery of commissioning products for the national commissioning
of prescribed services by NHS England. The CRGs will be the key
delivery mechanism for the development and assurance of
specialised services contracts products during 2013/14 required for
2014/15 contracts and beyond.
Each CRG has an identified ‘core’ set of products to develop in
2013/14 with a defined timeline for completion
Service
Specifications
Commissioning
Policy
Quality
Measures
Information
and Pricing
The
'Products'
Productivity
Innovation
Portfolio
CQUIN
Scope
Local Delivery of Specialised Services
Ten Areas Teams:
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•
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contract and performance management of activity, products, implementation
and compliance of service specifications
hold a single NHS England contract with providers in their area for all
specialised services (including Highly Specialised)
be responsible for oversight of time-limited derogation from the national
service specifications where required by local services
All Area Teams:
•
•
•
•
lead on local delivery of national standards and policies and contracting
be the hub for local knowledge ensuring local expertise on services, and
strong relationships with local stakeholders
deliver integration in patient pathways with CCGs and other commissioning
bodies
ensure local engagement and communication with Clinical Senates,
Strategic Clinical Networks, Operational Delivery Networks and providers
Commissioning: CCGs
• CCGs are designed to be clinically led and responsive to the health
needs of their local populations. They are made up of GP practices in
the area they cover.
• There are 211 CCGs with a median population of 250,000
• They commission from a range of providers for:
• Urgent and emergency care
• Elective hospital care
• Community health services
• Maternity and new born
• Mental health and learning disabilities
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Support for Commissioners:
Commissioning Support Units (CSU)
 Transactional commissioning – market
management, contract negotiation, information
and data analysis
 Transformational commissioning – supporting
service redesign
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Support for Commissioners: Strategic
Clinical Networks
• Focus on priority areas to improve equity, quality
of care, and health outcomes. Bring together
providers and commissioners to support more
effective service delivery,
• Cardiovascular
• Maternity, children and young people
• Mental health, dementia and young people
• Cancer
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Support for Commissioners: Clinical
Senates
• Multi-professional advisory groups of experts from across
health and social care.
• 12 clinical senates across England.
• Source of independent, strategic advice and guidance to
commissioners and other stakeholders to assist decision
making
• Comprised of a core Clinical Senate Council and wider
Clinical Senate Assembly or Forum
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Useful Links
• Web link for specialised commissioning and key
documents
http://www.england.nhs.uk/wpcontent/uploads/2014/06/simple-nhs-guide.pdf
http://www.england.nhs.uk/resources/spec-commresources/
http://www.england.nhs.uk/npc-crg/
http://www.england.nhs.uk/ourwork/d-com/specserv/crg/