presentation heading presented by / sub-heading commissioning explained sarah freeman local service...

Presentation headingPresented by / Sub-heading

Commissioning Explained

Sarah FreemanLocal Service Specialist – West Midlands Team

NHS Values• Working together for patients

• Compassion

• Commitment to Quality of Care

• Respect and dignity

• Improving lives

• Everyone counts

NHS | Presentation to MS EAG | 10th October 20142

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


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.


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


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


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

Local Delivery of Specialised ServicesTen Areas Teams:• 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


Support for Commissioners: Commissioning Support Units (CSU)

Transactional commissioning – market management, contract negotiation, information and data analysis

Transformational commissioning – supporting service redesign

NHS | Presentation to MS EAG | 10th October 2014]11

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

NHS | Presentation to MS EAG | 10th October 2014]12

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


Useful Links• Web link for specialised commissioning and key

documents

http://www.england.nhs.uk/wp-content/uploads/2014/06/simple-nhs-guide.pdf

http://www.england.nhs.uk/resources/spec-comm-resources/

http://www.england.nhs.uk/npc-crg/

http://www.england.nhs.uk/ourwork/d-com/spec-serv/crg/












presentation heading presented by / sub-heading commissioning explained sarah freeman local service...

Documents