Dr Caroline Gamlin

Director of Public Health NHS Somerset

World Class Commissioning

The Somerset Health Community

Population 524,600 Significant issues- rurality,

ageing population 2009/10 budget £800

million 4 major local NHS

providers, including ISTC 75 general practices, 13 community hospitals Strong Local Authority and

Third Sector partnerships

How does PH engage with commissioning in Somerset?

Identified PH leads for programme areas

Strong link with practice based commissioning

Commissioners linked in with JSNA

PH leads on selection of outcomes, needs assessments, evidenced based practice and supports benchmarking and care pathway design

Increasing involvement in procurement

Competencies: Skills and Behaviours

1. Locally lead the NHS

2. Work with community partners

3. Engage with public and

patients

4. Collaborate with clinicians

5. Manage knowledge and

assess needs

6. Prioritise investment

7. Stimulate the market

8. Promote improvement and

innovation

9. Secure procurement skills

10. Manage the local health system

11. Make sound financial investments

Competitive Procurements

5

Equitable Access to Primary Care

Chronic Obstructive Pulmonary Disease (COPD)

Commissioned in partnership with Practice Based Commissioning Consortium

Addressed service inequity and major gaps

5 expressions of interest, 3 bids submitted

Contract awarded to an independent partnership – two local GPs and BUPA Home Healthcare Ltd.

Somerset COPD

• Designed by Patients• Selected by Patients• Patient feedback

informs performance

Learning Points

PCT internal ‘firewall’

Capacity to support the process

Strength of joint PCT/PbC process

Value of patient engagement throughout

Performance Management

Contract Management

Process Redesign …

StrengtheningLeadership ...

Organisational Restructuring

Increasing Funding …

Building Capacity …

Clinical Improvement

Engaging with Customers …

Market Forces

Improving patient care

9

Competition is just one of a range of levers that PCTs can use to improve healthcare services ...

Challenges

What does world class look like? – getting comparative data on outcomes

Ensure rigour applied to acute health services can be replicated to wider health improvement agenda

Address inequalities and get PH messages to target populations

IMPROVING HEALTH/ELIMINATING WAITING/IMPROVING HEALTH SERVICES

PRIORITY WORK PROGRAMME

BEST IN NHS

Summary of model

Clinical outcomes

References

BEST IN WORLD

Summary of model

Clinical outcomes

References

NHS SOMERSET POSITION

Summary of Model

Clinical Outcomes

References

Links to Clinical Strategies

High Level Comparison : Best in UK and World / NHS Somerset position

Next steps

WORLD CLASS COMMISSIONING OUTCOMES: BEST PRACTICE TEMPLATE