Susan Davies

Acting Director South of England Specialised Commissioning Group (South West)

The NHS Commissioning Board Approach to

Contracting

The role and approach of the NHS Commissioning Board (NHSCB) in the new commissioning system

The key structures of the organisation

Approach to 2013/14

Overview

Responsible for ensuring the improvement of outcomes for all patients by:• Preventing people from dying prematurely

• Enhancing the quality of life for people with long term conditions

• Helping people recover from episodes of ill health or injury

• Ensuring people have a positive experience of care and treating; and

• Caring for people in a safe environment and protecting them from avoidable harm

Allocate £60bn to CCGs and support them in the effective use of that money to improve those outcomes for all patients

Directly commission health services worth £25bn including primary care, some public health services such as immunisation and screening, and specialised health services in England

Plan for civil emergencies and make sure the NHS is resilient

The Role and Approach of the NHSCB

The design of the NHS CB has been informed by the values and culture which the Board will foster. These include:

• A clear sense of purpose focused on improving quality and outcomes• Putting patients, clinicians and carers at the heart of decision-making• An energised, proactive organisation, offering leadership and direction • A focused and professional organisation, easy to do business with• An objective culture, using evidence to inform its activities• A flexible organisation, promoting integration, working across

boundaries and performing tasks at the right level• Committed to working in partnership to achieve its goals, in particular

by developing an effective, mutually supportive relationship with CCGs• An open and transparent approach, sharing information freely; and • An organisation with clear accountability arrangements and a grip on

those things for which it will be held to account

Values and Culture

A series of National Domain Directors: • Professor Sir Mike Richards – Director,  Domain 1- preventing people from dying

prematurely• Dr Martin McShane - Director, Domain 2 – enhancing the quality of life for people

with long term conditions• Professor Keith Willetts - Director, Domain 3 - recovering from episodes of ill health

or injury• Richard Gleave - Director, Domain 4 - positive experience of care• Dr Mike Durkin - a safe environment and protecting people from harm

For specialised services, a series of programmes of care, based around the Clinical Reference Groups:• Blood and Cancer• Internal Medicine• Women and Children• Mental Health• Trauma

A Focus on Quality and Putting Patients, Clinicians and Carers at the Heart of Decision Making

National level – set consistent national policy and strategy - based in Leeds with presence in London

9 corporate directorates

4 regional offices – assist in development of strategy and support/oversee local implementation

27 Local Area Teams - implement policies/ contract and relationship management

The Key Structures of the Organisation

Specialised Commissioning

North• Cheshire, Warrington and Wirral• South Yorkshire and Bassetlaw• Cumbria, Northumberland, Tyne and Wear

Midlands and East • Birmingham and the Black Country• Leicestershire and Lincolnshire• East Anglia

London

South• Surrey and Sussex• Wessex• Bristol, North Somerset, Somerset and South Gloucestershire

The 10 LATs Leading Specialised Commissioning

Outlined in the Recommendations of the Clinical Advisory Group for Prescribed Services (GATEWAY 17981) http://www.dh.gov.uk/health/2012/09/cagreport/, published on 11th September. Subject to consultation with NHSCB currently

Reviewed the services in versions 3 and 4 of SSNDS and includes previously nationally commissioned ‘highly specialised services’

Services need to meet four factors, outlined in the ‘Health and Social Care Act’:

a) the number of individuals who require the provision of the service or facility

b) the cost of providing the service or facility

c) the number of persons able to provide the service or facility

d) the financial implications for clinical commissioning groups if they were required to arrange for the provision of the service or facility

Prescribed Services

A national approach, applied consistently Only prescribed services will be commissioned by NHSCB. Other secondary

care/community services via CCGs A suite of contracting products will be used with the standard national

contract There will be a single contract per provider (including highly specialised

services) regardless of where the patient originates from LATs will lead on contracts for their geographic area A nominated LAT will be identified for those providers with multiple

national sites NHSCB/Specialised Commissioners will be responsible for quality issues

affecting their services Individual Providers will be expected to have the same price for the same

service for all activity commissioned by the NHSCB from 1st April National estimates of full cost of specialised services built into

CCG/NHSCB allocations exercise

Approach to Contracting in 2013/14

Any Questions?