Responding to the challenges of GP commissioning

Since July 2010, the scale and pace of change for the healthcare service in the UK and NHS commissioners in particular has been unparalleled. It is perhaps inevitable that with such a shift in economic and clinical responsibility, programmes for implementing the GP commissioning reforms can become focused on form. Issues of governance and accountability, organisational structures, roles and responsibilities come to dominate the discussion. This is common in change programmes seen across both private and public sector organisations.  

As the GP commissioning landscape evolves, clinical commissioning groups must focus on setting themselves up as robust business operations while making good commissioning decisions that provide both value for money and improved patient outcomes. There is now a fresh duty to engage with other clinician groups in clinical senates and have two other clinicians (nurse and hospital doctor) on the board. The role of the Health and Wellbeing Boards has also been clarified.

More than ever there is a need to develop strong partnership, and in doing so clinical commissioning groups need to focus on four key functional elements:

• Identifying population needs and designing the care pathways that can reduce costs and improve patient care locally. From day one it will be critical for new consortia to identify the models of care and prevention that are needed most to provide better, seamless care throughout the patient journey. Clinical commissioning groups will need strong clinical engagement and innovation to develop preventative care pathways to address health needs of those most at risk. This will require, for example, new models for managing long-term conditions, supporting the delivery of self-care and working collaboratively with patients to allow them to make full use of assistive technology.

• Engaging the right organisations and stakeholders that will help deliver consortia’s vision to improve health outcomes for the local population. Clinical commissioning groups will need to build the right multi-professional relationships across primary, secondary, social care providers, local authorities and undertake strong public consultation exercises, to deliver the service changes they wish to see. How you work with the Clinical Senate will be vital in driving forward changes. Critical to this will be identifying which community services can deliver the greatest improvements in the shortest time. Changes will require stronger integration between health and social care services if they are to successfully reduce patient demand in secondary care

• Building the right workforce culture and management capabilities. Achieving any transformational change will require consortia to build the right clinical leadership capabilities to support new ways of working, release new cultural behaviours and establish commissioning capabilities that will drive up service quality and patient outcomes. 

• Improving effectiveness by strengthening management capability and the quality of decision making. Collecting quality information on the population health needs, high risk patients, variations in practice or clinical commissioning group activity and spend will be essential to driving the right commissioning decisions. Accessing quality data and sharing and communicating it in a meaningful way will enable clinical commissioning groups to focus effort and resources on those health and social care services that deliver the greatest value.    

In responding to the challenges of commissioning it will be important that clinical commissioning groups identify how each of these four elements can contribute to their success. 

To learn how PA can help your clinical commissioning group or commissioning support organisation please contact us now.