Commissioning Specialist Health Services

Janet Finucane

Senior Specialist Commissioning Manager, Joint Commissioning

Team – (posh shopper!)

What I want to talk about

• Do a quick overview of the science of commissioning

• Discuss two areas of work that sit between our local communities and specialist services

• Discuss some challenges for keeping strong local links for services a step away from GPs.

Shopping!

• Bought a car in the last two years?

Did you?• Go back to the same

garage?• Buy the same model as

last year?• Pay the manufacturers

asking price?• Are you pleased with the

car in terms of comfort, speed and reliability

• Do you know if it was value for money?

Commissioning ?

Buying servicesNeeds to be freshQualityMeet needvfm

Commissioning the car?• Work out what you needed and how much it

would cost to run.• Buy ethically• Check carefully what other demands would be

placed on your budget • Shop around a few garages first to work out who

had the best deals for the car you wanted• Negotiate a good price including warranty and

servicing Did you shop/commission what you needed…..

Example 1 - HMPNeeds5000 paAgeing population70% MH needsHigh risk taking lifestyle(tb,Hep,dental decay,

infectious diseases),80% smokers? Improve Health…….

ChallengesSecurity comes firstStaffing require CTC – takes 3 monthsRequired to provide equitable services to

communityLimited escorts outNeed to get services in and integrate back homeService delivery long due to security inputs High dna rates…high waiting lists (Links)

What we have

• Strong in house team of nursing, mh and drugs staff

• Inpatient unit – 28 beds• Primary care centre with practitioners

(dental, pharmacy, podiatry)

Some examples of what we have bought and developed

• Telemedicine service offering A&E and clinics• New dental service• New anti coagulant service• New integrated drug treatment service• Stronger links with social care• Increased smoking cessation• Review of mental health services to link with

local pathways • Chronic disease registers and support for older

prisoners

Developments link into our local relationships and provisions

Will we still be able to link as effectively into the good will of our local services

Post the transfer of our community services

Will the working relationships between public health/prison/gp be strong enough?

Can you take on Bariatrics?• Budget based on last

years spend• Obesity crisis• Fern factor• Contract established

but lots of last years people still waiting!

• Pathway gaps• NICE levels

Scope out problem• Find out what bariatric surgery is• Find out how many people need it • Find out if we can afford it• Find out what processes are in place to

monitor and deliver it• Find out if we have users views

Local Bariatric Challenges • Handling expectation and

Need • Fit wit local services and

pathways • Current system gives GPs

barrier and not direct NO• Still need to commission

local dietetics service etc. ?