Commissioning for Value A programme to help CCGs identify value opportunities and improve healthcare for their populations September 2013
Feb 14, 2016
Commissioning for Value
A programme to help CCGs identify value opportunities and improve healthcare for their populations
September 2013
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Commissioning for Value is about identifying priority programmes which offer the best opportunities to improve healthcare for your populations; improving the value that patients receive from their healthcare and improving the value that populations receive from investment in their local health system.
Commissioning for Value – September 2013
What is Commissioning for Value?
“Value in any field must be defined around the customer, not the supplier. Value must also be measured by outputs, not inputs. Hence it is patient health results that matter, not the volume of services delivered. But results are achieved at some cost. Therefore, the proper objective is… patient health outcomes relative to the total cost (inputs). Efficiency, then, is
subsumed in the concept of value. ” Source: Porter ME. (2008). What is Value in Health Care? Harvard Business School.
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What is Commissioning for Value?
In his Dear Colleague letter to the NHS of 10 October – Planning for a sustainable NHS, Sir David Nicholson set out ten key points to support planning for a sustainable NHS. The letter included information about the ‘Commissioning for Value’ packs for CCGs to help you identify where there is greatest opportunity to improve outcomes.
The packs aim to help identify real opportunities for improvement of outcomes and to increase value for local populations. The localised information will support discussions about prioritising areas for change, utilising resources and will help you as local leaders make improvements in healthcare quality, outcomes and efficiency. They are also the first product CCGs will receive as part of the new planning round for commissioners - a vital part of NHS England’s ‘Call to Action’ where everyone is being encouraged to take an active part in ensuring a sustainable future for the NHS.
The Commissioning for Value approach begins with a review of indicative data to highlight the top priorities (opportunities) for transformation and improvement.
This is achieved using Programme Budgeting Marginal Analysis and Spend and Outcome data to highlight those clinical programmes where the health economy is an outlier and therefore will be most likely to yield the most improvements to clinical pathways and policies.
The approach - where to look...using indicative data
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Commissioning for Value – September 20135
Quality
Spend Direction of Travel
Bespoke Commissioning for Value insights packs CCGs
By mid-October, we will deliver bespoke Commissioning for Value packs to all 211 CCGs, with an offer of follow-up events and support.
These packs will have triangulated data for the top Programme Budget Categories by spend for your population and will suggest priority programme areas which offer the best value opportunity for service improvements
Commissioning for Value 20136
How will using this pack benefit my population?
• Achieved Turnaround (Warrington CCG - Winner of HSJ Commissioning Organisation of the Year 2012)• Financial sustainability (West Cheshire CCG - Winner of HSJ Commissioning Organisation of the Year 2010)• Clinically led annual QIPP planning and delivery (Borough of Wigan) Clinical Leaders driving change (Vale of York CCG)• Galvanising commissioners in a growing number of health economies (20+ CCGs and growing)
CCGs can and are using the “Right Care approach” to shift spend
Year 1 – “Came from behind” - Implemented system mid yearYear 2 – “Delivered as went along” - Began at year start, achieved by endYear 3 – “Planned ahead” - Began before year start, over- achieved Year 4 – “Ahead of the curve” - 20% of QIPP delivered by startYear 5 – Increased focus on Quality!
Achieving financial stability in West Cheshire
It’s not just about money - Right Care in West Cheshire led to real quality improvements in just one annual cycle
- A&E attends & admissions, Elective & Non-elective activity, OP Firsts and –
- Follow-ups – all decreased- Outcomes & Quality – improved- Integration occurred across health sectors and with social care
Enabled by, for example :- Medicines administration training to care homes- Personalised care plans (LTC)- Community endoscopy, optometry, ophthalmology, neurology & pain management pathways- MRI Scanner Direct Access
• Constant clinical focus on improving quality and outcomes• Significant engagement from constituent practices• Involvement of the wider clinical community in commissioning
Domain 1 A strong clinical and multi-
professional focus
• System-wide strategic planning• Evidence based operational planning• Effective delivery of the plan
Domain 3Clear and credible planning
and delivery
• CCG is clinically led and properly constituted with the right governance arrangements
• Delivers statutory functions efficiently, effectively and economically• Procures high quality support as required to meet the business
needs
Domain 4Robust governance
arrangements
The use of these packs and the approach described can help CCGs develop the strategic commissioning skills necessary for delivering quality care today and transforming services for tomorrow, as outlined in the following 3 of the 6 assurance domains:
How will using this pack help my CCG Development
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• understand what the insight packs are telling you about your population health outcomes
• how to use the insights in the packs to direct your improvement efforts • learn from early adopters who have successfully used this approach to deliver
results• get face to face support in surgeries where your insight packs can be
discussed on an individual, CCG basis• network with commissioning support services who can help you to move
forward
To support CCGs in making use of the insight packs, we are organising two follow-up events to help CCGs:
Commissioning for Value 2013
Two follow-up events for CCGs…
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London: Manchester:Venue: The Business Design Centre
Venue: Mercure Hotel, Manchester Piccadilly
Date: Tuesday 12th November Date: Wednesday 13th November
Time: 9:30am for 10:00 start Time: 9:30am for 10:00 start
An online registration form is available at the URL below:
www.rightcare.nhs.uk/commissioningforvalue
Commissioning for Value 2013
Book your place online…
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The Right Care website will offers a new Resource Centre to support CCGs including:
• Online videos and ‘how to’ guides• Theme based Webinars• Case studies with learning from previous pilots• Tried and tested process templates to support taking the
approach forward• Advice on how to produce level 2 packs locally, within the CCG or
working with local intelligence services
NHS England will also be publishing further material to help commissioners navigate their way through the planning process, including detailed planning guidance and financial allocations. You will be able to find out more about this in the CCG bulletin and on the NHS England website.
Commissioning for Value 2013www.rightcare.nhs.uk/resourcecentre
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