Commissioning Specialist Mental Health & LD services. Dr. Sabyasachi Bhaumik Medical Director Leicestershire Partnership NHS Trust
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1 Commissioning Specialist Mental Health & LD services Dr. Sabyasachi Bhaumik Medical Director Leicestershire Partnership NHS Trust
2 NHS Reforms 2010 White paper: Equity & Excellence: Liberating the NHS Transparency in outcomes Regulating health care providers Commissioning for patients Increasing democratic legitimacy in health
3 Health and social care bill 1. Establishes an independent NHS Board to allocate resources and provide commissioning guidance 2. Increases GPs powers to commission services on behalf of their patients 3. Strengthens the role of the Care Quality Commission 4. Develops Monitor, the body that currently regulates NHS foundation trusts, into an economic regulator to oversee aspects of access and competition in the NHS 5. Cuts the number of health bodies to help meet the Government's commitment to cut NHS administration costs by a third, including abolishing Primary Care Trusts and Strategic Health Authorities
4 Timelines (BMA)
5 The Proposed Structure for Commissioning Health Secretary CQC Clinical Interface / Cabinet groups National Commissioning Board Specialist Comm. Board Clinical Commissioning Groups Monitor Health & Well being Board Other Health Providers GP practices NHS Providers
6
7 The Commissioning Cycle
8 Issues arising out of proposed amendments (1) Commissioning arrangements are different Joint or Delegated Commissioning is the norm Difficult to distinguish between Health and Social care Interdependency on Outcomes
9 Issues arsing out of proposed amendments (2) Clarity between specialist and non-specialist services is lacking- however tiered model might help Historically, expertise belonged to local authorities Primary care expertise is just developing Any qualified provider- already exists, we are unsure about the extension of competition in other areas e.g sub-contract certain specialist elements like SALT, Psychology
10 Clinical commissioning - interface Clinical Commissioning Groups Vs National Commissioning Board Specialist Commissioning board and Clinical Commissioning Groups Social Care Vs Health Care Commissioning Health and Well being board Vs Social Care Commissioning Boards Total Place approach and role of Partnership Boards Personal health budgets
11 Debate Health versus social care what element of care would be provided in specialist health service Impact of efficiency savings impact on health and social care services Any qualified provider how do you manage continuity of service?
12 LD commissioning Tier 1 / 2 Would this be purely social care commissioning Tier 2/3 Clinical Commissioning Groups o Would they have the expertise o What role would social care / H&W board play Highly specialist elements: National Commissioning Board o Offenders with LD; o What other areas? Commissioning through Tenders- how prepared are we?
13 Primary-Secondary care collaboration: possible solutions Individual GP practices Barriers to individual patient pathways, feedback to commissioning Commissioning clusters Needs of the local population and pathways to care Clinical commissioning groups clinical care pathways and clinical networks
14 Primary-Secondary care collaboration: possible solutions Clinical commissioning boards local priorities Local clinical interface groups Prioritising commissioning intent, interface issues, designing pathways that improve efficiency of care and cost Health and well being boards health needs, joint strategic health needs assessment Specialist commissioning boards forensic service
15 Involvement of people with LD and carers LD partnership boards User representation in H&W boards Involvement in JSNA (Joint Strategic Needs Assessment) Involvement in Clinical Commissioning Board
16 Keeping services fit for competition (1) Partnerships Collaboration versus competition Preparing for bids expertise in identifying the market potential and prepare good bids. Improving data quality getting the real time data Pathways Joined up pathways with primary care o aims to achieve independence o focused on early identification and prevention, o person centred care
17 Keeping services fit for competition (2) How do you demonstrate Investment in LD service saves resources elsewhere? ( in acute care?) Patient experience and outcome real time patient experience, people with severe LD, involvement of carers Bench marking QIPP / Quality observatory
18 Thank you for listening! Any questions?
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