Tag Archives: Commissioning

Implementing the NHS five year forward view: aligning policies with the plan

Source:  Link to main document: http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/implementing-the-nhs-five-year-forward-view-kingsfund-feb15.pdf

Publication format:  PDF (36 pages)

Date of publication: February 2015

Summary of driver: This is the implementation plan for the NHS Five Year Forward View, which was published October 2014 and proposes major change within the NHS over a five year timeframe. The implementation plan describes why the changes need to be made, makes practical proposals to remove barriers to healthcare and how the new implementation models can be supported. The report highlights the levels of funding required to meet this vision and the need for the NHS to have high-quality and consistent leadership.

Key features of driver:

The document lists four key drivers, each with recommendations for action and finishes with a summary of recommendations

How services are commissioned and paid for

  • Innovations in commissioning and contracting – NHS commissioners to be supported by national bodies in order to achieve this
  • Importance of investing in the development of system leaders
  • Development of federation/networks/super partnerships (multispecialty community provider) to enable general practices to deliver a wider range of services
  • Provision of proactive care in the community
  • Integrated commissioning- combining CCG and NHS England funding
  • NHS commissioners to work with interested general practices as pilot MCPs.
  • Formation of primary and acute care systems- single organisations to provide NHS services (GP/hospital/mental health/community care) running as virtual or physical organisations
  • Innovation in payment systems- capitated budgets/pooled budgets/integrated personal commissioning

How the NHS is regulated

  • Improvements in quality of health and social care- CQC to survey patients and service users
  • Whole-system intervention regime to support challenged health economies
  • NHS England and Monitor should review current rules on procurement and tendering to enable creation of new care models
  • Opportunity for local areas to have access to central legal advice

How improvements in care are delivered by local leaders

  • Development of leaders at all levels in the NHS
  • Providing all NHS staff with the skills and support requires to improve patient care
  • Every NHS organisation to take responsibility for the development of leaders and providing staff with skills in quality improvement
  • National bodies to develop explicit strategy for quality improvement
  • Currently most NHS leaders are organisational leaders and the Five Year Forward View is aligned with system leaders
  • Provider leadership- outlined in the Dalton review

How might a transformation fund contribute?

  • King’s Fund has argued for a transformation fun d to help provide financial support through change
  • Prime role is for transformation fun to pump-prime new care models whilst existing models are decommissioned
  • Important to recognise that some health economies may gain, some may lose and new organisations may be created
  • Looking to how mental health moved from hospital care to community services and lessons learned

Where next?

  • Care models set out in the Five Year Forward View are a starting point and not the end of the story
  • Commitment to real-time evaluation and learning
  • Creation of vanguard sites to fast-track new care models
  • Imbalance between the opportunities offered by the Five Year Forward View and the current situation of financial deficits/A&E pressures/waiting time performance
  • National bodies have the responsibility to reinforce the idea that the delivery of the Five Year Forward View is as important an operational performance

Primary audience: NHS England, NHS Commissioners, NHS Providers

Impact on library policy/practice:

None of drivers are specifically aimed at libraries but there opportunities for libraries.

  • The recommendation for ‘Leadership and improvement expertise’ when referring to the NHS becoming a learning organisation states ‘national support for improvement being provided through small teams of credible experts’. We are the credible experts in our field (p20).
  • Vision of NHS becoming a learning organisation (as outlined in Berwick report 2013) is a great opportunity to expand and promote our skill sets and services (p20).
  • Providing all NHS staff with the resources required to update their skills – literature search training/critical appraisal training/how to access information online, I order to improve patient care.
  • Undertake literature searches on the relevant subjects and promote current awareness on leadership and community topics.
  • Possibility of keeping GPs engaged with library and knowledge services.


Date last updated: February 2015

Due for review:  December 2016

Group member responsible: LK

NHS Outcomes Framework 2013-2014

Title of driver: NHS Outcomes Framework 2013-2014

Source: Department of Health

Link to main document

Publication format: PDF

Date of publication: 13th November 2012

Summary of driver: The NHS Outcomes Framework 2013 to 2014 sets out the outcomes and corresponding indicators that will be used to hold the NHS Commissioning Board to account for improvements in health outcomes, as part of the government’s mandate to the NHS Commissioning Board.

Key features of driver: Follow this link to see a single page mindmap produced by the NHS Confederation. There are five key domains underpinning this framework:

  • Domain 1 – Preventing people from dying prematurely
  • Domain 2 – Enhancing quality of life for people with long-term conditions
  • Domain 3 – Helping people recover from episodes of ill health or following injury
  • Domain 4 – Ensuring that people have a positive experience of care
  • Domain 5 – Treating and caring for people in a safe environment and protecting them from avoidable harm

Primary audience: Commissioning groups and senior managers includiing Chief Executives from all trusts

Impact on library policy/practice: to be added

Case studies / Local service profile examples mapping to this driver: None currently

Date last updated: 3rd December 2012

Due for review: December 2013

Group member responsible: TP

Opportunity Locator

Title of driver: Opportunity Locator

Source: Institute for Innovation and Improvement

Link to main document

Publication format: Online tool

Date of publication:

Summary of driver:The Opportunity Locator is a data tool to support the commissioning priorities of local health communities. The purpose of the Opportunity Locator tool is to stimulate ideas on where commissioners should focus their attention in re-designing and shifting services away from the traditional setting of the hospital and out towards community based care.

The tool allows your PCT to benchmark costs against other PCTs, which will identify areas they cannot make changes to create significant savings.

Key features of driver:

  • Can compare SHAs, PCTs and GP surgeries within PCTs
  • Can drill down to-
    Emergency Admissions
    Intermediate Care
    Outpatient 1st Attendance
    Outpatient Follow Up

Primary audience: Commissioners

Impact on library policy/practice:
Library services can show how they can support the PCT is the keys areas identified as over-spend, by providing evidence of best practice that will drive change.

Case studies / Local service profile examples mapping to this driver:

Date last updated: Sept 2009

Due for review: Sept 2010

Group member responsible: LE

The way forward: strategic clinical networks

Title of driver: The way forward: strategic clinical networks

Source: NHS Commissioning Board

Link to main document

Publication format: PDF

Date of publication: July 2012

Summary of driver: The new network will work with local and operational delivery networks to support clinicians in gathering and sharing insight into treating conditions that are complex and offer treatment across a number of settings.  It aims to breakdown communication barriers to promote better, more consistent care for the patients, whilst developing greater opportunities for collaboration.

Key features of driver:
• Hosted by NHS Commissioning from April 2013
• Initial Operational Development Networks (ODN): Cancer; Cardiovascular; Maternity and Children; Mental health, dementia and neurological conditions.
• Strategic Clinical Networks (SCN) will support commissioners in change projects and improving patient outcomes.
• Guiding principles: Quality – contribution to the NHS Outcomes Framework; Clinical leadership; Patient and public voice; Equality and health inequalities; Innovation and the NHS change model.
• Networks divided into 12 regional areas (Senates)
• Will work alongside Academic Health Science Networks (AHSN) to support quality/service improvement and ultimately the achievement of patient and population health outcomes.

Primary audience: Commissioners and clinical staff.

Impact on library policy/practice: Networks and senates are designed to encourage provision of clinical advice to support local decision making, making it an ideal system for librarians to share their expertise in terms of literature searching, enquiry services and consolidation of information.

Case studies / Local service profile examples mapping to this driver: None as of 13.11.12

Date last updated: 13.11.12

Due for review: 13.11.13

Group member responsible: Sue Smith

Operating Framework for the NHS in England 2012-2013

Title of driver: The Operating Framework for the NHS in England 2012-2013

Source: The Department of Health

Link to main document

Publication format: PDF (via webpage)

Date of publication: 24th November 2011

Summary of driver: This document sets out the main planning framework, key financial assumptions and national targets for the NHS across all areas of activity.  The four priorities for the NHS over the next 12 months are:

  1. improving the quality of basic care for older and vulnerable patients
  2. maintaining a strong grip on performance including waiting times, finance and key quality measures
  3. meeting the ongoing quality and productivity challenge
  4. making the transition to the new health and care system.

Key features of driver:
A range of outcome measures are set out under the domains of the NHS Outcomes Framework.

  • PCT allocations will grow by at least 2.5 per cent in 2012/13 and PCT clusters must ensure all patients are seen on the basis of clinical need.
  • The running cost of clinical commissioning groups (CCGs) will be £25 per head and the tariff price adjuster will see a reduction of at least 1.5 per cent.
  • All NHS trusts are expected to achieve NHS foundation trust (FT) status by April 2014 other than by exceptional agreement.
  • There are key areas for improvement of dementia and care of older people, carers support, and military and veteran health.
  • CQUIN (Commission for Quality and Innovation) will be increased to 2.5 per cent on top of actual ‘outturn’ value.
    (Source: NHS Confederation Briefing Dec 2011)
    Link here for a guide to the Operating Framework as well as mindmaps to help you navigate the structure of the framework (produced by the NHS Confederation).

Link here for main points of the operating framework and its implications for primary care (produced by Primary Care Commissioning).

In March 2012 the Department of Health produced a special issue of the month on the passing of the Health and Social Care Bill and what this means to the NHS now and from 2013/14, including a series of updates in each of the key areas around the transition programme.

Primary audience: All NHS Trusts.

Impact on library policy/practice: Library and information services are likely to feel the effects of efficiency savings and structural changes across the NHS.  Library staff can play a key role in identifying the best evidence on which to base decisions surrounding QIPP, reorganisation and change.

Case studies / Local service profile examples mapping to this driver: None as of 16.4.12

Date last updated: 16.4.12

Due for review: 16.4.13

Group member responsible: Not yet identified

NHS Commissioning Board

Title of driver: NHS Commissioning Board

Source: NHS Commissioning Board

Link to website

Publication format: Website

Date of publication: October 2012

Summary of driver:
Formally established as an independent body, at arm’s length to the Government, on 1 October 2012, the NHS Commissioning Board will carry forward the preparatory work begun as the NHS Commissioning Board Authority while taking on initial statutory responsibilities. The most notable of these responsibilities is the authorisation of clinical commissioning groups (CCGs) which are the drivers of the new, clinically-led commissioning system introduced by the Health and Social Care Act. The NHS Commissioning Board will take up its full statutory duties and responsibilities on 1 April 2013. In the meantime, all current NHS planning and delivery responsibilities will remain with the Department of Health, strategic health authorities and primary care trusts until the end of March 2013.

Key features of driver:
The NHS CB will be responsible for five key areas:

  • Partnerships and relationships – with key partners at local and national level.
  • Direct commissioning – the NHS CB will commission specialised services and primary care services, as well as public health services on behalf of Public Health England. This leaflet provides the detail of the single operating model for primary care commissioning.
  • Quality improvement and clinical leadership – Clinical Commissioning Groups (CCGs) will be at the centre of the commissioning process, supported by clinical networks and clinical senates. At national level, the NHS Commissioning Board aims to deliver quality improvements against the NHS Outcomes Framework.
  • Our governing frameworks – the NHS CB is held accountable by a number of frameworks, including the NHS Outcomes Framework and the NHS Constitution.
  • Patient safety – key functions and expertise for patient safety developed by the National Patient Safety Agency (NPSA) has been transferred to the NHS Commissioning Board Special Health Authority.

A range of resources and factsheets are available on the Resources section of the NHS CB website.

Primary audience: Commissioning groups and senior managers including Chief Executives from all trusts.

Impact on library policy/practice: A new structure of health services commissioning will inevitably have an impact on the structure of organisations and libraries. The NHS CB will have Local Area Teams (LATs) and their staff will need access to local library and knowledge services to support their knowledge needs – this is a new market. There’s an opportunity for libraries to provide support for commissioning decisions via literature searching services, information skills training, enquiry services and managing knowledge.

Case studies / Local service profile examples mapping to this driver: None currently

Date last updated: 30th January 2013

Due for review: January 2014

Group member responsible: VT