Improving Commissioning

Course details
Course type PCT and GP Commissioning Consortia Courses
Accreditation equivalent: N/A
Course length 9 days
Location Nationwide
Next start date To be confirmed
Price £2,695 pp + Vat

Improving Commissioning

The course is the culmination of three separate modules:

If collectively taken i.e. continuous development over a nine month period, will result in the learner having completed an advanced course in NHS commissioning.

Overview of the Course:

There are three modules delivered in three day blocks of training. It is proposed two days will run concurrently and the final day of the block taking place 6 – 8 weeks later. The rationale being to get the basics in place within the two days, to reduce the number of days out of the office to be manageable for all concerned and to allow a reflective period for the candidate to come back and recap/refresh on the third day as well as being able to bring all learning together and produce an output for the next stage of the training.

Therefore the outline course will be:

i)              2 days  + 1covering: Strategic Planning

ii)             2 days + 1 covering: Procuring Services

iii)            2 days + 1 covering: Monitoring and Evaluation

Aims and Outcomes of the Course:

The course follows the Department of Health’s Commissioning Cycle in a detailed format, enabling participants to practice commissioning skills in a real way, for example conducting a service review, preparing a business case and presenting it at a board meeting.

The course is designed to work through the entire cycle and build on learning as the course progresses. Participants will also have access to a wealth of resources through both Unique Improvements web forum and Teesside University’s virtual learning environment.

At the end of the course participants should be able to:

  • Synthesise and critically appraise evidence to develop innovative approaches to the commissioning of services.
  • Demonstrate a comprehensive knowledge of the tools and techniques used within the commissioning of services.
  • Demonstrate a comprehensive knowledge of collaborative approaches, partnership working and patient and service user engagement to support effective commissioning.
  • Challenge existing approaches to commissioning to improve services.
  • Act autonomously to plan, implement and evaluate a commissioning project that will improve outcomes for service users

Course structure:

The first block of training will focus on Strategic Planning in particular:

i)    Provide an overview of the current policy and the impact of this on the NHS and its strategic partners.

ii)   The importance of a JNSA (Joint Strategic Needs Assessment) and ABCD (Asset Based Community Development) in understanding the wants and needs of a community plus the wider determinates of health and social care in today’s society.

iii)   Assessing if current service provision is meeting the identified need and using Service Reviews to reshape supply to meet that demand.

iv)   Having assessed need and reviewed current provision the organisation must agree its Priorities for the coming year (and the future) to improve life expectancy by adding years to life and life to years – this also has to take into account available resources.

A range of tools and techniques will be explored and candidates will be asked to source, investigate and interpret information to ensure informed choices are being made (Note: candidates will be required to bring a laptop with the facility to access the internet with them to enable practical learning to take place).

Example of areas covered:

Assessing Need

  • JSNA/ABCD/Local Area Agreements
  • Public Health data and information
  • Referral data – by GP and GP practice
  • NHS Comparators – referral and spend information
  • NICE guidelines – commissioning policies and evidence based commissioning
  • Mortality/morbidity rates – life expectancy of an area
  • Demographics – the wider determinants of health and social care

Reviewing Services

  • Follow up ratios – national rates vs. local delivery
  • Current spend – value for money?
  • Location – care closer to home, extended GP services
  • Cultural appropriateness – supporting choice
  • Staff resource and turnover – skills mix, clinical leadership
  • Patient complaints and feedback – “no decision about me without me”

Deciding Priorities

  • Local and National – “adding years to life and life to years”
  • Decision making tools – robust methodology that will stand up to scrutiny
  • Value for Money – VFM

The second block of training will focus on Procuring Services in particular:

i)    Having undertaken the strategic planning stage and agreed a set of priorities candidates will then be required to procure those services e.g. Design Services

ii)   To design a service successfully candidates will be required to understand their “market” and if necessary Shape the Structure of Supply

iii)  To ensure that providers can deliver what is required, candidates will need to be clear about demand and capacity within the market – Planning Capacity and Managing Demand are key building blocks of commissioning.

Example of areas covered:

Designing Services

  • Process mapping – from the patients point of view
  • Service Specification – if you don’t know what you want how will you know it is being delivered?
  • Focus group agenda and report (patient rep on tender panel) – local services for local people
  • Redesigning pathways – QIPP challenge
  • Board presentation – governance and approval every step of the way

Shaping Structure of Supply

  • Understanding the procurement pathway – European Law and the implications on health
  • Open Government and National Tenders – E-Tendering and being open and transparent
  • Market Management / Provider market days – format, feedback, commissioning intensions
  • Awarding contracts and keeping within the law

Planning Capacity and Managing Demand

  • Capacity and Demand Modelling – payment by results and contract management
  • Procurement and Contracting routes  - know your options and be clear about your choices
  • Communicating service change to all stakeholders:
    • Newsletter
    • Website text
    • Press release
    • Mail shots to existing patients
    • Leaflet for distribution in primary care
    • Decommissioning of existing service if appropriate

The third block of training will cover Monitoring and Evaluation:

i)    The final stage can also be the first stage and will be the first stage depending on the service issue. Choice is a fundamental principle of Government and has been strengthened over recent years. Supporting Patient Choice requires there to be a choice of provider, location and time to name only three areas. Candidates will be required to demonstrate this ability to deliver on this important agenda when planning services.

ii)   Understand roles and responsibilities and holding people / organisations to account is essential in the commissioning of services. Candidates will be required consider this aspect of Managing Performance including risk and integrated governance issues, which ensure services and staff are fit for purpose as part of their learning.

iii)  Government has set the mantra for the NHS as “no decision about me without me” and Seeking Public and Patient Views is the focal point of local accountability and delivery. The NHS Constitution has enshrined this into NHS organisational accountability and candidates will be required to build this into their planning and examples throughout the course.

Example of areas covered:

Supporting Patient Choice

  • Arrangements for Choice – quality, location, timings and travel supported by QIPP, PROMs

Managing Performance

  • Proactive management and regular review – learn to look forward and ‘act’ not backwards and ‘react’
  • Governance arrangements – risk and mitigation techniques
  • Standard NHS Contracts – know the content and use the levers, if necessary
  • Board Presentation – integrated governance and you

Seeking Public and Patient Views

  • Asset Based Community Development – new approach for engagement
  • Organisational membership – models including foundation trusts, focus groups and
  • Awareness raising and engagement – it must be consistent and clear, its your NHS

In summary:

Overall the content is designed to provide practical application – to equip the candidate with the tools and skills for their role as a commissioner as well as providing personal development opportunities.

Learning will take the form of tutorials and action learning based on case studies. At the start of the course candidates will be put into groups and asked to work through a case study for the duration of the course. It will include sourcing information, writing papers and role play involving presenting to a mock Commissioning Board for approval of their commissioning plans.

The process is aimed at being informative, developmental and practical thus providing a “reality based” learning environment in which candidates can feel safe to explore their commissioning skills and to hone their expertise before returning to their workplace.

Recent feedback…

“Enjoyed this session as it was more realistic which one can relate to and better understand it and different ideas from different groups. Good exercise”

Should you require any further information please contact one of the training team at Unique Improvements by calling 0151 486 6737 or send us a message using the contact form below.

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