The challenge of moving towards the new models of care outlined in the Five Year Forward View has led to lots of questions about the future of commissioning and its role in driving reform.
Last month, we had the opportunity to contribute to a commissioning masterclass which aimed to answer the question – what is the future of commissioning? The day-long event was organised and hosted by the University of Wolverhampton in association with its MSc in Commissioning for Health and Social Care.
Different presenters talked about international trends in commissioning, as well as what's happening in England including further integration between health and social care commissioning. It was great to hear from 2 MSc students who'd both been able to commission better quality services and achieve cost savings for their clinical commissioning groups (CCGs) using the skills they had learnt on the MSc course.
Our contribution to the day was to talk about the future of commissioning in the context of the regulatory framework for commissioners.
Here’s a brief summary of what we had to say:
Commissioning will continue to be really important
Commissioning has an important role to play in delivering services differently – being the patient voice and advocate in deciding who provides what and how.
This role will be crucial as the NHS seeks to adopt new ways of working to meet the needs of patients.
The regulations provide a framework for commissioners to ask the right questions
The Procurement, Patient Choice and Competition Regulations set out a number of questions commissioners need to ask which help them to improve services, for example:
- How can we make sure that the services are provided in a more joined-up way with other services?
- Could services be improved by giving patients a choice of provider to go to and/or by enabling providers to compete to deliver services
Importantly, while the Regulations provide the framework of questions for commissioners, they don't prescribe the answers, so there is lots of room for commissioning innovation to meet local patient need.
Changes to procurement rules won’t prevent anyone from delivering local solutions
There are currently 3 different regimes that commissioners need to take into consideration when procuring health care services for the purposes of the NHS:
- NHS (Procurement, Patient Choice and Competition) Regulations 2013
- Public Contract Regulations 2006
- Treaty on the Functioning of the European Union (where there is a cross-border interest)
The regulations do not impose any one way to procure services and commissioners need to consider a range of options.
From April 2016, the new European Procurement Directive (2014/24/EU) will apply to NHS health services. This won’t hold back anyone who wants to deliver local solutions: the only substantive change through the Directive is a shift is towards greater transparency in awarding contracts – something that we should all value anyway.
We are working with commissioners to resolve new challenges
The move towards service reform is presenting new challenges, and we want to work through them with commissioners. We always encourage commissioners and providers to contact us for advice and support.
Some of the recent issues we’ve encountered include:
- How to safeguard and value choice in a more integrated environment
- Getting the balance right between a stable environment – perhaps with long contracts - and the need to maintain commissioning levers for improvement
- The best way to integrate commissioning of health and social care
Is your organisation working towards or implementing a strategy to address any of these challenges?
If you are unsure about the regulatory implications of your reform plans or would like support to consider how improvement could be achieved through competition, choice and integration, you can contact us for advice (our details are towards the top of the right hand menu).
Thanks to the University of Wolverhampton for inviting us to participate in this commissioning masterclass event.
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