The NHS Commissioning Board Approach to Contracting

1. The NHS Commissioning Board Approach to Contracting Susan DaviesActing Director South of England Specialised Commissioning Group (South West)

2. Overview • The role and approach of the NHS Commissioning Board (NHSCB) in the new commissioning system • The key structures of the organisation • Approach to 2013/14

3. The Role and Approach of the NHSCB • Responsible for ensuring the improvement of outcomes for all patients by: • Preventing people from dying prematurely • Enhancing the quality of life for people with long term conditions • Helping people recover from episodes of ill health or injury • Ensuring people have a positive experience of care and treating; and • Caring for people in a safe environment and protecting them from avoidable harm • Allocate £60bn to CCGs and support them in the effective use of that money to improve those outcomes for all patients • Directly commission health services worth £25bn including primary care, some public health services such as immunisation and screening, and specialised health services in England • Plan for civil emergencies and make sure the NHS is resilient

4. Values and Culture • The design of the NHS CB has been informed by the values and culture which the Board will foster. These include: • A clear sense of purpose focused on improving quality and outcomes • Putting patients, clinicians and carers at the heart of decision-making • An energised, proactive organisation, offering leadership and direction • A focused and professional organisation, easy to do business with • An objective culture, using evidence to inform its activities • A flexible organisation, promoting integration, working across boundaries and performing tasks at the right level • Committed to working in partnership to achieve its goals, in particular by developing an effective, mutually supportive relationship with CCGs • An open and transparent approach, sharing information freely; and • An organisation with clear accountability arrangements and a grip on those things for which it will be held to account

5. A Focus on Quality and Putting Patients, Clinicians and Carers at the Heart of Decision Making • A series of National Domain Directors: • Professor Sir Mike Richards – Director,  Domain 1- preventing people from dying prematurely • Dr Martin McShane - Director, Domain 2 – enhancing the quality of life for people with long term conditions • Professor Keith Willetts - Director, Domain 3 - recovering from episodes of ill health or injury • Richard Gleave - Director, Domain 4 - positive experience of care • Dr Mike Durkin - a safe environment and protecting people from harm • For specialised services, a series of programmes of care, based around the Clinical Reference Groups: • Blood and Cancer • Internal Medicine • Women and Children • Mental Health • Trauma

6. The Key Structures of the Organisation • National level – set consistent national policy and strategy - based in Leeds with presence in London • 9 corporate directorates • 4 regional offices – assist in development of strategy and support/oversee local implementation • 27 Local Area Teams - implement policies/ contract and relationship management

7. Specialised Commissioning

8. The 10 LATsLeading Specialised Commissioning • North • Cheshire, Warrington and Wirral • South Yorkshire and Bassetlaw • Cumbria, Northumberland, Tyne and Wear • Midlands and East • Birmingham and the Black Country • Leicestershire and Lincolnshire • East Anglia • London • South • Surrey and Sussex • Wessex • Bristol, North Somerset, Somersetand South Gloucestershire

9. Prescribed Services • Outlined in the Recommendations of the Clinical Advisory Group for Prescribed Services (GATEWAY 17981) http://www.dh.gov.uk/health/2012/09/cagreport/, published on 11th September. Subject to consultation with NHSCB currently • Reviewed the services in versions 3 and 4 of SSNDS and includes previously nationally commissioned ‘highly specialised services’ • Services need to meet four factors, outlined in the ‘Health and Social Care Act’: • the number of individuals who require the provision of the service or facility • the cost of providing the service or facility • the number of persons able to provide the service or facility • the financial implications for clinical commissioning groups if they were required to arrange for the provision of the service or facility

10. Approach to Contracting in 2013/14 • A national approach, applied consistently • Only prescribed services will be commissioned by NHSCB. Other secondary care/community services via CCGs • A suite of contracting products will be used with the standard national contract • There will be a single contract per provider (including highly specialised services) regardless of where the patient originates from • LATs will lead on contracts for their geographic area • A nominated LAT will be identified for those providers with multiple national sites • NHSCB/Specialised Commissioners will be responsible for quality issues affecting their services • Individual Providers will be expected to have the same price for the same service for all activity commissioned by the NHSCB from 1st April • National estimates of full cost of specialised services built into CCG/NHSCB allocations exercise

11. Any Questions?