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Healthcare supply networks. Professor Christine Harland Director, CRiSPS, University of Bath President, HCSA. Healthcare supply networks. In any country healthcare supply networks are complex Most healthcare supply systems contain a large number of actors both public and private
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Healthcare supply networks Professor Christine Harland Director, CRiSPS, University of Bath President, HCSA
Healthcare supply networks • In any country healthcare supply networks are complex • Most healthcare supply systems contain a large number of actors both public and private • Internationally demands on healthcare supply systems are increasing
Commissioning – the network stimulus • Assessment of needs • Development of service priorities • Resource allocation across priorities • Procurement of healthcare services • Joining up with communities, patients and public • Minimisation of transaction costs • Management of financial risk
Continuum of commissioning networks Individual – Practitioner – Practice – Locality – Community – Region - Nation Primary care organisation/ PCT commissioning Multi-practice or locality commissioning National commissioning Patient choice Single practice-based commissioning Lead PCT/ LHB/ HB commissioning Joint commissioning Source: Ham C. (2007) Commissioning in the English NHS: the case for integration London: Nuffield Trust
Evidence of performance Comprehensive spending review CSR07 Public Service Agreements Departmental Strategic Objectives High level indicators
Primary Care Trusts Providers – choice Procurement Evidencing value DH commercial strategy Spotlight is now on…
£18 billion Value of the English healthcare networks £100 billion
STAGES OF PUBLIC PROCUREMENT Stage 7 Deliverer of broader government policy objectives 6 Supporter of broader government policy objectives 5 Value for money 4 Accountability 3 Efficient use of public funds 2 Compliance with legislation/ regulation 1 Sourcing and delivering goods and services Purpose of healthcare networks
Contracting in healthcare networks • Relational contracting • Partnership procurement • Distributed commissioning – diverse arrangements • Piggy-backing • Lead
Changing healthcare supply networks • Commercialisation of commissioning • Integrated commissioning network teams • Increased accountability • Lord Darzi’s next stage review • Innovation – league tables • Equitable access
The future…? Evidence based commercial commissioning Integrated commissioning teams Strategic commissioning Policy led commissioning
Commercial lens on healthcare supply networks • Clinical lens – cancer, cardio networks • Patient lens – voice • Commercial lens – value
Research required in healthcare networks • Examine commercial aspects of healthcare services • Assess capacity and capability within PCTs to perform, manage and measure procurement of healthcare • Identify and provide appropriate commercial support - contingent