Policy and Practice The changing face of commissioning in primary care

1. Policy and PracticeThe changing face of commissioning in primary care Dr Anne Mackie

2. Why countenance change ? • PCTs originally set up to commission on behalf of their populations and to take cognizance of the commissioning intentions of primary care • Systems worked in some areas better than others – but expected improvements did not materialize fast enough • Our populations deserve better – hence initiatives like practice based commissioning are some of the initiatives which will drive change

3. Is primary care up to the task ? • Where are the commissioning skills ? • Where is the knowledge outside their areas of experience ? • Is primary care homogenous enough to be able to take on this task ? • Is primary care able to understand and access the evidence base on which to base their initial commissioning assumptions

4. How can I contribute to the cycle of effective commissioning? Assessing need Reviewing provision Deciding priorities Designing services Shaping the structure of supply/procurement Contracting Clinical decision making Contract management Seeking views of patients and the public

6. What can I do today? • Get to know your area • Exploit your skills and share your knowledge • Develop relationships with primary care • Assist with the evidence base • Help with the interpretation of data – as far as you can • Encourage and support – you are a potential user too – it is in your interest

7. What will the landscape look like ? • Primary care will be made to be more consistent in terms of accountability, quality and depth • Public health will be seen as an integral and essential part of the commissioning process – straddling primary care and the PCTs – with responsibilities in both areas • Knowledge will be available and accessed regularly– not just masses of data only comprehensible to the few