Kings Fund 12 November 2015
- This paper proposes a new approach to tackling growing financial and service pressures felt by the NHS, arguing that NHS organisations need to establish place-based ‘systems of care’ in which they collaborate with other NHS organisations and services. Key to this approach is the development of strategic commissioning based on footprints much bigger than those typically covered by CCGs today.
- “Fundamental changes to the role of commissioners are needed to support the emergence of systems of care. Commissioning in future needs to be both strategic and integrated, based on long-term contracts tied to the delivery of defined outcomes. Scarce commissioning expertise needs to be brought together in footprints much bigger than those typically covered by CCGs, while retaining the local knowledge and clinical understanding of general practitioners .”
- "The starting point in establishing place-based systems of care is to define the population served and the boundaries of the system."
- “The case for strategic commissioning rests on the failure of commissioning to make a major impact in the NHS and the need to use scarce expertise as effectively as possible, not least to ensure that place-based provider collaborations are mirrored by a level of commissioning expertise that it is simply not possible to provide in more than 200 CCGs.”
- “Strategic commissioning will require thoughtful evolution towards a system in which the clinical expertise and local knowledge of CCGs are retained and where NHS commissioning is based on footprints much bigger than those typically covered by CCGs today.”
- The report describes existing examples of work to establish place-based systems of care on a more formal basis from across the NHS including York, Solihull, Isle of Wight, Morecombe Bay and Northumberland.
