CCG Improvement and assessment framework

CCG Improvement and Assessment Framework 2017/18 | NHS England 

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This updated framework describes the CCG annual performance assessment and the metrics that will inform that assessment for 2017/18; it replaces the Improvement and Assessment framework (IAF) for 2016/17.  The framework is accompanied by a technical annex which provides the detail of the construction and purpose of each of the indicators in the framework.

Full document at NHS England

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Collaboration in general practice

Collaboration in general practice: Surveys of GP practices and clinical commissioning groups | Nuffield Trust |  Royal College of General Practitioners

This report summarises the results of two surveys, sent to general practice staff and to CCG staff, aimed at finding out what had changed in the landscape of general practice since the previous surveys two years ago and to explore what GPs feel the future holds for them.

Key findings include:

  • The scaling up of general practice continues apace with 81% of general practice-based respondents reporting that they were part of a formal or informal collaboration, up from 73% in 2015.
  • However, the landscape is complex. Practices often belong to multiple collaborations that operate at different levels in the system, having been set up to fulfil different purposes.
  • The main priorities of all collaborations over the last year were: increasing access for patients, improving sustainability, and shifting services into the community. The priorities differed by size of collaboration. Both providers and commissioners reported that time and work pressures were the biggest challenge to collaborations achieving their aims.
  • When asked about developments in their local area, over half of GP staff and one-third of CCG staff surveyed felt practices and collaborations had not been at all influential in shaping the local sustainability and transformation partnership (STP). Only one-fifth of GPs thought STPs would deliver meaningful change in primary care. CCGs were more optimistic, with 61% reporting that meaningful change was probable.
  • When questioned about future models of care, around half of practice partners (53%) said they would be ‘unwilling’ or ‘very unwilling’ to give up their current GMS/PMS/APMS contract1 to join a new models contract (e.g. MCP or PACS contract2). The most common reason they gave was that they did not want to lose control of decision-making and leadership in their practice.

The report can be downloaded here

Strategic commissioning

Steering towards strategic commissioning: transforming the system | NHS Clinical Commissioners

Clinical commissioners are playing a key role as architects of the changing health and care landscape, analysis shows. A new publication by NHS Clinical Commissioners sets out CCGs’ vision for the future and what they need to get there at pace so they can deliver more for patients.

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Image source: http://www.nhscc.org/

Steering towards strategic commissioning shows there is a strong belief that healthcare commissioning must continue to be clinically led, operate at a scale larger than a CCG footprint, retain its purchasing function and remain accountable to the local population.

The analysis, which was informed by a survey and interviews with CCG leaders, shows that CCGs are embracing change, with 77 per cent of those surveyed intending to contract for a new care model in 2017/18, and 72 per cent planning on increasing their collaborative commissioning.

Related: The Changing Commissioning Landscape

NHS RightCare Pathway: Diabetes

NHS RightCare, in partnership with the Healthier You: NHS Diabetes Prevention Programme(NHS DPP) has published NHS RightCare Pathway: Diabetes.

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NHS RightCare Pathway: Diabetes is a tool that aims to support local commissioners to review local diabetes pathways in order to identify where potential improvements could be delivered. The pathway has been developed in collaboration with the National Clinical Director for Diabetes and Obesity at NHS England and Associate National Director for Diabetes, the NHS Diabetes Prevention Programme, Public Health England, Diabetes UK and patient groups.

NHS RightCare Pathway: Diabetes has two key elements:

  1. It describes the core components that should be present in an optimal diabetes service; right from detection and diagnosis through to ongoing treatment, management and care of people with diabetes
  2. It provides guidance for commissioners that will:
    1. Allow them to think through their existing diabetes service and compare it with an optimal diabetes service; and
    2. Provides guidance for commissioners about the scale of improvements that could be delivered through optimisation of local pathways.

Full resource: NHS RightCare Pathway: Diabetes

See also: Appendix 1: Examples of good practice

This resource outlines examples of models of integrated care between primary and secondary care, and contains useful links and resources.

 

IT intervention to support medicine optimisation in primary care

Jeffries, M. et al. (2017) Understanding the implementation and adoption of an information technology intervention to support medicine optimisation in primary care: qualitative study using strong structuration theory. BMJ Open. 7:e014810

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Objectives: Using strong structuration theory, we aimed to understand the adoption and implementation of an electronic clinical audit and feedback tool to support medicine optimisation for patients in primary care.

Conclusions: Successful implementation of information technology interventions for medicine optimisation will depend on a combination of the infrastructure within primary care, social structures embedded in the technology and the conventions, norms and dispositions of those utilising it. Future interventions, using electronic audit and feedback tools to improve medication safety, should consider the complexity of the social and organisational contexts and how internal and external structures can affect the use of the technology in order to support effective implementation.

Read the full article here

Early benefits of delegated commissioning

NHS England have produced a series of Delegated commissioning case studies to show how CCGs are using delegated commissioning to improve care for local people. 

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CCGs have reported that delegated commissioning is leading to:

  • The development of clearer, more joined up visions for primary care, aligned to wider CCG and STP plans for improving health services;
  • Improved access to primary care;
  • Improved quality of care being delivered to patients;
  • Improved CCG relationships with member practices, including greater local ownership of the development of primary care services;
  • Increased clinical leadership in primary care commissioning, enabling more local decision making;
  • Greater involvement of patients in shaping services;
  • A more sustainable primary care system for the future.

NHS England have produced a series of case studies to show how CCGs are using delegated commissioning to improve care for local people:

Shaping healthy cities and economies: the role of clinical commissioning

NHS Clinical Commissioners, December 2016

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NHS Clinical Commissioners

This report showcases how clinical leaders in England’s core cities – the eight largest cities outside of London – are looking at how the services they commission can improve not only the health but social and economic wellbeing of their populations. The report finds that in these areas, clinical commissioners are working with a wide range of partners to go beyond traditional boundaries to combat health inequalities and social exclusion, increase skills and employment and to attract inward investment to help realise the potential of their local economies.