Programmes to implement the GP commissioning reforms have often focused on form, perhaps inevitably given the unparalleled shift in economic and clinical responsibility that NHS commissioners have faced in recent years. Issues of governance and accountability, organisational structures, roles and responsibilities have come to dominate the discussion about how to implement GP commissioning. This focus on form is common in change programmes in both private and public sector organisations.
As the GP commissioning landscape evolves, clinical commissioning groups (CCGs) must focus on setting themselves up as robust business operations while making good commissioning decisions that provide both value for money and improved patient outcomes. There is a duty for clinical commissioning groups to engage with other clinician groups in clinical senates and to have two other clinicians (nurse and hospital doctor) on the board. The role of the Health and Wellbeing Boards has also been clarified.
More than ever, for the successful implementation of GP commissioning, there is a need to develop strong partnership, and in doing so clinical commissioning groups need to focus on four key functional elements:
Designing care pathways that can reduce costs and improve patient care locally
From the start, clinical commissioning groups must identify the models of care and prevention that are needed most to provide better, seamless care throughout the patient journey. Clinical commissioning groups will need strong clinical engagement and innovation to develop preventative care pathways to address the health needs of those most at risk. This will require, for example, new models for managing long-term conditions, supporting the delivery of self-care and working collaboratively with patients to allow them to make full use of assistive technology.
Engaging the right organisations and stakeholders
For GP commissioning to succed, clinical commissioning groups will need to build the right multi-professional relationships across primary, secondary, social care providers, local authorities and undertake strong public consultation exercises, to deliver the service changes they wish to see. How CCGs work with the Clinical Senate will be vital in driving forward changes. Critical to this will be identifying which community services can deliver the greatest improvements in the shortest time. Changes will require stronger integration between health and social care services if they are to successfully reduce patient demand in secondary care.
Building the right workforce culture and management capabilities
Achieving any transformational change envisaged by GP commissioning will require clinical commissioning groups to build the right clinical leadership capabilities to support new ways of working, release new cultural behaviours and establish commissioning capabilities that will drive up service quality and patient outcomes.
Improving management capability and decision-making
Collecting quality information on the population health needs, high-risk patients, variations in practice or clinical commissioning group activity and spend will be essential to driving the right commissioning decisions. Accessing quality data and sharing and communicating it in a meaningful way will enable clinical commissioning groups to focus effort and resources on those health and social care services that deliver the greatest value.
In responding to the challenges of GP commissioning it will be important that clinical commissioning groups identify how each of these four elements can contribute to their success.
To learn how PA can help your clinical commissioning group meet the GP commissioning challenge, please contact us now.