COVID-19: guidance for commissioners and providers of services for people who use drugs or alcohol

This guidance outlines COVID-19 advice for commissioners and service providers involved in assisting people who are dependent on drugs or alcohol or both| Public Health England and Department of Health and Social Care

  • drug and alcohol services do not need to close at the current time and are important to keep operating as they protect vulnerable people who are at greater risk from coronavirus (COVID-19) and help reduce the burden on other healthcare services
  • services should keep face-to-face contacts between staff and service users to a minimum and minimise the use of biological drug testing and breathalysers, where safe to do so
  • follow up-to-date guidance for infection prevention and control, including hand-washing, surface-cleaning, isolating people and sending staff home
  • arrangements for prescribing and dispensing of medicines used in drug and alcohol treatment will need to be changed to take account of service and pharmacy closures, staff unavailability, patients having to maintain social distance or self-isolate, including the most vulnerable being shielded and the need to reduce the spread of COVID-19
  • measures to reduce drug and alcohol-related harm, such as needle and syringe programmes (NSP), take-home naloxone, thiamine, advice on gradual reduction of alcohol consumption and e-cigarettes should all be increased where possible
  • drug and alcohol treatment staff are included in the government’s definition of key workers whose children can – if they cannot be kept safe at home – continue to attend school
  • usual expectations on services for local monitoring and reporting, contract and performance management and contract re-tendering can all be scaled back to enable services to focus on delivery.

Full detail: COVID-19 guidance for commissioners and service providers for those dependent on drugs or alcohol

Population health management

This report describes population health management (PHM) approaches across ten different areas of England.  It sets out the benefits these approaches are bringing to patients and organisations, and the challenges that are being faced | NHS Clinical Commissioners

Population health management (PHM) – the use of data to identify specific groups within a population that may have similar characteristics and similar needs, and develop targeted interventions to meet those needs – was a notable theme of the NHS Long Term Plan.

This report brings together PHM stories from ten different areas of England to demonstrate the progress that has been already been made in advancing this approach to healthcare, and what more will need to be done.

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

It shows that clinical commissioners are a key enabler of population health management approaches because they are well-connected across primary care and secondary care, with strong clinical leadership embedded in real-world practice. However, the report also identifies some real challenges around information governance and data sharing between organisations.

There are already some examples of where PHM is making a positive difference to patients, as well as wider benefits such as increased satisfaction among frontline clinical teams and closer collaboration between organisations.

This report clearly demonstrates that, while CCGs are at different stages of the PHM journey and may be approaching it in different ways, those who are going down this route are seeing the benefits and providing useful learnings for others to follow.

Full report: Advancing population health management | NHS Clinical Commissioners

See also: NHS Confederation blog

Commissioning liaison psychiatry services

The research in this report sought to identify the challenges faced by commissioners of liaison psychiatry services, and to see if these challenges were shared by hospital managers and mental health clinicians working within the services | Centre for Mental Heath

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Image source: http://www.centreformentalhealth.org.uk/

Commissioning liaison psychiatry services identifies four key issues facing commissioners:

  • It was felt that liaison services were subject to more tightly defined national frameworks than previously, which could limit their flexibility to respond to local needs
  • Liaison services were not always well connected with other mental health services
  • The creation of Integrated Care Systems provides an opportunity for joint commissioning of liaison services which could help to improve their consistency and connectedness
  • It was felt that there was insufficient data about activities or outcomes of liaison services, which made it more difficult to implement improvements

The report outlines a number of recommendations, including calls for acute hospitals to take a thorough audit of all mental health provision, and to adopt the outcome measurement framework proposed by Royal College of Psychiatrists.

Full document: Commissioning liaison psychiatry services | Centre for Mental Health

Thinking differently about commissioning

In recent years, national policy within the English NHS has promoted collaboration as a
key tool for improving health services. This report explores the implications of these ways of working for the development of integrated care systems, how NHS England and NHS Improvement’s regional teams operate, and wider ways of working among NHS national bodies.  

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This report aims to understand the approach being taken by some CCGs and local systems that are rethinking the role of commissioning; draw out learning for other areas as they work to change their approach; and explore the national policy implications of this new way of working and what national NHS bodies can do to support its development.

It is based around two CCGs (South Tyneside and Tameside and Glossop) and one group of CCGs (Bradford district and Craven).

Full report: Thinking differently about commissioning: learning from new approaches to local planning | The King’s Fund

Overview of the sexual health collaborative commissioning evaluation

Public Health England | January 2020 | Overview of the sexual health collaborative commissioning evaluation

Public Health England (PHE) has worked with partners to undertake a process evaluation of 4 localities that have been pioneering collaborative approaches to commissioning sexual health, reproductive health and HIV services between local government and the local National Health Service (NHS).

The main findings show that it is achievable for the responsible commissioners (local authorities, clinical commissioning groups and NHS England) to commission collaboratively and that this offers many potential benefits. For this to work effectively there needs to be:

  • clarity on the scope of the collaborative arrangements
  • clarity on, and understanding of, decision-making processes in each organisation
  • sufficient time to build local relationships and procure together
  • recognition of the importance of starting small and tackling manageable sized areas of work (Source: Public Health England)

Overview of the sexual health collaborative commissioning evaluation

NHS England will commission maternal intravenous immunoglobulin for the prevention of allo-immune fetal and neonatal haemochromatosis

NHS England |December 2019 |Maternal intravenous immunoglobulin for the prevention of allo-immune fetal and neonatal haemochromatosis 

NHS England will commission maternal intravenous immunoglobulin (IVIg) for the prevention of allo-immune fetal and neonatal haemochromatosis in accordance with the criteria outlined in this policy.

Clinical Commissioning Policy: Maternal intravenous immunoglobulin for the prevention of allo-immune fetal and neonatal haemochromatosis

 

Paediatric critical care and surgery in children review: Summary report

NHS England | November  2019 | Paediatric critical care and surgery in children review: Summary report

NHS England has summary report of the national review into paediatric critical care and specialised surgery in children, which took place in October 2016. The aims of the review were to ensure that services are sustainable and fit for the future, and to reduce any variation in the care being provided.

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Finance, Commissioning and Contracting Handbook

NHS England | August 2019 | Finance, Commissioning and Contracting Handbook

NHS England have published the Finance, Commissioning and Contracting Handbook for the NHS England Comprehensive Model for Personalised Care. It aims to provide finance, commissioning and contracting staff with the information required to implement personalised care locally.

Finance, Commissioning and Contracting Handbook

The relationships between statutory and voluntary sector mental health organisations

Voluntary and community organisations provide essential support for people’s mental health that complements what statutory services can offer, but financial pressures are putting them under severe strain, according to preliminary research published today by Centre for Mental Health

This document seeks to raise a number of questions and issues about the relationships between VCSE and statutory organisations in supporting people’s mental health and wellbeing.  Many of these will require investigation in greater depth and further consideration to develop policy and practice changes where these are needed.

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Image source: http://www.centreformentalhealth.org.uk

Arm in arm is based on interviews with both commissioners and providers of voluntary sector mental health support. It shows that commissioners in both local government and the NHS were keenly aware of the extra value that voluntary and community organisations can bring. Some commissioners had taken action specifically to support voluntary and community organisations to get funding and retain their distinctive approaches. But they were frustrated that competition for contracts often stopped organisations from working well together and could lead to come going out of business altogether.

The report finds that the deepest disagreements between commissioners and voluntary sector organisation often centred on monitoring and accountability. Commissioners need to know that public money was being well spent but most voluntary sector organisations don’t have the data collection capabilities of NHS trusts or larger private sector companies. Some had sought to resolve this through evaluation and qualitative evidence of impact rather than onerous outcome monitoring measures.

Full report: Arm in arm: the relationships between statutory and voluntary sector mental health organisations | The Centre for Mental Health

See also: Centre for Mental Health press release