Strategic commissioning

CCGs in the UK should move towards strategic commissioning if the healthcare system is to embrace a move toward integrated local care, claims a new briefing from NHS Clinical Commissioners (NHSCC).

The publication brings out lessons based on evidence from the UK and health systems abroad. These are drawn from the perspectives of those implementing and developing policy around the new care models and from research of international models, primarily of high performing place-based systems of care that have developed in New Zealand, Sweden, Spain and the United States.

‘Making strategic commissioning work’ puts forward a number of recommendations aimed at easing the transition to strategic commissioning models.

  • The patient must be placed at the centre with a focus on quality – targets, payment incentives and prescriptive regulation have proved largely unsuccessful in driving system improvement and ensuring financial sustainability.
  • Clinical commissioning leadership and engagement must be retained – the evidence shows that success of population level planning is reliant on the engagement of clinicians in primary, secondary and community care, as well as the wider workforce.
  • National clarity on the ‘end state’ is essential – while local areas must lead the development of models for integrated health and care delivery, internationally, no system has been implemented without clear political consensus and a legislative framework to support it on an ongoing basis. In the UK, this could mean a national framework is needed – provided this is not too prescriptive to limit local development.

Full document: Making strategic commissioning work: Lessons from home and away


Commissioning guidance for improved diabetic foot care


The Royal College of Podiatry has launched an online commissioner’s guide aimed at improving diabetic foot care.  The online toolkit resource aims to support CCGs in England to commission improved services for diabetic foot disease. It provides information on: the impact of diabetic foot ulcers and amputations on patients’ lives and on NHS costs; the potential for improved care to transform lives and reduce NHS expenditure, and what good care looks like and how to restructure services and pathways.

Lay members in the future of commissioning

NHS Clinical Commissioners has published the following documents which focus on the role that CCG lay members will play in the future of commissioning:

  • Supporting change in your NHS: the non-executive community in transformational change – summarises discussions held at two events earlier this year on the lay member and non-executive director (NED) role; insights on current system change and views on the next steps for lay members and NEDs
  • Checklist for professional development of CCG lay members – this is the third checklist looking at different aspects of the lay member role.  It covers appraisals, professional development, career development opportunities, and planning for the future.

Fifteen Steps Challenge: quality from a patient’s perspective

NHS England has published The Fifteen Steps Challenge: quality from a patient’s perspective: a guide for commissioners. This guide describes how commissioners can apply the 15 Steps Challenge to the services that they commission, resulting in higher quality care and effective patient engagement in the commissioning process.  There are also versions of this guide for acute inpatient settings, mental health settings, community settings, outpatients units, and children and young people’s inpatient units.

CCG Improvement and assessment framework

CCG Improvement and Assessment Framework 2017/18 | NHS England 


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

Commissioning primary care services

NHS England has updated the Primary medical care policy and guidance manual to reflect the changing landscape in primary care co-commissioning.   This document provides commissioners of primary care services the context, information and tools to safely commission and contract manage primary medical care contracts.

The document is split into four sections:

Part A – Excellent Commissioning and Partnership Working

Part B – General Contract Management

Part C – When things go wrong

Part D – General