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

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Accountable care

Accountable care: policy fad or step forward on the journey towards integrated care? | Nicola Walsh |The Kings Fund

Accountable care is under discussion almost everywhere in the NHS. Groups of NHS providers (sometimes with the local commissioner) are exploring how they can work more closely together to take on the responsibility for the health and care of a given population within a given budget. Currently, we are seeing emerging accountable care arrangements adopting various forms according to local needs and preferences: in some areas the focus is on creating a single organisation; in others, organisations are keen to use the words ‘system’ or ‘partnership’ – to reinforce the notion of working together.

In this Kings Fund blog, Nicola Walsh looks in more detail at Accountable Care Systems and partnerships.

Community hospitals and their services

The National Institute for Health Research has published Community hospitals and their services in the NHS: identifying transferable learning from international developments, scoping review, systematic review, country reports and case studies.

This study set out to understand better the role of different models of community hospital provision within the wider health economy and learn from experiences of other countries in order to inform the future development of community hospitals in England.

It concludes that at a time when emphasis is being placed on integrated and community-based care, community hospitals have the potential to assume a more strategic role in health-care delivery locally, providing care closer to people’s homes.

Related: Community hospitals: a traditional solution to help today’s NHS? | HSJ

New report by @Localis ‏| Rebooting Health And Social Care Integration

This report finds that the health and social care integration agenda has a future but it is dependent on moving away from notions of structural integration and reliance on central policy direction | Localis

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Image source: Localis

It concludes that the issue of funding and financial sustainability is critical but can only be influenced locally. The authors also believe that health and social care integration can create new value locally, but it must build on its most important point of consensus; greater person centred care. The report makes four strategic recommendations and six policy recommendations to support integration.

New publications from the NHS Confederation Mental Health Network

The NHS Confederation Mental Health Network has published two papers looking at the mental health workforce

The Future of the mental health workforce

The NHS Confederation Mental Health Network has published The future of the mental health workforce.  This discussion paper presents data on the current picture of the mental health workforce and looks at emerging findings from research to identify the challenges and opportunities that lie ahead for the mental health workforce. A final report will be published later in 2017.

Mental health and integrated care

Also published is Mental health and community providers: lessons for integrated care.  This briefing looks at how mental health and community provider organisations are exploring the multi-speciality provider model and how it can drive the delivery of integrated mental and physical healthcare.  The briefing presents key points and lessons learned.

Integrated care

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The European Commission’s Expert Group on Health Systems Performance Assessment has published BLOCKS: tools and methodologies to access integrated care in Europe.

Drawing on insights from experts from seventeen European countries, the report looks at the factors behind successful integrated care models including stakeholder engagement, patient empowerment and the use of information and communications technology.

Health and social care integration

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The Department of Health has published Social work: essential to integration.  This document is intended to support and inform local and regional health and social care integration initiatives.  It explains the contribution that social workers make to integrated services; how social work is essential to the whole system; and the necessity of support to ensure integration succeeds in providing the services people need.

It also includes ‘top tips’ for directors of adult social services and for principal social workers to assist in progressing the integration agenda.

It was developed in collaboration with the Association of Directors of Adult Social Services, the Principal Social Workers’ Network and the Department of Health.

The document can be downloaded here