CHIM

5 November 2008

World Class Commissioningand

Diverse Providers

Objectives of the session• To develop an awareness and understanding of

what commissioning is• To understand the D.O.H. approach to World

Class Commissioning and why it has been introduced

• To understand WCC and Diverse Providers in the wider context of government policy towards the NHS

• To understand the implications of WCC for PCT’s and the wider NHS

• To consider the implications for information management

CHIM – 5/11/0810.00 am – 1.00 pm10.00 Introductions

Objectives of the session10.05 The WCC Quiz10.15 Presentation – NHS Policy & Structure10.30 Group Work 111.15 Feedback11.30 Presentation – World Class Commissioning and

Diverse Providers12.00 Group Work 212.30 Feedback12.50 Review

NHS

Annual Spend 2007/08 £104 billion

Employs 1.3 million staff

10 SHAs

152 PCTs

262 Hospital Trusts

1.5 million patient contacts/day

Where taxpayer’s money is spent

Total managed expenditure - £587bn

Other expenditure £59bn

Housing and Environment £22bn

Public order and safety £33bn

Industry, agriculture, employment and training

£21bn

Debt interest £30bn

Defence £32bn

Education £77bn Health £104bn

Personal social services £28bn

Social protection £161bn

Transport £20bn

NHS

Key Issues

How do you improve

efficiency

quality

within budget

In context of

- Increasing no.s of elderly

- Improvements in medical technology

Structure of the NHS

Parliament

Sec. Of State

D.o.H.

S.H.A.

Trusts PCTs

£

Parliament

Sec. Of State

D.o.H.

S.H.A.

Foundation

Trusts

PCTs

£

Board of Governors

Members

Regulator

Before After

North East

North West

Yorkshire and The Humber

East Midlands

West Midlands

East of England

London

South East Coast

South Central

South West

What are Primary Care Trusts? PCTs are responsible for:

- ensuring people can get access to treatment when they are ill- improving health and well being

PCTs receive funding from the Department of Health via weighted capitation. This is around £1,560 per capita, egNewcastle PCT = £428.4m, and then they:

1. Identify the local health needs of their population

2. Receive guidance on national priorities and policies from DH

3. Commission service provision to meet population needs and meet national requirements

4. Establish LBC and SLAs based on activity required, funding levels and quality standards

5. Manage LBC and SLA contracts through Performance Management Systems to make sure they are delivered as planned

NHS North of Tyne

Where The £1.2billion Goes

New castle Upon Tyne Hospitals NHS Trust

22%

Capio Healthcare Ltd0%Voluntary

Organisations/Charities1%

All other inc. Private Sector1%

Primary Care Prescribing11%

PMS/GMS7%

Primary Dental Service2%

Out Of Hours Services0%

Commissioning Consortium/Public

Health/Other2%

Contractor Service Agency0%

Public Health0%

LDP Commitments4%

Public Bodies - Local Authorities

6%North East Ambulance Service NHS Trust

1%

North Tyneside Primary Care Trust Provider

2%

New castle, North Tyneside and Northumberland Mental

Health NHS Trust10%

Northumberland Care Trust Provider

2%New castle Primary Care

Trust Provider3%

Other NHS Trusts w ith SLAs/LBCs

1%

Northumbria Healthcare NHS Trust18%

All other NHS Trusts inc. NCAs

2%

Specialised Commissioned Services (NORSCORE)

4%

Group Work

1. Look at the slide – ‘Where the £1.2 billion goes’What % of total spend goes on Secondary Care?What % of total spend goes on Primary Care?What % of total spend goes on PCT provider services?Why is the money spent in this way?How do you think the PCT has decided to spend these sums of money on these services?

Group Work

2. What is Commissioning?

Discuss and come up with an agreed definition