Evidence based commissioning - now and moving forward

Anne Gray, Knowledge Officer, Arden & GEM CSU

HLG Conference September 2016

What is commissioning?

• Commissioning is the process of procuring health services.

• It is a complex process, involving the assessment and understanding of a population’s health needs, the planning of services to meet those needs and securing services on a limited budget, then monitoring the services procured.

[Faculty of Medical Leadership and Management, 2012]

A “plurality” of sources

[Swan 2012]

Analysis of items in 4 Knowledge@lerts July 2016• 20 - “expert” groups (Kings Fund, Nuffield Trust, Health

Foundation, NIHR)• 13 - NHS England/DH/PHE• 10 – clinical peer groups (Royal Colleges, Diabetes UK

etc)• 6 – Guidelines/standards (NICE,CQC,NHS Improvement)• 5 – Local Government Association• 3 - case studies (CCG board papers, magazines)• 1 – peer reviewed journal

Looking for the evidenceWhat the research says:• Commissioners look for themselves or rely on

colleagues• Email discussion lists & alerts• NHS sources are constantly changing and confusing • Difficult to find commissioning/ management evidence• Don’t ask the library unless they have had previous

contact• Library staff also found it difficult

[Edwards 2013, Wye 2015]

[Wye et al. 2015, Wilson 2016]

Using the evidence

A Commissioning Librarian

• Service model to help my customer• Searching skills to identify the plurality of

evidence• Report formats to meet the business need

Lessons learnt – Know your customer• What is business critical?• Understand national and local drivers• Speak the language• Tailored service

Rather than merely searching for relevant articles, Anne reflected on the problem areas, searched

for evidence of a range of successful interventions achieved elsewhere and provided a new measurable solutions for the CCG to adopt. This saved me time and added real value and a

new angle of approach. CCG Director

Lessons learnt – Searching Health Serv Deliv Res

Lessons learnt – Synthesis&Summary

• “Highlights …with an overview but also a link so I can go into more depth if interested

• For busy people, as we all are, the snippets are great as you don’t have to wade through a whole load of words to understand what the info is about

• Having everything in one email instead of having to remember where I saw this that and the other!!!”

[Ass Dir CCG]

Resources to build on• Alerting services (CASH, Kings Fund)• Evidence Works Toolkit (Avon Primary

Care Research Collaborative)• Commissioning Handbook for Librarians • Mailing lists• Embedded librarians / knowledge services

Skills to build on

• Graduate Evidence Assistant pilot (Avon Primary Care Research Collaborative)

• Knowledge for Healthcare– Synthesis techniques– Evidence for managers/commissioners training

• Communities of practice across NHS knowledge staff

Moving forward• What can your library build on?• How can you work with other libraries?• What can you do next week?

Bibliography 1/2• Faculty of Medical Leadership and Management, 2012

http://www.nhs.uk/NHSEngland/thenhs/about/Documents/Commissioning-FINAL-2015.pdf

• Epilepsy Commissioning Toolkit http://www.epilepsytoolkit.org.uk/• Swann J et al Evidence in Management Decisions (EMD) NIHR Health

Services and Delivery Research programme; 2012. http://www2.warwick.ac.uk/fac/soc/wbs/projects/emd

• Wye et al. BMC Health Services Research (2015) 15:430 http://www.biomedcentral.com/1472-6963/15/430

• Wilson PM, Effects of a demand led knowledge translation service on the uptake and use of research evidence by NHS commissioners compared with lower intensity untargeted alternatives. HS&DR - 12/5002/18 http://www.nets.nihr.ac.uk/projects/hsdr/12500218

Bibliography 2/2• Edwards et al Explaining Health Managers’ Information Seeking

Behaviour and Use. Final report. NIHR Service Delivery and Organisation programme; 2013) http://www.nets.nihr.ac.uk/projects/hsdr/081808243

• CASH portal http://www.netvibes.com/keeping-up-to-date#Home • Evidence Works (Avon Primary Care Research Collaborative) (Avon

Primary Care Research Collaborative, AHSN, NIHR CLAHRC West http://www.nhsevidencetoolkit.net/

• Commissioning Handbook for Librarians (NHS Librarians) http://commissioning.libraryservices.nhs.uk/

• KfH Learning Zone http://kfh.libraryservices.nhs.uk/learning-zone/specialist-and-technical-skills/