Developing a vision for PBC / clinical commissioning in NHS East Midlands Jeff Anderson 11th March 2010

Overview To develop a vision for PBC / clinical commissioning and a strategy for implementation in the light of current and future challenges which face the NHS Vision SHA feedback from PBC lead Capture initial views on the challenges for the future of clinical commissioning Describe what clinical commissioning will look like in the future around key themes for success Objectives 22nd February 2010 Stakeholder session GPs, PBC leads, PCT senior manager representatives (16) Involvement 04 May 2019

Summary of Challenges Different levels of GP understanding on hard budgets, and what it means for them Link between primary care performance and clinical commissioning GPs will take notice Different models may emerge – locality based; non-locality based Challenges for PCT, PBCs and GP levels Cultural and structural clashes Misalignment of current incentives Capacity, skills and confidence to lead the changes, transfer and manage hard budgets GP freedoms to innovate and take more control to create balance in the system Requirement for intelligent commissioning – transparency of contracts, data, and performance management Short sightedness – immediate pressure v long term change Addressing significant primary care variation 04 May 2019

Emerging Themes (and possible actions) Managing people and systems difficult – ACCEPT AND SUPPORT THIS Governance systems and processes – AGREE THIS Incentives and rewards – REALIGN THIS Enabling clinicians to lead – ENABLE THIS PCTs to be PBC-facing and to ‘let go’ – ACCEPT THIS Control and influence gained by clinical commissioners – LEAD THIS Primary care and clinical commissioning – The bottom line! – GET A VIEW ON THIS Readiness for hard budgets – CHECK THIS Pilot real budgets – DO THIS New models to emerge if hard budgets a reality – SCOPE THIS 04 May 2019

Success statements… A successful clinical commissioning culture is … where you listen to and involve clinicians, the work is driven by clinical and patient issues, and at the same time taking responsibility to enable commissioning change through partnership working and [letting go] risk taking from top to the bottom of the local health system Clinical commissioning roles for success come from … defining, accepting and believing in the role of a clinical commissioner at practice, PBC and PCT level, recognising the responsibilities of each and overcoming barriers to entry as well as increasing earned autonomy in the system 04 May 2019

Your views count! - Questions What will be necessary components in implementing successful clinical commissioning across the East Midlands? How should these be addressed? 04 May 2019