Wendy Saviour Director of Commissioning Development Safer, high quality care Better patient experience Improved health Value for money Real influence More accessible services

Liberating for Excellence Aims To: Empower clinicians to design services and make commissioning decisions in return for accountability for results. Empower patients to exercise choice and local populations to improve quality. Create a competitive market environment.

Commissioning for patients How: GP Commissioners PCTs NHS Commissioning Board Local Authority

Managing the transition SHA role: Build on progress made in the East Midlands in respect of commissioning Work and operate on the principle of subsidiarity Consider collaborative commissioning arrangements, (primary care, specialised, prisons, maternity) Advise, support and assure on the development of GP commissioning Influence emerging policy and the bill To ensure appropriate Leadership development for GP Commissioners

Managing the transition SHA Role Cont’d: Ensure engagement with wider stakeholders LAs, secondary care and related work programmes Develop authorisation process for shadow consortia in preparation for April 2011 Agree regional / national approach to regional budget setting Regional Information review - October Sharing best practice through existing networks - National pathfinders and PPI pilots Identifying commissioning capability and stimulating the market

GP Consortia Role – emerging themes All practices to be part of a GP commissioning consortium Duty to manage resources effectively as a provider Duty to offer choice Consortia to work with LA to undertake needs assessment Buy the services to meet the need Ensure expenditure does not exceed resources available

GP Consortia Role – emerging themes Consortia to monitor performance of practices Consortia to allocate the ‘Quality premium’ to its constituent practices Consortia to have an Accountable Officer and Chief Financial Officer Inform engage and involve the public Manage contracts with providers

GP Consortia Authorisation – emerging themes Consortium constitution Financial controls Geography – appropriate to address local issues Population size – viability Patient and public views Capability – internal and bought

Key issues Funding and incentives unknown at this stage GP contract Legacy financial positions Flexibilities to provide ? Clinical ownership to bring about behavioural change Relationships and stakeholder engagement FT universality Integration v competition & choice

Early thoughts on regional work programme What are the emerging issues for you? What do you need to support the development of shadow consortia? Roles and responsibilities - Doing the right things at the right level. Consortia, PCT and SHA. (principle of subsidiarity)