Dr Caroline Gamlin Director of Public Health NHS Somerset World Class Commissioning

The Somerset Health Community Population 524,600 Significant issues- rurality, ageing population 2009/10 budget £800 million 4 major local NHS providers, including ISTC 75 general practices, 13 community hospitals Strong Local Authority and Third Sector partnerships

How does PH engage with commissioning in Somerset? Identified PH leads for programme areas Strong link with practice based commissioning Commissioners linked in with JSNA PH leads on selection of outcomes, needs assessments, evidenced based practice and supports benchmarking and care pathway design Increasing involvement in procurement

Competencies: Skills and Behaviours 1. Locally lead the NHS 2. Work with community partners 3. Engage with public and patients 4. Collaborate with clinicians 5. Manage knowledge and assess needs 6. Prioritise investment 7. Stimulate the market 8. Promote improvement and innovation 9. Secure procurement skills 10. Manage the local health system 11. Make sound financial investments

Competitive Procurements Dialysis COPD & O2 Assessment Drugs and Alcohol Integrated Paediatric Therapies Emotional Health and Wellbeing 5 Equitable Access to Primary Care

Chronic Obstructive Pulmonary Disease (COPD) Commissioned in partnership with Practice Based Commissioning Consortium Addressed service inequity and major gaps 5 expressions of interest, 3 bids submitted Contract awarded to an independent partnership – two local GPs and BUPA Home Healthcare Ltd.

Somerset COPD Designed by Patients Selected by Patients Patient feedback informs performance

Learning Points PCT internal ‘firewall’ Capacity to support the process Strength of joint PCT/PbC process Value of patient engagement throughout

Performance Management Contract Management Process Redesign … Strengthening Leadership... Organisational Restructuring Increasing Funding … Building Capacity … Clinical Improvement Engaging with Customers … Market Forces Improving patient care 9 Competition is just one of a range of levers that PCTs can use to improve healthcare services...

Challenges What does world class look like? – getting comparative data on outcomes Ensure rigour applied to acute health services can be replicated to wider health improvement agenda Address inequalities and get PH messages to target populations

IMPROVING HEALTH/ELIMINATING WAITING/ IMPROVING HEALTH SERVICES PRIORITY WORK PROGRAMME BEST IN NHS Summary of model Clinical outcomes References BEST IN WORLD Summary of model Clinical outcomes References NHS SOMERSET POSITION Summary of Model Clinical Outcomes References Links to Clinical Strategies High Level Comparison : Best in UK and World / NHS Somerset position Next steps WORLD CLASS COMMISSIONING OUTCOMES: BEST PRACTICE TEMPLATE