Clinical commissioning and the voluntary and community sector Louise Edwards Commissioning Development team

A system focused on improving outcomes Robust economic regulation and quality inspection Clinically-led commissioning & payment for results Enhanced local voice Empowered professionals working in autonomous providers Informed patients exercising choice Summary of NHS reforms

licensing contract local partnership Parliament Department of Health NHS Commissioning Board GP Commissioning Consortia Local Authorities Care Quality Commission Local Health Watch Monitor (economic regulator) Providers Patients and Public Funding Accountability accountability for results Reformed NHS has lots of new structures that are supposed to look like this..

But it might look and feel more like this to you for a while!

In essence, it ’ s about putting accountability for decision making in the hands of those who commit resources. These reforms are all about putting clinicians in the driving seat…

And with that accountability comes high public expectations National IPSOS MORI/DH survey % of respondents said they were satisfied with the NHS as a national service 76% of respondents voiced pessimism in relation to the challenges facing the NHS in future years. 47% believe that NHS is understaffed. 75% of respondents feel that NHS spending should be protected. Where are the trade offs in here??

Do you know who your local clinical commissioning group is? In the North West we currently have 48 Clinical Commissioning Groups (CCG) that cover the geographical patch, all of whom have been approved as Pathfinders. The majority of the consortia have broad alignment with Local Authority boundaries and have representation on local Health and Wellbeing Boards alongside other key local stakeholders.

The CCG The Pre-Authorisation Timeline (i.e. the track) Phase 1 ‘Configuration’ October – December 2011 Phase 2 ‘Development path’ Now – Summer 2012 Phase 3 ‘Authorisation’ Summer April 2013 H1 H2 H3 = the standards required to demonstrate Domain Capability H4 = the final authorisation stage following validated evidence of fitness for purpose The Bar represents the aggregation of evidence required from all domains (i.e. the size of the challenge) The Pole represents the apparatus required to support effective trajectory and scale the challenge (i.e. the business support) ‘Authorisation’ of clinical commissioning groups will set the pace for their development between now and 2013

What does all this mean for the voluntary and community sector?

We know that all this change makes planning very difficult A huge number of voluntary organisations are currently delivering health related outcomes that are funded from within the health system – mainly through PCTs. Many of these organisations are looking to deliver more services but are currently struggling to come to terms with what clinical commissioning will mean for them. Planning in the sector is proving incredibly difficult in the current environment with so many uncertainties and organisations are struggling to make sense of how clinical commissioning will evolve.

VSNW/Regional Voices/NHSNW workshops November 2010-now Over the course of the last 8 months we’ve brought together a range of voluntary and community sector organisations to consider how the sector might respond to the commissioning reforms in the NHS. Brought together national voluntary organisations to explore potential role of sector in commissioning support (i.e. support to the new clinical commissioning groups) and to decide best way for an informed dialogue between commissioners and voluntary sector. Department of Health national workshop July 2011

What are the themes emerging from these workshops? New landscape is confusing for voluntary sector and we might lose really valuable assets if we’re not careful – NHS and DH need to help vcs interpret new landscape and make sense of it GPs don’t necessarily understand distinct contribution of vcs – hearts and minds awareness raising needed based on GP reality, not moral high ground How might vcs organisations work together and with other sectors to make themselves easier to commission – 3 ‘c’s for voluntary sector = collaboration, competition and co-opetition

Questions for today’s workshop Do the three themes resonate with you? What might be the practical ways DH/NHS can help vcs interpret new NHS commissioning landscape and make sense of it? Do you have experience of working with clinical commissioning groups, or GPs? How has that been? How might we enable and encourage vcs organisations to collaborate in order to grow their share of the market?