1. Anthony Kealy Commissioning Policy Team Policy & Strategy Directorate Developing Commissioning

2. Context of Health Reforms Health Reform in England: update and next steps Our Health, Our Care, Our Say NHS System Rules for 2006/07 Practice Based Commissioning Guidance PBC Early Wins and Top Tips Commissioning Policy Framework Dec 05 Jan 06 Feb 06 Jul 06

3. Framework for the Health Reforms Better care Better patient experience Better value for money More choice & stronger voice for patients (Demand-side reforms) More diverse providers with freedom to innovate & improve (Supply-side reforms) Money following the patient, rewarding & incentivising providers (Transactional reforms) Framework of system management, regulation and decision-making (System management reforms)

4. Commissioning Policy Framework Five areas of work: Creating the vision for commissioning Developing tools for effective commissioning The commissioner development programme Short-term actions to strengthen commissioning Significant policy questions

5. The Vision - Commissioning Cycle Needs Assessment Future Service Model Assess gaps in current services Investment Strategy Contracting & Procurement Patient & GP Feedback Contract Monitoring (Quality, performance, outcomes) Providers Service Development Published prospectus National Targets Referrals, individual needs assessment; advice on choices; treatment / activity

6. Tools for Effective Commissioning PCT Prospectus National contracting framework Infrastructure for core business processes PBC financial framework Demand management toolkit Support for care pathway development Tools for systematic patient feedback

7. Commissioner Development PBC Development collaborative PCT Fitness for Purpose Establishing a Commissioning Academy

8. Short Term Actions Recruiting the right people Identifying information requirements Creating an evidence base of effective practice Developing a performance management framework PBC Implementation

9. The Significant Policy Questions Securing the cash limit Explicitness of the NHS ‘offer’ Primacy of Choice / Targets / Commissioning Achieving a strategic shift in services Developing the public voice in commissioning The role of commissioning in improving quality Deciding who commissions